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Nutrition Assessment - Biochemical Data 10. Is Mr. Garcia at risk for metabolic syndrome? What is metabolic syndrome? Does he have any laboratory values that support this diagnosis? 11. Examine the laboratory results for Mr. Garcia. Which labs are consistent with the MI diagnosis? Explain. Why are the levels higher on 12/2? 12. List the abnormal values that are found in his lipid profile. What are the long-term implications? What are the possible treatment options for these abnormalities?

Nutrition Assessment - Biochemical Data 10. Is Mr. Garcia at risk for metabolic syndrome? What is metabolic syndrome? Does he have any laboratory values that support this diagnosis? 11. Examine the laboratory results for Mr. Garcia. Which labs are consistent with the MI diagnosis? Explain. Why are the levels higher on 12/2? 12. List the abnormal values that are found in his lipid profile. What are the long-term implications? What are the possible treatment options for these abnormalities?

Principles Of Pharmacology Med Assist
Principles Of Pharmacology Med Assist
6th Edition
ISBN:9781337512442
Author:RICE
Publisher:RICE
Chapter26: Medications Used In Treatment Of Endocrine Disorders
Section: Chapter Questions
Problem 24RQ
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Nutrition Assessment - Biochemical Data 10. Is Mr. Garcia at risk for metabolic syndrome? What is metabolic syndrome? Does he have any laboratory values that support this diagnosis? 11. Examine the laboratory results for Mr. Garcia. Which labs are consistent with the MI diagnosis? Explain. Why are the levels higher on 12/2? 12. List the abnormal values that are found in his lipid profile. What are the long-term implications? What are the possible treatment options for these abnormalities?
Transcribed Image Text:Nutrition Assessment - Biochemical Data 10. Is Mr. Garcia at risk for metabolic syndrome? What is metabolic syndrome? Does he have any laboratory values that support this diagnosis? 11. Examine the laboratory results for Mr. Garcia. Which labs are consistent with the MI diagnosis? Explain. Why are the levels higher on 12/2? 12. List the abnormal values that are found in his lipid profile. What are the long-term implications? What are the possible treatment options for these abnormalities?
Ref. Range 12/1 1957 12/2 0630 Nutrition: Diet order: no added salt/low saturated fat; low cholesterol History: Appetite good. He and his wife have been trying to change some things in his diet. Wife indicates that she has been using "corn oil" instead of butter and has tried not to fry foods as often. Typical dietary intake: Breakfast: Midmorning snack: Lunch: Dinner: Snack: Coffee with milk and sugar Egg and cheese on English muffin from work cafeteria; 8 oz. orange juice, 2-3 c coffee with milk and sugar Leftovers from home; if eats in cafeteria: soup, salad, or sandwich. Had tomato soup and grilled cheese yesterday. Rice-1 c; black beans-1 c; roast pork with tomato and peppers- approx. 