NR 228 Week 3 Discussion Question: Diet and Lab Values.
Mark, a single father of a 2-year-old son, Jacob, stops every morning at a local fast food
... [Show More] restaurant to pick up breakfast for himself and his son on their way to daycare. Mark says, “I don’t have time to cook in the mornings, and I can’t feed Jacob anything I would ever make at home any cheaper than this! Besides, he really loves these sausage and egg sandwiches, and at least I can get him to eat them!” Mark has a family history of diabetes, as well as hyperlipidemia, and has the following risk factors for cardiovascular disease: primary hypertension (treated with medication), cigarette smoking, inactive lifestyle, and occasionally eating foods high in sodium. Both of his parents died at young ages due to what Mark calls “heart troubles,” and his brother has high cholesterol. During his physical, Mark learns that his lipid panel is as follows: total cholesterol 245 mg/dl, LDL 180 mg/dl, and HDL 35 mg/dl.
Answer
1. As his nurse, you know that risk factors for cardiovascular disease are fixed or modifiable. Give at least two examples of each. For modifiable risk factors, what can be done to reduce risk?
The examples of fixed and modifiable risk factors for cardiovascular diseases are as follows:
Modifiable: hypertension, dyslipidemia, diabetes, cigarette smoking, obesity, and sedentary lifestyle. The non-modifiable or fixed risk factors are: race, advanced age, and family history (Huether & McCance, 2016). In order to reduce risk from modifiable factors, Mark needs to quit smoking, start exercising regularly, and eat healthy food.
2. What is the significance of Mark’s blood work? What a normal lipid profile look like?
By looking at Mark’s blood work, his total cholesterol is high, LDL is high, and HDL is low. The desirable total cholesterol is less than 200 mg/dl, borderline is 200 – 239 mg/dl, and high risk is 240 mg/dl and above. The desirable LDL is 60-130 mg/dl, borderline is 130-159 mg/dl, and high risk is 160-189 mg/dl. The desirable HDL is 60 mg/dl, borderline is 35-45 mg/dl, and high risk is less than 35 mg/dl (Huether & McCance, 2016).
3. Based on the information provided in the scenario how would you educate him? Be sure to include physical fitness and nutrition based on the USDA 2015 Dietary Guidelines, and choosemyplate.gov link covered in unit 1
Based on the above scenario, I would educate him about risk factors and complications of diabetes, hypertension, dislipidemia, and smoking. Since he has a family history of diabetes and dislipidemia, I would educate and recommend him to adopt a DASH diet, USDA 2015 Dietary Guidelines, and show and teach him regarding nutrition guide from MyPlate. A decreasing caloric intake, making more well-informed food choices, increasing one’s physical activity to reach and maintain a healthy weight, chronic disease risk reduction, and promotion of overall health (Grodner, Roth, & Walkingshaw, 2012). I would also advise him to think and eat about what goes into his plate, cup, and bowl. Since Mark has a son, he is also risk for genetic and environmental risk factor diseases. I would teach Mark how to maintain good health of his son from the childhood. The first and foremost thing that Mark needs to consider is to do regular exercise, quit smoking, and eat healthy food. I would show him the lipid profile and advise him regarding the risk factors associated with it. I would sit with him to make plans for daily interventions. Mark needs to decrease sodium intake, choose food items that are low in saturated fats, eat more fruits and vegetables, exercise regularly, and quit smoking.
References
Grodner, M., Roth, S. L., & Walkingshaw, B. C. (2012). Nutritional foundations and
clinical applications: A nursing approach (5th ed.). St. Louis, MO: Elsevier
Mosby.
Huether, S., & McCance, K. (2016). Understanding Pathophysiology (6th ed.). St. Louis,
MO: Elsevier.
RESPONSE:
I agree with you. The two types of risk factors for cardiovascular disease (CVD) are modifiable and non-modifiable. As nurses, it is important to focus health-promoting behaviors to reduce or to prevent CVD from modifiable risk factors. In the above scenario, we should encourage and focus Mark to do regular exercise, smoking cessation, and proper nutritional diet to decrease his risk for developing CVD and other illnesses. Since Mark has a family history of CVD, it is highly potential that he could and his child end-up getting CVD. Regular physical exercise or activity has been associated with reduced CVD risk factors; however, a decrease in the amount of time spent during the remainder of the day in sedentary behavior may be equally important (Saleh, Lennie, & Moser, 2015). A decreasing caloric intake, making more well-informed food choices, increasing one’s physical activity to reach and maintain a healthy weight, chronic disease risk reduction, and promotion of overall health are important considerations to maintain one’s health (Grodner, Roth, & Walkingshaw, 2012). As a nurse, I would properly give him knowledge about heart disease and behavioral intention to engage in reducing CVD. By looking at Mark’s blood work, his total cholesterol is high, LDL is high, and HDL is low. Educations decreasing sodium intake, choosing food items that are low in saturated fats, eating more fruits and vegetables, exercising regularly, and quitting smoking are some of the important topic I would consider him to teach.
Grodner, M., Roth, S. L., & Walkingshaw, B. C. (2012). Nutritional foundations and
clinical applications: A nursing approach (5th ed.). St. Louis, MO: Elsevier
Mosby.
Saleh, Z. T., Lennie, T. A., Moser, D. K. (2015). Decreasing sedentary behavior by 30
minutes per day reduces cardiovascular disease risk factors in rural
Americans. Heart & Lung, 44(5), 382-386. doi:10.1016/j.hrtlng.2015.06.008 [Show Less]