Impact of Nutritional Intervention for Patient with Cerebrovascular Accident and Atrial Fibrillation Secondary to Hypertensive Emergency
This case study aims to report on the nutrition management of Cerebrovascular Accidents (CVA) which have a higher risk of malnutrition due to dysphagia, hemiparesis, decreased mobility, and dementia. Mrs. L, a 76-year-old Chinese lady, was less responsive at home. Upon admission, she was diagnosed w...
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| Format: | Article |
| Language: | English |
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Bogor Agricultural University
2024-01-01
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| Series: | Jurnal Gizi dan Pangan |
| Subjects: | |
| Online Access: | https://journal.ipb.ac.id/index.php/jgizipangan/article/view/53497 |
| _version_ | 1797337125807456256 |
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| author | Noor Izati Roslan Aina Nadhra Ahmad Zamuri Mohd Ramadan Ab. Hamid Nurul Nurliana binti Baharudin |
| author_facet | Noor Izati Roslan Aina Nadhra Ahmad Zamuri Mohd Ramadan Ab. Hamid Nurul Nurliana binti Baharudin |
| author_sort | Noor Izati Roslan |
| collection | DOAJ |
| description | This case study aims to report on the nutrition management of Cerebrovascular Accidents (CVA) which have a higher risk of malnutrition due to dysphagia, hemiparesis, decreased mobility, and dementia. Mrs. L, a 76-year-old Chinese lady, was less responsive at home. Upon admission, she was diagnosed with hypertensive emergency complicated by CVA, newly diagnosed atrial fibrillation, and End-Stage Renal Disease (ESRD). Her Body Mass Index (BMI) is 22.5 kg/m2, which is underweight for her age. The patient, with abnormal blood results, high blood pressure, and poor Glasgow Coma Scale (GCS) score, was treated with nasogastric enteral feeding and a disease-specific formula for diabetes. Inadequate enteral nutrition infusion related to feeding has yet to optimize as evidenced by intake of 57% of energy and 0.6 g/kg body weight of protein. Mrs. L required 1,442 kcal of energy and 57.7 g of protein (1 g/kg body weight) to meet adequate bodily function and prevent further weight loss. The nasogastric enteral feeding was optimized to 250 mL, seven times daily using the same diabetic formula. Throughout follow ups, although the patient’s dietary intake improved, she experienced episodes of diarrhea. She was also put on a 500 mL fluid restriction per day. Considering those issues, the diseasespecific formula was changed to renal disease formula. The patient then progressed to a soft diet with improved GCS scores and other conditions. This case highlights dysphagia which is the leading cause of malnutrition in stroke patients, associated with poor prognosis, increased mortality, and deteriorated health outcomes, necessitating enteral nutrition support to enhance nutritional status and promote health. It can be concluded that MNT in managing patients with CVA, hypertensive emergency, and underlying diseases of diabetes and ESRD helps to improve the patient’s recovery. The patient's treatment and diet should be optimally adjusted through close monitoring and evaluation
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| first_indexed | 2024-03-08T09:04:54Z |
| format | Article |
| id | doaj.art-e2bb2e9697264b408add5540c2384a9e |
| institution | Directory Open Access Journal |
| issn | 1978-1059 2407-0920 |
| language | English |
| last_indexed | 2024-03-08T09:04:54Z |
| publishDate | 2024-01-01 |
| publisher | Bogor Agricultural University |
| record_format | Article |
| series | Jurnal Gizi dan Pangan |
