JP Slovack 2/10/14

Sage Nutrition Science Department - NCP Form

Patient: M ! "M "e#erre$ #or: Nutrition a e ment% Parkin on& '/ $( p)agia

NUTRITION ASSESSMENT
Food and Nutrition Related History: Patient )a )a$ recent trou*le 'allo'ing! Pt tate t)at c)ie# complaint i ever( time )e eat omet)ing get tuck in )er t)roat cau ing )er to coug) an$ #eel like )e i c)oking! +a$ regular meal t(pe at )ome! +a *een mo tl( con uming li,ui$ $ue to t)e $i##icult( 'allo'ing oli$ #oo$! "evie' o# a u ual 24-)our intake )o'e$ total con umption o# - .00 kcal/ 'it) -01 g protein! No $air( pro$uct con ume$ e2cept #or un peci#ie$ amount o# 23 milk in co##ee! 4na$e,uate intake o# grain / protein an$ #ruit /vegeta*le ! Anthropometric Measurements 5ge: 6. 7en$er: F +t: 608 91:2 cm; <t: .0 l* / 41 kg <t +2: =>< ? 110 l* 3 <t c)ange: 20 l* 91@3;in 6 mont) NaB 14: CB 4!1 +g* 11!: >M4: 11!6 ? un$er'eig)t

Biomedical ata! Medical Tests " #rocedures Aa* /Dat 5l*umin 7luco +*51 >=N e e C 2/10 1@ N/5 14 0!2

Creat 1!1

+ct 0:

MCD 14

Et)er Calcium @!. Protein :!@ Preal*umin 1: Fotal-C 10. +DA 40 <>C 11!. ">C 0!.

Fran #errin 0.2 Ferritin 11 Medical ia$nosis%#MH%Rele&ant 'onditions: Pt pre ent 'it) #ever an$ increa e$ <>C count! Famil( an$ pt! tate t)at )e )a )a$ $i##icult( 'allo'ing an$ o#ten c)oke $uring meal ! <eig)t )i tor( in$icate a lo o# 20 l* 9-1@3 o# =><; over pa t 6 mont) ! Mucou mem*rane are $r(/ )air i $ull/ pre ent 'it) temporal 'a ting/ an$ unken c)eek ! Gvi$ence o# mu cle lo in ,ua$ricep an$ ga trocnemiu ! Di pla( a *ilateral tremor! C)e t oun$ in$icate rapi$ re piration an$ crackling! =rine i $ark an$ clou$(! 7a troenterolog( con ult #or M>S an$ SAP con ult #or 'allo'ing evaluation! PM+: Diagno e$ 'it) Parkin on& $i ea e 10 (ear ago! Famil( report pt )a )a$ 0 #all over pa t 6 mont) ! >ilateral alpingooop)roectom( 9time unkno'n; #ertinent Medications +o pital: aHit)rom(cin 100 mg 4D once $ail( 9anti*iotic; +ome: Sinemet :0/200 mg controlle$ relea e ta*let 22 $ail( 9Parkin on& me$! Decrea e Citalopram 20 mg 12 9anti-$epre ant; G omepraHole 20 mg 12 $ail( 9anti-7G"D/ prevent tomac) irritation; Emega-0 F5 upplement 12 1000mg $ail( S(in status:

)aking/ ti##ne

/ lo'ne

x 4ntact Pre ure =lcer/Non-)ealing 'oun$% Comment : pale color an$ poor kin turgor/ ecc)(mo i pre ent/ mucou mem*rane $r(/ >ra$en core o# 1: 9lo' ri k;
#hysical Assessment: Dr(/ $ull )air/ unken c)eek / temporal 'a ting! Gl$erl(/ #ragile appearance 94&m a uming t)i $ue to lo' 'eig)t; Estimated Nutritional Needs Based on 'omparati&e Standards: >a e$ on =>< o# 110 l* /:0 kg Calorie : Protein Flui$ "GG #emale: 10 9:0; B 6!2:91:2; -:96.; I 1!: g/kg ? 1: g/$a( 9)ig)er $ue to 00 ml/kg ?1:00 mA ? 1!: A /$a( 161 cata*oli m in PD; "GG #emale: .44 kcal/$a( J 95F?1!2; ? 1102 kcal/$a( ?1100-1200 kcal/$a(

