NURP 113 THERAPEUTIC NUTRITION
SPECIAL WRITTEN ASSIGNMENTS

CASE STUDIES

Assignment:

Review each case study assigned. Perform research as needed to answer the questions accompanying each case study. Answers must be typed. Neatness counts! Each individual case study is worth 40 points. Turn in on the due date assigned. Use complete sentences. Each Case Study should be a MINIMUM of one type-written page.

HAND-IN AS AN ATTACHMENT TO AN E-MAIL TO PHOLLOWAY@CSI.EDU.

THERAPEUTIC NUTRITION
CASE STUDY #1

Sudah P. is a 22-year-old recent college graduate who began her first professional job in a marketing firm one month ago. As a college student, she occasionally experienced abdominal pain and cramping after eating. She also experienced frequent bouts of diarrhea and noticed that she felt better for a while after a bowel movement. Once Sudah began her new job, she noticed that her symptoms were occurring more frequently. At first she attributed her symptoms to the stress related to her new job, but when the symptoms continued for several months, she decided to see her physician. Sudah is 5 feet 3 inches tall and weighs 118 pounds. After taking a careful history and conducting several tests to rule out other bowel disorders, the physician diagnosed irritable bowel syndrome. The physician prescribed bulk-forming agents and advised Sudah to keep a food intake and symptoms record for one week. Sudah was then referred to a nurse/dietitian to review the records and recommend appropriate dietary suggestions. In reviewing Sudah's food intake records, it was noticed that Sudah eats many traditional Indian foods, which are highly seasoned and often contain legumes. Sudah says that she began to drink coffee and caffeinated cola drinks in college so that she could study for longer periods of time. She has continued to drink coffee since that time.

1) How would you explain irritable bowel syndrome to Sudah? Be specific. Use language that will be easy to understand.

2) What role does stress play in irritable bowel syndrome? Be specific.

3) Can Sudah's diet be responsible for causing irritable bowel syndrome? Why or why not? Can any of these foods or food components aggravate her symptoms?

4) What type of diet benefits people with irritable bowel syndrome? Be specific.

5) What problem(s) can this diet cause?

THERAPEUTIC NUTRITION
CASE STUDY #2

Charles Carter is a successful young businessman who works long hours and carries the major responsibility of his struggling small business. At his last physical checkup, the physician cautioned him about his pace because he was already showing some mild hypertension. His blood cholesterol was elevated, and he was overweight. In his desk job he got little exercise and found himself smoking more and eating irregularly under the stress of his increasing financial pressures. One day while commuting in the heavy freeway traffic, he felt a pain in his chest and became increasingly apprehensive. When he arrived home, the pain persisted and increased. He broke out into a cold sweat and felt nauseated. When he became more ill after trying to eat dinner, his wife called their physician and Mr. Carter was admitted to the hospital. After emergency care and tests, the doctor placed Mr. Carter in the coronary care unit at the hospital. His test results showed elevate total cholesterol, triglycerides, and lipoproteins, especially LDL, but low HDL. The electrocardiogram revealed an infarction of the posterior myocardium wall. When Mr. Carter was first able to take oral nourishment, he had only a liquid diet. As his condition stabilized, his diet was increased to 800 kcal (soft diet) with low cholesterol and low fat. By the end of the first week, his diet was increased again to 1200 kcal (full diet) with low cholesterol and only 25% of the