Research paper: diet and nutrition
Sakrina
N225_Final_research_paper.docx.pdf
1
Running head: NUTRITION FINAL RESEARCH PAPER
Diabetes and Hypertension
West Coast University – Ontario
Viviana Vo
NURS 225: Nutrition in Health and Disease 2019
https://www.coursehero.com/file/46678397/N225-Final-research-paperdocx/
Th is
stu dy
re so
ur ce
w as
sh ar
ed v
ia C
ou rs
eH er
o. co
m
2
Diabetes and Hypertension
Part I, Criteria # 1: Identification of Nutrients/Patient
J.W. is a 60-year-old African American male. He has a typical life and is married with
three children. His current weight is 230lbs and he is 6 feet tall. Body mass index (BMI) is a
measure of body fat based on height and weight that applies to adult men and women and based
on his height and weight, he is currently at a BMI of 31.2. With that into consideration, he is
believed to be at an obese weight. His current diet is high in fat and low in nutrients which can
be due to the fact that J.W consumes three fast food meals per day. An example of a fast food
meal is a McDonald’s big mac. Listed below are the nutrition facts for a big mac burger from
McDonald’s. As shown in the facts, this meal contains 950mg of sodium. With that being said,
this meal is not a great choice for him because he has a medical diagnosis of hypertension.
With this in mind, he currently has an excess in sodium, carbs, and a deficit in essential vitamins.
Sodium
“The American Heart Association recommends no more than 1,500 mg per day for most adults,
especially for those with high blood pressure.” (AHA,2016). With this in mind, J.W. has an
incredibly excess in the amount of sodium intake especially since he is having three fast food
meals per day, all of which will be high in sodium.
Carbohydrates
Carbs are essential so that it can provide fuel to our central nervous system and energy for our
muscles. The total amount of carbohydrates that J.W is currently consuming in fast food meals
are certainly high in carbs. The daily amount he should consume is around 130g. In just one
meal, he is consuming 45g and that does not include any sides or snacks.
Fats
https://www.coursehero.com/file/46678397/N225-Final-research-paperdocx/
Th is
stu dy
re so
ur ce
w as
sh ar
ed v
ia C
ou rs
eH er
o. co
m
3
We need to incorporate fats into our diet because it is used to give our body energy and support
cell growth. Fats also help absorb certain vitamins such as A, D, E, and K. However, in J. W’s
diet, he is consuming a lot of saturated fats. Foods such as cheese, butter, and red meat contain
saturated fats. With that being said, fast food contains a lot of the foods listed above and J.W.
consumes that daily due to his sedentary lifestyle.
. \] Part I, Criteria # 2: RDA Approval Analysis
There a couple of micronutrients that J.W can either an excess of or a deficit in. All of which are
listed below. The recommended daily number of calories is 1,500 per day. Also B\below is an
example of what J.W. consumes daily and as noted, it is very high in a lot of the macronutrients
such as fat and sodium. With this example, he is already at a negative 1,800 calories.
https://www.coursehero.com/file/46678397/N225-Final-research-paperdocx/
Th is
stu dy
re so
ur ce
w as
sh ar
ed v
ia C
ou rs
eH er
o. co
m
4
Potassium
Out of all the minerals, potassium is one of the most essential. Its function is to regulate fluid
balance, muscle contractions, and works with neurotransmitters. J. W’s sedentary lifestyle does
not meet the proper amount of potassium in his diet. An important fact about potassium is that it
may help to reduce blood pressure and fluid retention. Given that J.W has hypertension, a diet
high in potassium will greatly benefit him. Some great options for him are tomatoes, apricots,
medium bananas, and some yogurts. Potassium level should remain at a level between 3.5mEq/L
to 5 mEq/L.
