NFSC 471 – Medical Nutrition Therapy II (3 credits)
Tuesdays and Thursdays 12:30-1:45
Instructor: Courtney Clark, MS, RD
Office: Holt 133
Email: clclark@csuchico.edu
Office Hours: Tuesday, 11:30-12:30 and 2-3:15 pm, Thursday 2-3:15 pm
COURSE DESCRIPTION
A continuation of the investigation of the physiological and biochemical changes imposed on the body by
certain disorders as well as by dietary modifications, and analysis of nutritive value of diets prescribed for
treatment of disease as part of the nutrition care process. Adaptation of dietary patterns of individuals to
special needs. Pre-requisites: NFSC 470
COURSE OBJECTIVES
This course covers the following topics from the Accreditation Standards for the Didactic Program in
Dietetics:
• The curriculum must reflect the scientific basis of the dietetics profession and must include
research methodology, interpretation of research literature and integration of research principles
into evidence-based practice. (KRD 1.1)
• The curriculum must include opportunities to develop a variety of communication skills sufficient
for entry into pre-professional practice. (KRD 2.1)
• The curriculum must provide principles and techniques of effective counseling methods. (KRD
2.2)
• The curriculum must include opportunities to understand governance of dietetics practice, such
as the Scope of Dietetics Practice and the Code of Ethics for the Professional of Dietetics; and
interdisciplinary relationships in various practice settings. (KRD 2.3)
• The curriculum must reflect principles of Medical Nutrition Therapy and the practice of the
Nutrition Care Process, including principles and methods of assessment, diagnosis, identification
and implementation of interventions and strategies for monitoring and evaluation. (KRD 3.1)
• The curriculum must include content related to health care systems. (KRD 4.4)
• The curriculum must include content related to coding and billing of dietetics/nutrition services to
obtain reimbursement for services from public or private insurers (KRD 4.5)
• The physical and biological science foundation of the dietetics profession must be evident in the
curriculum. Course content must include organic chemistry, biochemistry, physiology, genetics,
microbiology, pharmacology, statistics, nutrient metabolism and nutrition across the lifespan.
(KRD 5.2)
REQUIRED READING
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Nelms, Sucher & Long: Nutrition Therapy and Pathophysiology
Nelms and Anderson: Medical Nutrition Therapy: A Case Study Approach, 3e
RECOMMENDED READING
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Pronsky: Food-Medication Interactions (a pocket sized book that will be very helpful during
internship).
Pagana: Mosby’s Diagnostic and Laboratory Test Reference
TEACHING METHODS AND LEARNING EXPERIENCES
Classes will include lecture with discussions, and in-class activities as well as a weekly 2-hour activity.
Course assignments will include exams, presentations, and writing assignments. Students will be
expected to work in groups both in and outside of class for some of these learning experiences.
VISTA
We will be using Blackboard Learn throughout the semester. All grades, lectures, activities and
assignments will be posted there for you to view and/ or print out at your convenience. We will only be
using section 1, so please ignore the section 2 page. It is your responsibility to monitor your grades and
postings on a regular basis. Please inform your instructor immediately if an error has been made. Keep
all documents (and emails) to verify mistakes.
ASSIGNMENTS AND GRADING
Assignment
Point Value
2 exams
Final cumulative exam
On-line case study quizzes (16 at 5 points each)
MNT I Review Worksheet
Case Study Presentation
Lab Reports
In and out of class activities (5 points each)
Total Points Possible
200
100
80
25
100
~195
30-60
710-740
QUIZZES, ASSIGNMENTS AND CASE STUDIES
Case Study Presentation
You will complete 1 case study presentation for a hypothetical patient with a diet-related disease. This
project will be presented on an assigned date. You must present on the topic assigned and on the date
assigned. Details for this assignment will be posted in the “Assignments” folder on your Vista page.
Please note: The nutrition case study is a component of your career portfolio.
Case Study Quizzes
There will be an open-book quiz on Blackboard Learn to be completed before each case study
presentation. It will be your responsibility to read the case study and take the quiz on Blackboard prior
to coming to class. See the course schedule for case study dates. There will be no make-ups on case
study quizzes.
Other Assignments
There will be many unannounced in-class assignments. Most of these will be completed with a partner.
These assignments are designed to provide opportunities for you to apply the course information as well
as to assess your understanding of the course content. You must be present in class to receive points for
in-class activities. Exceptions will only be made for extended illnesses with documentation.