6 oz; cornbread-2 squares, each 2" wide Typically has chips or popcorn and 1-2 beers Food allergies/intolerances/aversions: None Previous nutrition therapy? No Food purchase/preparation: Spouse Vit/min intake: None Laboratory Results Chemistry Garcia, José, Male, 61 y.o. Allergies: NKA Pt. Location: RM 704 Laboratory Results (Continued) Code: FULL Physician: RJ Warren Isolation: None Admit Date: 12/1 Magnesium (mg/dL) Calcium (mg/dL) Ref. Range 1.5-2.4 12/1 1957 12/2 0630 12/3 0645 2.0 2.3 2.0 8.6-10.2 9.4 9.4 9.4 Osmolality (mmol/kg/H,O) 275-295 292 290 291 Bilirubin total (mg/dL) ≤1.2 0.8 0.76 0.81 Bilirubin, direct (mg/dL) <0.3 0.10 0.11 0.14 Protein, total (g/dL) 6-7.8 6.0 5.9 ↓ 6.1 Albumin (g/dL) 3.5-5.5 4.2 4.3 4.2 Prealbumin (mg/dL) 18-35 30 32 31 Ammonia (pg/L) 6-47 26 22 25 Alkaline phosphatase (U/L) 30-120 75 70 68 ALT (U/L) 4-36 30 215 1 185 1 AST (U/L) 0-35 25 245 11 175 ↑ CPK (U/L) 30-135 F 75 500 11 335 11 55-170 M 12/3 0645 CPK-MB (U/L) 0 0 75 11 55 11 Lactate dehydrogenase (U/L) 208-378 325 685 1 365 Sodium (mEq/L) 136-145 141 142 138 Troponin I (ng/dL) <0.2 2.4 1 2.8 11 3.1 1 Potassium (mEq/L) 3.5-5.1 4.2 4.1 3.9 Troponin T (ng/dL) <0.03 2.1 1 2.7 It 3.2 1 Chloride (mEq/L) 98-107 103 102 100 Cholesterol (mg/dL) <200 235 11 226 11 214 1 Carbon dioxide (mEq/L) 23-29 23 24 26 BUN (mg/dL) HDL-C (mg/dL) >50 F >40 M 30 11 32 1 33 11 6-20 14 15 16 Creatinine serum (mg/dL) 0.6-1.1 F 1.1 1.1 1.1 VLDL (mg/dL) 7-32 44 It 49 11 51 It LDL (mg/dL) 0-99 160 It 150 1 141 1 0.9-1.3 M BUN/Crea ratio 10.0-20.0 12.7 13.6 13.3 LDL/HDL ratio <4.5 5.3 It 4.7 11 4.3 Uric acid (mg/dL) 2.8-8.8 F 5.1 5.7 6.1 Apo A (mg/dL) 80-175 F 721 80 98 75-160 M 4.0-9.0 M Est GFR, non-Afr Amer >60 68 68 68 Apo B (mg/dL) 45-120 F 50-125 M 115 110 105 (mL/min/1.73 m²) Glucose (mg/dL) 70-99 Phosphate, inorganic (mg/dL) 2.2-4.6 136 It 3.1 106 1 3.2 104 t 3.0 Triglycerides (mg/dL) <150 HbA1c (%) <5.7 220 11 5.5 245 11 257 11 (Continued) Garcia, José, Male, 61 y.o. Allergies: NKA Code: FULL Pt. Location: RM 704 Physician: RJ Warren Isolation: None Admit Date: 12/1 Allergies: NKA Pt. Location: RM 704 Code: FULL Physician: RJ Warren Isolation: None Admit Date: 12/1 Laboratory Results (Continued) Laboratory Results (Continued) Ref. Range 12/1 1957 12/2 0630 12/3 0645 Ref. Range 12/1 1957 12/2 0630 12/3 0645 Hematology WBC (x10³/mm³) 3.9-10.7 11.0 t 9.32 8.8 Ketones Blood Bilirubin Neg Trace It Neg Neg Neg Neg Neg Neg Neg Neg Neg Neg RBC (x 10%/mm³) 4.2-5.4 F 4.7 4.75 4.68 Nitrites Neg Neg Neg Neg 4.5-6.2 M Urobilinogen (EU/dL) 1.0 0 0 0 Hemoglobin (Hgb, g/dL) 12-16 F 15 14.8 14.4 Leukocyte esterase