Confused, need your help

[futuredream]

Hi everyone,

I am working on case study with a focus on nutrition, and have to relate it to pt's primary dx. My patient is 96 y.o female was admitted with chief complains of low back pain related to her recent fall. She also exhibited generalized weakness, fatigue and diaphoresis, non pitting edema of LU, and sacrum area graded 2 + .D.A was diagnosed with compression fractures of T12-L4 secondary to osteoporosis. D.A has a history of Congestive heart failure, gout, depression disorder, hypothyroidism and aspiration pneumonia. Labs are within normal values, except BUN and creatinine( both high) Her BMI 27.4, IBW more than 20%.She usually consumes 40-60 % of food. Meds have AE of n/v, anorexia, constipation. Mobility is limited, ambulated to wheelchair.

It's obvious she is overweight even though does eat much. But is it because she has edema( fluid retention) or limited activity.

I want to say : Imbalanced nutrition : more than body requremennts, but also thinking about :less than body requirements"

Could you please help me to understand my diagnosis and correctly intervene.

Thank you in advance, i really appreciate it

[morte, LPN, LVN]

if the BMI was computed using only ht/wt, you are right in being concerned about the result....she is also hypothyroid.....lack of mobilty.....she would need nutrient dense food choices, and if she is able - she needs to be consulted on her preferences. considering her hx of gout, was a uric acid run? good luck