|Categories:||Health and Social Care Case study Nutrition|
A heart bypass surgery is carried out to deter a narrowed segment of the coronary artery. The surgery is done by inserting a section of the patient's saphenous vein that is usually taken from the lower leg. The first few weeks or even months after the surgery affects a patients emotional fitness and even his/her thinking ability. One has to commit to a healthy lifestyle that includes exercising, quitting cigarettes and an improved diet for a long term well-being.
In this case study, Sherry underwent a bypass surgery and now suffers from bipolar disorder, depression and anxiety. She is under Lexapro and Topamax medication that will help to treat anxiety and bipolar. Family medical history is an important factor to consider in such a situation. For Sherrys case, her father has suffered from basal carcinoma of the face, her uncle suffered from Leukemia and her grandmother suffered from Lymphoma and pancreatic cancer. Also, there appear to be mental illness in the family since Sherrys grandmother was hospitalized for mental instability (Gravlee, 2008). Moreover, the family does not talk about the mothers medical history even though the fact that she suffers from asymmetric Rheumatoid arthritis is known. Also, the family diet seems to consist of mainly meats, starches and vegetables. Sherry needs other foods for sources nutrients that will aid in her recovery process.
History of family illness is essential in determining whether a patient is at risk of developing complications after surgery. With Sherrys case, the risk of suffering from mental illness is increased by the fact that her grandmother was hospitalized for the same case. The fact that Sherry is now suffering from depression and anxiety increases the risk. In addition, Lexapro, one of the drugs that she is taking has the side effect of giving a patient suicidal thought. Sherry is at risk of suffering from such thoughts considering that, she is already depressed. Topamax has the same effects as Lexapro in addition to reducing a patients appetite. History of diseases such as leukemia may pose a threat to the patient too. Cancer are thought of as genetic diseases that can reveal and repeat themselves in future generations. These might have an implication on Sherrys health and dietary requirements (Mulholland, 2007).
From the seven day dietary analysis for the patient, this is what is working for the patient in terms of her current diet and food consumption; Sherrys intake of protein meets the Recommended Dietary Allowance (RDA). She ingests above average intakes by 32% weekly. Secondly, she consumes a considerably acceptable amount of saturated fats with a deviation of about 4% on average from the RDA. Sherry also takes low amounts of cholesterol which is a good thing considering the family history of heart disease. She is at 26% below the average RDA. Abundance in vitamin B1 is a dietary benefit to her since she reports that she feels better when she has an abundance of the vitamin in her diet. Intake of the B1 vitamin is high by an average of 55%. The intake of vitamin B2 by the patient is also high by an average of 55%, she feels better when she has the vitamin in abundance in her diet. Her intake of vitamin B3 varies impressively. Her weekly intake of the vitamin averages 5% over the RDA, this is sufficient to meet her daily needs of the vitamin. Sherrys intake of vitamin C is enough; her weekly intake averages 60%. The RDA for phosphorus is met on a weekly basis and is exceeded by 29%. Daily fluctuations in phosphorous is a dietary benefit to her since it balances the weekly excessive intake (Sanfilippo, Astuto & Maybauer, 2014). For sodium, her intake is down by 20% but fluctuates so much during the week that the daily deficiency reported is harmless. Lastly, Iron consumption is in excess of 40%. This however, is a dietary benefit because the Iron rich diet is essential for the workouts that she loves to do.
Sherry does also have problems in her diet. Her foods are low in energy. Consumption of energy foods averages to 34% weekly. She does not consume enough food to produce energy that will sustain her body on a daily basis. Secondly, intake of water is low averaging to 24% on a weekly basis; it is consistently low on a daily basis. Lastly, Sherry needs to eat more of carbohydrates, as much as twice of what she is already consuming. She is consistently low by an average of 48%.
Vitamin B1 is critical in Sherrys diet because it processes carbohydrates into energy and is essential for nerve cell function. The vitamin is generally regarded to be safe even with high doses. Excessive doses may only lead to drowsiness or muscle relaxation. There are therefore no health risks for Sherry when it comes to the intake of vitamin B1.Vitamin B2 is needed for the production of red blood cells. Excess vitamin B2 is usually eliminated through urine. However extreme doses of the vitamin may cause kidney stones, numbness, itchiness and light sensitivity. There is no cause of alarm for Sherry though with vitamin B2 intake. Vitamin B3 is needed to control cholesterol which is good for Sherrys health. In addition, vitamin B3 processes alcohol, keeps the skin health and converts carbohydrates to energy. Excess doses of vitamin B3 could lead to liver toxicity but since the patients intake of vitamin C is in check, there is no need to worry. Vitamin C is critical in the process of wound healing and aids the body in absorbing iron. Excess vitamin C is unlikely to cause any harm ('Vitamins', 2011). However, if taken in extreme doses, vitamin C can cause abdominal bloating, nausea and vomiting, insomnia, kidney stones, heartburn and diarrhea.
Considering that the use of Lexapro reduces the levels of sodium in the blood, I would recommend that Sherry keeps watch of the level of sodium in her blood by keeping the current levels constant. She also needs to increase the intake of cholesterol to maintain the homeostasis of cholesterol compounds in the body. The patient must increase the consumption of calcium to aid in the development of strong bones and aid in prevention of osteoporosis. Dairy foods that she seems to stay away from are what she needs for her source of calcium. Lastly, the patient might need to cut down on her intake of vitamin A simply because it is in excess in her entire dietary analysis. She might supplement the excessive consumption of carrots with intake of foods that contain sodium.
Gravlee, G. (2008). Cardiopulmonary bypass. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Mulholland, J. (2007). Cardiopulmonary bypass. Surgery (Oxford), 25(5), 217-219. http://dx.doi.org/10.1016/j.mpsur.2007.04.012
Sanfilippo, F., Astuto, M., & Maybauer, M. (2014). Effects and Timing of Tranexamic Acid on Transfusion Requirements in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass. Anesthesiology, 121(4), 902. http://dx.doi.org/10.1097/aln.0000000000000378
Vitamins. (2011). Clinical Chemistry And Laboratory Medicine, 49(s1). http://dx.doi.org/10.1515/cclm.2011.532
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