The patient will gain weight progressively and achieve a normal body mass index. Interventions: Assess the causative factors of weight loss by discussing adaptation to the disease process (SLE). Determine ability to swallow food in the presence of mouth ulcers. Discuss patient’s eating habits, food preferences and allergies. Assess weight, age, body built to evaluate the degree of weight deficit. Take note of the patient’s total daily intake (caloric intake).
Calculate basal energy expenditure using the Harrison Benedict formula and subcutaneous fat and muscle mass via triceps skinfold and midarm muscle circumference. Establish nutritional plan that consists of nutrient-rich diet such as nuts, fish and fish oils (Simopoulos, 2002), olive oil, fruits, vegetables and whole grains rich in phytochemicals, omega-3 fatty acids and antioxidants. Other spices rich in phytochemicals are tumeric, red pepper, cloves, basil, garlic and pomegranate, rose mary ( Aggarwat & Shishodia, 2004).
Educate the patient that diet rich in saturated fats (fatty beef and dairy products) may trigger a flare or inflammation (Jewett-Tennant, 2008). Nutrition Monitoring and Evaluation The patient will gain weight gradually towards a weight of 60 kilograms, with a BMI value within 18. 5 – 24. 9. The patient will demonstrate behavioral changes as well as lifestyles to regain appropriate weight in a week. The patient will verbalize understanding of the causative factors of weight loss and necessary measures to gain weight in 24 hours.
References Aggarwat. B. B. & Shishodia, S. (2004). Suppression of the nuclear factor-kappa B activation pathway by spice-derived phytochemicals: reasoning for seasoning. Ann N. Y. Acad Sci, 1030. Retrieved from http://www. ncbi. nlm. nih. gov/pubmed/15659827 Escott-Stump, S. (2008). Nutrition and diagnosis related-care. Philadelphia: Lippincott Williams & Wilkins. Fauci, A. S. , Braunwald, E. , Kasper, D. L, Hauser, S. L. , Longo, D. L. , Jameson, J. L. , & Loscalzo, J. (2008). Harrison’s principle of internal medicine (17th Ed). New York: McGraw-Hill Companies Inc.
Grodner, M. , Long, S. & DeYoung, S. (2004). Foundations and clinical applications of nutrition: A nursing approach (3rd Ed. ). St. Louis, Missouri: Elvesier, Mosby Jewett-Tennant, J. (2008). Your lupus diet: Proper nutrition for a lupus diet. About. com. Retrieved from http://lupus. about. com/od/livingwithlupus/a/LupDiet. htm Morgan, S. L. & Weinsier, R. L. (1998). Fundamentals of clinical nutrition (2nd Ed). St. Louis, Missouri: Elvesier, Mosby National Institute of Arthritis and Musculoskeletal and Skin Disease (2006).
Lupus: a patient care guide for nurses and other health professionals. Retrieved July 27, 2010 from http://www. niams. nih. gov/Health_Info/Lupus/Lupus_Guide/chapter_4. asp Nettina, S. M. (2006). Lippicott manual of nursing practice (8th Ed. ) Philadelphia: Lippincott Williams & Wilkins. Somopoulos, A. (2002). Omega-3 fatty acids in inflammation and autoimmune diseases. Am Coll Nutr, 21 (6). Retrieved from http://www. ncbi. nlm. nih. gov/pubmed/12480795 The Lupus Site (2010). Mouth and nose ulcers. Retrieved July 26, 2010 from http://www. uklupus. co. uk/ulcers. html