Tired Swimmer Case

Case 105: Cooper

COOPER IS A 65 YEAR-OLD ACCOUNTANT. HE IS 6’2", 363 LBS, WITH A LARGE FRAME. IN HIGH SCHOOL HE PLAYED FOOTBALL AND WAS PHYSICALLY FIT. IN RECENT YEARS, HE HAS GAINED WEIGHT AND DEVELOPED HIGH BLOOD PRESSURE. HE HAS A FAMILY HISTORY OF TYPE 2 DIABETES, HEART DISEASE AND HYPERTENSION. COOPER HAD A SEVERE STROKE TWO WEEKS AGO. HE HAS PARTIAL PARALYSIS ON THE LEFT SIDE. HE HAS SLURRED SPEECH. COOPER IS ADMITTED TO GOLDEN MEADOWS REHABILITATION CENTER FOR PHYSICAL AND SPEECH THERAPY. HE MADE A LOT OF PROGRESS IN THE HOSPITAL, BUT CONTINUES TO HAVE TROUBLE CHEWING, SWALLOWING, WALKING AND SPEAKING CLEARLY. A SPEECH THERAPIST HAS EVALUATED HIS SWALLOWING, AND RECOMMENDS A NDD LEVEL 1• DYSPHAGIA PUREED WITH NECTAR-LIKE LIQUIDS. HIS COMPLETE DIET, AS ORDERED BY THE PHYSICIAN, IS: DASH WITH NDD LEVEL 1• DYSPHAGIA PUREED WITH NECTAR-LIKE LIQUIDS.

Questions

1. DETERMINE COOPER’S IBW. DETERMINE COOPER’S PERCENT IBW. WHAT WOULD BE A SAFE AND REASONABLE RATE OF WEIGHT LOSS FOR HIM? 3 PTS

106+(5x14)=176 A Safe and reasonable weight loss for him is approx. 100lbs so that he can be at a healthy weight.

176+10% of ibw=193.6

193.6=IBW

2. Cooper’s family wants him to eat regular food, with nothing pureed. Explain why he is on these multiple diet restrictions. What would you tell members of his family? 3 pts

Cooper has trouble chewing and swallowing since his server stroke. Placing Cooper on this diet prevents the dangers of aspiration, choking, dehydration and malnutrition over time. With these specific diets, it would be much easier and safer for Cooper to digest food, confirm proper nutrition and ensure a faster recovery.

3. Cooper’s family wants him to come home for the holidays. You have instructed them on how to prepare pureed foods and follow the DASH and Dysphagia diet. Look at the holiday menu they have planned. Modify it for his diet as ordered. 4 pts

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