New Era University

No. 9 Central Avenue, New Era, Quezon City 1107, Philippines

College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

Laboratory Exercise 04 – Case Analysis 02 for the Course

NCM105L-18 Nutrition and Diet Therapy Laboratory

Submitted to

Dr. LAMBERTO F. VALERA JR.

Prof. ANELITA R. DELA CRUZ

Submitted by: CON 1B

Ferrer, Allain Christopher L. Rivera, Carel Ken M.

Gallito, Russell Kristoffer C. Romano, Joanne A.
Mago, Nathalia Andrei U. Sagum, Hanna Arlyn M.
Mallo, Elvem Joy N. Salak, Jean Marielle C.
Mendoza, Rocelle M. Santos, Rose Anne Heart C.
Nicolas, Kate Ann H. Tabelin, Jennever M.
Paloma, Chantal E. Tiu, Rica Mae T.
Pangan, Danica Mae M. Velarde, Arlyn D.
Paqueo, Aubrey T. Villan, VJ Hilway R.
Pedarse, Lissan V. Villasoto, Allyza Trixia Joyce
Ramirez, Pamela B. Wenceslao, Karen Vannessa J.
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

Ranes, Jon Kenshin A. Ysagun, Mikaela Andrea S.

Ritualo, Iryna Sheene I.

Case Scenario for Group 2 (Adult Obesity):

Mr. Alex Cabral is a 37-year-old, single parent weighing 110 kg and with a height
of 5 feet 10 inches. He started to gain weight two years ago when his wife died due to
post-partum complications. He mentioned about his weight gain and some health
problems during the interview. Mr. Cabral is currently working as a Toll Gate cashier
and his last annual medical examination was done before the start of pandemic in
March 2019. His BP is 140/100 mmHg and the most significant laboratory results are as
follows:
          Total Cholesterol = 340 mg/dl
          HDL = 40 mg/dl
          LDL = 300 mg/dl
          Triglycerides = 290 mg/dl
          Serum Glucose = 112 mg/dl

1. Formulate at least three (3) applicable nursing diagnoses for Mr. Cabral.
a. Obesity related to average daily physical activity is less than recommended, as
evidenced by the client's BMI of 34.8
b. Ineffective health maintenance related to complicated grieving, as evidenced by
weight gain after the death of his wife
c. Risk for decreased cardiac output

2. What is your analysis and interpretation on the given laboratory results of

Alex?
Interpretation: First, the client’s HDL is 40 mg/dl to specify normal HDL
level, however, his LDL is 300 mg/dl which indicates high cholesterol according
to the normal level of less than 100 mg/dl for adults. Mr. Cabral also has high
Triglycerides equivalent to 290mg/dl which is higher than the normal range of
150 mg/dl for adults and a serum glucose level of 112 mg/dl which is within the
normal range of less than 140mg/dl of serum glucose level in adults.
Analysis: Some of the factors that are included in obesity is having a
high total cholesterol of 340 mg/dL which is high compared to the normal range
of 125-200 mg/dL and triglycerides, equivalent to 290 mg/dl which is higher than
the normal range of 150 mg/dl.
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

3. Formulate two goals with 3 specific objectives per goal in order to address the
health problems of the client.
a. Obesity related to average daily physical activity is less than
recommended, as evidenced by the client's BMI of 34.8.
● Within 25 minutes of nursing intervention, the client will know the ideal
weight and proper eating habits ideal for his condition.
○ Within 10 minutes, the client will be able to verbalize at least 6 out of 8
importance of a healthy lifestyle and appropriate type of physical activity
that he needs, providing visual aids and presentation and with the help of
a healthcare provider.
○ Within 5 minutes, the client will identify at least 4 out of 5 proper eating
habits by the use of illustrations together with the assistance of a nurse.
○ Within 10 minutes, the client will be able to state at least 4 out of 8 weekly
weight loss goal exercises with the provided visual presentations and with
the help of a nurse.
● Within 30 minutes of nursing intervention, the client will know how to
overcome obesity to reduce the risk of cardiac diseases.
○ By providing written instructions within 10 minutes, the client will be able to
identify at least 3 to 5 risk factors for cardiac diseases with the help of a
nurse.
○ Within 10 minutes, the client will be able to describe at least 5 of the 8
symptoms of hypertension using visual aids with the assistance of a
healthcare provider.
○ Within 10 minutes of visual presentation, the client will state 3 out of 5
benefits of daily exercise in lowering the risk of developing a complication
of obesity with the help of a healthcare provider.
b. Ineffective health maintenance related to complicated grieving, as
evidenced by weight gain after the death of his wife.
● Within 1 hour of nursing intervention the client will engage in health
promoting activities regarding the health benefits.
○ After 10 minutes of nursing intervention, the client will identify at least 4
out of 5 factors preventing him from applying healthy practices with the
help of the nurse.
○ After 10 minutes of nursing intervention, the client will state at least 3 out
of 5 of his past habits and health maintenance with the help of a nurse.
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

