A DETAILED REPORT OF HOSPITAL PRACTICE

DONE AT

LAUTECH TEACHING HOSPITAL, OGBOMOSO, OYO STATE, NIGERIA.

WRITTEN BY

HAMZAT FATHIA OLUWAKEMI

MATRIC NO : 204072

GROUP 1

SUBMITTED TO

DEPARTMENT OF NUTRITION AND DIETETICS

FACULTY OF FOOD AND CONSUMER SCIENCES

LADOKE AKINTOLA UNIVERSITY OF TECHNOLOGY

P.M.B 4000 OGBOMOSO, OYO STATE, NIGRIA.

IN PARTIAL FULFILMENT OF REUIREMENT FOR THE AWARD OF BACHELOR OF

TECHNOLOGY (B.TECH) IN THE DEPARTMENT OF NUTRITION AND DIETETICS.

OCTOBER, 2023.
 CERTIFICATION

This is to certify that Hospital practice report is originally written by HAMZAT FATHIA OLUWAKEMI
with matric number 204072. Department of NUTRITION AND DIETETICS, LADOKE AKINTOLA
UNIVERSITY OF TECHNOLOGY, OGBOMOSO, OYO STATE on the completion of Hospital Practice.

SUPERVISOR
SIGNATURE/DATE

HEAD OF DEPARTMENT
SIGNATURE/DATE
 ACKNOWLEDGEMENT

My sincere gratitude goes to the giver of life, my creator, the Almighty God for giving me this opportunity
to accomplish this HOSPITAL PRACTICE and to be able to write this report.

I will also like to appreciate the Dean of Faculty of Food And Consumer Sciences in person of Professor
E.A AKANDE for the opportunity his office has given to us to exercise HOSPITAL PRACTICE in the
department of NUTRITION AND DIETETICS LAUTECH,OGBOMOSO.

Also, I am using this medium to appreciate the tiredless effort of the head of department of Nutrition And
Dietetics in person of DR (MRS) BABARINDE in making the program possible.

To my HOSPITAL PRACTICE coordinator, I so much appreciate your effort and support.

To the Dietitian in charge in person of Dietitian (MRS) Ifeoluwa Ajumobi, I say a very big thank you for
the knowledge impacted.

To my adorable parents for their encouragement and support in all ramifications.

Final to my group member for their team spirit and cooperation also for their tenacity.
 DEDICATION

I dedicate this report to Almighty God who is the only determinant of success and progress upon my life.

I also dedicate this report to my Parents, Faculty of Food and Consumer Sciences, Department, Staff and
Students.
 TABLE OF CONTENT

