The goal of this assignment is to demonstrate a strong foundational understanding of the nutrition concepts relevant in the selected case and develop a care plan for the patient. Provide a written report that addresses the case study below. Please consult and reference at least 5 outside sources and include a works cited in APA Your report should be 2-4 pages. Be sure to include outside resources and appendices (e.g., nutrient analysis reports), as appropriate. Be sure to include all answer to each question below in your report. THIS IS A PAPER. I attached the grading rubric.

                                                                      Donna’s Diabetes

For the past 2 or 3 years, Donna has always had fasting blood sugar levels in the 100-120 mg/dL range. When she presents in your clinic however, her fasting blood sugar is 137 and her hemoglobin A1c is 8.3%. Donna is 58 years old, does not have a history of diabetes, is 5’4” and weighs 165# and she is on medication for hypertension. She says she has tried to lose weight many times in the past and often has success, but she always gains it back. She reports that she eats a “fairly healthy” diet but just loves to bake and often indulges in sweets. She does not know much about diabetes, except that it requires you to give yourself shots—and she hates needles, saying “Don’t expect me to give myself a shot!” Donna’s 24-hr recall includes:

· Breakfast: English muffin with 2 t. butter, 1 slice American cheese, 1 Jimmy Dean sausage patty, 20 oz. water

· Snack: 1 large (4×4”) brownie

· Lunch: chicken salad sandwich on 2 slices wheat bread with lettuce, tomato, and mayonnaise, 1 oz. BBQ chips, 12 oz. orange soda

· Dinner: Lean Cuisine Alfredo Pasta with Chicken & Broccoli, 16 oz. sweet tea

· Snack: 2 c. chocolate Haagen-Dazs ice cream

Assessment and DiagnosisDescribe your patient’s health status and/or condition and their diet. 

What clinical data are used to assess and diagnose or observe this condition? What are the nutritional considerations for this patient and how does their diet impact the progression of their disease or experience? How common is this disease or situation and what are the different approaches to treatment or health promotion? What are the food groups and nutrients of interest for this patient and why? Where can you find these nutrients in food? Are there certain aspects of this patient’s diet that are concerning to you?

Conduct a nutrient analysis of the 24-hour recall that is provided. 

Include calorie calculations and appropriate reports from dietary analysis software and cite specific nutrient amounts.

Assess your patient’s readiness to change.

 At what level of readiness to change is this patient for which specific behaviors? What are some areas of strength for this patient and what are some resources? What are some areas of weakness for this patient?

Intervention:

Describe your strategy for counseling this patient. 

 Considering your above assessment, what behaviors would you focus on? What counseling strategies would you implement?

Suggest patient resources. 

 Provide a link to a website or handout that you would refer this patient to and include the handout or screenshot. Why did you select it? What specific behaviors are you targeting? What do you hope the outcome will be?

Monitoring and Evaluation:

Identify 5 SMART goals for this patient. 

Discuss why you would recommend these particular goals and strategies you might suggest for your patient. Describe what the monitoring and follow-up for the patient will be, and how you expect these goals to develop and evolve over time.