○ The client will verbalize at least 5 out of 10 elements to maintain a healthy

lifestyle after 30 minutes of nursing interventions with the assistance of a
nurse.
● After 1 hour of nursing intervention the client will be able to show
insights of appropriate attitude towards loss.
○ After 20 minutes of nursing intervention, the client will show 2 out of 3
signs of trust regarding the verbalization of his feelings towards the loss of
a loved one with the help of a nurse.
○ The client will be able to state 3 out of 5 stages of grief after 10 minutes of
nursing intervention with the help of visual aids.
○ After 20 minutes, the client will verbalize at least 2 out of 3 coping
strategies concerning the loss of a loved one.
c. Risk for decreased cardiac output.
● Within 30 minutes of nursing intervention, the client will learn about the
factors that affect cardiac output.
○ After 10 minutes, the client will be able to identify at least 3 out of 5 factors
that will contribute to his risk for decreased cardiac output with the
guidance of healthcare professionals.
○ After 10 minutes, the client will be able to verbalize at least 4 out of 5
actions and precautions that he can do to decrease his risk for decreased
cardiac output with the help of a healthcare provider.
○ Within 10 minutes, the client will state at least 5 out of 10 signs and
symptoms of decreased cardiac output with the presence of a healthcare
professional.
● Within 8 hours of nursing intervention, the client will demonstrate
adherence and compliance to the ways he can improve his cardiac
output.
○ Within 4 hours, the client will demonstrate 3 out of 4 exercises that can
improve his cardiac output with the supervision of a healthcare
professional.
○ Within 30 minutes, the client will state 3 out of 4 different varieties of foods
that can improve his cardiac output with the help of a nurse.
○ Within 3 hours, the client will verbalize at least 5 out of 6 lifestyle elements
that can improve his heart health with the help of a healthcare provider.

4. What could be the possible causes of Mr. Cabral’s weight problem?

 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

Mr. Cabral's weight problems could be caused by a variety of factors, including

stress. Stress appears to affect overall food intake in two ways, resulting in either
under- or overeating, depending on the degree of the stressor. Chronic life stress
appears to be linked to a preference for high-energy, nutrient-dense diets, such as
those heavy in sugar and fat.
Fat- and sugar-rich foods appear to have a feedback effect after consumption,
dampening stress-related responses and feelings. These foods are truly "comfort"
foods in the sense that they appear to alleviate stress, which may contribute to
people's stress-induced cravings for them. Overeating isn't the only stress-related
behavior that can lead to weight gain. People who are stressed are more likely to
lose sleep, exercise less, and consume more alcohol, all of which can lead to weight
gain.
Mr. Cabral's food preferences are influenced by stress, and he may eat
unhealthy foods without controlling the amount of calories consumed, which leads to
obesity and other health concerns such as high LDL cholesterol, low HDL
cholesterol, or high levels of triglycerides, and high levels of cholesterol.

Normal Values Lab Results of Mr.

