Author Question: Evaluate Mrs. Joaquin's chemistry report. What labs are altered due to her diagnosis of Stage 5 CKD? ... (Read 53 times)

09madisonrousseau09 · **on:** Aug 21, 2018

Evaluate Mrs. Joaquin's chemistry report. What labs are altered due to her diagnosis of Stage 5 CKD?

What will be an ideal response?

Question 2

Assess Mr. McKinley's height and weight. Calculate his BMI and usual body weight. What would be a reasonable weight goal for Mr. McKinley? Give your rationale for the method you used to determine this goal weight.

What will be an ideal response?

Pariscourtney · **Reply #1 on:** Aug 21, 2018

Answer to Question 1

Sodium (low): Edema; decreased elimination of fluids (hemodilution)
Potassium (high): Retaining K, decreased elimination
PO4 (high): Retention and release of P from bone breakdown
Total CO2 (high): Acidosis (from decreased ability to excrete H+) increased oxidation of branched-chain amino acids, increased protein degradation and PNA, and decreased albumin synthesis
Albumin (low): Edema malnutrition
Protein (low): Edema, malnutrition
BUN (high): Retention
Creatinine (high): Retention
Calcium (low): Decreased active vitamin D/edema
RBC, Hgb, Hct (low): inadequate EPO production
Protein, glucose, and ketones in the urine (high): damaged glomeruli (protein, glucose) and malnutrition (ketones)

Answer to Question 2

BMI = 703 x 410 lbs/70 in./70 in.= 59
UBW = (410 lbs/434 lbs) x 100 = 95 UBW
A reasonable weight goal would be to lose 30-35 of body weight within 1-2 years post-op.
0.3 x 410 = 123 lbs, 410-123 lbs = 287 lbs.
0.35 x 410 = 143.5 lbs., 410-143.5 = 266.5 lbs.
Therefore, since research shows that most patients lose about 30-35 of their weight, it would be reasonable for Mr. McKinley to lose between 123 and 144 lbs. within the first two years.
Studies demonstrate that 60 of patients typically maintain weight once weight is lost post-surgery.
Another goal would be to get Mr. McKinley's BMI below 30, since evidence shows a significant reduction in the risk for co-morbidities associated with obesity when BMI is less than 30 . This is equivalent to a goal weight <209 lbs.