'Case Study on Calculous Cholecystitis Essay\r'

'I.Introduction\r\nA. Concepts in livelihood, health check nutrition therapy, and organ systems concerned\r\n upkeep is the deliberate of fodder in relation to health. The Food and Nutrition Council of the American Medical Association defined nutrition as the â€Å"science of regimen, the nutrients and other substances at that placein, their action, interaction and equilibrize in relation to health and di sease, and the processes by which the existence ingests, digests, absorbs, transports, utilizes and excrete food substances.”\r\nNutrition is withal concerned with the physiologic needs of the body in price of specific nutrients, the means of supplying these nutrients by dint of nice pabulums, and the effects of failure to meet nutrient needs. In this similar viewpoint, nutrition is too concerned with the social, economic, cultural, and psychological implications of food and eating. Nutrition follows the four basics concepts, that is to say: 1.) Adequate nutri tion is essential for health. 2.) Food items ar classified according to content in ground of majority of nutrients, broadly classified as carbohydrates, proteins, fatten ups, minerals, vitamins and water supply and be needed daily in the aliwork forcet of humans. 3.) An adequate diet is the nominateation of good nutrition, and it should brood of a wide mannikin of natural foods. 4.) Nutrients should be provided preformed in food, whereas a few may be synthesized within the body. 5.) Nutrients ar interrelated and there should be metabolic balance in the body. 6.)\r\nThe body constituents ar in a dynamic state of equilibrium. 7.) sympathetic requirements for certain nutrients are known quantitatively within certain limits. 8.) The effects of nutritionary in enough are more than physical; behavioral patterns and mental deed are also compromised, and; 10.) Proper education, technical expertise in addition to the use of each(prenominal) resources getable in the appl y of nutrition will financial aid upgrade the nutritionary status of people. (Lagua, Claudio and Ruiz, 2004) Race has been a predisposing factor in evolveing gallstones. Westerners normally crack cholesterol stones, while Asians tend to have pigment or mixed stones. at that place has been an increasing prevalence of calculous cholecystitis in the Philippines. Whatever the type, size or origin of these stones, they can preface with a variety of signs and symptoms.\r\nStones develop in a sluggish, diseased gallbladder. makeup of stones may be collectible to transmittal, stagnation of the freshness or changes in the chemical composition of the impertinence, englut or poor eating habits. Obesity is passing associated with prevalence of gallstones. Prevalence increases with age, history of diabetes mellitus and elevated serum triglycerides ( Lagua, Claudio, 2011)\r\nThe gallbladder may contain one epic stone or many small ones. contagion accompanied by formation of gall stones is referred as calculous cholecystitis.\r\nOften times, people with gallstones must have their gallbladder removed through a process called cholecystectomy. enactment diets are given accordingly after functioning and if the enduring advances to an oral diet post-surgery, dream of fat is digested as tolerated. As an accessory organ, the gallbladder is clean easy to live with extinct. Once it is removed, bile travels from the colored directly into the small intestine.\r\nB. IMPORTANCE/ SIGNIFICANCE OF THE chew over\r\nDisorder of the accessory organs present a significant impact on the absorption and nutritional status of an individual. Failure to give neighboring(a) give-and-take could bring about complications which are more knockout to manage. These complications may or may not perhaps depart to death of an individual.\r\nThis remove was conducted to enable the students to practice his/ her skills on Diet Therapy I. It may help the students to date better the disease condition, the actions and interactions of food and medications to the body and the rule for the diet prescription for the persona uncomplaining role. Moreover, it would help the students, as well as the readers to draft a nutritional care plan for patient ofs with calculous cholecystitis upon acquiring breeding about the disease through selective information collection. C. Objectives (General and Specific)\r\nThe use up generally aims to analyze, assess and give proper recommendations to a patient diagnosed with calculous cholecystitis. This study was also conducted to allow students to apply the knowledge gained in the lecture and science lab class of Diet Therapy I.\r\nThe study specifically aims to:\r\n1) put together all the incumbent information from the patient’s medical records and the interview 2) Assess the patient’s nutritional status and disease condition ungenerous from the information obtained 3) Know the causes, signs and symptoms of th e disease condition and its complications 4) go down and relate the factors and causality for the formation of the patient’s disease 5) Interpret and relate the findings to the patient’s disease condition 6) Formulate a nutritional care plan for the patient\r\n7) Provide a diet prescription appropriate for the condition of the patient 8) Provide short and long term noise for the patient and other recommendation that could help the delay disease condition of the patient.\r\nD. Limitations of the Study\r\nThe pillowcase study is only limited to the disease condition of the patient with calculous cholecystitis and its possible complications if not given immediate incumbrance. Due to time constraints, the attending physician and suck were not interviewed for moreover understanding of the disease. There was also no diet prescription written on the patient’s medical chart, thus, the infirmary’s cycle menu was used as a basis for some computations and ana lysis.\r\nII. Methodology\r\nStudents of Diet Therapy I were grouped into pairs and were asked to get a patient for the case study. Approved letters provided by instructors of Diet Therapy II, requesting for a case patient with infections, burns, surgery, allergies and diseases of the gastro-intestinal tract were personally submitted to various hospitals in Laguna. Laguna Provincial Hospital in Sta. Cruz Laguna accommodated the request, with the approval of the medical director and aid of the attending physician, nurse and head nutritionist-dietitian. In the nurses’ station, the necessary information was gathered on the selected case patient and the medical records were copied as data for the study. An interview with the case patient followed afterwards. The patient, together with her aunt, was interviewed to collect necessary data such as personal information, nutritional and dietetic history and the 24hr. food recall.