Winifred, a 38 year old F, is seen at City Hospital emergency department (ED). She has a history of hypertension, obesity and unsuccessful weight loss attempts. She loves fried foods, soft drinks, beer and pretzels. She has a history of binge eating. Winifred is required to have a yearly physical by her employer, but has put off scheduling the appointment until she can lose some weight. She fell down some stairs in a work-related accident and was sent to the ED for observation. The emergency department doctor determined that Winifred has no broken bones, but is concerned about her elevated blood pressure, 185/98. The doctor orders laboratory tests and Winifred is admitted to the hospital. Her medical profile today is:
Winifred is referred for medical nutrition therapy. NFPA indicates a robust female, with excessive fat stores, normal muscular development and no fluid accumulation. Assess her nutrition status using the data provided.
Nutrition Diagnostic Statement
Altered laboratory values related to disordered eating pattern as evidenced by signs of nutritional anemia and dyslipidemia.
Nutrition Care Questions
1. Estimate Winifred’s energy and protein needs based on her anthropometric data.
2. Considering Winifred’s medical history, what does her laboratory report for hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration suggest?
3. What does her laboratory report for total cholesterol, LDL, HDL and triglycerides values suggest?
4. What does her laboratory report for sodium, blood urea nitrogen and glucose suggest?
5. What additional laboratory tests would be helpful for a comprehensive nutrition assessment?