COR JESU COLLEGE, INC.

COLLEGE OF HEALTH SCIENCES

Tres de Mayo, Digos City, Davao del Sur

Bachelor of Science in Nursing

Second Semester; AY: 2022 – 2023

NCM 105 ACTIVITY 3

Chapter 3: :  Digestion, Absorption, and Metabolism

NAME: (LASTNAME, FIRST NAME, MI.)

G E R S A L I A C H R I S T I E N NI K K I R
Carl is a 30-year-old Caucasian male with Crohn’s disease, primarily of the large
intestine and colon. He is 5 feet 9 inches tall and weighs 200 pounds. He knows he is
prone to flare-ups of malabsorption of carbohydrate, protein, fats, and folate. He has
been having diarrhea on and off for three weeks. It has been very bad these last two
weeks. He has lost 10 pounds. He would like to get his weight down even more. His
physician ordered blood for CBC, albumin, folic acid, and B12. She has written a
dietary referral for a low-lactose, low-fat, high-fiber, high-protein diet.

ASSESSMENT

1. What is the pertinent objective and subjective data related to Carl’s problem?
a. Subjective- He knows he is prone to flare-ups of malabsorption of carbohydrate, protein, fats, and
folate.
b. Objective- He has been having a diarrhea on and off for three weeks. It has been very bad these
last two weeks and he has lost 10 pounds.

2. Calculate Carl’s target caloric intake and weight according to Tables 3-2 and 3-3.
a. 2400 caloric intake needed; and 129-169 pounds
b. Carbohydrates- 1080 cal; 20g (45%)
Fats- 480 cal; 53.33g (20%)
Protein- 840 cal; 210g (35)

3. Calculate Carl’s REE using the Harris-Benedict equation.

REE= 66 + (13.7 x 90.7kg) + (5 x 175.26cm) – (6.8 x 30yrs old)
= 66 + (1242.59) + (876.3) – (204)
REE= 1980.89

DIAGNOSIS

4. Write a nursing diagnosis for Carl.

- Anxiety r/t in health status; Diarrhea; Acute pain r/t increased peristalsis; Ability to digest and
absorb food; Risk factor: abnormal fluid loss with diarrhea; Repeated of diarrhea; Fatigue; and
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 Overload stress

5. What is the cause of Carl’s problem with elimination?

- Carl could be lactose intolerant hence it was written a dietary referral for Low lactose. Eliminate
dairy products, alcohol, saturated fats (coffee, tea, chocolate), fatty foods, foods rich in fiber, and
carbonated beverages.

PLAN/GOAL

6. Write a measurable goal for controlling Carl’s diarrhea.

- Eating healthy; Change in drinking water or food intake of unsafe food; Avoid greasy and low fat
food, limit foods that are high in fiber, and take medication as physicians prescribed for diarrhea

7. Write a goal to help Carl adapt to his new diet. Incorporate Carl’s desire to lose weight.
- Carl may apply nutrition therapy and combined it with medications and he can follow a low fiber
diet to reduce the risk of intestinal blockage

8. Where could the dietitian direct Carl to obtain information to increase his understanding of his
disease and the related nutrition issues?
- Gastroenterologist

IMPLEMENTATION

9. List at least one action to help Carl meet the goal.

- Drink a lot of water
- Take a proper medication to decrease the inflammation to prevent flare-ups of his sysmptoms
- And choose food carefully

10. List two foods Carl should avoid.

- Spicy food
- Alcohol

11. List three foods Carl needs to include.

- Oatmeal
- Low fiber foods
- Calcium rich foods

EVALUATION/OUTCOME CRITERIA

12. What will Carl report when your plan for his diarrhea is effective?
- Carl will no longer suffer a excruciating damage when his immune system is functioning
normally. Symptoms including discomfort, exhaustion, and diarrhea have disappeared in
exception.

13. How will Carl know his new diet is successful?

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 - When the inflammation will stop that cause to his bowel and his colon a painful damage because
it is important for his immune system to work for a remission and no more symptoms like
diarrhea.

14. What can the doctor measure when all the goals are successful?
- A endoscopy, MRI or ultrasound to check inside of the digestive tract to see if the damage has
healed.

15. If the plan were not successful, what would Carl be experiencing?
- If the plan were not successful Carl may experience a urgent bowel movement and abdominal
pain. Carl may loss a lot of weight due to loss of appetite along these having a anemia that leads
to fatigue. If possible he will have a Colon cancer if the Crohn is still untreated.

16. What could be an unplanned, undesirable outcome of this diet change?

- A certain food may cause flare-ups in Crohn’s disease
- Foods that are high in dietary fiber, fat, dairy products, and carbonated beverages are more likely
to have this symptom
- A untreated Crohn’s disease may worst into a colon cancer
- May include loss appetite

THINKING FURTHER

1. What challenges does Carl face with chronic progressive disease?

- Malnutrition
- Intestinal obstruction
- Ulcers
- Inflammation in other areas of the body
- Anal fissures
- Fistulas

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