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- Mrs. Mardigrascia, G10 pregnant comes for prenatal consult in the martinez medical clinic. History reveals that she takes vitamin supplements because she is afraid of getting sick. The nurse counsel her to avoid taking which of the following?
- Vitamin E
- Folic acid
- Beta carotene
- Vitamin c
- Vitamin A
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- A 55-year-old woman with a prior history of partial colectomy w/colostomy and small bowel obstruction three months ago that resolved with bowel rest and required no surgical intervention. Three days ago Mary developed a sudden onset of sharp generalized abdominal pain with nausea, vomiting and decreased output from her colostomy bag. She has had two small glasses of water today. Mary is admitted to the medical/surgical unit and you will be the nurse caring for her. You receive the following highlights of report from the emergency department (ED) nurse: CT of her abdomen/pelvis revealed high-grade small bowel obstruction. Lactate 2.8, WBC 14.7, Sodium 143, Potassium 3.7, Creatinine 1.35 An NG was placed and she is on low intermittent suction. She had NG output of 225 mL of bile green liquid. Received hydromorphone 0.5 mg IV for pain one hour ago. Abdominal pain decreased from 9/10 to 3/10 and she is resting more comfortably. Abd. is firm, slightly distended, with tympanic bowel sounds.…Julia is 28 years old. She is 5′6″ tall and weighs 103 pounds. She has had intermittent bouts of diarrhea, painful abdominal cramping, bloating, and a lot of flatus. She is tired all the time and her boss has reprimanded her for not completing her assigned work in a timely manner. Julia has a hard time keeping warm. She wears a sweater all the time even in the middle of the summer. Julia is quite discouraged and her mom suggests that she go to the doctor for a complete physical. Her blood workup reveals hemoglobin level at 8.2 g/dL, red cell count 3.8 million/mm3, hematocrit 30%, ferritin 18 µg/ml, red cell folate 200 nmol/L, and B12 100 pg/L. The doctor orders a bone scan using DEXA and this reveals a measure of osteoporosis. The doctor then suggests that Julia fill out a food intake form. A dietitian evaluates the results and cannot find any indication that Julia is inadequately nourished. The doctor scratches his head for an appropriate diagnosis when suddenly, while Julia is in his…1. Madame. BA 62 years, premenopausal, does not smoke and never drinks alcohol. Since being diagnosed with hypertension, Mrs. BA started a diet and aerobic routine and managed to lose 10 kg in 18 months. His current weight is 72 kg with a height of 165 cm. Blood pressure 150/94 mmHg. All laboratory tests were normal except for the lipid profile. Mrs. BA has a problem with her medical expenses. Mrs.BA started buying over-the-counter medications like Vitamin D, and wanted to start taking Hydrochlorothiazide 25 mg/day. A. Hydrochlorothiazide should be given to Mrs. BA? Explain your answer! After 4 weeks of taking Hydrochlorothiazide 25 mg/day, there were no complaints from Mrs. BA and always on a diet. The results of the current blood pressure examination are 142/86 mmHg with the result laboratory: Serum potassium 3.8 mEq/L (last month 4.0 mEq/L) urate 7.3 mg/dl (last month 6.8 mEq/L) Glucose 99 mg/dl (last month 95 mg/dl) B. Your assessment regarding the efficacy and toxicity of…
- Adelaide, 30, a native of Brazil, is in the United States attending college at the local university. She is married to an Americanand is expecting her first child. She is admitted and delivers a healthy baby girl. Adelaide asks the nurse to get her a vegetarian diet for her meal. The nurse brings her meal tray for breakfast which contains eggs, milk, cereal and fruit. Adelaide is visibly upset and asks the nurse for a different meal stating,“I am a vegetarian, I can’t eat that.” When Adelaide refuses to eat eggs or milk she reveals that she is a particular type of vegetarian. What type of diet does she follow? What are the other types of diets and how are they different?Lavonne is 42-years-old and has always had to watch her intake and maintain an active lifestyle to stay at a healthy weight. She is 5'8" tall and until a couple of months ago, maintained a healthy weight of 160 pounds, with a BMI in the normal range of 24.3. However, a couple of months ago, Lavonne was training for her first marathon and while running, she stepped in a hole and broke her ankle. She has been unable to keep up her training regimen and is very disappointed that she can't participate in the marathon. Lavonne has been indulging in her favorite foods to make herself feel a little better and has gained 18 pounds and her BMI is now 27.1. She's also discovered that as she gains weight, the weight seems to be settling in her middle as her waist circumference has increased by two full inches to 34"! Question 1: Define energy balance and explain Lavonne's weight gain in terms of factors affecting energy intake and all areas of energy expenditure.Match the condition with either high hematocrit or low hematocrit.
