Describe Mrs. Washington's potential nutritional problems upon ...

[misspop]

Describe Mrs. Washington's potential nutritional problems upon discharge. What recommendations could you make to her husband to prevent each problem you identified? How would you monitor her progress?
 
  What will be an ideal response?

Question 2

Mr. Garcia may be at risk for metabolic syndrome. What is this? Does he have any laboratory values that would support this diagnosis?
 
  What will be an ideal response?

[yasmina]

Answer to Question 1

 Acute nutritional problems may involve impairment of the ability to chew, swallow, or self-feed, which may lead to weight loss and generalized malnutrition.
 Aspiration may occur. I would educate the husband on how to thicken liquid or soft foods to a consistency tolerable for his wife.
 This would include use of gelatin, pureed thick vegetables, pureed fruits or applesauce, baby rice cereal, and baby apple flakes.
 Additionally, there are many commercial thickeners available for use.
 Mrs. Washington's progress could be monitored by use of 24-hour recalls, monitoring her weight, and also updates from a speech-language pathologist.

Answer to Question 2

 Metabolic syndrome - constellation of metabolic risk factors that include abdominal obesity, insulin resistance, dyslipidemia, hypertension, and prothrombotic state
 Metabolic syndrome criteria that Mr. Garcia meets (3 needed for diagnosis):
- Possible abdominal obesity (> 40 in or 102 cm) as indicated by the nursing assessment (rounded, obese abdomen)
- Triglycerides > 150 mg/dL (220 mg/dL)
- HDL < 40 mg/dL (30 mg/dL)
- Blood pressure  130/85 mmHg (140/99)
- Insulin resistance; FBG  100 mg/dL (136 mg/dL)

[misspop]

Excellent

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TYSM