Gina is a 74-year-old woman with a history of type 2 diabetes, hypertension, and arthritis. She states that her dentist told her she has xerostomia and periodontal disease and will need multiple tooth extractions and a full maxillary (upper) and partial mandibular (lower) denture. Because of the condition of her teeth she consumes soft foods and lots of diet soda because her mouth always feels dry. She takes glyburide for glucose control, amlodipine (Norvasc) for blood pressure control, and glucosamine and chondroitin to alleviate her arthritis. She is 5’1” and weighs 176 lb. She lives alone, but receives assistance with food shopping and cooking from her family and friends. She occasionally conducts self-monitoring fasting glucose via fingerstick and states that her usual reading is 150 mg/dl.
Nutrition Diagnostic Statements
1. Chewing difficulty secondary to poor dentition and xerostomia as evidenced by patient report and choice of soft foods.
2. Altered nutrition-related laboratory value (glucose) secondary to diabetes and possibly food choices as evidenced by inadequate blood glucose control.
Nutrition Care Questions
1. What are the cultural, educational, and environmental influences affecting dental and nutritional health?
2. What are the diet counseling recommendations for the dental conditions (anticipated extractions, dry mouth, full and partial dentures)?
3. List an appropriate intervention for each of the diagnostic statements. How would you evaluate the impact of your intervention?
4. What would you assess at your follow-up (monitoring) appointment with Gina?