NFS 3250: Case Study on IBD

Alex Rokosz

Instructions: Below you will find a description of a patient's medical and nutritional
history. Complete the questions and submit this form as a hard copy at the start of class.
Answers must be typed. Do your own work. Identical answers will receive a score of
zero for all parties involved. Point values for each question are given in parentheses.
Due: February 16th at the start of class.

Patient: Ms. Burnett is a 28 year old woman, 5' 4" and 130 pounds. She was 155
pounds before she was diagnosed with Ulcerative Colitis 1 month ago. She has a very
stressful job as a police officer. She suffers from inflammation, anorexia, nausea,
steatorrhea and blood in the stool. Currently, she is taking sulfsalazine. Her CDAI is
300. Her hemoglobin is 8 g/dl. Her MCV is high. Her serum albumin is 2.5 g/dl.
Serum Transferrin is 400 mg/dl.

1. What is Ulcerative Colitis? How is Ulcerative Colitis different from Crohns Disease?
Use complete sentences to answer this question. (3)

Ulcerative colitis ocuurs only in the large intestine, or colon, while Crohns can affect the
entire intestinal tract. They both cause inflammation of the intestinal tract, pain, diarrhea,
steatorrhea, bloody stools, and malnutrition.

2. Is Ms. Burnett's weight loss significant? Calculate her % weight change to help
answer this question. Go back to the assessment chapter of the text if you need help.
Show your calculation to receive credit.(3)
(155-130)/155
25/155= 16% weight change in 1 month. This is a significant weight loss.

3. Write an ADIME note for Ms. Burnetts chart. The whole thing. (9)
A: Pt is a 28 year old, 58, 130 lb female.
UBW 155 lbs/59 kg
EER:2065 kcal (59kgx35)
EPR: 59-70 g/day
medical dx:ulcerative colitis
medications: sulfsalazine
Labs:
Serum albumin:2.5 (low)
Serum transferrin: 400 (high)
Serum hemoglobin:8 g/dl (low)
High MCV

D: Inadequate energy intake NI-1.4, as related to anorexia (low appetite), as evidenced by

weight loss of 25 lbs (16% weight loss) in 1 month.
I: Recommend Iron supplement at DRI levels
Recommend B12 supplement at DRI levels
Recommend 59-70 g protein/day (1-1.2 g/kg)
Recommend 2060 kcal/day
Recommend low residue diet
Recommend low fiber diet <8 g of fiber/day increase fiber as tolerated
Recommend supplement vitamins A, D, E, K at DRI levels
Recommend low fat diet <45g/day (20% of kcals)
Recommend MCT supplement
Recommend glutamine supplement
Recommend prealbumin labs in 2 days
Recommend transferrin labs in 10 days
Recommend estimated kcal count

M/E:
Monitor for blood in stool
Monitor for steatorrhea and diarrhea
Monitor pain and nausea
Will follow up in 1 week to assess weight and food intake

Extra Credit: (2)

What does a CDAI score of 300 indicate?
CDAI is Crohns disease activity index, which is a measure of the severity of the IBD
symptoms. A CDAI of 300 indicates that her disease and symptoms are considered
moderate.