GUIDELINES FOR CLINICAL NUTRITION CASE STUDY
The case study assignment will be completed during the clinical services rotation. You should consider this a major research project and you need to become an expert in the illness you are presenting in your case study.
With the guidance of the supervising RD/RDN and/or Site Coordinator, select a patient who has a nutrition-related medical condition. Consider the disease condition carefully. The disease selected should have significant effects on overall health and nutritional status. There should be evidenced to support the use of nutrition intervention in the treatment or prevention of the illness. (i.e. do not choose a routine appendectomy). Once you have chosen a patient, you must notify the Internship Program Director. The purpose of this is to ensure that each intern is researching a different medical condition.
You must get consent from your patient to present their information as a case study. You can assure them that the information will be presented without any identifying personal information.
Conduct the patient/client family interviews as soon as possible. Collect all relevant information regarding medical and family history. Discuss the patient/client will all appropriate caregivers. Review the medical record carefully, taking notes (within the guidelines of HIPPA) of labs, medications, interventions, etc. As you develop nutritional care plans, communicate with the RD Supervisor and/or Site Coordinator. Complete all the details as described below. Relate all findings to literature review and reference readings.
The written report should be no less than 10 pages, but no longer than 15 pages, excluding title sheet, abstract, appendices and bibliography. This MUST be submitted in a report cover or binder. Loose papers or stapled papers will not be accepted. It should cover all information as described below. Literature review should be complete and disease and normal state fully described, for example:
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Renal disease: the normal kidney vs. the diseased kidney, structure at the cellular level, other organs affected, function of each segments of the kidney, changes that occur during the course of the disease
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Diabetes: Normal pancreas, structure and function, including all enzymes produced, changes that occur at the cellular level as the disease progresses
You must discuss how the disease state and the medical/nutritional interventions affected your patient. Which of the symptoms did her/she demonstrate? Fully describe the course of treatment. Use the Academy of Nutrition and Dietetics Nutrition Care Process model as you discuss your patient.
You must include printouts of the nutrition notes from your case study as an appendix. You must black out any patient identifying information (name, MRN number, etc).
The oral report will include of an Abstract of 300 to 500 words, copies of your PowerPoint presentation, and a Bibliography. You must bring a copy of this on the day of your presentation; I will not accept electronic versions. The oral case study presentations will be scheduled towards the end of your internship. The oral presentation will be 35-45 minutes with time for questions.
It should be a summary of your paper, including the literature review as well as patient care. You should feel extremely comfortable with your information and the presentation should NOT be read. Slides should be legible and graphics included as appropriate.
Be sure to have Oral Evaluation forms available for all attendees.
CASE STUDY GUIDELINES
Abstract: 300 to 500 words
Body of Presentation:
I. Presentation of Condition
A. Literature Review
1. Normal parameters
2. Disease conditions
3. Disease treatment
II. Introduction of Patient
A. Client/patient identification
1. Initials
2. Gender
3. Age
B. Date of admission
C. Date of discharge
D. Units of hospital where treated
E. Diagnosis
1. Admitting
2. Discharge
III. History
A. Psycho-social history
1. Area of residence
2. Occupation
3. Annual income, standards of living
4. Marital status
5. National origin
6. Dependents, family responsibilities
7. Home environment, living conditions
8. Disabilities
9. Smoking/alcohol/drug addiction
B. Medical History
1. Past illness(es)/surgeries
2. Chronic diseases
C. Medication History
1. Include all home medications, including those not continued in hospital, as well as OTC meds and supplements
2. Drug-nutrient interactions
D. Dietary History
1. Nausea, vomiting, diarrhea, constipation
2. Anorexia
3. Chewing or swallowing problems
4. Altered sense of taste or smell
5. Ethnic, personal or other limitations of diet
IV. Nutrition Assessment
A. Admission evaluation
1. Current admission - date and length of stay
2. Onset of current symptoms
3. Complications
4. Medications prescribed in hospital
B. Physical Examination
1. Height
2. Weight
a. Current
b. Past
c. Desirable
3. Condition of eyes, nails, mouth, gums, hair, etc.
4. Anthropometrics, if possible
C. Laboratory Data
1. Blood Levels
a. Patient levels
b. Normal levels
c. Comparison and interpretation of levels
2. Urine levels
a. Patient levels
b. Normal levels
c. Comparison and interpretation of levels
D. Dietary Findings
1. Assessment of a typical day’s intake, calorie count/nutrient intake analysis
2. Diet orders: compare with laboratory findings and clinical symptoms
3. Objectives of dietary treatment
4. Nutrition education and expected compliance
5. Results of consultations with family, health care team, as appropriate
V. Discussion
A. Nutrition Diagnosis
B. Nutrition Intervention
C. Nutrition Monitoring Evaluation
VI. Summary
A. Correlation between all the data
VII. Bibliography
A. At least ten current references
B. Use APA bibliographic format