Scenario 1

Mr. Jones is a 67-year-old client on the medical-surgical floor who recently underwent a colon resection. See Figure 14.14 for an image of Mr. Jones.^[1] He is post-op Day 2 and has been NPO since surgery. He has been receiving IV fluids but has been asking about when he can resume eating.

Questions:

1. What assessments should be performed to determine if the client’s diet can be progressed?
2. What are the first steps during dietary transition from NPO status?

Scenario 2

Mrs. Casey is a 78-year-old widow who recently had a stroke and continues to experience mild right-sided weakness. See Figure 14.15 for an image of Mrs. Casey.^[2] She is currently receiving physical therapy in a long-term care facility and ambulates with the assistance of a walker. Mrs. Casey confides, “I am looking forward to going home, but I will miss the three meals a day here.”

Her height is 5’2″ and she weighs 84 pounds. Her recent lab work results include the following results: Hgb: 8.8 g/dL, WBC 3500, Magnesium 1.4 mg/dL, Albumin 1.0 g/dL

Questions:

1. What is Mrs. Casey’s BMI and what does this number indicate?
2. Analyze Mrs. Casey’s recent lab work and interpret the findings.
3. Describe focused assessments the nurse should perform regarding Mrs. Casey’s nutritional status.
4. Create a PES nursing diagnosis statement for Mrs. Casey based on her nutritional status.
5. Create a SMART outcome statement for Mrs. Casey.
6. Outline planned nutritional interventions for Mrs. Casey while she is at the facility, as well as when she returns home.
7. How will you evaluate if your nursing care plan is successful for Mrs. Casey?