Analyze the data gathered during nutritional counseling.
Mastery level: Student work demonstrates the ability to
calculate and assess BMI
assess and evaluate nutrition specific lab values
evaluate a food record and identity correctly areas needing improvement
identify specific goals with measurable outcomes.
Instructions
Imagine yourself in the role of a Nutrition Counselor and Josephine is your client.
Josephine is a 20-year-old female who is present for purging disorder, an “Other Specified
Feeding or Eating Disorder” (OSFED). She currently teaches salsa lessons at the
community college and is in her last semester of college. She reports she is living at home
and the food her mom prepares is not the healthiest because her mom is from Honduras
and her father is from Guatemala, so the food is prepared differently. She indicates she
has been thin all her life, although she has struggled to maintain her weight since going
through puberty, and since she is a salsa instructor, she has to remain fit. She reports she
feels very guilty if she has consumed fried foods during the day, but since that is the way
her mom primarily cooks, she feels awful to tell her mom to stop cooking that way. She
reports if she does consume too much fried foods or junk food, she will run at least 2-3
miles that day or else force herself to vomit, but all the food does not come out. She
reports sometimes if she has a later class, she will not eat dinner or only eat 1 meal per
day. She has tried counting calories, but then she gets so mad at herself for having more
than 1200 calories it causes her to exercise more, which then leads her to feeling
exhausted. She indicates she is on no medication, but does take a multivitamin when she
remembers. She indicates she has gone from 110 pounds to 125 pounds over 5 years
and wants to be back down to 110 or even less. She also had gone to the doctor and he
was quite concerned with her lab values. She has provided you a 24 hour meal record:
12/7/21, 9:05 AM Unit 4 Assignment – NS420 Nutritional Counseling
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Breakfast:
1-6” corn tortilla
½ cup fried beans cooked with peppers, onions and oil
½ cup rice
1 cup no sugar added orange juice
Lunch:
1 slice of whole wheat bread
2 slices turkey
1 small apple
Dinner:
2- 6” tortillas
Beef with onions, peppers cooked in oil
Tomato, onion, pepper salad (made with oil and lime juice)
2 cups of rice
Height: 5’2” Weight: 117 pounds (based on your scale in the office)
Labs:
Test Result Reference
Units
Albumin (visceral
protein stores)
3.3
g/dL
3.5-4.8
g/dL
Sodium 133
mEq/L
136-145
mEq/L
Potassium 3.8
mEq/L
3.5-5.2
mEq/L
12/7/21, 9:05 AM Unit 4 Assignment – NS420 Nutritional Counseling
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Iron 0.4
mg/dL
0.6-1.1
mg/dL
Vitamin B12 185
pg/mL
200-835
pg/mL
Questions for Unit 4:
1. Based on her height and weight, what is her BMI (Body Mass Index)? Is this considered
underweight, normal or overweight/obese? (Support your conclusion with academic
citations.)
2. What lab values are elevated or decreased? What are some nutrition specific reasons
for these high or low values? (Support your conclusion with academic citations.)
3. Based on her above food record, identify at least three areas that need improvement.
What nutrition recommendations would you provide to see improvement? (Support your
conclusions and recommendations with academic citations.)
4. Provide at least three specific goals you would want to establish with this client. When
writing goals to ensure we can see a good outcome, remember to be positive and
specific. For example, do not write “She will eat consistently”–rather write “She is going
to eat 3 meals per day at consistent times (7:30am, 1:30pm, and 7pm).”