TITLE PAGE

CERTIFICATION

ACKNOWLEDGEMENT

DEDICATION

CHAPTER ONE

1.0 MEANING OF HOSPITAL PRACTICE

1.1 SIGNIFICANCE OF HOSPITAL PRACTICE

1.2 A DIETITIAN

1.3 MATERIALS AND EQUIPMENT USED BY A DIETITIAN

1.4 BED SIDE MANNERS FOR COUNSELLING PATIENT

1.5 IDEAL BODY WEIGHT MEASUREMENT FOR MEN AND WOMEN

CHAPTER TWO

2.0 MEANING OF DIABETES

2.1 TYPES OF DIABETES

2.2 SYMPTOMS OF DIABETES

2.3 CAUSES OF DIABETES

2.4 RISK FACTORS OF DIABETES

2.5 COMPLICATIONS OF DIABETES

2.6 DIETARY MANAGEMENT OF DIABETES

CHAPTER THREE

3.0 MEANING OF RENAL (KIDNEY)

3.1 FUNCTIONS OF AN HEALTHY KIDNEY

3.2 TYPES OF KIDNEY DISEASES

3.3 SYMPTOMS OF KIDNEY DISEASES

3.4 CAUSES OF KIDNEY DISEASES

3.5 RISK FACTORS OF KIDNEY DISEASES

3.6 COMPLICATIONS OF KIDNEY DISEASES

3.7 DIETARY MANAGEMENT OF KIDNEY DISEASES

CHAPTER FOUR

4.0 MEANING OF HYPERTENSION

4.1 RISK FACTORS OF HYPERTENSION

4.2 COMPLICATIONS OF HYPERTENSION

4.3 BLOOD PRESSURE CHART

4.4 FACTORS THAT CAUSE HYPERTENSION

4.5 SYMPTOMS OF HYPERTENSION

4.6 DIETARY MANAGEMENT FOR HYPERTENSION

CHAPTER FIVE

5.0 RECOMMENDATION

5.2 CONCLUSION

5.3 REFERENCES
 CHAPTER ONE

1.0 MEANING OF HOSPITAL PRACTICE

Hospital practice refers to the application of nutritional knowledge and guidelines in a hospital
setting to ensure optimal nutrition and well-being of patients. It involves assessing patients’ nutritional
needs, developing personalized meal plans and monitoring their nutritional status during their stay in the
hospital. It plays a crucial role in supporting the healing process and promoting overall health.

1.1 SIGNIFICANCE OF HOSPITAL PRACTICE

1. Exposing students to the practical, as opposed to nearly the theoretical side of Nutrition and Dietetics

2. It gives student the opportunity to apply their learnings in a practical setting

3. It gives students hands-on experience and helps understand the value for labour

4. It helps to ensure that patients receive the right nutrient to support their recovery and overall health

5. It plays a crucial role in promoting healing and well-being

1.2 A DIETITIAN

A dietitian is a health professional who specializes in nutrition and dietetics. They provide expert advise
on nutrition, create personalized meal plans, and help individual make healthy food choices.

Dietitians can help with various health conditions, weight management and overall wellness. They work
closely with individual to develop sustainable and balanced eating habits that align with their specific
needs and goals.

1.3 MATERIALS AND EQUIPMENT USED BY A DIETITIAN

1. Weighing scale: It is used to determine the total body weight

2. A food weighing scale: It is used to determine the weight of food

3. Stadiometer: It is used for measuring height

4. Glucometer: It is used for measuring blood sugar level

5. Sphygomanometer: It is used for measuring blood pressure

6. Tape rule: It is used for measuring hip and tommy circumference

7. MUAC (Fat measurement)

8. Stetoscope: It is used to calculate heart

9. Food charts, Food models, measuring cups and spoon

10. Referrals/consult: It is sent by the doctors to dietitians stating the information of the patient like name,
the height, weight, blood sugar level, blood pressure and the disease condition and hereby asking the
dietitian to please manage according to the disease condition
1.4 BED SIDE MANNERS FOR COUNSELLING PATIENT

1. You must be pleasing enough and acceptable to patient physically

2. You must be respectful

3. Do away with all chewing items

4. Always give listening ears

5. Be ready to work with other health professionals as a dietitian

6. Be compassionate (show love and empathy)

7. Do not counsel a patient without their case note

1.5 IDEAL BODY WEIGHT FOR MEN AND WOMEN

1. For women;

For every height above 1.52m (constant)

45.5+1.1x (Assumed height- constant)

2. For men;

For every height above 1.52m (constant)

48.1+0.9x (Assumed height- constant)

 CHAPTER TWO

2.0 DIABETES

Diabetes is a chronic medical condition characterized by high levels of sugar (glucose) in the blood. It
occurs when the body either doesn’t produce enough insulin (a hormone that helps to regulate blood sugar)
or when cells become resistant to the effects of insulin, leading to improper glucose utilization.

2.1 TYPES OF DIABETES

1. Type 1 diabetes: It is an autoimmune condition where the immune system mistakenly attacks and
destroys the insulin-producing Beta cells in the pancreas. As a result, people with Type 1 diabetes require
insulin injections or an insulin pump to manage their blood sugar levels.

2. Type 2 diabetes: It is the most common form of diabetes, accounting for about 90-95% of all cases. In
Type 2 diabetes, the body either doesn’t produce enough insulin or the cells become resistant to insulin’s
effects.

