Case Study JB is a 53 yo male who was recently divorced.He has experienced periods of depression and decreased appetite.Family reports history of heavy drinking habits and 15# weight lost.He was previously diagnosed with cirrhosis and portal hypertension and paracentesis and TIPS procedures were performed.Mr.JB's condition seems to have worsened; he c/o stomach pains, nausea, and vomiting at times.His abdomen is sore to touch and feels swollen.Mr.JB has developed ascites and pedal edema; his urinary output has decreased and he continues to lose weight.Mr.JB also c/o pain when swallowing food.Because of JB's persistent symptoms, he's been admitted to the hospital. A referral to the SLP for a MBS was also ordered and resulted in dysphagia, pureed diet recommended.By day 2 Mr.JB still c/o of nausea and no po intake has been reported.The MD rx'd dietary consult: RD to assess patient and recommend alternate means of nutrition support, currently NPO. Ht: 5'11'' Wt: 145# UBW: 163# Dx: End-stage liver cirrhosis, dysphagia PMH: alcoholic cirrhosis, portal hypertension Labs:

Na: 134 Cl: 101 BUN: 4 Alb: 2.3 TG: 305 Transferrin: 101 NH4: 53

Glu: 139 AST: 45 ALT 48 Alk Phos: 40 Billirubin: 2.1

K: 5.2 CO₂ Cr: 1.8 H/H: 11/35

Diet: NPO Meds: Neomycin, Aldactone, Lasix, Reglan -What will the registered dietitian recommend for JB's ascites?

Question

Case Study
JB is a 53 yo male who was recently divorced.He has experienced periods of depression and decreased appetite.Family reports history of heavy drinking habits and 15# weight lost.He was previously diagnosed with cirrhosis and portal hypertension and paracentesis and TIPS procedures were performed.Mr.JB's condition seems to have worsened; he c/o stomach pains, nausea, and vomiting at times.His abdomen is sore to touch and feels swollen.Mr.JB has developed ascites and pedal edema; his urinary output has decreased and he continues to lose weight.Mr.JB also c/o pain when swallowing food.Because of JB's persistent symptoms, he's been admitted to the hospital.
A referral to the SLP for a MBS was also ordered and resulted in dysphagia, pureed diet recommended.By day 2 Mr.JB still c/o of nausea and no po intake has been reported.The MD rx'd dietary consult: RD to assess patient and recommend alternate means of nutrition support, currently NPO.
Ht: 5'11'' Wt: 145# UBW: 163#
Dx: End-stage liver cirrhosis, dysphagia
PMH: alcoholic cirrhosis, portal hypertension
Labs:

Na: 134	Cl: 101	BUN: 4	Alb: 2.3	TG: 305	Transferrin: 101	NH4: 53
Glu: 139	AST: 45	ALT 48	Alk Phos: 40	Billirubin: 2.1
K: 5.2	CO₂	Cr: 1.8	H/H: 11/35

Diet: NPO Meds: Neomycin, Aldactone, Lasix, Reglan -What will the registered dietitian recommend for JB's ascites?

Quizplus · Accepted Answer

The registered dietitian would recommend fluid and sodium restrictions for JB's ascites. These dietary modifications will help reduce fluid accumulation in the abdomen and improve symptoms. High-fiber and high-fat foods are not appropriate recommendations for JB's condition. A fluid restriction alone may not sufficiently address the problem, as sodium intake can also contribute to fluid retention. The best option for JB's ascites is fluid and sodium restriction. This will help decrease fluid accumulation in the abdomen and improve symptoms. High-fiber and high-fat foods are not recommended as they may exacerbate JB's symptoms and make digestion more difficult. NPO status (nothing by mouth) should be maintained until the cause of JB's nausea and vomiting is identified and treated. An alternate means of nutrition support may be necessary if oral intake is inadequate for an extended period of time.

Case Study JB Is a 53 Yo Male Who Was Recently Divorced.He