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Diet Er$er: NPE

Fee$ing 5*ilit( 4n$epen$ent Aimite$ 5 i tance x G2ten ive/Fotal 5 i tance

N/5

Eral Pro*lem C)e'ing Pro*lem x S'allo'ing Pro*lem Mout) Pain None o# t)e 5*ove

4ntake 7oo$ 9M 1:3; Fair 9appro2! :03; Poor 9N:03; Minimal I 9N2:3; x NPE

No Nutritional Diagno i at t)i time NUTRITION IA)NOSIS

P 9pro*lem;OO4na$e,uate Eral 4ntakeOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOrelate$ to:

x Procee$ to Nutrition Diagno i >elo'

G 9Gtiolog(;OOOD( p)agia a ociate$ 'it) Parkin on& Di ea eOOOOOOOa evi$ence$ *(: S 9Sign P S(mptom ; Current NPE Statu Previou intake o# .00 kcal an$ 01 g protein per $a( 9*a e$ on u ual $ietar( intake provi$e$; ')en compare$ to e timate$ nee$ 91100-1200 kcal an$ :0-1: g protein per $a(; =ninten$e$ 'eig)t lo o# 20 l* 91@3; over 6 mont) S 9Sign P S(mptom ; Con umption o# protein t)roug)out $a( *a e$ upon u ual $ietar( intake provi$e$

P 9pro*lem;OOFoo$-me$ication interaction OOOOOOOOOOOOOOOOOOOOOOOOOOOOrelate$ to:

G 9Gtiolog(;Oinge tion o# A-Dopa an$ proteinOOOOOOOOOOOOOOO OOOOOOOa evi$ence$ *(:

INTER*ENTION
Nutrition Pre cription: >a e$ upon SAP an$ M>S re ult / recommen$ mec)anicall( altere$ an$/or puree$ $iet 'it) )one( t)ickene$ li,ui$ to provi$e 1100-1200 kcal/$a(/ :0-1: g protein/$a( an$ min! 1:00 mA o# 'ater per $a(! "ecommen$ multivitamin 9'it) N: mg vitamin >6; an$ omega-0 #att( aci$ upplement 91000 mg/$a(;! Fake MD4 upplement eparate time o# $a( #rom me$ication! Protein con umption )oul$ *e minimiHe$ $uring *reak#a t an$ lunc)/ an$ concentrate$ at $inner time to prevent interaction *et'een protein an$ A-$opa! =tiliHe Snack in *et'een meal i# patient i una*le to con ume #ull meal ! Foo$ or Nutrient Deliver(: meal an$ nack : te2ture mo$i#ie$ $iet Nutrition e$ucation: ')en patient i rea$( #or $i c)arge a$vi e Multivitamin 9taken eparate time o# $a( t)an me$ication; patient an$ #amil( on u e o# o#tening an$/or purQeing #oo$ ! Emega-0 #att( aci$ upplement 1000 mg per $a( Feac) patient an$ #amil( )o' to t)icken li,ui$ an$ $i cu Con umption o# Protein at $inner commercial t)ickener availa*le! Di cu 'it) patient eparation =tiliHation o# nack i una*le to con ume #ull meal ! o# me$ication an$ MD4 timing! Di cu con uming protein in t)e evening to prevent interaction *et'een A-Dopa an$ protein! Nutrition Coun eling: N/5 Coor$ination o# Care 9re#er to;: Continue to ee SAP 7oal9 ;: $( p)agia $iet tarte$ 'it)in 24 )our Patient meeting appro2imatel( 1:3 o# recommen$e$ nutritional nee$ 'it)in one 'eek

MONITORIN) " E*A+UATION

4n$icator : Fotal energ( intake Fotal protein intake an$ protein timing Fotal #lui$ intake <eig)t Criteria: 1100 to 1200 kcal per $a( :0 to 1: g o# protein per $a( 'it) 1:3 con ume$ at $inner/evening 5t lea t 1:00 mA o# 'ater per $a( 4ncrea e o# 'eig)t/ -1l*/'eek

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