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
-The registered dietitian has performed a complete nutrition assessment Which of the following nutrition assessment parameters is going to be invalid due to JB's condition?
A) AST/ALT
B) weight
C) patient intake history
D) triglycerides
Correct Answer:
Verified
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