Discussion: Diet And Lab Values For A 2-Year-Old Father

Discussion Diet And Lab Valuesmark A Single Father Of A 2 Year Old S

Discussion: Diet and Lab Values Mark, a single father of a 2-year-old son, Jacob, stops every morning at a local fast food restaurant to pick up breakfast for himself and his son on their way to daycare. Mark says, “I don’t have time to cook in the mornings, and I can’t feed Jacob anything I make at home any cheaper than this. Besides, he really loves these sausage and egg sandwiches, and at least I can get him to eat them!” Mark has a family history of diabetes, as well as hyperlipidemia, and has the following risk factors for cardiovascular disease: primary hypertension (treated with medication), cigarette smoking, inactive lifestyle, and occasionally eating foods high in sodium. Both of his parents died at young ages due to what Mark calls “heart troubles,” and his brother has high cholesterol.

During his physical, Mark learns that his lipid panel is as follows: total cholesterol 245 mg/dl, LDL 180 mg/dl, and HDL 35 mg/dl. As his nurse, you know that risk factors for cardiovascular disease are fixed or modifiable. Give at least two examples of each.

1. For modifiable risk factors, what can be done to reduce risk?

Modifiable risk factors are lifestyle aspects that individuals can change to decrease their risk of developing cardiovascular disease. For Mark, two modifiable risk factors include smoking and dietary habits. Quitting smoking is one of the most impactful changes he can make, as smoking accelerates atherosclerosis and increases cardiovascular risk (U.S. Department of Health and Human Services, 2014). Approaching smoking cessation through counseling, nicotine replacement therapy, or medications can greatly improve his overall cardiovascular health. Additionally, dietary modifications are essential. Reducing intake of sodium, saturated fats, and trans fats can lower blood pressure and improve lipid profiles (Appel et al., 2011). Incorporating more fruits, vegetables, whole grains, and lean proteins aligns with USDA guidelines and can help improve cholesterol levels and blood pressure (U.S. Department of Agriculture, 2015). Increased physical activity is another modifiable behavior; engaging in at least 150 minutes of moderate-intensity exercise weekly can enhance HDL levels, improve weight, and reduce cardiovascular risk (American Heart Association, 2014).

2. What is the significance of Mark’s blood work? What does a normal lipid profile look like?

Mark’s lipid panel indicates elevated total cholesterol (245 mg/dl), high LDL cholesterol (180 mg/dl), and low HDL cholesterol (35 mg/dl). These values suggest increased risk for atherosclerotic cardiovascular disease (ASCVD). According to current guidelines, desirable levels are: total cholesterol below 200 mg/dl, LDL cholesterol below 100 mg/dl, and HDL cholesterol above 40 mg/dl for men. Elevated LDL levels promote plaque buildup in arteries, while low HDL levels impair reverse cholesterol transport, both contributing to cardiovascular risk (National Cholesterol Education Program, 2002). The significance of Mark’s results underscores the need for lifestyle modification and possibly pharmacologic intervention if risk factors persist. Early intervention is critical to prevent the progression of coronary artery disease and its complications such as myocardial infarction or stroke.

3. Based on the information provided in the scenario, how would you educate him? Be sure to include physical fitness and nutrition based on the USDA 2015 Dietary Guidelines and choosemyplate.gov.

Educating Mark requires a comprehensive approach focused on lifestyle modifications aligned with USDA 2015 Dietary Guidelines and the ChooseMyPlate framework. First, emphasizing nutritional changes is vital. He should be encouraged to replace high-sodium, high-fat processed foods with nutrient-dense options, such as fruits, vegetables, whole grains, lean meats, and low-fat dairy. The guidelines recommend filling half the plate with fruits and vegetables, choosing lean protein sources, and limiting saturated and trans fats (U.S. Department of Agriculture, 2015). This not only promotes lipid balance but also supports weight management. Physical activity is equally important; recommending at least 150 minutes of moderate-intensity exercise per week can aid in increasing HDL cholesterol and lowering LDL levels, as well as helping control blood pressure (American Heart Association, 2014). Strategies for integrating activity into daily routines include walking during breaks or taking family walks after dinner. Additionally, reducing sodium intake to less than 2,300 mg per day, as advised by the American Heart Association and USDA, can help manage hypertension (AHA, 2014). Finally, smoking cessation support, routine health monitoring, and adherence to medication if prescribed are critical components of this educational plan. Overall, making incremental, sustainable changes can significantly reduce Mark’s cardiovascular risk and promote overall health for him and his family.

References

• American Heart Association. (2014). 2014 AHA Guidelines for Physical Activity and Public Health. Circulation, 130(24), e278–e319.
• Appel, L. J., et al. (2011). Dietary Approaches to Prevent and Treat Hypertension: A Scientific Statement from the American Heart Association. Hypertension, 57(2), 174–186.
• National Cholesterol Education Program. (2002). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report. Circulation, 106(25), 3143–3421.
• U.S. Department of Agriculture. (2015). Dietary Guidelines for Americans 2015-2020. 8th Edition. Washington, DC: U.S. Government Printing Office.
• U.S. Department of Health and Human Services. (2014). The Health Consequences of Smoking—50 Years of Progress. A Report of the Surgeon General.