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: 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 Lab Test Date eGFR 6/5 Result 45 mL/min/1.73m² BUN 6/5 38 mg/dL Creatine 6/5 Albumin 6/5 Prealbumin 6/5 Glucose 6/5 3 mg/dL 4.8 mg/dL 35 mg/dL 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 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% • о 1 ½ cups Raisin Bran о 1 cup 2% milk O 1 cup of fresh raspberries о Snack 1 O 8 oz of unsweetened green tea 1 cup yogurt ½ cup diced honeydew o 20 oz bottle of Diet Dr. Pepper . Lunch ° ° Salad о • Snack 2 1 can of Progresso Chicken Noodle Soup 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 0 10 whole wheat crackers ° 2 oz of swiss cheese Dinner 6 oz pork chopped (braised) о 1 cup of mashed potatoes ½ cup of brown gravy о 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: 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 Lab Test Date eGFR 6/5 Result 45 mL/min/1.73m² BUN 6/5 38 mg/dL Creatine 6/5 Albumin 6/5 Prealbumin 6/5 Glucose 6/5 3 mg/dL 4.8 mg/dL 35 mg/dL 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 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% • о 1 ½ cups Raisin Bran о 1 cup 2% milk O 1 cup of fresh raspberries о Snack 1 O 8 oz of unsweetened green tea 1 cup yogurt ½ cup diced honeydew o 20 oz bottle of Diet Dr. Pepper . Lunch ° ° Salad о • Snack 2 1 can of Progresso Chicken Noodle Soup 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 0 10 whole wheat crackers ° 2 oz of swiss cheese Dinner 6 oz pork chopped (braised) о 1 cup of mashed potatoes ½ cup of brown gravy о 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

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