\r\nBefore the said interview, a questionnaire was for mulated to systematically and fulfilly obtain all the essential information for a better further analysis. Questions include the 24-hour food recall of the patient food intake (prior to admission and during confinement), personal data, signs and symptoms undergo, patient’s tolerance and acceptance to the food given in the hospital, and some other information that would be in force(p) to the study. aft(prenominal) data gathering, the case was analyzed and a case study was then formulated. This was done through evaluation of the disease condition of the patient and correlating the symptoms experient by the patient with the clinical manifestation of the disease.\r\nThe dietetical and the medical intervention given to the patient were also analyzed. This included correlating the principle and rationale of the diet with the patients’ demonstrable unsoundness. The possible nutrient-drug interaction that can happen due to the prescribed medication to the patient was a lso analyzed. The end of the laboratory and biochemical findings of the patient was also interpreted. After this, the diet of the patient PTA and DC were analyzed quantitatively and qualitatively. The diet was evaluated quantitatively by computing the CPF of the patient’s food intake and computing the adequacy of that diet. Qualitative evaluation, on the other hand, was used utilize RDA. After analyzing the recommendations given to the patient, short-term and long-term diet plan was prepared for the patient.\r\nIn computing the suitable body weight (DBW), the Tanhausser’s Method. The WHO standards for body multitude index served as the basis in find whether the client’s nutritional status. Method I was used to determine the patient’s summate energy requirement (TER) for long term intervention and the carbohydrates-protein-fat distribution was distributed using the non-protein calorie method.\r\nIII. Theoretical Considerations\r\nA. unsoundness Condi tion\r\nCalculous cholecystitis or cholecystolithiasis, is caused by the downfall of the substances contained in the bile, mainly cholesterol and bilirubin with serial ardor. The bile is consisted of bile salts, cholesterol, bilirubin, lecithin, fatty acids, electrolytes and water usually found in the plasma. The cholesterol formed in the bile has no function; it is only a by-product of bile salt formation and the social movement is only linked in the excretion of bile. cholesterol is normally insoluble in water and this is where lecithin and bile salts combine with it to form micelles. Inside the gallbladder, water and electrolytes are mantled in the liver bile, causing it to be more concentrated. Lecithin and bile salts are not absorbed in the gallbladder, their concentrations increases alongside cholesterol’s. This is the mechanism of maintaining the solvability of cholesterol.\r\nB. Definitions and Classifications\r\nCholecystitis †inflammation of the gallbladd er. There has been an association of cholecystitis with cholelithiasis. There is well-nigh always a close association with complete or partial parryion of the stones formed inside the gallbladder.\r\nCholelithiasis †gallstones that precipitated from bile, cholesterol or bilirubin due to damage gallbladder function or excessive deed of by-products from fat digestion.\r\nC. Etiology\r\nGallstone formation is due to bile salt, pigments and cholesterol salt accumulation. The stones rub move out on the walls of the gallbladder, causing agony and inflammation in the subsequent internal structures. There is also a link between elevated or aberrant estrogen levels with gallstone formation.\r\nD. Incidence/ Prevalence\r\nThere is a 10% incidence of adults getting gallstones. Approximately, there are twice as many women who develop this disease and it increases with age: after 60 years old, there is a 10-15% prevalence in men while a 20-40% prevalence in women was noted.\r\nE. Pat hology\r\nGallstones obstruct bile flow and causes reflux and subsequent inflammation in the gallbladder. The inflammation is caused by chemical rawness from the concentrated bile, along with the swelling of the mucosal body politic and ischemia from venous congestion and stasis. Bacterial infections may be a complication and this could account for the infection and could reach the adjacent gallbladder through the circulation. staph and enterococci are the most common pathogens. Perforation of the gallbladder could lead to gangrene.\r\nF. Clinical Manifestations and Underlying Mechanisms\r\nPain is evident in early cholecystolithiasis. There is similarity in the pain undergo with biliary colic and is usually entangle after a fatty meal. Pain is experienced in the right upper quadrant and there is spasm in the right, subcostal region. There is elevation in total serum bilirubin, amino transferase and alkaline phosphatase.\r\nG. outlook\r\nAfter cholecystectomy, patients can ret urn to work in a span of 1-6 weeks.\r\nIV. The Patient\r\nA. Personal entropy\r\nThe patient is Chastine Salazar, 28 years old, female admitted on January 3, 2013 at Laguna Provincial Hospital in Sta Cruz, Laguna. Her physician is Dr. Flores.\r\nB. Socio-Economic History\r\nThe patient works as a registrar in the Head single-valued function of AMA in Quezon City, Philippines. Due to her sedentary lifestyle, she and her husband jogs for 2 hours every weekend. Her middle-class income allows her to select food items of high market value, thus chocolate is always present after every meal. The patient does not supergrass nor drink but based on the interview, it was found out that she uses laxatives due to harm problems.\r\nC. Present illness and chief complaint\r\nPatient has cholecystolithiasis with cholecystectomy as the functional procedure of which 8 marble-sized gallstones were removed. Pain and vomiting was experienced by the patient and was immediately rushed to the hospital on January 3, 2013.\r\nD. Past Illnesses and surgery, allergies, hospitalization\r\nThere were no family history of predisposing risk factors to cholecystolithiasis but it was found out from the interview that the patient has allergic reaction to sea foods and patient has allergic rhinitis of which she has treated beforehand with steroids.\r\nE. Physical State of Health\r\nPatient has allergy to sea foods and has allergic rhinitis. Patient also has constipation of which she self-medicates with laxatives.\r\nG. Nutritional and Dietary History\r\nIt was observed from the 24-hr food recall that the patient has frequent consumption of chocolates and change beverages. There was also a high intake of fatty and fried food and dishes every day. Snacking patterns are also noted as the patient tends to choke up every 3 hours.\r\n'