LATE POLICY
There will be no make-ups for exams, quizzes, or assignments. Assignments are due at the beginning of
class. After lecture begins, 5% of the possible points will be deducted from your score. An additional 5%
will be deducted for every CALENDAR day it is late thereafter. (That means if it’s due Thursday and you
turn it in the next Tuesday, you’ll have 30% deducted from your score.)
Please do not slide papers under my office door. If you do, then the receive date is whenever I find it.
Take any late papers to Holt 123, have them time and date stamped, and put them in my box. Many
assignments will be submitted on Blackboard. Please do not email me assignments.
Any discussion concerning grades will be handled during office hours, not during class. If it pertains to
you and only you, it probably belongs in office hours.
If you are unable to sit for an exam or turn in an assignment due to unforeseen events such as illness,
funerals, flat tires, etc, let me know ahead of time and bring in verifiable documentation (i.e. receipt from
the tire shop, doctor’s note, program from the funeral, etc.). I will allow you to take an exam early or turn
in an assignment late without penalty if you have verifiable documentation.
EXTRA CREDIT
If I assign extra credit this semester, it’ll be just that: extra. It is in addition to completing all assignments,
not a way to replace one you missed. Therefore, I’ll only accept extra credit if you have completed all
assignments.
EVALUATION
A = >93%
A- = 90-92%
B+ = 87%-89%
B = 83-86%
B- = 80-82%
C+ = 77-79%
C = 73-76%
C- = 70-72%
D+ = 67-69%
D = 60-66%
F = 59% and below
STUDENT RESPONSIBILITIES AND EXPECTED BEHAVIORS
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You will be expected to download lecture outlines before coming to class.
If you need help, it’s your responsibility to seek it.
Any discussion concerning grades will be handled during office hours, not during class.
The schedule is subject to change. Changes will be announced in class and/or on the web.
Be respectful of everyone in the class. I reserve the right to ask you to leave if you are disruptive to
me or to other students. Don’t text message, web surf, do other homework, or have earphones
in during class. It is distracting to me and to those around you.
Do not ‘pack up’ before lecture has concluded. It is distracting to your classmates and me.
If you must miss an exam or deadline you must have a valid, verifiable excuse with written
documentation, and you must contact me via phone or email before the exam or deadline (even if it’s
the morning of the exam). I must be able to verify your excuse, so be sure contact information is
included. No exceptions.
KEEP COPIES OF EVERYTHING. If you fail to do so, and you lose your assignment (or it
mysteriously evaporates from the stack of turned in materials) you will have to redo it.
DO NOT SLIDE ANY ASSIGNMENT PAPERS UNDER MY DOOR. Take them to the department
office (Holt 123) and have them time and date stamped by one of the office secretaries.
Papers found under my door or in my box without a date stamp will be considered ‘received’
when I personally find them. I do not accept assignments by email.
A NOTE ABOUT OFFICE HOURS: To make the best use of your time, my time and the time of your
fellow students, please come to office hours prepared. That is, have your notes with you, have your
questions organized, and the appropriate readings in the textbook completed.
Don’t cheat. Don’t plagiarize. Any violation of the university’s academic honesty policy will result in a
report to Student Judicial Affairs.
Exams: Bring a pencil and a calculator to every exam. No cell phones, PDAs, or MP3 Players.
Readings: Please be aware that I cannot possibly cover everything in class. For this reason, you’ll
be responsible for all textbook readings listed on the course schedule, below.
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You are to treat all members of the class (myself and classmates) with respect.
Any violation of the university’s academic honesty policy will result in an automatic F in the course
and a report to Judicial Affairs.
BE HONEST, DON’T CHEAT, & DON’T DROP (if it’s too late)
Academic Rigor and Honesty:
This professor is committed to compliance with the University’s statement on academic integrity. Please
see the university’s web site for complete text of these policies:
http://www.csuchico.edu/prs/EMs/2004/04-036.shtml
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Cheating is “intentional fraud or deception for the purpose of improving a grade or obtaining
course credit and includes all behavior intended to gain unearned academic advantage. Cheating
includes either helping or attempting to help another person cheat.”
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Unauthorized Collaboration is “working with others on assignments without the permission of
the instructor. This rule includes but is not limited to in-class, take home, or online tests; writing
assignments; lab work; or any homework assignment or class project. Students may not
collaborate without authorization from the instructor.”
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Plagiarism is “the use of someone else's work, including words, ideas, projects and/or any other
material without citing the source.”
Any suspicion of plagiarism will be thoroughly investigated. Plagiarism will NOT be tolerated.
Please take caution when working in groups or utilizing on-line resources.