Neg Neg Neg Neg 14-17 M Prot chk Neg Neg Neg Neg Hematocrit (Hct, %) 37-47 F 45 45 44 WBCs (HPF) 0-5 0 ° ° 41-51 M RBCs (HPF) 0-2 1 0 0 Mean cell volume (μm³) 80-96 91 92 90 Bact 0 0 0 0 Mean cell Hgb (pg) 28-32 30 31 30 Mucus 0 0 0 0 Mean cell Hgb content (g/dL) 32-36 33 32 33 Crys 0 0 0 0 RBC distribution (%) 11.6-16.5 13.2 12.8 13.0 Casts (LPF) 0 0 0 0 Platelet count (x 10³/mm³) 150-350 320 295 280 Yeast 0 0 0 0 Hematology, Manual Diff Neutrophil (%) 40-70 55 58 62 Lymphocyte (%) 22-44 22 23 35 Note: Values and units of measurement listed in these tables are derived from several resources. Substantial variation exists in the ranges quoted as "normal" and these may vary depending on the assay used by different laboratories. Monocyte (%) 0-7 4 4 7 Eosinophil (%) 0-5 0 0 0 Basophil (%) 0-2 0 0 0 Blasts (%) 3-10 3 3 4 Segs (%) 0-60 45 47 52 Bands (%) 0-10 15 If 17 ↑ 8 Urinalysis Collection method Color catheter pale catheter pale yellow yellow catheter pale yellow Appearance clear clear clear Specific gravity 1.001-1.035 1.020 1.015 1.018 PH 5-7 5.8 5.0 6 Protein (mg/dL) Neg + I↑ Neg Neg Glucose (mg/dL) Neg Neg Neg
Transcribed Image Text:Ref. Range 12/1 1957 12/2 0630 Nutrition: Diet order: no added salt/low saturated fat; low cholesterol History: Appetite good. He and his wife have been trying to change some things in his diet. Wife indicates that she has been using "corn oil" instead of butter and has tried not to fry foods as often. Typical dietary intake: Breakfast: Midmorning snack: Lunch: Dinner: Snack: Coffee with milk and sugar Egg and cheese on English muffin from work cafeteria; 8 oz. orange juice, 2-3 c coffee with milk and sugar Leftovers from home; if eats in cafeteria: soup, salad, or sandwich. Had tomato soup and grilled cheese yesterday. Rice-1 c; black beans-1 c; roast pork with tomato and peppers- approx. 6 oz; cornbread-2 squares, each 2" wide Typically has chips or popcorn and 1-2 beers Food allergies/intolerances/aversions: None Previous nutrition therapy? No Food purchase/preparation: Spouse Vit/min intake: None Laboratory Results Chemistry Garcia, José, Male, 61 y.o. Allergies: NKA Pt. Location: RM 704 Laboratory Results (Continued) Code: FULL Physician: RJ Warren Isolation: None Admit Date: 12/1 Magnesium (mg/dL) Calcium (mg/dL) Ref. Range 1.5-2.4 12/1 1957 12/2 0630 12/3 0645 2.0 2.3 2.0 8.6-10.2 9.4 9.4 9.4 Osmolality (mmol/kg/H,O) 275-295 292 290 291 Bilirubin total (mg/dL) ≤1.2 0.8 0.76 0.81 Bilirubin, direct (mg/dL) <0.3 0.10 0.11 0.14 Protein, total (g/dL) 6-7.8 6.0 5.9 ↓ 6.1 Albumin (g/dL) 3.5-5.5 4.2 4.3 4.2 Prealbumin (mg/dL) 18-35 30 32 31 Ammonia (pg/L) 6-47 26 22 25 Alkaline phosphatase (U/L) 30-120 75 70 68 ALT (U/L) 4-36 30 215 1 185 1 AST (U/L) 0-35 25 245 11 175 ↑ CPK (U/L) 30-135 F 75 500 11 335 11 55-170 M 12/3 0645 CPK-MB (U/L) 0 0 