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A Case Study of the Dietitian’s Role in Rehabilitation of Stroke Patients through Medical Nutrition Therapy
Delia Alviarez, Kathryn Ayres *
1  West Coast University


A registered dietitian is an expert in dietetics and nutrition. Dietitians also monitor the tube feeding and lab values. Registered Dietitians are trained professionals in nutrition and work in many settings such as hospitals, public health facilities, sports nutrition, and research (“Registered Dietitian Career Overview”, n.d.). The scope of practice focuses on the nutrition, food, and dietetics practice, to protect the community and population, but also determining the education, credentials and training levels needed for a registered dietitian. When there is a patient in a coma, the RD recommends the patient receives a nasogastric tube feeding. Stroke is the fifth leading cause of death in the United States. The cause of stroke is due to hemorrhaging of blood in the brain caused by aneurysms.

During a case study on a recent stroke patient, a registered dietitian provided medical nutrition-therapy based on evidence-based science. Patient X received nutrition, hydration and medication through the nasogastric tube. The RD’s interventions were in response to lab values being monitored daily. Residuals in the stomach were used to evaluate the tolerance of the tube feed formula. Protein status was monitored by prealbumin levels. Hydration was measured by specific gravity in the urine output.

As the residuals decreased in the stomach, the protein status increased to normal levels. Due to dehydration, the patient became constipated, as evidence by the lack of bowel movement. When fluid levels were increased in the tube feed and specific gravity returned to normal ranges, indicated the patient was hydrated.

The data shows that when residuals are low, the prealbumin levels will be high, indicating that the patient is absorbing protein. The data also supports that RD are essential in health care outcomes of stroke patients. The number three cause of death is due to medical errors due to the lack of interprofessional communications. A dietitian working with a stroke patient knows how to collaborate with other departments, by knowing the skills and expertise the other team members do.

Keywords: dietitian; interprofessional education, stroke, medical nutrition therapy,