- CC: My blood sugars have not been very good lately. I’m doing everything I am supposed to be doing HPI: A 24-year-old male patient comes to your primary care clinic to establish care. He has type 1 diabetes mellitus diagnosed at age 11. He has not seen a provider in about 9 months. Currently, he is taking NPH insulin 30 units bid (8 a.m. and 6 p.m.) with 10 units Humalog before each meal. He does not take any other medications. He does not use tobacco products but does drink alcohol on the weekends. He reports checking blood glucose (BG) levels three to four times daily but did not bring his glucose log or meter. He reports his fasting blood sugar runs 150 to 190 and prandial glucose readings are 140- 250. He reports hypoglycemic episodes one to two times per week. He exercises intermittently but is not on a regular schedule. He does not eat on a regular schedule every day although he says he knows that he should. He works at a light-activity job 8 hours daily. Reports fatigue and…A 25 y/o pregnant female has been diagnosed with gestational diabetes. Her OB/GYN wants her to meet with this healthcare professional to help develop a diet plan to follow during her pregnancy.Jonathan. is a 4-year-old boy recently diagnosed with cow's milk allergy and has been recommended outpatient nutrition counseling. He is 39 inches tall and weighs 35 pounds. His diet contains limited sources of vitamin D. Food records completed by his mother reveal an average intake of 300 milligrams of calcium per day. He currently takes no medications or dietary supplements. Jonathan's mother states that she has substituted fruit juice with milk in Jonathan's diet because of the fear that "milk substitute" beverages may contain cow's milk.
- CASE #1. Alicia is 48 year old female of 76 kilograms and height of 161.5 centimetres. Although she attempted reduced weight, but she has gained instead 11.4 kilograms in the previous months. She also sleeps for 14-16 hours a day. Her movements were slothful, and she has slight enlargement of the neck area, coarse textured hair and dry skin. When her blood sample was analyzed it showed that the hormone T4 (thyroxin) levels were 3.2 micrograms/millilitre which is lower than the normal range, 4.2-11.2 micrograms/millilitre. In addition to this her TSH (thyroid stimulating hormone) levels were high. 1. List possible causes of this case.A 50 year old male is experiencing fatigue, dizziness, and headaches with a rapid decline in his visual acuity. He treats his hypertension and type 2 diabetes with medications. His brow and jaw are enlarged (proganthism), his hands and feet and fingers are wide. His wedding ring no longer fits on his finger. He is obese and has a deep voice. -His lab tests show high blood glucose, high GH, high IGF1, normal prolactin, and low testosterone.There was a pituitary mass seen on his CT scan. A CT scan in both the 50 year old man and a 14 year old girl show a pituitary mass. Why are their symptoms not similar? a.) One is producing GH, the other isnt b.) They are the same c.) They are of different ages d.) They are of different gendersKL is a 24-year-old female with diagnosis of obesity and asthma. She shows up today in primary care physician office for her annual physical exam. While you are getting her vitals and weight, KL tells you she has gained 10# in the last 2 months, and that she really wants to lose some weight. She is 5 feet 1 inch tall and weighs 235 pounds currently. You also got her measurement of waist circumference, which is 42 inches. KL mentions she read from the Internet that “The Rock” has a high BMI and is technically “obese”, and wonders if BMI is useful. She describes her typical day as below: she has a sedentary lifestyle and sits in front of a computer all day at work. She usually gets a quick breakfast from McDonald’s or Dunkin’ Donuts when she gets her morning coffee on the way to work, and then a quick lunch from one of the fast-food restaurants near work during her 30 minutes lunch break. She drinks bottled iced tea throughout the day because she doesn’t like the taste of tap water.…
