CASE STUDY 3  Lipids

Description:
You are the nutritionist giving advice to only one of the case study scenarios below based on which group you are in.  In these scenarios, the patient has come to you for a consultation.  During the consultation they tell you about themselves but there is also other information provided. In order to answer the questions you will need to figure what information is missing and pharse it as a probing question in order for you to give advice to your patient. For more info see rubric located under the assignement submission.  
Case Study - Lipids Julie
Julie is a 36-year-old woman who has given birth given birth six months ago.  Her pre-pregnancy weight was 146 pounds.  Her weight as of today is 192Lb, blood pressure 155/100, total cholesterol 260, HDL 50 mg/dl, LDL 210 mg/dl.  She has three children six months old, ten years old, and 14 years old. Patient claimed that for her two previous pregnancies she gained between 30 -45 pounds and was able to mostly return to her previous weight.  Her goal weight is 135 pounds. Julie tells the nutritionist “That at the height of my pregnancy, I weighed 206 pounds, having gained an extraordinary 60 pounds. My blood pressure was high, and my gynecologist told me my cholesterol levels (LDL) had doubled, so she placed me on medication. I was flabbergasted. I was already depressed because the pounds weren't coming off.  I couldn't exercise due to the complications I had during delivery, and now this. How could I be on cholesterol meds when I was only in my mid-thirties?  I am eating healthy and trying to lose weight on the keto diet and have cut down on my carbs.  I eat for breakfast fried eggs with bacon NO bread, just a few nuts as a snack, for lunch try to always eat meat with lettuce wrap – although it is tough now that meat prices have gone up – so, sometimes I buy fatty meat or ham hocks cook it for a long time to make a soup, a light dinner of healthy avocado with cheese and my after-dinner dessert a couple of times a week is a really fun keto treat chocolate mixed with either grass-fed butter or healthy peanut butter.  I walk my 10-year-old to school and back with my baby even walking at least 10 to 20 blocks more.  I don’t give in to my hunger and just eat a few nuts.  What’s wrong and why did the doctor place me on cholesterol meds? I’m here today because I thought I should get a second opinion.  I am thinking the medication is only masking the problem and will bring down my cholesterol. I realized that his time I am older but isn’t the key is nutrition and exercise.  Did I mention that I had an emergency cesarean and due to that I couldn't exercise? I knew I had to focus on nutrition, so I did my research on the internet a found out about the keto diet. I am so frustrated because the weight is just not coming so here I am.  As a nutritionist what do you recommend?”
What are Julie’s risk factors for heart disease? Please explain if you think her diet is contributing to elevated LDL levels or if it is helping her with her weight loss goal.  Think about her blood pressure and diet.  Discuss any  links between the two.  What changes do you think Julie could make to start addressing their dietary and physical activity needs? Given Julie’s actual condition, what health complications could she have?
What are some probing questions you would ask the patient to better understand their case?

Requirements:

• To answer the questions, use what we learned in class, power points, and the book.  
• Your response should include questions you would probe and ask your patient for more information on their case.  
• Read and answer each questions.  Remember to ask probing questions if you would like to know more information in order to better answer the question. 
• Answer all questions in approximately 300 words, explain and justify your answers. Use correct spelling, punctuation, and grammar. Include probing questions.
• Rubric is located under the assignement submission.
• Either upload the word document to BB or write it out and submit directly in BB.
• Format: MS Word document