Senior Assessment on Bill Ekberg
By Rachel Hammerling
FND 238: Life Cycle
Professor: Dr. Betty Larson
12/11/07
Nutrition Assessment on Bill Ekberg
A nutritional assessment was conducted on Bill, which required him to record what he ate for three consecutive days. Bill was given instructions on food portion sizes and everything that he would need to know to complete an accurate diet record. Since Bill’s wife is a diabetic, they are accustomed to writing down what they eat every day. A physical assessment was conducted to note the clinical signs of Bill’s nutritional status. His general appearance was alert and responsive. His hair had a nice and shiny sheen, and his lips consisted of a good color. For an 84-year-old, Bill showed signs of clean teeth with minor staining due to aging, and a healthy looking tongue with no lesions. Overall, Bill has a healthy appearance being energetic with great endurance. Bill’s age, height, weight, and consumption of vitamins are listed below.
Age: 84
Height: 77 inches or 6 feet 5 inches
Weight: 172 pounds
Medications: None
Vitamins: 1000 mg of Vitamin D
Multivitamin
300 mg of calcium
Other: 10 ounces of Metamucil
A level one screening of the National Nutrition Screening Initiative was completed on Bill, and his nutrition score ended up being zero. Zero to two is good and based on these numbers there are no nutritional risks. Rechecking nutritional scores in 6 months is advised.
The Mifflin St. Jeor Equation (more accurate than Harris-Benedict Formula)
Males: RMR = (10 X wt) (6.25 X ht) – (5 X age) 5
= (10 X 78.2) (6.25 X 195.6) – (5 X 84) 5
= (782) (1222.5) – (420) 5
= 1579.5 Calories X Activity Calories (1.5 for normally active person)
= 1579.5 X 1.5 2369
= 2369 Calories/day
Compared Kcalorie requirement to intake:
Day 1: 2139 kcal
Day 2: 2456 kcal
Day 3: 2261 kcal
Bill is consuming adequate kilocalories, and no recommendations are needed.
Calculation of protein intake:
Day 1:
102.51 gm of protein
102.51 gm X 4 kcal/1 gm = 410.04 kcal
410.04 kcal/2139 total kcal = 19 % of total energy from protein
Day 2:
129.18 gm of protein
129.18 gm X 4 kcal/1 gm = 516.72 kcal
516.12 kcal/2456 total kcal = 21 % of total energy from protein
Day 3:
104.44 gm of protein
104.44 X 4 kcal/1 gm = 417.76
417.76 kcal/2261 total kcal = 18 % of total energy from protein
Calculation of protein RDA:
78.2 kg X 1.0-1.25 g/kg = 78.2-97.75 gm
Bill is eating adequate protein. He is exceeding the requirement, but he is below the maximum of 25% of total Kcalories.
Dietary fiber:
Day 1: 33.80 gm of fiber
Day 2: 18.83 gm of fiber
Day 3: 22.62 gm of fiber
Bill is consuming enough fiber in his diet, within 20 to 30 grams, so no recommendations would be needed.
Fat allowance (20-35%):
2369 Kcal X .20 = 4742369 Kcal X .30 = 711
474/9 = 53 grams minimum 711/9 = 79 grams maximum
Fat allowance range: 53-79 grams
Day 1: 70.04 gm of fat (29%)
Day 2: 121.84 gm of fat (45%)
Day 3: 78.44 gm of fat (31.23%)
Bill is within the recommended amount of fat two out of the three days, and therefore no recommendations are needed.
Sodium recommendations:
Day 1: 2306 mg of sodium
Day 2: 3702 mg of sodium
Day 3: 2674 mg of sodium
Bill is consuming more than 2300 mg, so recommendations for decreasing sodium intake would be necessary. He should decrease his sodium intake by 370 to 1400 mg. Bill could decrease these sodium levels by limiting consumption of processed foods, for example, chicken wings, and eating fresh foods, such as fruits and vegetables.
Fluid intake:
Day 1: 1 L (~ 4 cups) of water
Recommended 2.1 L
Day 2: 1 L (~ 4 cups) of water
Recommended 2.5 L
Day 3: 1 L (~ 4 cups) of water
Recommended 2.3 L
Bill is obviously inadequate in fluid consumption, and he will need to increase (double) his fluid intake by one liter or by 4 cups.
Bill’s Food Pyramid:
Recommended 2200 Calories/dayFruits: 2 cups
Grains: 7 ouncesMilk: 3 cups
Vegetables: 3 cupsMeat and Beans: 6 ounces
According to the food pyramid, Bill is within the Calorie range that they recommend for someone his age, height, and weight.
Bill is deficient in calcium and fluids. Even with his calcium supplement of 300 mg, he is still inadequate. To increase his calcium intake he could eat a serving of 1 cup of yogurt, 1-cup milk, or ½ cup of broccoli. To increase his fluid intake, he will need to drink 1 extra liter. Overall, Bill is eating well and is sufficient in everything but calcium and fluids.
NCP Chart Note
S. No medications taken, only Vitamin D, calcium, multivitamin, and Metamucil; no allergies or chronic or acute illnesses
O. Age: 84 Height: 6’5” Weight: 172 lbs Protein: 78.2-97.75 gm
A. Client consuming inadequate calcium as evidenced by food log of 344 to 1408 mg, below recommended intake of 1200 mg, inadequate fluid intake by 1 liter
P. Educate Bill of yogurt, milk, and broccoli as sources of calcium, encourage to drink 1 liter more of fluids