NR 228 Discussion 3 Latest 2023 / 2024
Mark, a single father of a 2-year-old son, Jacob, stops every morning at a local fast food restaurant to pick up breakfast for himself and his son on their way to daycare. Mark says, “I don’t have time to cook in the mornings, and I can’t feed Jacob anything I would ever make at home any cheaper than this! Besides, he really loves these sausage and egg sandwiches, and at least I can get him to eat them!” Mark has a family history of diabetes, as well as hyperlipidemia, and has the following risk factors for cardiovascular disease: primary hypertension (treated with medication), cigarette smoking, inactive lifestyle, and occasionally eating foods high in sodium. Both of his parents died at young ages due to what Mark calls “heart troubles,” and his brother has high cholesterol. During his physical, Mark learns that his lipid panel is as follows: total cholesterol 245 mg/dl, LDL 180 mg/dl, and HDL 35 mg/dl.
- As his nurse, you know that risk factors for cardiovascular disease are fixed or modifiable.
Give at least two examples of each. For modifiable risk factors, what can be done to reduce risk?
Fixed factors include age and genetics. Modifiable factors include inactive lifestyle and smoking. To reduce the risk from modifiable factors, Mark could quit smoking and exercise.
- What is the significance of Mark’s blood work? What a normal lipid profile look like?
His cholesterol is high, is LDL is high, and his HDL is low. These values place him at risk for cardiovascular disease.
If normal is defined by the most common levels, his is probably normal since 68% of America is obese and only 21% meet the federal guidelines for adequate physical activity.
If normal is defined as ideal, his cholesterol should be below 200, his LDL should be below 100, and his HDL should be over 150.
- Based on the information provided in the scenario how would you educate him? Be sure to
include physical fitness and nutrition based on the USDA 2015 Dietary Guidelines, and choosemyplate.gov link covered in unit 1
I would advise him to adopt a DASH diet. A good way to make sure that this is convenient is that, on his days off, he could make a week worth of healthy breakfasts and lunches that he could grab on his way out the door. He should gradually try to eat more vegetables and fruits, incorporate non-fat options into his diet, choose food items that are low in saturated fats, limit his meat intake to 6 oz daily, increase rice, pasta, and dry beans in meals, and carry snacks such as unsalted pretzels and nuts, graham crackers, or salt-free and butter-free popcorn.
Because of his current physical condition, I would recommend that Mark start to do aerobic exercise for 2 hours and 30 minutes weekly, spread over at least 3 days and done for at least 10 minutes at a time, of moderate exercise. He should also try to work in some strength training exercise at least 2 days a week. If he doesn’t like organized exercise, I would recommend that he
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