Marywood University/Dietetic Internship Clinical Case Study Presentation Evaluation Form Inte Name_EQ1//y S04) pate 3/12/18 Description of Case: A2ale P+ wy ley wounds} Please evaluate each statement by checking the box. nontem pane iT e zg 1. | Ability to describe patient profile and background information: + Medical history + Family history + Health history + Personal data + Reason for admission. + Psycho/social/economic information 2, | Skill at developing background of disease: * Definition + Etiology + Treatment + Nutritional intervention + Prognosis + Application to patient + Pathophysiology with emphasis on nutritional implications + Symptoms/clinical manifestations 3 | Abin + Diagnosis + Treatments, to describe factors surrounding current admissio + Diagnostic tests, procedures with interpretations, | + Medications, OTCs, supplements |,_| Application of the Nutrition Care Process: + Appropriate nutrition assessment + Diet order + Anthropometries * Biochemical data = Diethistory + Food/shopping/cooking habits + Previous MNT, instruction, outcome, compliance + Evaluation of intake, current and PTA + Assessment, level of risk + Macronutrient needs + Determination of Nutrition Diagnosis, ineluding development of PES Statements. + Development of Nutrition Intervention/Care Plan + Monitoring and follow up to measure patient's response 5._| Skill at focusing presentation on nutritional factors. 6._| Ability to summarize and review key points u 7._ | Overall organization of presentation Z 8.__| Professional content level va Additional Co Look. teas tate t Pupeceon I PPT. kok rae t/, nahh, P ae ¢ / Reviewer Signature: nswoedy. /