Hematocrit NCP

A 22-year-old lactating female was diagnosed with microcytic anemia based on low hemoglobin (9.5 g/dL) and hematocrit (30%) levels. She follows a lacto-ovo-vegetarian diet and discontinued vitamin/mineral supplementation prescribed by her doctor. The nutrition assessment found her iron intake was inadequate due to her diet, discontinuation of supplements, and lactation. The nutrition intervention plan aims to increase iron intake through foods like dark leafy greens and legumes, resume supplementation, provide education on proper nutrition for lactating women, and normalize hemoglobin and hematocrit levels within 3 months through follow-up calls and testing.

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Hematocrit NCP

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Jessilyn Cauble

March 2, 2015
Hematocrit NCP

Nutrition Assessment
Diagnosis: microcytic anemia
Age, gender: 22, female
Dietary intake: PO intake
Lifestyle habits include following a lacto-ovo-vegetarian diet and discontinued use of
supplementation prescribed by doctor
Symptoms: fatigue
Lactating
Anthropometric measurements
o Ht/wt: 54 / 162.6 cm and 108lbs / 49.1kg
o BMI = 18.6 kg/m2 (normal)
o IBW = 120lbs/54.5kg, %IBW = 90.0% (mild malnutrition)
Energy, protein, and fluid needs
o Range
Total energy = 1236-2107 kcal/d
Protein = 51.3-61.1 g/d
Fluid = 1236-2107 mL/d
o Basis for estimations (Based on BW of 50.9kg)
For energy, used Mifflin-St. Jeor formula to determine REE then
multiplied by activity (1.3) & added injury factor for lactation (500)
For protein, used non stressed state 0.8-1.0 g PRO/kg
For fluid needs, used 1mL/kcal (adult) multiplied by estimated caloric
requirements (kcal)
Labs/tests
o Hemoglobin= 9.5g/dL, low (11-16 g/dL)
o Hematocrit 30%, low (37-47%)
Nutrition Diagnosis
Inadequate iron intake R/T inadequate intake in diet, discontinuation of vitamin/mineral
supplementation, and lactation AEB fatigue, low hemoglobin level 9.5g/dL, and low
hematocrit level 30%.
Nutrition Intervention
1. Meals and snacks
a. Increase intake of iron rich foods for a lacto-ovo-vegetarian diet (darky leafy
greens, legumes, lentils) along with vitamin C to increase absorption (bell
peppers, kiwi, citrus fruit)
b. Resume taking vitamin/mineral supplementation
2. Nutrition education
a. Proper nutrition for lactating women
Goals
1. Increase intake of iron rich food immediately
2. Resume consumption of supplementation immediately
3. Normalize hemoglobin and hematocrit levels within 3 months
4. Reach ideal body weight within 2 weeks
Nutrition Monitoring and Evaluation
Follow-up phone call within 1 week
Ask the patient to do 3-day food record and bring it to clinic to reassess consumption of
iron rich food and vitamin/mineral supplement
Re-assess weight in 2 weeks