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Mrs. Fu is a 72 years old widow who eats independently in her family home. Her usual meals are tea and toast for breakfast, canned fruit and a muffin for lunch and frozen pot pie or canned hash for dinner. She complains that she has been having trouble chewing with her old dentures and has not been eating as much as food as she usually does. She does not like milk. CARE PLAN Subject Data- Food deficit as evidence by usual food intake information has trouble chewing Does not like milk. Objective Data- Height 5ft 4 in. Weight 130lbs loose- fitting-dentures Analysis-Inadequate intake of protein and kilocalories, related difficulty chewing, as evidenced by stated usual intake of 28 to 32 grams of protein per day and body mass index of 17.73, classified as underweight. Plan Desired outcomes evaluation criteria Action/Interventions Rationale Client will gain 1 lb. per week during the next 2 weeks Encourage easily chewed sources of complete protein; cheese, eggs, ground meat, and fish Complete protein food contains all essential amino acids and necessary for tissue building Client will increase her total protein intake by 14-18 grams per day by 2 weeks follow up. Create model meal plant with Mrs. Fu using the exchange group system to count grams of protein. Ms. Fu RDA is 46 grams of protein. The meal plan she described in her history contains only 28-32 grams depending on dinner-selection. Client will call for dental appointment within next 2 weeks. Explore sources of financial assistance for dental care if necessary of refer to social worker. Better fitting dentures would permit Mrs. Fu a wider variety of foods. When following up after 2 weeks, the nurse finds that Mrs. Fu has gained one half pound instead of 2 as set in the desired outcome. She has increased her intake of eggs and cheese on occasion but says she feels full before finishing her meal. She has not made a dental appointment. Her dentist retired, and she is embarrassed to have to negotiate payment with a new one. The nurse refers the client to the agency social worker. What other food groups or nutrients are lacking in Mrs. Fu usual diet? Would you have given any of them a higher priority than protein? Why or Why not? Speculate on the reasons Mrs. Fu has developed her present meal pattern. What additions could you make to the care plan to take those reasons into consideration? If Mrs. Fu one egg and one ounce of Swiss cheese per day without changing the other components if her meal plans, to what extent would she have her protein needs? What additional interventions would you suggest.

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