Cabral’s

High-density Lipoproteins 40 mg/dl or higher 40 mg/dl

Low-density Lipoproteins Less than 100 mg/dl 300 mg/dl

Triglycerides Below 150 mg/dl 290 mg/dl

Total Cholesterol Less than 200 mg/dl 340 mg/dl

5. Based on the gathered data, what complications Alex may experience if early
interventions were not done?
Mr. Alex has a BMI of 34.8 putting himself at the obese category and his
total cholesterol being higher than normal. With all this data, Mr. Alex will have
different diseases revolving around his health, especially his heart. If this
becomes untreated, he can experience cardiac diseases such as stroke and
heart attack. This is because of the cholesterol blocking his blood vessels,
causing high blood pressure. Mr Alex will experience severe chest pain,
diaphoresis or excessive sweating, difficulty breathing, vomiting, nausea, and
dizziness.

6. Calculate the DBW of Alex using Ador Dionisio’s formula.

Name: A.C. Age: 37 years old Sex: Male

Height: 5’10” Weight: 110 kgs BMI: 34.8

 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

1. Calculate your own DBW, 5 feet tall, medium built, performing moderate activity.

ADOR DIONISIO’S METHOD

Height = 5 feet =110 lbs

Inches =10 (2) = 20 lbs

Age = (37) 2

------------- = 14.8 lbs

DBW = 110 lbs + 20 lbs + 14.8 lbs

= 144.8 lbs / 2.205

= 65.6kg or 66kg

DBW = 65.6kg or 66kg

= 144.8 lbs or 145 lbs

2. Calculate the daily energy requirement of the same subject.

NUTRITIONAL MEASUREMENTS ANSWER

1. Basal Metabolic Rate

Kilograms MBS (kg) ¾

5 3.3
Ador Dionisio’s Formula: 66kg
10 5.6
= 21.6 x 70
15 7.6
= 1,512 kcal
20 9.5

25 12.1

30 12.8

35 14.4

40 15.9

45 17.4

50 18.8

65 21.6

70 24.2

80 26.7
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

90 29.2

100 31.6

1. Determine the DBW in kg of the individual.

= 66 kg

2. Determine the basal needs.

Male = 1 kcal/kilo of DBW/hr x 24

= 66 x 1 x 24

= 1,584 kcal

2. Estimation of Daily Energy Requirement

3. Subtract 0.1 calorie/kilo of DBW/hours of
Activity Increment sleep.

kcal / day = 66 x 0.1

ACTIVITY
MEN WOMEN = 6.6 x 8

Sedentary or light work 225 225 = 52.80

Moderate work 750 500 = 66 – 52.80

Heavy work 1,500 1.000 = 13.20
Very heavy work 2,500 - = 1,584 kcal - 13.2

= 1,570.80 kcal

4. Add the activity increment.

= 1,570.8 + 750

5. Sum = Approximate daily calorie

requirement.

= 2,320.80 kcal

3. Estimation of Total Energy Need FEMALE MALE

OCCUPATIO
= 66 kg x 40 kcal/kg N / ACTIVITY kcal/lb kcal/kg kcal/lb kcal/kg

= 2,640 kcal Bed patient 12 25 14 30

Light work 14 30 16 35

Moderate
16 35 18 40
work

Heavy work 18 40 20 44
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

Tannhauser’s Method

Height in cm = 177.80 cm

(factor) = 100 a

= 77.80

(10% of answer obtained to adjust weight to

4. Estimation of Energy Balance
suit Filipino standard)

= 77.80 x .10

= 7.78

= 77.8 – 7.78

= 70.02

7. What type of diet will you recommend for Mr. Cabral, why?
The type of diet that can be recommended for Mr. Carbal is the weight-
reducing diet for his high cholesterol and triglycerides. In the case scenario,
some laboratory results of the client, such as cholesterol and triglycerides, are
high. Hence, a menu plan where the source of the foods are low in cholesterol
and triglycerides are needed. We may suggest his lifestyle, which includes
weight control, frequent physical activity, and nutritious foods like okra,
eggplants, carrots, and potatoes. entire grains and fruits, such as apples It
consists of low-fat fish, chicken, and beans. Saturated fat-rich foods should be
avoided. Fatty meats, full-fat dairy products, and other high-fat meals are among
them. Omega-3 fatty acid-rich foods have been proven to be quite effective at
lowering triglycerides. Furthermore, too much saturated fat can cause cholesterol
to build up in arteries (blood vessels). Saturated fats raise LDL (bad) cholesterol.
High LDL cholesterol increases risk for heart disease and stroke. This diet
recommendation can help to prevent some risks of cardiac diseases or
complications to the health of the client.