| spelling | doaj.art-e2bb2e9697264b408add5540c2384a9e2024-02-01T06:29:54ZengBogor Agricultural UniversityJurnal Gizi dan Pangan1978-10592407-09202024-01-0119Supp.110.25182/jgp.2024.19.Supp.1.53-62Impact of Nutritional Intervention for Patient with Cerebrovascular Accident and Atrial Fibrillation Secondary to Hypertensive EmergencyNoor Izati Roslan0Aina Nadhra Ahmad Zamuri1Mohd Ramadan Ab. Hamid2Nurul Nurliana binti Baharudin3Centre of Dietetics Studies, Faculty of Health Sciences, Universiti Teknologi MARA, 42300 Puncak Alam, Selangor Darul Ehsan, MalaysiaCentre of Dietetics Studies, Faculty of Health Sciences, Universiti Teknologi MARA, 42300 Puncak Alam, Selangor Darul Ehsan, MalaysiaCentre of Dietetics Studies, Faculty of Health Sciences, Universiti Teknologi MARA, 42300 Puncak Alam, Selangor Darul Ehsan, Malaysia; Integrated Nutrition Science and Therapy Research Group (INSPiRE), Faculty of Health Sciences, Universiti Teknologi MARA, 42300 Puncak Alam, Selangor Darul Ehsan, Malaysia Jabatan Dietetik dan Sajian, Hospital Tuanku Ampuan Najihah, 72000 Kuala Pilah, Negeri Sembilan, MalaysiaThis case study aims to report on the nutrition management of Cerebrovascular Accidents (CVA) which have a higher risk of malnutrition due to dysphagia, hemiparesis, decreased mobility, and dementia. Mrs. L, a 76-year-old Chinese lady, was less responsive at home. Upon admission, she was diagnosed with hypertensive emergency complicated by CVA, newly diagnosed atrial fibrillation, and End-Stage Renal Disease (ESRD). Her Body Mass Index (BMI) is 22.5 kg/m2, which is underweight for her age. The patient, with abnormal blood results, high blood pressure, and poor Glasgow Coma Scale (GCS) score, was treated with nasogastric enteral feeding and a disease-specific formula for diabetes. Inadequate enteral nutrition infusion related to feeding has yet to optimize as evidenced by intake of 57% of energy and 0.6 g/kg body weight of protein. Mrs. L required 1,442 kcal of energy and 57.7 g of protein (1 g/kg body weight) to meet adequate bodily function and prevent further weight loss. The nasogastric enteral feeding was optimized to 250 mL, seven times daily using the same diabetic formula. Throughout follow ups, although the patient’s dietary intake improved, she experienced episodes of diarrhea. She was also put on a 500 mL fluid restriction per day. Considering those issues, the diseasespecific formula was changed to renal disease formula. The patient then progressed to a soft diet with improved GCS scores and other conditions. This case highlights dysphagia which is the leading cause of malnutrition in stroke patients, associated with poor prognosis, increased mortality, and deteriorated health outcomes, necessitating enteral nutrition support to enhance nutritional status and promote health. It can be concluded that MNT in managing patients with CVA, hypertensive emergency, and underlying diseases of diabetes and ESRD helps to improve the patient’s recovery. The patient's treatment and diet should be optimally adjusted through close monitoring and evaluation https://journal.ipb.ac.id/index.php/jgizipangan/article/view/53497cardiovascular diseasediarrheadysphagiamalnutrition |
| spellingShingle | Noor Izati Roslan Aina Nadhra Ahmad Zamuri Mohd Ramadan Ab. Hamid Nurul Nurliana binti Baharudin Impact of Nutritional Intervention for Patient with Cerebrovascular Accident and Atrial Fibrillation Secondary to Hypertensive Emergency Jurnal Gizi dan Pangan cardiovascular disease diarrhea dysphagia malnutrition |
| title | Impact of Nutritional Intervention for Patient with Cerebrovascular Accident and Atrial Fibrillation Secondary to Hypertensive Emergency |
| title_full | Impact of Nutritional Intervention for Patient with Cerebrovascular Accident and Atrial Fibrillation Secondary to Hypertensive Emergency |
| title_fullStr | Impact of Nutritional Intervention for Patient with Cerebrovascular Accident and Atrial Fibrillation Secondary to Hypertensive Emergency |
| title_full_unstemmed | Impact of Nutritional Intervention for Patient with Cerebrovascular Accident and Atrial Fibrillation Secondary to Hypertensive Emergency |
| title_short | Impact of Nutritional Intervention for Patient with Cerebrovascular Accident and Atrial Fibrillation Secondary to Hypertensive Emergency |
| title_sort | impact of nutritional intervention for patient with cerebrovascular accident and atrial fibrillation secondary to hypertensive emergency |
| topic | cardiovascular disease diarrhea dysphagia malnutrition |
| url | https://journal.ipb.ac.id/index.php/jgizipangan/article/view/53497 |
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