Nutritional Assessment

A 46-year-old male complaining of chest pain is brought into the urgent care unit.
I observed that the client was warm and diaphoretic, while rubbing his chest; which
could have been from the hot and humid temperature outside. He is over weight, has a
sedentary office job, and lives a sedentary lifestyle. The patient stated that when the
pain started he was working in his backyard building a patio; building a patio involves
lifting heavy patio stones. He suffers from asthma and GERD. His respirations sounded
wheezy and he complained of shortness of breath. He complained of indigestion and
said he has not eaten today. It is clear that there are many priority areas in regards to
this patient. While doing a nutritional assessment I will be looking at how obesity and his
current lifestyle will impact his life. An individuals life can be greatly impacted by their
nutrition problems.
A nutritional problem could be a person who is malnourishment or obese; in this
case, it states that the patient is over weight. This patient may not be obese, but he may
be at risk of becoming obese due to his life style. Because he is overweight he may not
be able to do tasks as easily as a person of normal weight. Because the patient lives a
sedentary lifestyle, he is at risk of continuing to gain weight. Energy and nutrient needs
increase with greater physical activity, especially in individuals who participate in
competitive sports or perform manual labour. Inactive or sedentary lifestyles often lead
to excess weight gain (Jarvis, 2014. pgs 206-207). Because this patient lives a
sedentary lifestyle, he is at risk of gaining more weight and becoming obese. If he
became a more active adult, a job around the house would not be as much of a
challenge. With the patient, we could discuss what kind of activities he could do to
control his weight. The activities would start off simple to not aggravate his asthma, but

Nutritional Assessment

will slowly increase in physical demand. The more weight he gains while being less
active, the more immobile he can become. One of the patients complaints is that he
has indigestion. Consuming fatty foods can often cause indigestion; this may be an
indication that the patient is not consuming a proper diet. If the patient continues to
consume fatty foods, he is at risk of increasing in weight. With the patient I would review
the cause for being over weight. We could identify whether or not he has been eating
unhealthy foods and suggest healthier options. The patient and I can implement a diet
and exercise diary to see where the patient can improve. With the diary, the patient can
visibly see why he might be overweight. A priority problem is obesity during a nutritional
assessment, but also the lifestyle that the patient lives.
An individuals lifestyle may impact their life positively or may be a problem for
their health. As stated: the patient is over weight, but he did not eat much during the
day. His diet may be unbalanced by not eating a proper breakfast or lunch. Because he
is not eating much during the day, he may be over eating during dinner. This may impact
his lifestyle because he is unable to do things throughout the day due to his weight and
indigestion. With the patient I would emphasize the importance of eating a healthy
breakfast, lunch, and dinner to minimize the odds of obesity and indigestion. This
patient works a sedentary job and lifestyle. Because the patient is quite inactive, the
biggest problem is gaining weight. Because he lives a sedentary lifestyle, it is safe to
assume he does not engage in physical activity. Not being physically active is a great
concern because many health problems can occur. After the age of 50, energy
requirements decrease by approximately 5% per decade. Decreasing metabolic rate,
combined with an inactive lifestyle, increases the risk for chronic diseases associated

Nutritional Assessment

with overnutrition, including obesity, type 2 diabetes, hypertension, and cardiovascular

disease (Jarvis, 2014. Pg. 200). This patient is reaching an age where his metabolic
rate starts to slow down, and other concerns may arise. If this patient were to continue
to live a sedentary lifestyle, his lifestyle could drastically change if her were to develop
one of those diseases. Because the patients lifestyle involves little physical activity, he
struggled to do chores at home. I would identify realistic weekly goals with the patients
in order to keep him motivated to stay active, given his circumstances. An obstacle that
may impact this patients lifestyle is the fact that he suffers from asthma. Having asthma
might be a reason as to why this patient may not be active; he may not want to engage
in physical activity because he might be scared of triggering an asthma attach. Asthma
patients often limit physical exercise to avoid respiratory symptoms, and preliminary
evidence indicates that there is a self-imposed decrease in physical activity among
asthmatics, even among those with mild asthma, and patients with asthma seem to
have lower physical fitness than their peers. Exercise-induced asthma has caused fear
for breathlessness and asthma attacks, and the lack of proper exercise guidelines often
limits asthma patients from taking part in physical activity. However, exercise induced
bronchoconstriction can be prevented or reduced by pretreatment with short-acting
bronchodilator medication and with a 1015-min warm-up (Heikkinen, 2012. Pg. 397).
Asthma has impacting his life in a negative way, because he might be scared to
exercise. If the patient doesnt engage in physical activity due to his asthma, his
physical level will continue to fall. I would encourage the patient to know his disease by
taking his medication, and encourage him to take precautions while exercising by during
his warm-ups. An individuals lifestyle can impact their nutrition and health in a positive

Nutritional Assessment

or negative way.
This patient has many priority areas while doing a nutritional assessment. The
first priority area was obesity. Due to lack of physical activity and possible unhealthy diet
choices, this patient is at risk of becoming obese. The second priority was lifestyle; this
patients problem area could be his lifestyle because of the unbalanced diet he
consumes, the sedentary life he lives, and how his asthma may hold him back from
being physically active. With the guidance provided to the patient, he may be able to
improve on the problem areas.

Nutritional Assessment

References
Heikkinen, S.A.M., Quansah, R., Jaakkola, J.J.K., Jaakkola, M.S. (April, 2012). Effects
of Regular Exercise on Adult Asthma. European journal of epidemiology.
http://web.b.ebscohost.com.rap.ocls.ca/ehost/pdfviewer/pdfviewer?
vid=1&sid=53d51a1e-4d99-4c74-96d1-2dc6e0dd98ce
%40sessionmgr111&hid=115
Jarvis, Carolyn, Annette Browne, June MacDonald-Jenkins, Marian Luctkar-Flude.
(2014). Physical Examination and Health Assessment, Canadian Edition, 2 nd
Edition. Saunders Canada. VitalBook file.