8. Calculate the diet of Alex, taking into consideration his health profile.
1. Following the steps in estimating desirable body weight (DBW), calculate the total
energy allowance (TEA).
2. Determine the height = 177.80 cm Actual body weight = 110 kg
3. Calculate the basal needs = 1 x 66 kg (DBW) x 24 = 1,584 kcal
4. Estimate physical activities = 1,584 kcal x 0.70 = 1,108.80 kcal
Physical needs = approximate percentage increase above basal needs
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

(use lower factor for women)

Bed rest 10-20%

Sedentary 30%

Light activity 50-60%

Moderately active 60-70%

Severely active 90-110%

5. Add values from 3 and 4 to get TEA = 1,584 kcal + 1, 108.80 kcal = 2,692.80 kcal
6. Distribute the total energy allowance among carbohydrates, proteins and fats as follows:

7. For a normal diet, allow 65% of the total energy allowance for carbohydrates,
15% proteins and 20% fats. Thus the corresponding energy contributors of the
three nutrients are as follows:
Carbohydrates = 2,692.80 kcal x 0.65 = 1,750.32 kcal
Proteins = 2,692.80 kcal x 0.15 = 403.92 kcal
Fats = 2,692.80 kcal x 0.20 = 538.56 kcal
Total = 2,692.80 kcal
TEA = 2,692.80 kcal
8. Calculate the number of grams of carbohydrates, proteins and fats by dividing
the calories for each nutrient by corresponding physiologic fuel values (CHO and
CHON = 4 kcal/g and Fat = 9 kcal/ g).
Carbohydrates = 1,750.32 kcal/ 4 = 437.58 g
Proteins = 403.92 kcal/ 4 = 100.98 g
Fats = 538.56 kcal/ 9 = 59.84 g
9. For simplicity and practicality of the diet prescription (Rx), round off calories to
the nearest 50, and carbohydrates, proteins and fats to the nearest 5 g. Thus,
your diet prescription is:
Diet Rx: 2,693 kcal/day
438 g Carbohydrates
101 g Proteins
60 g Fats

9. Prepare a one-day menu plan, emphasizing the type of diet you have
recommended in problem number 7.
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

A. Meal Plan for Normal Diet (438 g CHO, 101 g CHON, 60 g Fat, 2,693 kcal)
CHO CHON Fat Energy Meal Distributions
Food Exchanges No. of Exchanges
g g g kcal B L D Snacks
1 cup carrot apple 1 cup carrot
40 2 13 160+8+117=285
salad apple salad
1. Vegetables
2 medium size sweet 2 medium size of
48 4.6 0.3 192+18.4+2.7=213.1
potato sweet potato

1 apple
1 apple (medium) 25 0.5 0.3 100+4+2.7=106.7
(medium)

1 glass of
1 glass of kiwi juice 31 1.3 0.6 124+5.2+5.4=134.6
kiwi juice

1 slice of
1 slice of avocado toast 20 3.8 11 80+15.2+99=194.2
avocado toast
3. Fruits
1 cup sliced
1 cup sliced banana 43 2 0.6 172+8g+5.4=185.4
banana

1 cup dried
1 cup dried raisins 34 1.3 0.2 136+5.2+1.8=143
raisins

1 glass of grape
1 glass of grape juice 37 0.9 0.3 148+3.6+2.7=154.3
juice
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

1 glass of
9. Milk 1 glass of rice milk 22 .7 2.3 88+2.8+20.7=111.5
rice milk

1 cup of
1 cup of brown rice 46 4.6 1.6 184+18.4+14.4=216.8
brown rice

10. Rice 1 cup of oatmeal 28 5.9 3.6 112+23.6+32.4=168 1 cup of oatmeal

1 slice of
1 slice of wheat bread 14 3.1 0.9 56+12.4+8.1=76.5
wheat bread

13. Meat 1 tuna steak 0 25 .5 100+4.5=104.5 1 tuna steak

5 tsps of
5 tsps of sugar 4.2 0 0 16.8
sugar
14. Sugar 1 glass water 1 glass water
2 glasses of water with
34 0.1 0 136+0.4=136.4 with 1 tbsp with 1 tbsp
2 tbsp of honey honey honey