Add/Drops
University policy states that Add/Drops must be completed within the first two to four weeks of the
semester. Following this time period, students must have a “serious or compelling reason” to add or drop
a course. It is the student’s responsibility to add/drop classes, not the instructor’s (even if you have come
to class only one time).
AMERICANS WITH DISABILITIES ACT
If you need course adaptations or accommodations because of a disability or chronic illness, or if you
need to make special arrangements in case the building must be evacuated, please make an
appointment with me as soon as possible, or see me during office hours. Please also contact
Accessibility Resource Center (ARC) as they are the designated department responsible for approving
and coordinating reasonable accommodations and services for students with disabilities. ARC will help
you understand your rights and responsibilities under the Americans with Disabilities Act and provide you
further assistance with requesting and arranging accommodations.
PORTFOLIO
Case Study Presentation and ADIM/E Charting Note
TENTATIVE SCHEDULE
DATES
TOPICS
READINGS
ASSIGNMENTS
Jan 20
Intro to MNT II
Scope of Practice Article on
Vista
Assigned: MNT I
Review Worksheet
Health Care Policy and Health
Insurance for Nutrition Services
Jan 22
Jan 21 & 22
Jan 27
Jan 29
Jan 28 & 29
Feb 3
Feb 5
Feb 4 & 5
Feb 10
Feb 12
Feb 11 &12
Feb 17
Feb 19
Feb 18 & 19
Feb 24
Feb 26
Feb 25 & 26
Mar 3
Mar 5
Mar 4 & 5
Mar 10
Mar 11
Mar 11 & 12
Mar 24
Mar 26
Mar 25 & 26
Mar 31
Apr 2
Apr 1 & 2
Apr 7
Apr 9
Scope of Dietetics Practice
Framework
Nutrition and Pharmacology
Lab: Billing and Coding & Scope of Dietetics Practice Framework
Charting: ADIM/E and SOAP
MNT I Review
Due: MNT I Review
Worksheet
Lab: Charting and Drug/Nutrient Interactions
MNT I Review
Pulmonary Disease
Chapter 21
Lab: MNT I Nutrition Support Calculations Practice & Nutrition Informatics
Pulmonary Disease
Chapter 21
Pulmonary Disease cont
Chapter 21
Lab: Pulmonary Disease Counseling Session
Case Study Presentations
Case 21, COPD
Due: Case Study
Case 3, Cystic Fibrosis
Quizzes
Cardiovascular Disease
Chapter 13
Lab: Exam I
Case Study Presentations
Case 25 PCOS
Due: Case Study
Case 9: GERD
Quizzes
Cardiovascular Disease
Chapter 13
Lab: Cardiovascular Disease – Dr. Katie Silliman
Case Study Presentations
Case 7 Myocardial Infarction
Case 8 CHF
Lecture: Weight: Obesity, Bariatric Surgery and Eating Disorders
Diet Book Presentations
Case Study Presentations
Case 1 Childhood
Overweight
Case 4 Eating Disorders
Cancer
Chapter 23
Lab: Diet Book Presentations
SPRING BREAK March 16-20th
HIV/AIDS
Chapter 24
Case Study Presentations
Case 32 Esophageal Cancer
Case 29 AIDS
Lab: Bariatric Surgery Survivor
Lab: Empathy Lab
Kidney Disease
Chapter 18
Exam II
Kidney Disease
Chapter 18
Case Study Presentations
Case 22 Diabetes Type I
Due: Case Study
Quizzes
Due: Case Study
Quizzes
Due: Case Study
Quizzes
Due: Case Study
DATES
TOPICS
Apr 8 & 9
Apr 14
Lab: Guest Speaker Dialysis
Case Study Presentations
Apr 16
Apr 15 & 16
Apr 21
Food Allergies and Intolerances
Metabolic StressChapter 22
Food Allergies and Intolerances
Apr 23
Case Study Presentations and
Apr 22 & 23
Apr 28
Apr 30
May 1
Apr 29 & 30
May 5
May 7
May 6 & 7
May 8
Week of
May 11
READINGS
ASSIGNMENTS
Case 23 Diabetes Type 2
Quizzes
Case 26 CKD
Case 27 Renal Transplant
Chapter 9, pages 176-178
Case 15 Chronic
Pancreatitis
Case 17 Cirrhosis
Lab: Food Allergies and Intolerances
SimCenter Prep
TBA
SimCenter
SimCenter – No lab this week
TBA
Possible review for exam
SimCenter – No Lab this week
SimCenter
Final Exam (cumulative of
both 470 and 471)
Due: Case Study
Quizzes
Due: Case Study
Quizzes
Due: SimCenter
Reflection and ADIME