Cystic Fibrosis Related Diabetes Mellitus (CFRDM)
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As Sally's nursing professional, understand her case study thoroughly and then complete the following tasks.
First, using the ABCDs of nutritional assessment, write a brief nutritional assessment that includes:
An analysis of Sally's anthropometrics. Include % desirable body weight, % weight change, and BMI.
The significance of her biochemical data. Do her lab values indicate optimal blood sugar control?
Now that you have analyzed Sally's objective data, list the indicators of potential nutritional problems (nutritional risks). For each nutritional problem, list one intervention that could be tried.
Using the Exchange lists for meal planning (loacted in the Appendix), or food labels, estimate the number of grams of total carbohydrates in each of Sally's meals.
Explain to Sally how she can count the total carbohydrate intake for herself. Be specific: will she need measuring cups, etc.? How can she use the exchange lists? How should she read a food label to get grams of carbohydrates?
Using her 24-hour recall, explain to her how to determine the amount of NovoLog to take with her meals.
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Solution Summary
This response (composed of over 900 words, including calculations and references to external resources) is specific to a case study regarding the nutritional requirements of an adolescent girl. Detailed explanations are provided for each section of the case study.
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To determine anthropometrics:
I found a calculator of % ideal body weight for females at the following link:
http://www.emedicinehealth.com/etools/ideal-body-weight-pct-female.asp
It uses the formula
(Weight x 100) / (Height x 2.54 / 100) x (Height x 2.54 / 100) x 21.5 x 2.2
So for Sally, using her most recent height and weight measurements, the formula will look like this:
% ideal body weight = (101 lbs x 100) / (63.25 x 2.54 / 100) x (63.25 x 2.54 / 100) x 21.5 x 2.2
= 77.3%
I assume that % weight change is referring to the change over the course of her three visits. I would verify that this is the proper way to calculate this value as it is really my best guess.
Sally's lowest weight was 98 lbs and her highest weight was 101 lbs. This means that the % weight change was:
% weight change = (101 lbs - 97 lbs)/101 lbs X 100
= 3.96%
To calculate BMI, you can use a calculator like the one at this link:
http://www.nhlbisupport.com/bmi/
Or this formula:
BMI = (weight in pounds X 703)/height in inches squared
= (101 lbs X 703)/(63.25 inches ^2)
= 17.75
b) Blood sugar normal values are:
70 to 120 mg/dl
Sally was measured at 128 which is high. Does not indicate optimal sugar control.
For HgbA1c, normal range is 4-5.9%.
Sally's value was 7.4, which is high.
For albumin, normal range is 3.2 - 5 g/dl
Sally's level was ...
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