Patient Name: Cindy Wrella Occupation: Administrative Assistant DOB: 5/15/1962 Past Medical History: T2DM (dx: 2009), HTN (dx: 2012), Hysterectomy in 2015 Anthropometrics: Height: 5'5"; Admit weight: 174 lb; Stated Usual Body Weight: 165 lb History of Present Illness: Mrs. Wrella came to the ER with worsening SOB over the past 2 days and swelling in both her legs. She was diagnosed with CKD Stage III, and the physician has ordered diet education. Medications: glimepiride, metformin, and amlodipine Labs: Lab Test Date 65 NFPE: +1 pitting edema to legs; BP of 152/94 mm Hg Diet History: Mrs. Wrella is the person in her household that is primarily responsible for buying and preparing food. She and her husband eat out 2-3 times/week at a diner near their house. She also loves Diet Dr. Pepper and drinks two 20 oz bottles each day. She says she usually walks her small dog for 15 min each day, but she hasn't been feeling well for the past few days so she has not taken him out for walks. Typical Day of Eating for Mrs. Wrella: ⚫ Breakfast 。 1½ cups Raisin Bran 。 1 cup 2% milk 1 cup of fresh raspberries o 8 oz of unsweetened green tea Snack 1 。 1 cup yogurt • ½ cup diced honeydew 。 20 oz bottle of Diet Dr. Pepper • Lunch 1 can of Progresso Chicken Noodle Soup 。 Salad Result eGFR 6/5 45 mL/min/1.73m² BUN 6/5 38 mg/dL Creatine 6/5 3 mg/dL Albumin 6/5 4.8 mg/dL Prealbumin 6/5 35 mg/dL Glucose 6/5 130 mg/dL PTH 6/5 120 pg/mL Calcium 6/5 8.2 mg/dL Phosphorus 6/5 5.6 mg/dL Potassium 6/5 5.3 mEq/L Sodium 6/5 155 mEq/L • Dinner Cholesterol 6/5 205 mg Cholesterol, LDL 6/5 120 mg Cholesterol, HDL 6/5 45 mg Triglycerides 6/5 142 mg/dL Hemoglobin 6/5 10.5 g/dL Hematocrit 6/5 32% 1 cup raw spinach ■ ½ cup sliced cucumber ■ A "handful" of croutons (1-2 oz) 2 Tbsp of "Lite" bleu cheese dressing 。 20 oz bottle of Diet Dr. Pepper Snack 2 。 10 whole wheat crackers • 2 oz of swiss cheese • 6 oz pork chopped (braised) 。 1 cup of mashed potatoes ½ cup of brown gravy 1 cup steamed broccoli • 1 small dinner roll • 8 oz unsweetened iced tea According to the Choose Your Foods guide and the USDA Food Composition Database, her diet provides 2078 kcal (28 kcal/kg), 120g protein (1.6 g/kg), 3454 mg potassium, 2330 mg phosphorus, and 7889 mg sodium. * Choose Your Foods used for calories and protein. USDA Database for minerals.* Previous diet education: Diabetes diet education upon diagnosis. Pt states she has been following carb counting since then. Recommended Nutrient Ranges: • 23-35 kcal/kg energy ⚫ 0.6-0.8 g/kg protein (at least 50% HBV) ⚫ 3-4 carbohydrate choices per meal and 1-2 choices per snack (for DM) 800-1000 mg of phosphorus <2400 mg of sodium <2400 mg of potassium
Patient Name: Cindy Wrella Occupation: Administrative Assistant DOB: 5/15/1962 Past Medical History: T2DM (dx: 2009), HTN (dx: 2012), Hysterectomy in 2015 Anthropometrics: Height: 5'5"; Admit weight: 174 lb; Stated Usual Body Weight: 165 lb History of Present Illness: Mrs. Wrella came to the ER with worsening SOB over the past 2 days and swelling in both her legs. She was diagnosed with CKD Stage III, and the physician has ordered diet education. Medications: glimepiride, metformin, and amlodipine Labs: Lab Test Date 65 NFPE: +1 pitting edema to legs; BP of 152/94 mm Hg Diet History: Mrs. Wrella is the person in her household that is primarily responsible for buying and preparing food. She and her husband eat out 2-3 times/week at a diner near their house. She also loves Diet Dr. Pepper and drinks two 20 oz bottles each day. She says she usually walks her small dog for 15 min each day, but she hasn't been feeling well for the past few days so she has not taken him out for walks. Typical Day of Eating for Mrs. Wrella: ⚫ Breakfast 。 1½ cups Raisin Bran 。 1 cup 2% milk 1 cup of fresh raspberries o 8 oz of unsweetened green tea Snack 1 。 1 cup yogurt • ½ cup diced honeydew 。 20 oz bottle of Diet Dr. Pepper • Lunch 1 can of Progresso Chicken Noodle Soup 。 