| Course | NR 228 Nutrition, Health & Wellness |
|---|---|
| Week | 5 |
| Paper type | Therapeutic diet write-up |
| Length | About 1,110 words, 3 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 228 Week 5
Therapeutic Diet Write-Up: Two Grams of Sodium and Two Liters of Fluid for a 68-Year-Old Woman With Heart Failure, Written Out as a Day of Eating
Student Name
College of Nursing, Chamberlain University
NR 228: Nutrition, Health & Wellness
Instructor Name
Month Day, Year
Therapeutic Diet Write-Up: Two Grams of Sodium and Two Liters of Fluid for a 68-Year-Old Woman With Heart Failure, Written Out as a Day of Eating
The Restriction, Stated in Figures
Mrs. Ruth A. is 68, a retired school secretary with heart failure with reduced ejection fraction, who came home yesterday from a four-day admission for fluid overload. Her provider has prescribed a diet of no more than 2,000 mg of sodium a day and a fluid limit of 2 liters (about 64 ounces) a day, with daily weights. She lives with her husband, who does most of the grocery shopping; she does the cooking. Details are composite.
The evidence for the sodium figure deserves an honest word. In the SODIUM-HF trial, 806 outpatients with heart failure were randomized to a diet of less than 1,500 mg of sodium a day or to usual care; over 12 months, the combined rate of death, cardiovascular hospitalization and cardiovascular emergency visits was 15% in the low-sodium group and 17% in usual care, a difference that was not statistically significant (Ezekowitz et al., 2022). The trial does not show that sodium does not matter, and her provider's prescription of 2,000 mg is a common target. But it means the diet should be presented to her as a way to help keep fluid off, measured by her weight, not as a promise that salt restriction alone will keep her out of hospital.
Where the Sodium Actually Hides
Mrs. A. told me she "never adds salt," and that is probably true. Most of the sodium in her diet comes from food that arrives already salted. Her usual day, reconstructed with her, included two slices of bread (about 300 mg), a slice of deli ham (about 450 mg), a slice of processed cheese (about 400 mg), a cup of canned vegetable soup (about 700 mg), a frozen dinner (often 700 to 900 mg), and a tablespoon of soy sauce in her stir-fry (about 900 mg). Those six items alone come to more than 3,500 mg, without a salt shaker on the table. The figures are typical label values; her actual brands will vary, which is why she will read labels rather than rely on this list.
What Goes Back on the Plate
Table 1 lists swaps for the foods that carry most of her sodium, including where the swap tastes worse.
Table 1
Swaps for the Main Sources of Sodium in Her Usual Day
| Her usual food | Swap | Honest note |
|---|---|---|
| Deli ham, 1 slice | Leftover roast chicken or pork cooked at home without salt | Needs cooking ahead; tastes better than packaged low-sodium ham |
| Processed cheese slice | Swiss cheese, 1 oz | Swiss is among the lower-sodium cheeses; different taste |
| Canned soup, 1 cup | Low-sodium canned soup, or homemade | Low-sodium versions taste flat to most people at first; pepper and lemon help |
| Frozen dinner | Home-cooked extra portion from the night before | Takes planning; her husband can reheat |
| Soy sauce, 1 tbsp | Reduced-sodium soy sauce, 1 tsp, with garlic and ginger | Still salty; used in much smaller amounts |
| Bread, 2 slices | Keep, but check labels for the lowest brand | Bread matters because it is eaten every day |
Note. Values are approximate and vary by brand; she will check each label for milligrams per serving.
The Sample Day
0730 breakfast: oatmeal made with milk (1 cup cooked), a banana, coffee (8 oz). About 150 mg sodium; fluid 16 oz counting the milk and coffee.
1200 lunch: sandwich of home-roasted chicken (2 oz) on the lowest-sodium bread (2 slices) with lettuce, tomato and a teaspoon of mayonnaise; an apple; water (8 oz). About 450 mg sodium; fluid 8 oz.
