Increased fruit and vegetable intake is associated with decreased ...

[meagbuch]

Increased fruit and vegetable intake is associated with decreased risk of overweight. What foods in Jamey's diet fall into these categories?
 
  What will be an ideal response?

Question 2

Identify and discuss any abnormal laboratory values measured upon his admission. How did they change after hydration and initial treatment of his HHS?
 
  What will be an ideal response?

[brittrenee]

Answer to Question 1

Apple juice, fried okra, and potatoes are the only fruit and vegetables she consumed.

Answer to Question 2

Initial lab values:
 Glucose: 1524 mg/dL (high)  due to HHS with dehydration.
 Creatinine: 1.9 mg/dL (high)  elevated due to admitting dehydration.
 Sodium: 132 meq/L (low)  osmotic diuresis. Loss of sodium in urine.
 Phosphate: 1.8 (low)  osmotic diuresis; loss of phosphate in urine; kidney function may be impaired due to very high level of hyperglycemia.
 Cholesterol: 205 mg/dL (high)  related to cardiovascular risk factors and diagnosis of hyperlipidemia
 HbA1c: 11.5 (high)  average blood glucose levels are very high as patient has uncontrolled type 2 diabetes and is not taking his medications as prescribed.
 C-peptide: 1.10  means that patient is producing insulin, but insulin resistance is a problem.
 Osmolality: 322.6 mmol/kg (high)  because HHS is a hyperosmolar condition triggered by an illness and severe dehydration.
 Specific gravity (1.045) high  due to dehydration.
 BUN: 31 (high)  due to dehydration and HHS, which is a hyperosmolar condition.
 Glucose in urine: present due to diabetes. High blood glucose levels >180 mg/dL allow glucose to spill over into the urine due to impaired kidney filtration.
 Protein in urine: presence of protein in urine is indicative of impaired kidney function secondary to his diabetes.
 Triglycerides: 185 mg/dL (high) - due to diagnosis of hyperlipidemia
Changed values:
 Glucose: 475 mg/dL, lowered with insulin therapy but still high as glucose is above 200 mg/dL and patient has been NPO.
 Osmolality decreased to 303.5 mmol/kg but is still considered high.
 Sodium is still low, but is improving as pt. is receiving hydration via saline solution.
 Phosphate: still low but levels are improving as pt. is receiving electrolytes and is rehydrated.

[meagbuch]

Excellent

[Joy Chen]

Gracias!