Which diagnostic laboratory test should the nurse anticipate ...

[JGIBBSON]

Which diagnostic laboratory test should the nurse anticipate being ordered for the purpose of evaluating an individual's acute, unexplained weight loss? Select all that ap-ply.
 
  a. A complete blood count (CBC)
  b. Urinalysis
  c. Fecal Occult Blood
  d. Serum Potassium
  e. Serum Electrolytes

Question 2

A 75-year old resident in the nursing home has end stage dementia and experiences a 10-pound weight loss over the course of 2 months. The resident has become increasingly difficult to feed and often spits out food, pockets food, and frequently drools. The
 
  a. Recommend to the physician that a gastric feeding tube be placed.
  b. Recommend to the physician that a swallowing evaluation be done.
  c. Amend the care plan to include vigorous feeding by the nursing assistants.
  d. Assure the family that feeding issues are often a characteristic of end-stage dementia.

[stallen]

Answer to Question 1

ANS: A, B, C
A complete blood count helps assess the presence of diseases known to affect weight loss or cause loss of appetite. Urinalysis to rule out infection, as well as a stool sample for fecal oc-cult blood, should be included to rule out bleeding from ulcers or cancer. The remaining op-tions are unlikely to provide information regarding the client's weight loss.

Answer to Question 2

ANS: B
It is important to do a careful assessment for swallowing disorders and other factors that in-fluence intake before considering severe dietary restrictions or feeding tubes, especially in patients with dementia. Feeding tubes are not the first line of action; a complete assessment is done to identify the problem. The word vigorous implies force-feeding, which is never recommended. It would be especially contraindicated in this patient because there is evi-dence of a swallowing problem (spitting out food, pocketing food, and excessive drooling). While feeding issues are common at this stage of dementia, this option does not address the family's concern.

[JGIBBSON]

Thanks for the timely response, appreciate it

[tuate]

Excellent