1500 snack: unsalted almonds (a small handful) and a cup of plain yogurt. About 120 mg; fluid counted as 6 oz.
1800 supper: chicken stir-fry with fresh vegetables, 1 tsp reduced-sodium soy sauce with garlic and ginger, 1 cup rice; a small salad with oil and vinegar; water (8 oz). About 600 mg sodium; fluid 8 oz.
Through the day: water or other drinks to bring the total to no more than 64 ounces, including soups, milk and anything liquid at room temperature.
Total: about 1,300 to 1,500 mg sodium and 46 ounces of counted fluid before the extra drinks, leaving room for a second cup of coffee or a bowl of low-sodium soup within both limits.
Fluid, Counted
The fluid limit is harder for most people than the sodium limit, because thirst does not negotiate. Two liters is about eight cups, and everything liquid at room temperature counts: coffee, milk on cereal, soup, gelatin, ice cream and ice. Mrs. A. will fill a 2-liter pitcher with water each morning, and every time she drinks anything else, she will pour the same amount out of the pitcher into the sink. When the pitcher is empty, the day's fluid is used. It is a crude method, but it needs no arithmetic and her husband can see it too.
For thirst, the plan offers things that do not add much fluid: small cups instead of large glasses, sugar-free hard candy or chewing gum, frozen grapes, and rinsing her mouth without swallowing. Some of her medicines are taken with water, and those sips count; she will take them with meals, when she is drinking anyway. Less salt usually means less thirst, which is the one place the two limits help each other. If she finds herself going over the limit most days, that is a reason to tell her provider rather than to struggle alone, since the limit can be adjusted.
How Anyone Will Know It Worked
The measure is her weight, not her sodium intake, which she cannot count exactly. She will weigh herself every morning after using the bathroom and before breakfast, in the same clothes, and write it down. Chaudhry et al. (2007) found that weight began to rise in the days to week before hospitalization for heart failure, which is why a daily weight can give warning. Her provider's instruction is to call if the scale shows a gain of two or three pounds overnight, or five across a week, or if she becomes more short of breath or her ankles swell. Her husband will bring the list of low-sodium brands to the store each week, and the first follow-up visit in one week will review her weight log and a two-day food recall together.
References
Chaudhry, S. I., Wang, Y., Concato, J., Gill, T. M., & Krumholz, H. M. (2007). Patterns of weight change preceding hospitalization for heart failure. Circulation, 116(14), 1549-1554. https://doi.org/10.1161/CIRCULATIONAHA.107.690768
Ezekowitz, J. A., Colin-Ramirez, E., Ross, H., Escobedo, J., Macdonald, P., Troughton, R., Saldarriaga, C., Alemayehu, W., McAlister, F. A., Arcand, J., Atherton, J., Doughty, R., Gupta, M., Howlett, J., Jaffer, S., Lavoie, A., Lund, M., Marwick, T., McKelvie, R., . . . Zieroth, S. (2022). Reduction of dietary sodium to less than 100 mmol in heart failure (SODIUM-HF): An international, open-label, randomised, controlled trial. The Lancet, 399(10333), 1391-1400. https://doi.org/10.1016/S0140-6736(22)00369-5
NR 228 Week 5 instructions, in plain terms
For Week 5 you write up a therapeutic diet for a patient with a specific condition, such as heart failure, diabetes or kidney disease. Most prompts list the parts: the order and its reason, foods to choose and limit, a sample menu, teaching points and monitoring, all written in APA with current sources. The diet should be turned into real foods with amounts, not left as grams on an order. Explain why each restriction exists so the patient can keep it. Name what goes onto the plate as well as what comes off. Account for culture, budget and who cooks. Monitoring should include something the patient can notice at home.
