Review the patient's chemistries upon admission. Identify any ...

[darbym82]

Review the patient's chemistries upon admission. Identify any that are abnormal and describe their clinical significance for this patient, including the likely reason for each abnormality and its nutritional implications.
 
  What will be an ideal response?

Question 2

Are any clinical signs of malnutrition noted in the patient's admission history and physical?
 
  What will be an ideal response?

[qytan]

Answer to Question 1

Albumin 9/5, 9/11: normal 3.5-5.5, Mr. Seyer 3.1, 3.0
 Reason for abnormality:
- Inadequate nutritional intake
- Increased nutritional needs
- Malnourished
- Inflammatory response - serum levels are reduced as a result of inflammatory process and a reduction in hepatic synthesis
 Nutritional implications:
- Decreased levels are associated with increased risk of morbidity and mortality.
- Increase protein intake and provide adequate nutrition support.
Total protein 9/5, 9/11: normal 6-7.8, Mr. Seyer 5.7
Prealbumin 9/5, 9/11: normal 18-35, Mr. Seyer 15, 12
 Reason for abnormality:
- Inadequate nutritional intake
- Increased nutritional needs
- Malnourished
- Inflammatory response - serum levels are reduced as a result of inflammatory process and a reduction in hepatic synthesis
 Nutritional implications: Provide adequate nutrition support.
RBC 9/5, 9/11: normal 4.5-6.2, Mr. Seyer 4.2, 4.3
 Reason for abnormality:
- Possible anemia
- May be associated with malignancy and subsequent bone marrow suppression
 Nutritional implications:
- No specific nutritional implications but supports overall need for nutrition therapy
- Adequate kcal and protein
HGB 9/5, 9/11: normal 14-17, Mr. Seyer 13.5, 13.9
 Reason for abnormality:
- Possible anemia
- May be associated with malignancy and subsequent bone marrow suppression
- Protein-energy malnutrition
 Nutritional implications:
- No specific nutritional implications but supports overall need for nutrition therapy
- Adequate kcal and protein
HCT 9/5, 9/11: normal 41-51, Mr. Seyer 38
 Reason for abnormality:
- Possible dehydration (9/5)
- Possible anemia
- May be associated with malignancy and subsequent bone marrow suppression
 Nutritional implications:
- No specific nutritional implications but supports overall need for nutrition therapy
- Adequate kcal and protein
MCH 9/5, 9/11: normal 26-32, Mr. Seyer 32.4, 32.3
MCHC 9/11: normal 32-36, Mr. Seyer 36.5
 Reason for abnormality:
- Possible anemia
- May be associated with malignancy and subsequent bone marrow suppression
 Nutritional implications:
- No specific nutritional implications but supports overall need for nutrition therapy
- Adequate kcal and protein

Answer to Question 2

 Sunken eyes
 Evidence of some muscle wasting in extremities

[darbym82]

TYSM

[juliaf]

Excellent