Medical Nutrition Therapy: A Case Study Approach, 6th Edition

Marcia Nelms, Kristen Roberts

Copyright 2022
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Medical Nutrition Therapy: A Case Study Approach 6th Edition by Marcia Nelms/Kristen Roberts

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Overview
Meet the Authors
What's New
Features
Table of Contents
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Overview

Building a bridge from classroom to clinical practice, this casebook is composed of 29 realistic case studies appropriate for introductory and advanced level courses in nutrition and medical nutrition therapy. Each case study uses the medical record as its structure and is designed to resemble the electronic medical record. The student "solves the case" by using the medical record information provided such as hospital admission data, laboratory test results, intake/output records, and the physician and other health care provider progress notes. The case is followed by a series of questions that focus on pathophysiology; assessment; clinical, nutritional, and behavioral outcomes; interventions; and appropriate follow-up for the patient. Questions are posed within the framework of the Nutrition Care Process. This real-world approach helps prepare the student for the professional setting. Objectives for student learning within each case are built around the nutrition care process and competencies for dietetic education.

Faculty will find that they can incorporate these cases in multiple ways. Using the entire case allows for students to thoroughly research the MNT for a particular diagnosis. Instructors can also use components of cases within their classroom teaching to highlight particular topics such as malnutrition, nutrition support, or fluid and electrolyte balance. New one-page excerpts of cases guide the instructor and student to focus on an abbreviated version of the case allowing for small group work and problem based learning.

Meet the Authors

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Marcia Nelms

Dr. Nahikian-Nelms is a professor and Director of Academic Affairs in the School of Health and Rehabilitation Sciences/College of Medicine at The Ohio State University. At Ohio State, she has previously served as the program director for dietetics education in the Division of Medical Dietetics. She has also served as nutrition faculty for the LEND (Leadership Education in Neurodevelopmental Disabilities) program and the Division of Gastroenterology, Hepatology and Nutrition and within the Department of Family Medicine. She has practiced as a dietitian and public health nutritionist for over 35 years. She is the lead author for the textbooks NUTRITION THERAPY AND PATHOPHYSIOLOGY and MEDICAL NUTRITION THERAPY: A CASE STUDY APPROACH. Additionally, she has contributed to the ACADEMY OF NUTRITION AND DIETETICS NUTRITION CARE MANUAL for the sections on gastrointestinal disorders and is the author of numerous peer-reviewed journal articles and chapters for other texts. Her clinical expertise focuses on the development and practice of evidence-based nutrition therapy for a variety of conditions including diabetes, gastrointestinal disease, and hematology/oncology for both pediatrics and adult populations and the development of alternative teaching environments for students within their clinical training. Recently, her scholarly work has focused on interprofessional education and the use and development of simulation activities as a component of the dietetic curriculum. Dr. Nahikian-Nelms has received the Outstanding Teaching award at The Ohio State University, Governor’s Award for Outstanding Teaching for the State of Missouri, Outstanding Dietetic Educator in Missouri and Ohio, and the PRIDE award from Southeast Missouri State University in recognition of her teaching. Dr. Nahikian-Nelms has previously served in her district and state dietetic associations as well as on the ACEND board and as a program reviewer.

Kristen Roberts

Dr. Roberts is an assistant professor of Clinical Health and Rehabilitation Sciences and lead faculty for medical nutrition therapy and clinical nutrition content for the Future Education Model Program through ACEND. At Ohio State, she also serves as nutrition faculty in Gastroenterology, Hepatology and Nutrition and has practiced as a dietitian for over 15 years. She has published several peer-reviewed journal articles, book chapters and has edited a text titled, SHORT BOWEL SYNDROME: NUTRITIONAL, MEDICAL AND SURGICAL MANAGEMENT. Additionally, she has contributed to the Academy of Nutrition and Dietetics Evidence Analysis Library with a focus on celiac disease. Her clinical roots as a critical care dietitian on a nutrition support team have branched into numerous clinical areas such as pancreatology, hematology/oncology, gastroenterology and hepatology. Her training in translational science supports her research efforts to elucidate the impact of dietary patterns and bioactives on chronic disease. Dr. Roberts is engaged in local and national committees through the American Society of Parenteral and Enteral Nutrition and is an active member within and through various practice groups such as Dietitians in Nutrition Support and the Medical Nutrition Practice Group.

What's New

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NEW CASES: The 6th edition offers several new cases addressing important health care concerns in the United States: short bowel syndrome, renal transplant, pediatric traumatic brain injury, Type 2 Diabetes Mellitus, Cystic Fibrosis, and colorectal cancer.
FOCUS ON MNT CONCEPTS: This new edition highlights important MNT concepts crucial for practice: malnutrition, use of the nutrition-focused physical exam, treatment of micronutrient deficiencies, nutrition support, and techniques for assessment including indirect calorimetry and DXA.
FLEXIBLE ORGANIZATION: New one-page abbreviated versions of some cases provide a structure for use in the classroom and for small group learning. As in the prior edition, instructors may pick and choose from a variety of questions, allowing for variable completion/grading/time requirements.
REWRITTEN CONTENT AND QUESTIONS: Revised cases and questions have been rewritten so each case features a smaller number of more focused questions and revised content now incorporates new evidence-based guidelines for both medical and nutritional care.

