Joseph has recently lost 15 pounds at the advice of his primary care physician. His body mass index (BMI) is 24.0, meaning he is at an ideal body weight for his height of 71 inches. His physician also advised him to remove as much sodium from his diet as possible due to increasing blood pressure readings and his cardiac history. According to Joseph, his last blood pressure reading was 152/92 (J. Barbera, personal communication, March 12, 2013). He states the only pain he experiences is in his calves if he walks too far. He does not exercise regularly and he has recently lessened the amount of time he spends gardening. He states he does feel safe at home and since his wife is becoming more independent after an injury due to a fall, he feels his stress has lessened from where it was a year ago.
Health Risk Factors
Joseph has an extensive cardiac history including hypertension, CAD, CABG, and pacemaker placement. Additional cardiac risk factors or circulatory problems include high cholesterol and intermittent claudication. Also, according to Edelman and Mandle, “older adults experience a decline in their respiratory vital capacity” (Edelman & Mandle, 2010, p. 621). Joseph fits this mold since he was recently hospitalized for a respiratory related illness. His physician has already made recommendations for a lower sodium diet to help reduce his blood pressure.
Joseph has recently lost 15 pounds and his physician placed him on a lower sodium diet. A nutritionist has also recommended that he cut out red meat and include more fresh fruits and vegetables to help reduce his high cholesterol. He rarely drinks alcohol but does enjoy his sweets on occasion. This does not bode well for his diabetes. Joseph does understand the consequences if he partakes in too many sweets so he says he does keep it to a minimum J. Barbera, personal communication, March 12, 2013). He does not require insulin; he controls his blood sugars with diet and Metformin....