1 pc of
1 pc of salmon fillet 0 50 28 200+252=452
salmon fillet
16. Fat & Oil 1 tbsp of
1 tbsp of coconut
10 0.2 3.1 40+0.8+27.9=68.7 coconut
cream
cream

TOTAL 426.20 g 78.40 g 66.30 g 2,767.5

 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

B. Sample Menu for a Normal Diet

Breakfast Lunch Dinner
1 cup carrot apple salad 1 cup vegan mapo tofu 1 slice of avocado toast

1 apple (medium) 1 glass of kiwi juice 1 cup of brown rice

1 glass of soy milk 5 tsps of sugar 1 skinless chicken breast

1 slice of wheat bread 1 pc of salmon fillet 1 glass water with 1 tbsp honey

Snacks

AM Snack PM Snack Midnight Snack

1 cup sliced banana 2 medium size of sweet potato

1 glass of grape juice
1 cup of oatmeal 1 glass water with 1 tbsp honey

10. Develop a health teaching plan for Alex, include the necessary visual aids.
HEALTH TEACHING PLAN
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

Name of Patient (Optional): A.C. a Age: 37 years old a Gender: Male a Date of Birth: Not Applicable
Address: Not Applicable a
Chief of Complaint: Weight gain and Health Problems a Medical Diagnosis: Obesity a
Hospital: Not Applicable s Room No.: Not Applicable k Ward Classification: Not Applicable k

Assessment of Learner: A 37-year-old single-parent man, working as a toll gate cashier, started to gain weight two years ago after his wife died. He weighs 110
kilograms and has a height of 5 feet and 10 inches. The client mentioned his weight gain and some health problems during the interview.

Nursing Diagnosis: Obesity related to average daily physical activity is less than recommended, as evidenced by the client's BMI of 34.8

Long-Term Goal: Upon completion of the instructional session, the client will follow the dietary guidelines and prevent future risks of cardiac diseases.
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

Learning Objectives Content Outline Teaching Methods Evaluation

Upon completion of the instructional After the instructional session, the
session, the client will: client was able to:

1. State at least 5 out of 9 amounts of 1. Food intake planning - Provide the client a copy of 1. State 7 out of 9 amounts of
serving for each food category in resources (see attachments) FNRI’s nutritionally adequate serving for each food
FNRI food pyramid by providing menu and food pyramid category within 5 minutes.
resources for food planning within applicable to his age.
5 minutes.

2. Identify at least 3 out of 5 factors 2. Factors of cardiac diseases - Identify the factors of cardiac 2. Identify 5 factors that raise the
that raise the risk of cardiac include diabetes, increased diseases. risk of cardiac diseases within
diseases by providing written LDL cholesterol, decreased - Provide written instructions to the 5 minutes.
instructions within 5 minutes. HDL cholesterol, increased client.
triglycerides, and obesity
(Adult Overweight & Obesity,
2018).

3. Describe at least 7 out of 10 signs 3. The signs and symptoms of - Describe the signs and 3. Describe 8 signs and
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

and symptoms of obesity by obesity include sleep apnea, symptoms of obesity. symptoms of obesity within 7
providing written instructions within excessive sweating, heat - Provide written instructions to the minutes.
7 minutes. intolerance, skin folds client.
infection, fatigue, dyspnea,
darkening and swelling of the
skin, presence of stretch
marks, BMI greater than 30
kg/m2, and waist
circumference of 102 cm in
men and 88 cm in women
(Martí, Alejos, & Meneses,
2018).

4. Describe at least 4 out of 9 4. Symptoms of high cholesterol - Describe the symptoms of high 4. Describe 7 symptoms of high
symptoms of high cholesterol by (see attachments). cholesterol using a visual aid that cholesterol within 3 minutes.
using a visual aid within 3 minutes. contains the symptoms as well
as the appropriate pictures.