Iron
Iron is used in the transportation of oxygen throughout the body and it is an important part of
hemoglobin. When our bodies are unable to make enough red blood cells, it can result in iron
https://www.coursehero.com/file/46678397/N225-Final-research-paperdocx/
Th is
stu dy
re so
ur ce
w as
sh ar
ed v
ia C
ou rs
eH er
o. co
m
5
deficiency anemia. According to J. W’s diet, he does not consume enough iron and he is at risk
for anemia. The average amount he should have per day is 19-20mg/day.
Vitamin A
Vitamin A is a fat-soluble vitamin that is usually in plenty of foods such as fish, cantaloupe,
fortified breakfast cereals and carrots. The main role of vitamin A is to support good vision and
helps with the immune system. We all need vitamin A; however, the amount needed is different
for all age groups. “ The Recommended intakes for vitamin A for people aged 14 years and older
range between 700 and 900 micrograms (mcg)”(NIH, 2018). J.W is likely deficient in vitamin A
because of all the fast food he consumes. Fast food does not contain all of the vitamins and
minerals needed in a daily diet.
Vitamin C
Vitamin C is an important vitamin that helps us speed along wound recovery and acts as an
antioxidant that helps protect our cells from free radicals caused by smoking, air pollution and
even ultraviolet lights from the sun. As previously stated, fast food does not provide enough of
this vitamin to meet the needs of the body. E
Vitamin B1
Given that J.W is diabetic and has hypertension, his energy levels might be a little low
throughout the day. His energy levels are most likely low due to the lack of vitamin B1. Vitamin
B1 also called Thiamin is used to help use carbohydrates as energy in the body. Without enough
of this vitamin he might feel fatigue, irritable and have blurry vision. Great options for vitamin
B1 are peas, peanuts and dried beans.
Part 2, Criteria 1# Nutrition and Pathophysiology
https://www.coursehero.com/file/46678397/N225-Final-research-paperdocx/
Th is
stu dy
re so
ur ce
w as
sh ar
ed v
ia C
ou rs
eH er
o. co
m
6
J.W has a medical history of hypertension and diabetes type two. Both of these conditions
are likely the result from unhealthy food choices and a sedentary lifestyle. “High blood pressure
is a common condition in which the long-term force of the blood against your artery walls is high
enough that it may eventually cause health problems, such as heart disease.” (Mayo Clinic,2016).
High blood pressure can continue to cause long term damage and can even lead to a stroke.
Given that J.W. lives a sedentary lifestyle, he can also develop hyperlipidemia. Secondly, “Type
2 diabetes develops when β-cells fail to secrete sufficient insulin to keep up with demand,
usually in the context of increased insulin resistance.” (ADA,2017). Medications such as
metformin will be needed in order to help improve insulin sensitivity.
J.W. is currently prescribed Metformin 500mg twice daily for diabetes type two, and
Metoprolol 200mg daily. He is also taking a multivitamin daily. Metformin is an oral medication
taken for diabetes type two and in order to control glucose properly, diet and exercise will also
need to take part in the plan. Furthermore, metformin should also be taken with meals in order to
help reduce side effects of the stomach. Metoprolol is a medication used to treat both
hypertension and angina (chest pain). It is important to check vital signs before taking this
medication. Typically, if the heart rate is below 70, it is not appropriate to administer medication.
Part 3, Criteria # 1 Nutrient Calculations
J.W. is a 60-year-old male that is 6’0” (72 in), 230lbs (105kg).
BMI
According to the BMI calculation, J.W has a BMI of 31.2. This BMI is considered to be
obese and weight loss will greatly help to prevent future medical problems.
230/ 72 X 72 (5184) = 0.0265 X 703 = 31.2 BMI
BMR
https://www.coursehero.com/file/46678397/N225-Final-research-paperdocx/
Th is
stu dy
re so
ur ce
w as
sh ar
ed v
ia C
ou rs
eH er
o. co
m
7
Based upon height, weight, and age. We are able to calculate J. W’s BMR and he needs to
burn approximately 2270 calories on a typical day. He will need to cut 500 calories per day in
order to lose 1 pound per week. Losing 1 pound per week for three months is actually one of the
goals that he needs to meet. He will need to consume 1,500 calories per day.