Salad Result eGFR 6/5 45 mL/min/1.73m² BUN 6/5 38 mg/dL Creatine 6/5 3 mg/dL Albumin 6/5 4.8 mg/dL Prealbumin 6/5 35 mg/dL Glucose 6/5 130 mg/dL PTH 6/5 120 pg/mL Calcium 6/5 8.2 mg/dL Phosphorus 6/5 5.6 mg/dL Potassium 6/5 5.3 mEq/L Sodium 6/5 155 mEq/L • Dinner Cholesterol 6/5 205 mg Cholesterol, LDL 6/5 120 mg Cholesterol, HDL 6/5 45 mg Triglycerides 6/5 142 mg/dL Hemoglobin 6/5 10.5 g/dL Hematocrit 6/5 32% 1 cup raw spinach ■ ½ cup sliced cucumber ■ A "handful" of croutons (1-2 oz) 2 Tbsp of "Lite" bleu cheese dressing 。 20 oz bottle of Diet Dr. Pepper Snack 2 。 10 whole wheat crackers • 2 oz of swiss cheese • 6 oz pork chopped (braised) 。 1 cup of mashed potatoes ½ cup of brown gravy 1 cup steamed broccoli • 1 small dinner roll • 8 oz unsweetened iced tea According to the Choose Your Foods guide and the USDA Food Composition Database, her diet provides 2078 kcal (28 kcal/kg), 120g protein (1.6 g/kg), 3454 mg potassium, 2330 mg phosphorus, and 7889 mg sodium. * Choose Your Foods used for calories and protein. USDA Database for minerals.* Previous diet education: Diabetes diet education upon diagnosis. Pt states she has been following carb counting since then. Recommended Nutrient Ranges: • 23-35 kcal/kg energy ⚫ 0.6-0.8 g/kg protein (at least 50% HBV) ⚫ 3-4 carbohydrate choices per meal and 1-2 choices per snack (for DM) 800-1000 mg of phosphorus <2400 mg of sodium <2400 mg of potassium
Basic Clinical Laboratory Techniques 6E
6th Edition
ISBN:9781133893943
Author:ESTRIDGE
Publisher:ESTRIDGE
Chapter4: Basic Immunology And Immunohematology
Section4.4: Tests For Human Chorionic Gonadotropin
Problem 2CT
Related questions
Question
Nutrition Intervention
Nutrition Monitoring & Evaluation
Needed:
- Protein sources
- Amount to eat daily
- Protein and other foods high in phosphorus (I.e. cheese, legumes)
- Cooking method of protein sources Urine produced daily
- Dividing fluids throughout the day
- Types of fluid
- Acceptable fluids (Le. ginger ale)
- Fluids to avoid (I.e. dark colas)
- Food considered fluid (I.e. jello)
- Tips to reduce thirst
How would you educate the pt?
![Patient Name: Cindy Wrella
Occupation: Administrative Assistant
DOB: 5/15/1962
Past Medical History: T2DM (dx: 2009), HTN (dx: 2012), Hysterectomy in 2015
Anthropometrics: Height: 5'5"; Admit weight: 174 lb; Stated Usual Body Weight: 165 lb
History of Present Illness: Mrs. Wrella came to the ER with worsening SOB over the past 2 days
and swelling in both her legs. She was diagnosed with CKD Stage III, and the physician has
ordered diet education.
Medications: glimepiride, metformin, and amlodipine
Labs:
Lab Test
Date
65
NFPE: +1 pitting edema to legs; BP of 152/94 mm Hg
Diet History: Mrs. Wrella is the person in her household that is primarily responsible for buying
and preparing food. She and her husband eat out 2-3 times/week at a diner near their house. She
also loves Diet Dr. Pepper and drinks two 20 oz bottles each day. She says she usually walks her
small dog for 15 min each day, but she hasn't been feeling well for the past few days so she has
not taken him out for walks.
Typical Day of Eating for Mrs. Wrella:
⚫ Breakfast
。 1½ cups Raisin Bran
。 1 cup 2% milk
1 cup of fresh raspberries
o 8 oz of unsweetened green tea
Snack 1
。 1 cup yogurt
• ½ cup diced honeydew
。 20 oz bottle of Diet Dr. Pepper
• Lunch
1 can of Progresso Chicken Noodle Soup
。 Salad
Result
eGFR
6/5
45 mL/min/1.73m²
BUN
6/5
38 mg/dL
Creatine
6/5
3 mg/dL
Albumin
6/5
4.8 mg/dL
Prealbumin
6/5
35 mg/dL
Glucose
6/5
130 mg/dL
PTH
6/5
120 pg/mL
Calcium
6/5
8.2 mg/dL
Phosphorus
6/5
5.6 mg/dL
Potassium
6/5
5.3 mEq/L
Sodium
6/5
155 mEq/L
• Dinner
Cholesterol
6/5
205 mg
Cholesterol, LDL
6/5
120 mg
Cholesterol, HDL
6/5
45 mg
Triglycerides
6/5
142 mg/dL
Hemoglobin
6/5
10.5 g/dL
Hematocrit
6/5
32%
1 cup raw spinach
■
½ cup sliced cucumber
■
A "handful" of croutons (1-2 oz)
2 Tbsp of "Lite" bleu cheese dressing
。 20 oz bottle of Diet Dr. Pepper
Snack 2
。 10 whole wheat crackers
• 2 oz of swiss cheese
• 6 oz pork chopped (braised)
。 1 cup of mashed potatoes
½ cup of brown gravy
1 cup steamed broccoli
•
1 small dinner roll
• 8 oz unsweetened iced tea
According to the Choose Your Foods guide and the USDA Food Composition Database, her diet
provides 2078 kcal (28 kcal/kg), 120g protein (1.6 g/kg), 3454 mg potassium, 2330 mg
phosphorus, and 7889 mg sodium.
