The Application of the Standardized Nutrition Care Process in a Hospitalized Patient with Coronary Heart Disease: A Case Study and Nursing Implications
Keywords:
Coronary heart disease, nutrition care process, nutritional risk, dietary intake, hospitalized patientAbstract
Background: Coronary heart disease (CHD) requires multidisciplinary management that integrates control of cardiometabolic risk factors with assessment of nutritional status and food intake during hospitalization. Nutritional risk may occur across body mass index categories, including obesity.
Objective: To describe the application of the standardized Nutrition Care Process (NCP) in a hospitalized patient with CHD and to examine its implications for nutritional monitoring in nursing practice.
Methods: A descriptive observational case study was conducted in a 60-year-old man admitted with unstable angina pectoris, with non-ST-elevation myocardial infarction considered in the differential diagnosis, at Undata Regional General Hospital, Palu, Indonesia, from 22 to 28 March 2025. Data were collected using the Malnutrition Screening Tool (MST), anthropometry, 24-hour dietary recall, a food frequency questionnaire, physical and clinical observation, interviews, and medical-record review. Data were analyzed descriptively by comparing intake with individualized requirements and monitoring clinical changes over seven days.
Results: The patient weighed 85.9 kg, was 165.3 cm tall, and had a body mass index of 31.55 kg/m², consistent with class I obesity. An MST score of 3 indicated a positive nutritional-risk screening result, warranting comprehensive nutrition assessment to determine the presence and severity of nutritional impairment. Initial energy, protein, fat, and carbohydrate intakes were 36.84%, 48.13%, 45.23%, and 35.10% of estimated requirements, respectively. The intervention comprised a low-sodium, energy-restricted cardiac diet and nutrition education for the patient and family. Nutrient adequacy varied over the seven-day observation period. On day 7, energy, protein, fat, and carbohydrate adequacy were 53%, 57%, 56%, and 51%, respectively, coinciding with documented recurrence of clinical symptoms. This temporal association did not establish a causal relationship.
Conclusion: This case demonstrates that obesity does not exclude the possibility of nutritional risk or inadequate intake during acute CHD hospitalization. The NCP provides a structured framework for integrating anthropometric, clinical, biochemical, and dietary information; however, adequacy of nutrition during acute illness cannot be inferred from diet prescription and education alone. This case highlights the importance of repeated dietary-intake assessment and timely nurse–dietitian communication in identifying nutritional deterioration and informing individualized care adjustments during acute coronary hospitalization
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