(230 x 104.54kg) + (6.25 x 182.88) – (5 x 60yrs) + 5 = 1,893
CHO
“Carbohydrate counting, also called carb counting, is a meal planning tool for people
with type 1or type 2 diabetes. Carbohydrate counting involves keeping track of the amount of
carbohydrate in the foods you eat each day.” (NIH,2018).
1893 X 0.45 = 665 calories then/by 4calories/gram = 166 grams/day
1893 X 0.65 = 960 calories then/by 4 calories/gram = 240 grams/day,
Daily range 2005 calories/day from CHO, 175 - 240 grams/day,
PRO
The DRI (Dietary Reference Intake) is 0.8 grams of protein per kilogram of body weight,
or 0.36 grams per pound. For J.W., it is important to increase the amount of protein whenever
there is a wound that needs to heal.
240 lb. / 2.2 kg/lb. = 104.54kg. X 0.8 gm/kg = 80.6 grams protein daily FAT
Since the patient has a diagnosis of diabetes, he should be placed in a low-fat diet. The
dietary reference intake (DRI) for fat in adults is 20% to 35% of total calories from fat.
2839 X 0.35 = 568 calories then/by 9 calories/gram = 63 grams/day
Part 3, Criterion #2 SMART Goals and Patient Care Plan
https://www.coursehero.com/file/46678397/N225-Final-research-paperdocx/
Th is
stu dy
re so
ur ce
w as
sh ar
ed v
ia C
ou rs
eH er
o. co
m
8
SMART goal #1: The patient will be given a total of three days to develop a list of preferred
healthy foods that he likes to have or will be able to eat on a daily basis without any
complications so that he can reduce his weight.
SMART goal #2: J.W. will consult with a dietician and demonstrate an understanding of his new
diet.
SMART goal #3: Lastly, J.W. will be able to teach me the signs and symptoms of a hyper and
hypoglycemia during our 30 min discussion.
By implementing all of these goals, J.W will have a better understanding of his diagnosis
and will understand the importance of complying with medications and exercise regimen. Some
nursing strategies are to give him a list of healthy quick recipes to make at home. By providing
him with a list, it is less work for him to do and will make it easier for J.W. to cook more at
home. Secondly, encouraging him to take daily walks will motivate him to actually complete the
exercise daily. Lastly, it is important to facilitate learning by using short and simple directions so
that the patient does not get confused.
https://www.coursehero.com/file/46678397/N225-Final-research-paperdocx/
Th is
stu dy
re so
ur ce
w as
sh ar
ed v
ia C
ou rs
eH er
o. co
m
9
References
ADA. (2017). Differentiation of Diabetes by Pathophysiology, Natural History, and Prognosis.
Retrieved from https://diabetes.diabetesjournals.org/content/66/2/241
AHA. (2016). Shaking the Salt Habit to Lower Blood Pressure. Retrieved from
https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-
manage-high-blood-pressure/shaking-the-salt-habit-to-lower-high-blood-pressure
Mayo Clinic. (2016). High Blood Pressure. Retrieved from
https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-
causes/syc-20373410
NIH. (2018). Vitamin A and What it Does. Retrieved from
https://ods.od.nih.gov/factsheets/VitaminA-Consumer/
NIH. (2018). Carbohydrate counting and diabetes. Retrieved from
https://www.niddk.nih.gov/health-information/diabetes/overview/diet-eating-physical-
activity/carbohydrate-counting
https://www.coursehero.com/file/46678397/N225-Final-research-paperdocx/
Th is
stu dy
re so
ur ce
w as
sh ar
ed v
ia C
ou rs
eH er
o. co
m
Powered by TCPDF (www.tcpdf.org)