Features

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EVIDENCE-BASED: Cases are consistent with evidence-based guidelines and incorporate up-to-date medications, surgical and other treatments, tests, and normal lab values to simulate current clinical practice.
A MEDICAL RECORD APPROACH: Using the medical record as structure, the cases represent the most common diagnoses that rely on nutrition therapy as an essential component of medical care as well as those in which nutrition therapy plays a supporting role. The case layout and organization closely resemble the electronic medical record in both outpatient and inpatient care settings.
APPLICABLE: The foundational concepts and steps for nutrition care process can apply to numerous medical conditions other than the ones presented.
A LIFE SPAN APPROACH: The cases cross the life span, allowing students to see the practice of nutrition therapy during childhood, adolescence, pregnancy, and adulthood through the years.
A WIDE RANGE OF CASES: Representing both introductory and advanced-level practice, the cases allow the instructor to choose the cases that fit the students' level of expertise. Faculty are encouraged to not only use full cases for assignments but also to pick specific questions within a case to provide practice on more specific topics such as assessment, nutrition support or fluid and electrolyte balance. New, one-page, "Quick Cases" are abbreviated versions of cases that provide a structure for use in the classroom and for small group learning.
ADAPTABLE: Cases can be easily adapted for use with simulation, standardized patients or interprofessional education scenarios.
REALISTIC MEDICAL SCENARIOS: This is the only text on the market that uses cases reflecting realistic medical scenarios that impact nutritional care.
A FOCUS ON CLINICAL DECISION-MAKING: This edition's 29 case studies place students in clinical situations that support integration of knowledge from many sources, facilitate use of previously learned information, put the student in a decision-making role, and nurture critical thinking.
A CRITICAL THINKING APPROACH: Research is required to complete each case. Students must stretch beyond the basics and examine multiple resources to build rationales and evidence for clinical decision-making.
COMPETENCY-BASED: Objectives for each case are coordinated to meet dietetic education competencies.

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UNIT ONE: ENERGY BALANCE AND BODY WEIGHT.
1. Pediatric Weight Management.
2. Bariatric Surgery for Morbid Obesity with long-term nutritional complications.
3. Malnutrition Associated with Chronic Disease.
UNIT TWO: NUTRITION THERAPY FOR CARDIOVASCULAR DISORDERS.
4. Hypertension and Cardiovascular Disease.
5. Myocardial Infarction.
6. Heart Failure with Resulting Cardiac Cachexia.
UNIT THREE: NUTRITION THERAPY FOR UPPER GASTROINTESTINAL DISORDERS.
7. Gastroesophageal Reflux Disease.
8. Gastroparesis.
UNIT FOUR: NUTRITION THERAPY FOR LOWER GASTROINTESTINAL DISORDERS.
9. Celiac Disease.
10. Irritable Bowel Syndrome (IBS).
11. Inflammatory Bowel Disease and Short Bowel Syndrome: Crohn’s Disease with surgery.
UNIT FIVE: NUTRITION THERAPY FOR HEPATOBILIARY AND PANCREATIC DISORDERS.
12. Non-Alcoholic Fatty Liver Disease (NAFLD).
13. Acute Pancreatitis.
UNIT SIX: NUTRITION THERAPY FOR ENDOCRINE DISORDERS.
14. Pediatric Type 1 Diabetes Mellitus.
15. Type 2 Diabetes Mellitus in The Adult.
16. Adult Type 2 Diabetes Mellitus: Transition to Insulin.
UNIT SEVEN: NUTRITION THERAPY FOR RENAL DISORDERS.
17. Chronic Kidney Disease (CKD) Treated with Dialysis.
18. Chronic Kidney Disease: Treated with Transplant
19. Acute Kidney Injury (AKI).
UNIT EIGHT: NUTRITION THERAPY FOR NEUROLOGICAL DISORDERS.
20. Ischemic Stroke.
21. Progressive Neurological Disease: Alzheimer’s Disease
22. Pediatric Traumatic Brain Injury (TBI).
23. Pediatric Cerebral Palsy.
UNIT NINE: NUTRITION THERAPY FOR PULMONARY DISORDERS.
24. COPD With Respiratory Failure.
UNIT TEN: NUTRITION THERAPY FOR METABOLIC STRESS AND CRITICAL ILLNESS.
25. Metabolic Stress and Trauma: GSW.
26. Nutrition Support in Sepsis and Morbid Obesity.
UNIT ELEVEN: NUTRITION THERAPY FOR NEOPLASTIC DISEASE.
27. Nutrition and Breast Cancer.
28. Tongue Cancer Treated with Surgery and Radiation.
29. Nutrition and Colorectal Cancer
APPENDICES.
A: Class Activity: Quick Case
B: Common Medical Abbreviations.
C: Normal Values for Physical Examination.
D: Routine Laboratory Tests with Nutritional Implications.