| Course | NS490 Medical Nutrition Therapy II |
|---|---|
| Unit | Unit 10 |
| Paper type | Interdisciplinary case presentation |
| Length | About 1,150 words, 7 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | BS in Nutrition Science |
| Updated | October 2026 |
Free sample paper for NS490 Unit 10
Weight Before Chemotherapy, Without the Lows: A Unit 10 Interdisciplinary Case Presentation After a Whipple Procedure
[Student Name]
Purdue University Global
NS490: Medical Nutrition Therapy II
Unit 10 Case Presentation
[Instructor Name]
[Date]
The patient and her figures are composite; the pancreatic surgery nutrition position paper, the exocrine insufficiency guideline and the pancreatogenic diabetes review cited are real.
Slide 1: The Question for the Team
Slide text: How can Marlene regain weight in four weeks without destabilizing her glucose?
Speaker notes: I am opening with the decision rather than the history, because that is what I need from you today. Marlene starts adjuvant chemotherapy in four weeks. She is eating very little, losing fat in her stools and taking insulin for the first time. The nutrition plan touches every one of your roles, so I would like agreement on it before she leaves clinic.
Slide 2: The Patient
Slide text: 63 years old. Pancreaticoduodenectomy for pancreatic adenocarcinoma, six weeks ago. Weight 66 kg before surgery, 58 kg now. Lives with her husband. Retired bookkeeper.
Speaker notes: Her recovery from surgery was otherwise uneventful. She went home on day nine. She has lost 8 kg, about 12 percent of her weight, most of it since discharge.
Slide 3: What She Is Eating
Slide text: Broth, crackers and tea. About 800 kcal and 25 g protein a day by her three-day record.
Speaker notes: She cut her diet down herself because rich foods brought on cramps and loose, pale stools that float. She thought fat was the problem and stopped eating it. This is the single most important finding on the case slides, because it explains both her weight loss and her stools.
Slide 4: Problem 1, Enzymes
Slide text: Finding: fatty stools, no enzymes at discharge. Why it matters: she cannot absorb fat or much protein. Response: enzymes with every meal and snack. Owner: prescriber.
Speaker notes: Exocrine insufficiency is common after this operation, and UK practical guidance recommends starting replacement at 50,000 lipase units with meals and 25,000 with snacks, adjusted to symptoms (Phillips et al., 2021). The order is the surgeon's or oncologist's. My part is to teach her to take the capsules with the first bites of food, to spread doses through a longer meal, and to recognize under-dosing: floating stools, bloating and continuing weight loss.
Slide 5: Problem 2, Glucose
Slide text: Finding: A1C 8.2 percent on basal insulin. Why it matters: diabetes after pancreatic surgery brings lows as well as highs. Response: consistent carbohydrate, glucose checks before meals and at bedtime. Owner: endocrinology and nursing.
Speaker notes: Her diabetes is pancreatogenic. Removing part of the pancreas takes away glucagon as well as insulin, so her body has less defense against a low (Hart et al., 2016). As she starts eating more and absorbs better with enzymes, her insulin needs may change quickly in either direction. That is why glucose sits on the same slide as weight gain rather than in a separate plan.
Slide 6: Problem 3, Energy and Protein
Slide text: Target 1,740 to 2,030 kcal and 70 to 87 g protein a day. Current: 800 kcal and 25 g.
Speaker notes: These figures use 30 to 35 kcal and 1.2 to 1.5 g protein per kilogram of her current 58 kg weight. The pancreatic surgery position paper supports early, active nutrition support after pancreatic resection, with enzyme replacement where insufficiency is present (Gianotti et al., 2018). She needs about 1,000 kcal more each day. Small meals every three hours, an oral supplement twice a day, and full-fat dairy will close most of that gap within two weeks if the enzymes work.
Slide 7: Problem 4, Micronutrients
Slide text: Check vitamins A, D, E and K, iron studies, B12 and folate.
Speaker notes: Removing the duodenum affects iron absorption, and poor fat absorption puts the fat-soluble vitamins at risk. B12 depends partly on pancreatic enzymes for release from food. I am asking for baseline levels now so chemotherapy does not start on top of a deficiency.
