Case Study:

BETTY
Mansfield Center for Nursing Rehab

Courtney LeDuc - Fall 2022

 OVERVIEW
Reason for Admission Laboratory Data

Demographics Intervention & Evaluation

Course of Hospitalization Meal Plan

Medical & Diet History PES Statement

Medications & Interactions Future Changes

About Betty…
Reason for
● Female Admission
● 82 y.o.
● Height - 5’ 0” Orthopedic Aftercare for
● Weight - hip fracture
○ 09/28/22 - 150.5
○ 10/05/22 - 155.1
○ 10/12/22 - 158.5 NFPE Observations
○ 10/19/22 - 162.5 ● Wheelchair for recovery
● Edema
● Widowed ● Healthy hands and skin
● Lives alone ● All teeth
● Catholic ● Uses oxygen
● Anxiety & Depression
Course of Hospitalization

Betty experienced a fall the night of 9/23/22 while

reaching for her walking getting out of bed

Was hospitalized for a fractured femur and required

surgery

Admitted to Mansfield Rehab Center 9/27/22 to

recover and received PT/OT
 Medical & Diet History
Main Diagnoses

Type 2 Diabetes Hypertension

Pulmonary Fibrosis Kidney Failure

Heart Failure Hyperlipidemia

Diet Orders
Consistent Carbohydrate and Cardiac
Key Medications & Interactions
*15 Total
Metoprolol Atorvastatin
Beta Blocker Humalog
Treats high cholesterol
Treats angina and HTN Insulin
● Alcohol
● Alcohol Lower blood sugar
● Grapefruit juice
● Multivitamins ● Alcohol
● Food
● May alter serum
Prednisone Lantus Solostar
lipid profile Steroid Long Acting Insulin pen
Decreases inflammation
Improves blood sugar
● Fluid retention
Diltiazem control
● May elevate serum
Treats hypertension ● Alcohol
triglyceride and
● Alcohol LDL cholesterol
● Grapefruit juice
Laboratory Data
10/22/22 A1C
9/29/22
Temp: 98.5 F

7.6 Diabetes
BP: 125/57 mmHg Hypertension
Pulse: 44 BPM
Respirations: 20 per min
O2: 97%
Blood Sugar
10/11/22
10/21/22
Glucose: 207 mg/dL High
7:34am - 133mg/dL
BUN: 20
12:19pm - 197mg/dL
Creatinine: 0.7
5:24pm- 252mg/dL
GFR: 83
7:55pm - 247mg/dL
HBG: 11.0 Low
HCT: 34.7 Low
 Intervention
After Betty’s husband passed, she had to learn to prepare food for just herself
Her daughter discovered a meal preparation business that offered ready-to-eat meals
The meals are designed to cater specific dietary needs
Betty really enjoys them and contributes managing her diabetes over the past year

Strategies
● Heart Healthy Cardiac &
Consistent Carbohydrate Diet
● 2-3 carb servings per meal
● Less than 200mg cholesterol
per day
● Limiting sodium to
1,500-2,00mg per day
Evaluation
● Diabetes management
● 8% weight increase
● Food preparation at home
● High blood pressure
Sample Menu for 1,350 Calorie Day
 PES
Excessive carbohydrate intake related to diagnosis of
Type 2 Diabetes and usual diet inconsistency as
evidenced by elevated blood sugar and A1C levels
since admission.
 What would I do
differently?
● Discuss knowledge of diabetic exchanges
● More info about A1c management and medical
condition hx
● Physical Activity
● Focused communication
Questions?