Formato Caso Clnico

Nut. Carolina Gutirrez Schiavon

No. de Caso: __________ Nombre del caso clnico: _______________

Alumno: ______________________________

Datos del paciente

Antropomtricos Bioqumicos Clnicos Dietticos

CT PA R24
Peso: LDL Lpidos
Talla: HDL Protena
% GC TG HC
%HC
IMC Medicamentos:

Notas:________________________________________________________________________________________
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1. Diagnstico nutricio:

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2. Objetivos del tratamiento nutricio:

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3. Estrategia Nutricia

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 Formato Caso Clnico
Nut. Carolina Gutirrez Schiavon
4. Desarrollo de la estrategia nutricia:

GEB: ___________ GEB: __________________

Factor AF: ______ ETA (10%):_____________

GET: ___________ % A. fsica: _____________

GET: __________________

Distribucin de macro nutrimentos y micro nutrimentos:

Macro Nutrimento % g Micro Nut IR Micro Nut IR

Hidratos de Carbono Fibra
Protena Lquidos
Lpidos

Grupo Cantidad Kcal Protena Lpidos HC

Verduras
25 2 0 4
Frutas
60 0 0 15
Cereales sin grasa
70 2 0 15
Cereales con grasa
115 2 5 15
Leguminosas
120 8 1 20
POA MB
40 7 1 0
POA B
55 7 3 0
POA Moderado
75 7 5 0
POA Alto
100 7 8 0
Leche Descremada
95 9 2 12
Leche Semi
100 9 4 12
Leche Entera
150 9 8 12
Leche c/ Azcar
200 8 5 30
Aceites y grasas SP
45 0 5 0
Aceite y grasas CP
70 3 5 3
Azcares SG10
40 0 0 10
Azcares CG
85 0 5 10
Total
Requerido
% Adecuacin

 Formato Caso Clnico
Nut. Carolina Gutirrez Schiavon
5. Men

Tiempo de comida Men ejemplo

Desayuno




Comida




Cena

Total de __Saturados___ _ __MUFAS_________ _PUFAS_______ _Colesterol_______

6. Recomendaciones nutricias:

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7. Referencias:

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8. Preguntas de caso clnico:

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Calificacin y comentarios de la profesora:

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 Formato Caso Clnico
Nut. Carolina Gutirrez Schiavon
Recordatorio de 24hrs

Tiempo Alimento Cantidad y Grupo

Desayuno



Colacin


Comida




Colacin


Cena

Grupo Cantidad Kcal Protena Lpidos HC

Verdura
Fruta
Cereal sg








Total

VET Consumo Real/ Terico % Adecuacin

Kcal
Protena
Lpidos
HC