Review the following case study details for a patient with COPD and respiratory failure:
Mr. C is a 72-year-old male who was admitted to the hospital complaining of shortness of breath. Mr. C has a
complicated medical history that includes: COPD, HTN, depression, obesity, and sleep apnea. Mr. C has
smoked since the time he was a teenager. He is a retired auto-mechanic and is married to his wife, Mrs. C. Mr.
C is 5’10″ and 240 pounds. He has been instructed to follow a heart healthy diet and to lose weight, but his
wife reports that he is non-compliant with any dietary therapy. He is currently taking a diuretic, a blood pressure
medication, and an antidepressant, and he uses an inhaler when SOB (shortness of breath). The patient uses
a breathing mask at night due to his sleep apnea history. His wife reports that she recently bought him a
special multi-vitamin containing omega 3 fatty acids. It is designed to help older men’s hearts and other
medical issues.
Upon admission to the hospital, Mr. C’s respiratory status declines, and the ER physician decides to intubate
the patient in order to deliver proper oxygenation. The MD also starts the patient on IV fluids consisting of NS
(normal saline) for hydration. While on ventilator support, the patient is sedated and is unable to talk or
consume an oral diet. The medical chart notes from the pulmonologist reveal that there are no immediate plans
to extubate the patient (wean from the ventilator). Currently, the laboratory lab values of the patient are all
within normal limits (WNL). However, upon admission and before vent support was initiated, his labs were
abnormal. Some affected lab values were: CO2, BUN/Cr, pH, and Na. The patient has had an NPO (nothing by
mouth) diet order status for 4 days and has only received IV fluids for intake. The nursing notes reveal that he
has normal urine output and bowel sounds are present and normal.
As a nutrition professional working at this hospital, you are to start the nutrition care process on this patient.
Your hospital has a protocol to see all patients that have NPO diet orders and/or are on the ventilator for more
than 4 days. You have NOT received a doctor’s consult for a tube feeding (enteral) order; however, it is
imperative that this patient is assessed and appropriate nutrition recommendations are made.
For this Assignment, you will write a descriptive essay concerning COPD. The essay will include a detailed
definition and explanation of COPD. The patient’s personalized ADIM/E chart note (nutrition care plan) should
include an appropriate nutrition intervention based on the patient’s current nutritional problem (nutrition
diagnosis). You MAY use the ADIM/E Chart Note TEMPLATE located in Course Resources.
This descriptive essay should include the following:
Describe COPD, its risk factors, and its common treatments.
Explain Mr. C’s current status. Describe why he was intubated and how vent support can impact a patient.
What are the nutrition therapy goals for a patient with COPD receiving vent support?
What are your specific nutrition therapy recommendations for Mr. C while he is on ventilator support? Include
estimated calorie and protein requirements and the method(s) for how he should receive these nutrients
(enteral, parenteral, or oral diet/supplements). You do not need to include details of specific brands,
amounts/serving sizes and/or infusion rates.
When the condition of the patient improves and he is taken off the vent, what are your recommendations for
nutrition therapy for Mr. C upon discharge from the hospital? What are specific diet plans, oral drink
supplements, or vitamin/herbal therapies that may benefit Mr. C? Appendix: Write a Nutrition Care Plan/Chart
note on this COPD patient, addressing the current clinical situation of the patient. Write this note as though you
were the nutrition professional caring for this patient in a hospital setting. See the Nutrition Diagnostic
Terminology PDF file in Course Resources along with Box 10-2, Table 10-3 and Table 10-4 for examples of
nutrition diagnostic (PES) statements. You may utilize/edit the TEMPLATE for the ADIM/E Chart note
TEMPLATE available in Course Resources for this section of the assignment. Then, attach your chart note with
assignment essay into the dropbox.