Slide 8: Why Not Restrict Fat
Slide text: Fat restriction: not part of the plan.
Speaker notes: Marlene's instinct to avoid fat is understandable, but it is the wrong answer. Restricting fat removes her most concentrated energy source and treats a symptom that enzymes are meant to treat. The UK guidance advises against a low-fat diet in exocrine insufficiency (Phillips et al., 2021). If symptoms continue on a normal fat intake, the enzyme dose is raised, not the fat lowered.
Slide 9: The Plan
Slide text: First: enzymes and energy. Second: consistent carbohydrate. Not included: fat restriction.
Speaker notes: The order matters. Weight gain before chemotherapy is the priority, so enzyme adherence and energy come first. Carbohydrate is spread evenly across six small meals so glucose is easier to predict, rather than cut.
Slide 10: Monitoring
Slide text: Weekly weight. Stool diary. Glucose four times daily. Review at two and four weeks.
Speaker notes: The stool diary is simple: number of stools, whether they float, and any cramping. If her weight has not risen by two weeks, we discuss an enteral supplement.
Slide 11: Teaching Marlene and Her Husband
Slide text: Enzymes with first bites. Six small meals. Snack at bedtime. Know the signs of a low.
Speaker notes: Her husband does the cooking now, so he attends the teaching. Both learn the signs of hypoglycemia and keep glucose tablets in the kitchen and her purse.
Slide 12: What I Am Asking You to Agree
Slide text: Enzyme order today. Endocrinology review this week. Nutrition review in two weeks.
Speaker notes: Three decisions, and I can answer questions now.
Appendix: Prepared Answers by Discipline
Surgeon: Why not wait for the enzymes to settle before adding supplements? Because four weeks is too short to wait. Supplements and enzymes start together, and the stool diary shows which change helped (Phillips et al., 2021).
Endocrinologist: Will more food mean more insulin? Likely at first, but absorption also improves with enzymes, so lows are possible. That is why she checks four times a day and calls with any reading under 70 mg/dL (Hart et al., 2016).
Oncologist: Will this be in place before chemotherapy? Yes. The review at four weeks falls the week she starts, and early nutrition support is part of preparing her for it (Gianotti et al., 2018).
Nurse: What should she do if she forgets her enzymes? Take them as soon as she remembers during the meal. After the meal they do little, so she skips that dose rather than doubling the next.
Pharmacist: Do enzymes interact with her other medicines? A drug that reduces stomach acid is sometimes added to help enzymes work, which is a prescriber decision to raise if symptoms persist on a full dose.
Each prepared answer ties back to the decision on slide one, so the questions strengthen the plan rather than reopen it.
References
Gianotti, L., Besselink, M. G., Sandini, M., Hackert, T., Conlon, K., Gerritsen, A., Griffin, O., Fingerhut, A., Probst, P., Abu Hilal, M., Marchegiani, G., Nappo, G., Zerbi, A., Amodio, A., Perinel, J., Adham, M., Raimondo, M., Asbun, H. J., Sato, A., . . . Bassi, C. (2018). Nutritional support and therapy in pancreatic surgery: A position paper of the International Study Group on Pancreatic Surgery (ISGPS). Surgery, 164(5), 1035-1048. https://doi.org/10.1016/j.surg.2018.05.040
Hart, P. A., Bellin, M. D., Andersen, D. K., Bradley, D., Cruz-Monserrate, Z., Forsmark, C. E., Goodarzi, M. O., Habtezion, A., Korc, M., Kudva, Y. C., Pandol, S. J., Yadav, D., & Chari, S. T. (2016). Type 3c (pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer. The Lancet Gastroenterology and Hepatology, 1(3), 226-237. https://doi.org/10.1016/S2468-1253(16)30106-6
Phillips, M. E., Hopper, A. D., Leeds, J. S., Roberts, K. J., McGeeney, L., Duggan, S. N., & Kumar, R. (2021). Consensus for the management of pancreatic exocrine insufficiency: UK practical guidelines. BMJ Open Gastroenterology, 8(1), Article e000643. https://doi.org/10.1136/bmjgast-2021-000643
What the NS490 Unit 10 assignment asks for
The final NS490 unit asks students to present a complex case to an interdisciplinary team. Prompts typically set a slide count or time limit and require speaker notes. Open with the decision you need from the team rather than a long history. Give each problem its own slide with the finding, why it matters, the response and who owns it. Keep slides short and put detail in the notes. Present prescriptions such as enzymes as the prescriber's order, with the nutrition role explained. Address conflicts directly, such as weight gain against glucose control. Include monitoring and patient teaching. Prepare answers to the questions each discipline is likely to ask, with sources. A reference slide or list in APA 7 is expected. Most presentations aim for ten to fifteen slides and about fifteen minutes.