5. Describe at least 5 out of 8 5. Symptoms of hypertension - Describe the symptoms of 5. Describe 7 symptoms of
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

symptoms of hypertension through (see attachments). hypertension by presenting hypertension within 3

infographics within 3 minutes. infographics to the client. minutes.

6. Determine at least 3 out of 4 6. Changing eating habits is an - Explain the strategies how to 6. Determine 4 changes in
changes in eating habits by effective way to lose weight. It change eating habits to avoid eating habits within 3 minutes.
providing written instructions within can be done by using a eating more than the required
3 minutes. smaller plate for meals, eating amount of food intake for adults.
slowly, eating nutritious foods
(like vegetables and fruits),
and keeping healthy snacks
around in case of hunger
(Perreault, 2021).

7. State at least 4 out of 7 benefits of 7. The benefits of burning fat - Explain the benefits of burning fat 7. State 5 benefits of burning fat
burning fat with the help of nurses include efficient weight loss to the client to be motivated in within 2 minutes.
within 2 minutes. faster, better cholesterol doing fat-burning exercise.
levels, less risk for
cardiovascular disease,
increased mental focus,
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

eliminates hunger pains,

stable blood glucose level,
and improved skin condition.

8. Identify at least 4 out of 7 needed 8. Equipment needed for - Demonstrate how to use the 8. Identify at least 4 of the
equipment for exercise by exercise includes skipping equipment needed for exercise. equipment needed for
demonstrating them to the client ropes, ankle weights, exercise within 3 minutes.
within 3 minutes.  dumbbells, pull-up/chin-up
bar, push-up handles, hula
hoops, and gloves.

9. Demonstrate at least 3 to 5 sets of 9. Total body fat burning - Demonstrate the total body fat 9. Demonstrate 4 sets of fat-
fat burning workouts by showing workout (see attachments). burning workout with the client. burning workouts within 15
pictures within 15 minutes - Guide the client throughout the minutes.
demonstration.
- Advice to repeat the total body
fat workout 3 times a week to
reduce body weight and improve
health.
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

10. State the normal systolic and 10. Understanding blood - Interpret the blood pressure 10. State the normal systolic and
diastolic blood pressure pressure readings (see readings to the client and let the diastolic blood pressure
measurement by providing the attachment) (Beckerman, client state the normal readings measurement within 10
table of blood pressure readings 2021). for blood pressure. minutes.
within 10 minutes.

11. Perform the 12 steps of taking
blood pressure measurement by
utilizing actual blood
equipment within 15 minutes.
11. Twelve steps of taking blood - Perform with the client the 12 11. Perform the 12 steps of taking
pressure (see attachments) steps of taking blood pressure blood pressure measurement
pressure (Beckerman, 2021). measurement. within 15 minutes.
- Teach the client techniques to
obtain accurate readings.

12. Identify at least all-important 12. Follow-up visit (see written - Provide written instruction that 12. State correctly the date, time,
details (date, time, and location of instructions) includes when and where the and location of the next visit
follow-up appointment) for the next visit will be. within 2 minutes.
progress report by providing
written instructions within 2
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

minutes.
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

ATTACHMENTS
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

WRITTEN INSTRUCTIONS
Patient’s Name: Alex Cabral
Age: 37 years old
Date of Birth: Not Applicable
Chief of Complaint: Weight Gain and Health Problems
Medical Diagnosis: Obesity

● Follow the meal plan provided.