How this NR 228 Week 5 example is built
The paper opens with Mrs. A., home after a four-day admission for fluid overload, and states the order in figures. It summarizes the SODIUM-HF trial from Ezekowitz et al. (2022) honestly. A section reconstructs her usual day to show that most sodium arrives already in the food. Table 1 lists swaps for deli ham, processed cheese and canned soup, each with an honest note on taste or effort. The sample day runs from 0730 oatmeal to an 1800 stir-fry, with sodium and fluid counted at each meal. A fluid section explains what counts and offers thirst relief. The close uses daily weights, citing Chaudhry et al. (2007), with a rule for when to call.
Reading the NR 228 Week 5 grading rubric
Therapeutic diet rubrics usually reward an accurate explanation of the diet and its purpose, appropriate food choices, a realistic sample menu, patient teaching, monitoring and APA. The menu and food choices carry the largest share, so the sample day is timed and counted against both limits. Accuracy includes describing the evidence fairly, as the trial summary does. Teaching earns more when each restriction has a reason and each removed food has a replacement. Monitoring scores when the measure is one the patient can take at home. Attention to thirst, taste and effort meets the patient-centered criteria many sections add. Current sources on heart failure and sodium support the clinical points.
NR 228 Week 5 help from the desk
The costliest version hands over prohibitions without reasons, which patients abandon within two weeks. Taking foods away without naming anything to replace them is close behind. Restrictions quoted in grams and never turned into groceries leave the patient stuck in the aisle. Fluid limits that forget soup, ice and water with tablets, menus nobody could shop for, culture added as an afterthought and monitoring with nothing the patient could notice all lose points. Keep the disease process short and practical. If the diet conflicts with family cooking, say so and plan around it. Send the diet order and the patient's usual day for a write-up built from them.
Get a NR 228 Week 5 example written to your instructions
Send the case, the rubric and any template your classroom uses, and a custom therapeutic diet write-up comes back inside 24 to 48 hours, free the first time. Say which diagnosis you were given and whether the patient has a fluid limit or a texture change, since those two rewrite almost every line of the sample day.
More NR 228 papers and pre-licensure samples
- NR 228 Week 1: One Food Discussion Post
- NR 228 Week 2: Three-Day Diet Analysis
- NR 228 Week 3: Eight Nutrient Report
- NR 228 Week 4: Older Adult Life Stage Case
- NR 228 Week 6: Patient Teaching Handout
- NR 228 Week 7: Food Myth Analysis
- NR 228 Week 8: Nutrition Care Plan
- NR 283 Week 5: Laboratory Value Interpretation
- NR 226 Week 5: Patient Concept Map
- NR 293 Week 5: Drug Class Write-up
- NR 224 Week 5: Fall Safety Scenario Response
NR 228 Week 5 questions, answered
How much of the disease process belongs in this paper?
One paragraph, aimed at the restriction. Explain what the kidney or the heart is no longer doing and how the removed nutrient makes that worse, then stop. Pages of pathophysiology with no line drawn to a food are the classic correct answer that scores poorly, because the assignment is a diet write-up rather than a disease report.
The diet conflicts with what my patient's family cooks. Do I write that down?
Yes, and it tends to earn points rather than cost them. A plan ignoring the food a household actually makes is a plan quietly abandoned. Name the conflict, then find the version that survives it: the pot seasoned before any salt goes in, a portion set aside early, an exchange the rest of the table will tolerate without noticing.
Is it enough to say low sodium and list the foods to avoid?
That is the version most likely to come back marked down. The write-up needs the figure, the reason, the exchanges and a day of eating somebody could actually cook. A bare list of banned items is forgotten by the second week, which is roughly when the soup comes back into the cupboard.
Where can I find a free NR 228 Week 5 sample paper?
The full Week 5 therapeutic diet write-up for Mrs. A., with the sodium swaps table, the timed sample day and the fluid counting, appears below with margin notes.
How does the NR 228 Week 5 example measure whether the diet works?
It uses a daily morning weight in the same clothes, citing Chaudhry and colleagues' finding that weight rises in the days before a heart failure admission, with a set gain that triggers a call.