3. Gestational diabetes: Is a type of diabetes that can develop during pregnancy in women who don’t
already have diabetes

2.2 SYMPTOMS OF DIABETES

1. Excessive urination (polyuria)

2. Excessive thirst (polydipsia)

3. Excessive hunger (polyphagia)

4. Weight loss or gain

5. Fatigue

6. Blurred vision

7. Decrease sex drive (in men)

8. Poor muscle strength (in men)

9. Urinary tract infections (in women)

10. Vagina dryness (in women)

11. Dry itchy skin (in women)

12. Yeast infections (in women)

2.3.1 CAUSES OF TYPE-1 AND TYPE-2 DIABETES

1. Overweight, obesity and physical inactivity

2. Insulin resistance

3. Genes and family history

4. Genetic mutations

5. Hormonal diseases

6. Exposure to viruses and other environment factors

7. Damage to or removal of the pancreas

2.3.2 CAUSES OF GESTATIONAL DIABETES

1. Being overweight or obese

2. Not being physically active

3. Having prediabetics

4. Having had gestational diabetes during a previous pregnancy

5. Hormone levels changes

2.4 RISK FACTORS OF DIABETES

1. Overweight or obesity

2. Pregnancy

3. Age (people older than 40 and above)

4. Family history

5. People with high blood pressure

6. People with pre-diabetes (diabetes higher than normal blood sugar level althrough)

2.5.1 COMPLICATIONS OF DIABETES

1. Cardiovascular diseases: Diabetes can put you at high risk of blood clot, this can lead to chest pain,
heart attack, stroke or heart failure.

2. Nerve damage from diabetes (diabetic neuropathy)

3. Kidney damage from diabetes (diabetic nephropathy)

4. Eye damage from diabetes (diabetic retinopathy)

5. Foot damage

6. Skin and mouth conditions

2.5.2 COMPLICATIONS OF GESTATIONAL DIABETES

1. Still birth

2. Jaundice

3. Premature birth
4. Low blood sugar (hypoglycemia)

5. Serious breathing difficulties

2.6 DIETARY MANAGEMENT OF DIABETES

1. Carbohydrate control: Monitoring and balancing the intake of carbohydrate is crucial to prevent rapid
spikes in blood sugar level. Choose complex carbohydrates with a low glycemic index such as whole
grains, legumes and non-starchy vegetables is recommended.

2. Balanced nutrition: Emphasizing a balanced intake of protein, healthy fat and fibre is important for
overall health and blood sugar control.

3. Limiting sugary and processed foods: Foods high in added sugars, sugary beverages and processed
snacks should be minimized or avoided altogether.

4. Portion control: Controlling portion sizes helps manage calorie intake and prevent large fluctuations in
blood sugar levels after meals.

5. Hydration; Staying well hydrated is important but sugar-sweetened beverages should be avoided.
 CHAPTER THREE

3.1 RENAL (KIDNEY)

Kidneys are responsible for the regulation of pH, salt and potassium level in the body. They produce the
hormones that regulate the blood pressure and controls the production of red blood cells.

3.2 FUNCTIONS OF AN HEALTHY KIDNEY

1. Kidney controls the production of red blood cells

2. It balance the body’s fluids

3. Kidney produce an active form of Vitamin D that promotes strong and healthy bones

4. Kidney release hormones that regulate blood pressure

5. It removes drugs from the body

6. It removes waste products from the body

7. It controls pH levels

3.3 TYPES OF KIDNEY DISEASE

1. Chronic Kidney Disease (CKD): CKD occurs when a disease or condition impairs kidney functions,
causing kidney damage to worsen over several months.

2. Kidney stones: Also called NEPHROLITHIASIS. It is a small hard deposits that forms in the kidneys.
Kidney stones are hard deposits of minerals and acid salt that stick together in concentrated urine. They
can be painful when passing through the urinary tract, but usually don’t cause permanent damage.

3. Glomerulonephritis: Is the inflammation and damage to the filtering part of the kidneys
(GLOMERULUS). It can come on quickly or over a longer period of time. Toxins, metabolic wastes and
excess fluid are not properly filtered into the urine. Instead, they build up in the body causing swelling and
fatigue.

4. Kidney cancer: Is a cancer that starts in the cells of the kidney. Kidney cancer develops when cells in the
kidneys grow out of control.

5. Acute Kidney Injury (AKI): Is also called Acute Kidney Failure. It is a condition in which the kidneys
suddenly can’t filter waste from the blood. Acute Renal Failure develops rapidly over a few hours or days.
It may be fatal and it is most common in those who are critically ill and already hospitalized.

6. Polycystic Kidney Disease: Is an inherited disorder in which clusters of cyst develop in the kidneys. The
cysts in Polycystic Kidney Disease are non-cancerous sacs containing water-like fluid.

7. Kidney Cysts: Are round pouches of fluid that form on or in the kidney. Kidney cysts can occur with
disorders that may impair kidney function.

3.4 SYMPTOMS OF KIDNEY DISEASES

1. Poor appetite
2. Swollen feet’s and ankles (edema)

3. Polyuria especially at night

4. Fatigue

5. Muscle cramping

6. Puffiness around the eyes especially in the morning

7. Itchy skin

8. Difficulty sleeping (insomnia)

3.5.1 CAUSES OF CHRONIC KIDNEY DISEASE

1. Diabetes

2. Heart (cardiovascular) disease

3. Smoking

4. High blood pressure

5. Obesity

6. Family history of kidney disease

7. Abnormal kidney structure

3.5.2 CAUSES OF KIDNEY STONES

1. Drinking too little water

2. Exercise (too much or too little)

3. Obesity

4. Weight loss surgery

5. Eating food with too much salt or sugar

6. Infections and family history might be important in some people

3.5.3 CAUSES OF GLUMERULONEPHRITIS

1. Toxins or medications

2. Viral infections such as HIV, hepatitis B and C viruses

3. Bacterial infections that commonly cause throat and skin infections, such as strep or staph bacteria

4. Lupus-related kidney inflammation

3.5.4 CAUSES OF KIDNEY CANCER

1.Smoking: Smokers have almost twice the risk of developing kidney cancer as nonsmokers.
2. High blood pressure

3. Being overweight or obese

4. Family history or kidney cancer

5. Workplace exposure to chemicals such as arsenic, some metal degreasers or cadmium used in mining,
welding, farming and painting.

6. Having advanced kidney disease

7. Being male: Men are more likely to develop kidney cancer

3.5.5 CAUSES OF ACUTE KIDNEY INJURY (AKI)

1. Blood or fluid loss

2. Blood pressure medications

3. Heart attack

4. Heart disease

5. Infection6. Liver failure

7. Use of aspirin, ibuprofen or related drugs

3.5.6 CAUSES OF POLYCYSTIC KIDNEY DISEASE

1. Abnormal genes

2. Genetic mutation

3.6 RISK FACTORS OF KIDNEY DISEASE

1. Diabetes

2. Hypertension

3. Any form of chronic disease

4. Elderly people are at risk of kidney disease

5. Inherited kidney disease

6. Obesity

7. Smoking

3.7 COMPLICATIONS OF KIDNEY DISEASE

1. Anemia

2. Heart disease
3. Fluid retention; which could lead to swelling in the arms and legs, high blood pressure or fluid in the
lungs (pulmonary edema)

4. A sudden rise in potassium levels in the blood (hyperkalemia) which could impair your heart’s function
and can be life-threatening

3.8 DIETARY MANAGEMENT OF KIDNEY DISEASE

1. Limit sodium intake: There should be reduction in salt consumption

2. Low intake of potassium and phosphorus

3. Limit alcohol or preferably no alcohol intake

4. Low protein intake

5. Quit smoking

6. Getting enough calories if you are loosing weight

 CHAPTER FOUR

4.0 MEANING OF HYPERTENSION

Hypertension, also called high blood pressure, is a condition where the force of blood against the walls of
your arteries is too high. The instrument used in measuring hypertension is called
SPHYGMOMANOMETER. Hypertension have a normal blood reading of 120/80mmHg.

4.1 RISK FACTORS OF HYPERTENSION

1. Older age

2. Genetics

3. Being overweight or obese

4. Not being physically active

5. High-salt diet

4.2 COMPLICATIONS OF HYPERTENSION

1. Heart attack or stroke: Hardening and thickening of the arteries due to high blood pressure or other
factors can lead to a heart attack, stroke or other complications.

2. Aneurysm: Increased blood pressure can cause a blood vessel to weaken and bulge, forming an
aneurysm. If an aneurysm ruptures, it can be life-threatening.

3. Heart failure: When you have high blood pressure, the heart has to work harder to pump blood. The
strain causes the walls of the heart pumping chamber to thicken. This condition is called left ventricular
hypertrophy. Eventually, the heart can’t pump enough blood to meet the body’s needs, causing heart
failure.

4. Kidney problems: High blood pressure can cause the blood vessels in the kidneys to become narrow or
we his can lead to kidney damage.

5. Eye problems: Increased blood pressure can cause thickened, narrowed or torn blood vessels in the eyes.
This can result in vision loss.

4.3 BLOOD PRESSURE CHART

Systolic Diastolic
Typical Below 120 Below 80
Elevated 120-129 Below 80
Stage 1 HTN 130-139 80-90
Stage 2 HTN 140 and 90 and
above above
Hypertensive Over 180 Over 120
crisis

4.4 FACTORS THAT CAUSES HYPERTENSION

1. Obesity

2. Type 2 diabetes

3. Kidney disease

4. Lupus

5. Underactive and overactive thyroid gland

4.5 SYMPTOMS OF HYPERTENSION

1. Severe headache

2. Chest pain

3. Dizziness

4. Difficulty breathing

5. Nausea

6. Vomiting

4.6 DIETARY MANAGEMENT OF HYPERTENSION

1. DASH DIET

Dash diet is a healthy eating plan designed to help treat or prevent high blood pressure (hypertension).

The DASH diet include foods that are rich in potassium, calcium, and magnesium. These nutrients help
control blood pressure. The diet limits food that are high in sodium, saturated fat and added sugars.

Studies have shown that the DASH diet can lower blood pressure in as little as two weeks. The diet can
also lower low-lipoprotein (LDL or bad) cholesterol levels in the blood. High blood pressure and high
LDL cholesterol levels are two major risk factors for heart disease and stroke.

It involves eating a lot of fruits, vegetables, lean meat, whole grains, deskinned meat, nuts and legumes.

Foods to avoid include:

i. Canned foods

ii. Fast and fried foods

iii. Fatty meals and palm oil

iv. Sugary drinks

 CHAPTER FIVE

5.1 RECOMMENDATION

Eating a healthy diet is a very important step towards ensuring a healthy lifestyle. Diet-related non-
communicable diseases can be prevented and also well-managed if a healthy dietary practice can be
adopted. Hence it is recommended that campaigns for healthy dietary choices be encouraged to get people
aware of the need to eat well. Nutrition education should be encouraged among all people.

5.2 CONCLUSION

The two weeks long hospital practice was indeed an interesting experience; it gave a more practical
approach to the theoretical knowledge already acquired and it’s an experience to remember. . The
DIETITIAN in charge of the hospital practice took the students round the ward which includes: The male
ward, the female ward and the paediatics (children) ward. We were shown different patient case file and
how to manage their diseases

5.3 REFERENCES

1. Meigs JB, Muller DC, Nathan DM

2. American Diabetes association

3. Aileru AA, Logan E, Callahan M, Ferrario CM, Ganten D, Diz Dl.

4. Aperia A, Ibarra F, Svensson LB, Klee C, Greengard P.

5. Bachmann S, Bosse HM, Mundel p.

6. The Ministry of Health, Labour, and Welfare. The 2010 National Health and Nutrition Survey in Japan,
2012.

7. Miura K, Nagai M, Ohkubo T. Epidemiology of hypertension in Japan

8. Lawes CM, Vander Hoorn S, Rodgers A, Intertional Society of Hypertension.