* Choose Your Foods used for calories and protein. USDA Database for minerals.*
Previous diet education: Diabetes diet education upon diagnosis. Pt states she has been following
carb counting since then.
Recommended Nutrient Ranges:
• 23-35 kcal/kg energy
⚫ 0.6-0.8 g/kg protein (at least 50% HBV)
⚫ 3-4 carbohydrate choices per meal and 1-2 choices per snack (for DM)
800-1000 mg of phosphorus
<2400 mg of sodium
<2400 mg of potassium](/v2/_next/image?url=https%3A%2F%2Fcontent.bartleby.com%2Fqna-images%2Fquestion%2F5044c2d8-efd7-4b57-b91c-d6b899d655c8%2Fc1df91b5-a28a-48eb-92c9-44ef5d62bee0%2F1hwk7so_processed.jpeg&w=3840&q=75)
Transcribed Image Text:Patient Name: Cindy Wrella
Occupation: Administrative Assistant
DOB: 5/15/1962
Past Medical History: T2DM (dx: 2009), HTN (dx: 2012), Hysterectomy in 2015
Anthropometrics: Height: 5'5"; Admit weight: 174 lb; Stated Usual Body Weight: 165 lb
History of Present Illness: Mrs. Wrella came to the ER with worsening SOB over the past 2 days
and swelling in both her legs. She was diagnosed with CKD Stage III, and the physician has
ordered diet education.
Medications: glimepiride, metformin, and amlodipine
Labs:
Lab Test
Date
65
NFPE: +1 pitting edema to legs; BP of 152/94 mm Hg
Diet History: Mrs. Wrella is the person in her household that is primarily responsible for buying
and preparing food. She and her husband eat out 2-3 times/week at a diner near their house. She
also loves Diet Dr. Pepper and drinks two 20 oz bottles each day. She says she usually walks her
small dog for 15 min each day, but she hasn't been feeling well for the past few days so she has
not taken him out for walks.
Typical Day of Eating for Mrs. Wrella:
⚫ Breakfast
。 1½ cups Raisin Bran
。 1 cup 2% milk
1 cup of fresh raspberries
o 8 oz of unsweetened green tea
Snack 1
。 1 cup yogurt
• ½ cup diced honeydew
。 20 oz bottle of Diet Dr. Pepper
• Lunch
1 can of Progresso Chicken Noodle Soup
。 Salad
Result
eGFR
6/5
45 mL/min/1.73m²
BUN
6/5
38 mg/dL
Creatine
6/5
3 mg/dL
Albumin
6/5
4.8 mg/dL
Prealbumin
6/5
35 mg/dL
Glucose
6/5
130 mg/dL
PTH
6/5
120 pg/mL
Calcium
6/5
8.2 mg/dL
Phosphorus
6/5
5.6 mg/dL
Potassium
6/5
5.3 mEq/L
Sodium
6/5
155 mEq/L
• Dinner
Cholesterol
6/5
205 mg
Cholesterol, LDL
6/5
120 mg
Cholesterol, HDL
6/5
45 mg
Triglycerides
6/5
142 mg/dL
Hemoglobin
6/5
10.5 g/dL
Hematocrit
6/5
32%
1 cup raw spinach
■
½ cup sliced cucumber
■
A "handful" of croutons (1-2 oz)
2 Tbsp of "Lite" bleu cheese dressing
。 20 oz bottle of Diet Dr. Pepper
Snack 2
。 10 whole wheat crackers
• 2 oz of swiss cheese
• 6 oz pork chopped (braised)
。 1 cup of mashed potatoes
½ cup of brown gravy
1 cup steamed broccoli
•
1 small dinner roll
• 8 oz unsweetened iced tea
According to the Choose Your Foods guide and the USDA Food Composition Database, her diet
provides 2078 kcal (28 kcal/kg), 120g protein (1.6 g/kg), 3454 mg potassium, 2330 mg
phosphorus, and 7889 mg sodium.
* Choose Your Foods used for calories and protein. USDA Database for minerals.*
Previous diet education: Diabetes diet education upon diagnosis. Pt states she has been following
carb counting since then.
Recommended Nutrient Ranges:
• 23-35 kcal/kg energy
⚫ 0.6-0.8 g/kg protein (at least 50% HBV)
⚫ 3-4 carbohydrate choices per meal and 1-2 choices per snack (for DM)
800-1000 mg of phosphorus
<2400 mg of sodium
<2400 mg of potassium
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