Answer to Question 1
Elevated AST and ALT lab results suggests liver damage/fatty accumulation
Diagnosed after exclusion of all other causes of abnormal LFTs and results from liver ultrasound
Dyslipidemia (primarily high triglycerides) and altered glucose values are associated with NAFLD.
Dyslipidemia as a risk factor may be only associative with NAFLD when obesity and insulin resistance are present.
Answer to Question 2
20 mL/hour of Peptamen Bariatric and increase as tolerated by 10-20 mL every 8-12 hours until goal rate of 80 mL/hour (based on 22 hours per day for an ICU patient) is reached. This will provide 1760 mL total volume, 1760 total kcalories, 164 g protein, and 1478 mL free water. Provide approximately 5 flushes of 60 mL free sterile water throughout the day (every 4 hours).
This formula is chosen for Mr. McKinley because it has a high protein-to-calorie ratio and can help meet the protein requirement for the critically ill obese population. It is also a hydrolyzed formula, which may assist in optimal absorption. It has a lipid profile to support modulation of proinflammatory mediators in the critically ill, along with carbohydrate levels to support the nutrition management of blood glucose levels for those with diabetes or under metabolic stress. A continuous feed would be best for Mr. McKinley because a continuous feed with a slower advancement will be better tolerated with his bowel reconstruction and allow for a more stabilized blood glucose.
Iron Deficiency Symptoms
This young child is pulling at the ear and acting fussy, two important signs of otitis media.
Dehydration Signs
Common skin signs are often evidence of an illness or disorder. A papule is a solid, circumscribed, ...
Signs of stress.
Density of some common substances