Assignment:
View an introduction to the Assignment here. Be sure to adjust your audio settings.
Unit outcomes addressed in this assignment:
- Discuss applications of motivational interviewing to nutrition counseling.
- Understand the Health Insurance Portability and Accountability Act (HIPAA).
Course outcome assessed/addressed in this assignment:
Identify documents used for nutritional counseling.
Mastery level:
"Student work demonstrates the ability to identify and discuss all information which needs to be documented in the medical record and accurately describe and apply privacy policies when it comes to sharing client information."
Assess the progress of the client and modify the therapy based upon obstacles to success.
Mastery level: "Student work demonstrates the ability to understand and assess client progress by identifying the importance of follow-up sessions and how often to schedule them, information which needs to be collected during follow-up sessions, how to assess previously set goals and modify treatment based on progress, as well as identify obstacles which could impede success and how to overcome them."
Formulate a logical solution to a problem.
Mastery level: "Work demonstrates the ability to apply critical thinking skills to formulate a logical solution to a problem. This includes the ability to define the problem; analyze the problem; design possible solutions; examine solutions and select the best solution."
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:
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
Iron
0.4 mg/dL
0.6-1.1 mg/dL
Vitamin B12
185 pg/mL
200-835 pg/mL
Questions for Unit 9:
Documentation needs to be completed at each nutrition counseling session. What information needs to be documented and kept in Josephine's medical record?
Can we provide Josephine's health and nutrition information to another health professional? Why or Why not? When is her permission required? When is it not required?
In order for Josephine to continue to follow up, how do we address payment and reimbursement? How will you handle it if she has insurance? If she does not have insurance?
What motivational techniques would you use to motivate Josephine to continue making progress?
It is important to ensure Josephine is progressing through each counseling session. Answer the following questions regarding Josephine's progress:
a. How often would you schedule follow-up sessions with Josephine, and why?
b. What type of information would you like to collect at the follow-up appointments?
c. How would you assess her previously set goals? How would you modify her treatment based on her progress?
d. Identify any obstacles which could impede her success at achieving these goals.
e. How would you help her get beyond these obstacles?
Please do not use question and answer format in your essay. Instead, please write an essay with a separate paragraph to answer each question.
Requirements
This assignment needs to be at least two pages in length and include at least two references.
This Assignment should be in APA format and follow the conventions of Standard American English (correct grammar, punctuation, etc.).
Your writing should be well ordered, logical, and unified, as well as original and insightful. Your work should display superior content, organization, style, and mechanics. Be sure to use APA in-text citations and a reference page to attribute each source.
Please watch this short video for an overview of APA style.