You are now seeing Mrs. Bernhardt at her second visit to pulmonary rehabilitation. She provides you with the following information from her food record. Her weight is now 116 lbs. She explains that adjustment to her medications and oxygen at home has been difficult, so she hasn’t felt like eating very much. When you talk with her, you find she is hungriest in the morning, and often by evening, she is too tired to eat. She is having no specific intolerances. She does tell you that she hasn’t consumed any milk products because she thought they would cause more sputum to be produced.
Food Diary
Monday
Breakfast: Coffee—1 c with 2 tbsp nondairy creamer, orange—½ c, 1 poached egg, ½ slice toast
Lunch: ½ tuna salad sandwich (3 tbsp tuna salad on 1 slice wheat bread), coffee—1 c with 2 tbsp nondairy creamer
Supper: Cream of tomato soup—1 c, ½ slice toast, ½ banana, Pepsi—approx 36 oz
Tuesday
Breakfast: Coffee—1 c with 2 tbsp nondairy creamer, orange juice—½ c, ½ c oatmeal with 2 tbsp brown sugar
Lunch: 1 chicken leg from Kentucky Fried Chicken, ½ c mashed potatoes with 2 tbsp gravy, coffee—1 c with 2 tbsp nondairy creamer
Supper: Cheese—2 oz, 8 saltine crackers, 1 can V8 juice (6 oz), Pepsi—approx 36 oz
a. Is she meeting her calorie and protein goals?
b. What would you tell her regarding the use of supplements and/or milk and sputum production?
c. Using the information from her food diary as a teaching tool, identify three interventions that you would propose for Mrs. Bernhardt to increase her calorie and protein intake.