● Be guided with the recommended food intake of FNRI.
● Have a healthy diet.
● Choose minimally processed:
Whole grains: protein, fiber, B vitamins, antioxidants, and trace minerals
Vegetables: vitamins A (beta-carotene), C and E, magnesium, zinc,
phosphorous and folic acid.
Whole fruits: vitamin C, potassium and folate
Fish: omega-3 fatty acids and vitamins such as D and B2 (riboflavin)
Poultry: Vitamin A, B6, B12, C, D, E, K. Also, Carnitine, Thiamin, Riboflavin,
Biotin, Niacin, Folic Acid, Choline and Pantothenic Acid.
Nuts: vitamins E, B6, niacin and folate; and minerals
Beans: protein, fiber, folate, iron, potassium and magnesium
Plant oils: vitamin E (alpha-tocopherol) and carotenoids.
.
In case of emergency please contact the following:
1. San District Hospital
605 Boni Ave, Quezon City,
Metro Manila
Tel. No. 021 -202-7447
2. Ms. Isobel Manhattan
Visiting Nurse
Mobile No. 0926-298-3164

Your follow-up treatment plan:

Where: San Jose District Hospital
605 Boni Ave, Quezon City,
Metro Manila
When: August 18, 2021
8:00 am
 New Era University
No. 9 Central Avenue, New Era, Quezon City 1107, Philippines
College of Nursing
NCM105L-18
Summer Term SY: 2020-2021

References:
American Academy Of Family Physicians. (2021). AAFP. Helping Patients Set Fitness
Goals. from https://www.aafp.org/family-physician/patient-care/prevention-wellness/
healthy-lifestyle/obesity-activity/helping-patients-set-fitness-goals.html
Balentine, J. (2021). Obesity and overweight. Retrieved August 3, 2021, from
https://www.medicinenet.com/obesity_weight_loss/article.htm
Beckerman, J. (2021, May 06). Checking your Blood Pressure at Home. Retrieved
August 3, 2021, from https://www.webmd.com/hypertension-high-blood-pressure/
guide/hypertension-home-monitoring
Cabezas, M., Elte, J., & Klop, B. (2013). Dyslipidemia in Obesity: Mechanisms and
Potential Targets. Retrieved August 4, 2021, from https://www.ncbi.nlm.nih.gov/
pmc/articles/PMC3705344/
Definition & Facts for Adult Overweight & Obesity. (2018, February). Retrieved August
4, 2021, from https://www.niddk.nih.gov/health-information/weight-management/adult-
overweight-obesity/definition-facts
Harvard Health Publishing (2021). Why stress causes people to overeat. Harvard
Medical School. Retrieved August 3,2021, from https://www.health.harvard.
edu/staying-healthy/why-stress-causes-people-to-overeat
Healthy Weight Checklist. (2021b, April 9). Obesity Prevention. Retrieved August 3,
2021, from https://www.hsph.harvard.edu/obesity-prevention-source/diet-lifestyle-to-
prevent-obesity/
Martí, A., Alejos, S., & Meneses, L. (2018, August 17). Symptoms of Obesity. Retrieved
August 3, 2021, from https://www.clinicbarcelona.org/en/assistance/
diseases/obesity/symptoms
Mayo Clinic Staff. (2018, November 18). Obesity. Mayo Clinic. Retrieve August 3, 2021,
from https://www.mayoclinic.org/diseases-conditions/obesity/diagnosis-treatment/drc-
20375749
MedlinePlus. (2021, August 2). DASH Eating Plan. Retrieved August 3, 2021, from
https://medlineplus.gov/dasheatingplan.html
MedlinePlus. (2021, May 5) How to Lower Cholesterol with Diet. Retrieved August 3,
2021, from https://medlineplus.gov/howtolowercholesterolwithdiet.html
Perreault, L. (2021, June 18). Patient Education: Losing Weight. Retrieved August 3,
2021, from https://www.uptodate.com/contents/losing-weight-beyond-the-basics
Research Center Weight Loss Specialists. (2021). 7 Benefits of Burning Fat for Energy.
Retrieved August 3, 2021, from https://www.emetabolic.com/locations/ centers/
Russellville/blog/weight-loss/7-benefits-of-burning-fat-for-energy/
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Torres, S & Nowson, C. (2007, December 23). Relationship between stress, eating
behavior, and obesity. Nutrition. 887-94. doi: 10.1016/j.nut.2007.08.008. Epub 2007 Sep
17. PMID: 17869482
Whitworth, G. (2019). How does stress affect cholesterol levels? Retrieve from
https://www.medicalnewstoday.com/articles/313207
World Health Organization (2021). Obesity and overweight. Retrieved August 3, 2021,
from https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight