Major Case Study Assignment

Instructions:

Read the provided case study below and reply to each of the questions, following the prescribed order and formatting. Please limit each response to no more than a half page. Include in-text citations throughout your responses and a works cited list (formatted using APA style guidelines) at the end of this assignment. Please submit your completed assignment as a .pdf or .doc via Blackboard by the scheduled due date.

Case Study #3: Harold's Heartache

Harold is 46 and recently divorced. Since he and his wife separated, he noticed that he has been eating a lot of premade processed foods and putting on some extra pounds, and his weight has climbed from 185 to 205 pounds (his height if 5' 11") within the past 9 months. He's been stressed with the divorce settlement and has started smoking again. Both of Harold's parents had heart disease and he's been on hypertension medications for 5 years. When he went to see his doctor, his blood pressure was143/85 mmHg and a lipid panel revealed that his total cholesterol is 260 mg/dL with an LDL level of 167 mg/dL and an HDL level of 35 mg/dL. He shared with his doctor that he used to exercise regularly, but had been physically inactive for over 6 months. When asked if he would like to start exercising again, Harold responded, "I definitely know I should, and I remember it used to make me feel so good! I was thinking of buying a new bike!" Harold's doctor collected a 24-hour recall from Harold, which included the following:

• Breakfast: McDonald's Sausage McMuffin with egg, 16 oz. orange juice
• Snack: 3.5 oz. Nacho Cheese Doritos
• Lunch: 1 bowl (12 oz.) French onion soup with 3 oz. Swiss cheese, a large serving of French fries with 4 T. ketchup, and 16 oz. Coke
• Dinner: 1 bowl (12 oz.) beef chili with 2 T. bacon crumbles, 3 T. cheddar cheese, and 3 T. sour cream, with 16oz. Coca Cola

When asked what he thought of his diet, Harold responded, "I think my diet's pretty good. I try to make sure I'm eating three square meals per day and get plenty of protein!"

Case Study Questions

Assessment and Diagnosis

1. Describe the definition (types), prevalence, and etiology of heart disease.

[Insert response.]

1. What is the role of serum cholesterol and blood pressure in heart disease risk? Why does smoking increase the risk of heart disease? What are the nutritional considerations?

[Insert response.]

1. Determine Harold's risk for developing heart disease. What tools are calculations were used for this assessment? Identify his modifiable and non-modifiable risk factors.

1. What clinical data are used to assess and diagnose his condition and what are the relevant cut-points?

[Insert response.]

1. Conduct a nutrient analysis of Harold's 24-hour recall and describe his diet. What are the food groups and nutrients of interest for Harold and why? How does his intake compare to the recommended intake? Be sure to include output reports from dietary analysis software.

[Insert response.]

1. Assess Harold's readiness to change various behaviors related to his health condition and provide evidence for your observations. What are some areas of strength and what are some resources? What are some areas of weakness and what are some threats?

[Insert response.]

Intervention

1. Describe your strategy for counseling Harold. Considering your assessment of his readiness to change, what behaviors would you focus on? What counseling strategies would you implement?

[Insert response.]

1. Suggest patient resources. Provide a link to a website or handout that you would refer Harold to and include the handout or screenshot. Why did you select it? What specific behaviors are you targeting and what do you hope the outcome will be?

[Insert response.]

Monitoring and Evaluation

1. Identify 3-5 SMART goals for Harold. Discuss why you would recommend these particular goals and strategies.

[Insert response.]

1. Describe what the monitoring and follow-up for the patient will be, and how you expect these goals to develop and evolve over time. What information you will use to track Harold's progress?

[Insert response]