Inside the NS490 Unit 10 example
Slide 1 states the question: how to regain weight in four weeks without destabilizing glucose. Slides 2 and 3 give the patient and her intake, including the broth and crackers diet she chose to avoid symptoms. Slide 4 covers enzyme replacement at 50,000 lipase units with meals and 25,000 with snacks. Slide 5 explains that pancreatogenic diabetes brings lows as well as highs because glucagon is lost. Slide 6 sets energy and protein from her current weight. Slide 7 asks for vitamin and iron checks. Slide 8 explains why fat is not restricted. Slides 9 to 11 cover the plan, monitoring and teaching, and slide 12 lists three decisions. An appendix gives a prepared answer for each discipline, and the highlighted sentence ties those answers back to slide one.
Reading the NS490 Unit 10 grading rubric
Case presentations are marked on organization, clinical accuracy, the speaker notes and readiness for questions. Opening with a clear decision earns points for focus. Each problem slide should follow a consistent pattern. Accuracy in enzyme dosing, glucose risks and energy targets is essential. Slides overloaded with text lose points, while notes that carry the detail gain them. Addressing a conflict, such as weight gain against hypoglycemia, shows integration across conditions. Monitoring and teaching complete the plan. The question appendix is often graded most closely, because it shows the student can defend the plan to each discipline. Timing within the limit matters. Citations on slides and a reference list in APA 7 finish the rubric.
Common NS490 Unit 10 mistakes, and how to avoid them
Many presentations open with a long history and reach the decision only at the end. Slides are often dense paragraphs that no audience can read. Enzyme sections sometimes present a dose as the dietitian's prescription rather than the prescriber's order. Pancreatic diabetes is treated like type 2, with no mention of lows. Fat restriction appears in plans even though it removes the most concentrated energy source. Speaker notes repeat the slides instead of adding to them. Question preparation is skipped. If you have a case to present and a slide count to meet, our team can write the slides, notes and prepared answers around your patient.
Get an NS490 Unit 10 example written to your instructions
The patient in your NS490 Unit 10 presentation may carry different diagnoses, and the format may be recorded, live, or slides with notes only. Upload the case, the presentation requirements, including time and slide limits, and the rubric. Slides, notes and a discipline-by-discipline question appendix come back together within 24-48h, and the first custom sample is free. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
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NS490 Unit 10 questions, answered
How many slides should a case presentation have?
As many as the time allows at roughly one slide per minute, unless a limit is set. Ten to fifteen is typical for a fifteen-minute slot. Fewer, clearer slides with detail in the speaker notes usually outperform dense ones, because a team reads a slide in seconds and listens for the reasoning.
Should the presentation include references on the slides?
A short citation on the slide where a claim appears, with a full reference list on a final slide, is the common pattern. Follow the citation style your course requires. Speaker notes can carry fuller detail about a source, which helps when a team member asks where a target came from.
How do I prepare for questions I cannot predict?
Group likely questions by discipline and prepare those, then decide in advance how you will handle one you cannot answer: acknowledge it, say what you would check and where. Teams respect a presenter who knows the limits of the case far more than one who guesses, and some rubrics reward that composure directly.
Where can I find a free NS490 Unit 10 sample paper?
The complete NS490 Unit 10 case presentation on this page has twelve slides with speaker notes for a woman after a Whipple procedure, plus prepared answers for five disciplines.
Why is fat not restricted in the NS490 Unit 10 sample?
Fat is her most concentrated energy source, and she needs to regain weight before chemotherapy. UK guidance advises against a low-fat diet in exocrine insufficiency; if symptoms persist, the enzyme dose is raised instead.