75 11 55 11 Lactate dehydrogenase (U/L) 208-378 325 685 1 365 Sodium (mEq/L) 136-145 141 142 138 Troponin I (ng/dL) <0.2 2.4 1 2.8 11 3.1 1 Potassium (mEq/L) 3.5-5.1 4.2 4.1 3.9 Troponin T (ng/dL) <0.03 2.1 1 2.7 It 3.2 1 Chloride (mEq/L) 98-107 103 102 100 Cholesterol (mg/dL) <200 235 11 226 11 214 1 Carbon dioxide (mEq/L) 23-29 23 24 26 BUN (mg/dL) HDL-C (mg/dL) >50 F >40 M 30 11 32 1 33 11 6-20 14 15 16 Creatinine serum (mg/dL) 0.6-1.1 F 1.1 1.1 1.1 VLDL (mg/dL) 7-32 44 It 49 11 51 It LDL (mg/dL) 0-99 160 It 150 1 141 1 0.9-1.3 M BUN/Crea ratio 10.0-20.0 12.7 13.6 13.3 LDL/HDL ratio <4.5 5.3 It 4.7 11 4.3 Uric acid (mg/dL) 2.8-8.8 F 5.1 5.7 6.1 Apo A (mg/dL) 80-175 F 721 80 98 75-160 M 4.0-9.0 M Est GFR, non-Afr Amer >60 68 68 68 Apo B (mg/dL) 45-120 F 50-125 M 115 110 105 (mL/min/1.73 m²) Glucose (mg/dL) 70-99 Phosphate, inorganic (mg/dL) 2.2-4.6 136 It 3.1 106 1 3.2 104 t 3.0 Triglycerides (mg/dL) <150 HbA1c (%) <5.7 220 11 5.5 245 11 257 11 (Continued) Garcia, José, Male, 61 y.o. Allergies: NKA Code: FULL Pt. Location: RM 704 Physician: RJ Warren Isolation: None Admit Date: 12/1 Allergies: NKA Pt. Location: RM 704 Code: FULL Physician: RJ Warren Isolation: None Admit Date: 12/1 Laboratory Results (Continued) Laboratory Results (Continued) Ref. Range 12/1 1957 12/2 0630 12/3 0645 Ref. Range 12/1 1957 12/2 0630 12/3 0645 Hematology WBC (x10³/mm³) 3.9-10.7 11.0 t 9.32 8.8 Ketones Blood Bilirubin Neg Trace It Neg Neg Neg Neg Neg Neg Neg Neg Neg Neg RBC (x 10%/mm³) 4.2-5.4 F 4.7 4.75 4.68 Nitrites Neg Neg Neg Neg 4.5-6.2 M Urobilinogen (EU/dL) 1.0 0 0 0 Hemoglobin (Hgb, g/dL) 12-16 F 15 14.8 14.4 Leukocyte esterase Neg Neg Neg Neg 14-17 M Prot chk Neg Neg Neg Neg Hematocrit (Hct, %) 37-47 F 45 45 44 WBCs (HPF) 0-5 0 ° ° 41-51 M RBCs (HPF) 0-2 1 0 0 Mean cell volume (μm³) 80-96 91 92 90 Bact 0 0 0 0 Mean cell Hgb (pg) 28-32 30 31 30 Mucus 0 0 0 0 Mean cell Hgb content (g/dL) 32-36 33 32 33 Crys 0 0 0 0 RBC distribution (%) 11.6-16.5 13.2 12.8 13.0 Casts (LPF) 0 0 0 0 Platelet count (x 10³/mm³) 150-350 320 295 280 Yeast 0 0 0 0 Hematology, Manual Diff Neutrophil (%) 40-70 55 58 62 Lymphocyte (%) 22-44 22 23 35 Note: Values and units of measurement listed in these tables are derived from several resources. Substantial variation exists in the ranges quoted as "normal" and these may vary depending on the assay used by different laboratories. Monocyte (%) 0-7 4 4 7 Eosinophil (%) 0-5 0 0 0 Basophil (%) 0-2 0 0 0 Blasts (%) 3-10 3 3 4 Segs (%) 0-60 45 47 52 Bands (%) 0-10 15 If 17 ↑ 8 Urinalysis Collection method Color catheter pale catheter pale yellow yellow catheter pale yellow Appearance clear clear clear Specific gravity 1.001-1.035 1.020 1.015 1.018 PH 5-7 5.8 5.0 6 Protein (mg/dL) Neg + I↑ Neg Neg Glucose (mg/dL) Neg Neg Neg
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