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Concept explainers
To discuss:
The possible hindrance like Ms. J’s weight, history of non-adherence and past visit to emergency department will affect the treatment, the biases that affect while providing treatment, and the self-awareness to reduce the effect of bias on the quality of care provided to Ms. J.
Case summary:
Ms. J is a 44-year-old overweight insulin dependent, who is homeless due to the downsizing of her company. She stays in various family members and friends house. She works in a part-time and unable to find a fulltime job. She came to the emergency department with the blood sugar of 322 and hemoglobin of A1C of 11%. Ms. J is assigned to a nursing student S to take care of her. S finds out that Ms. J is constantly admitted in the hospital due to diabetes management. S also finds out that she cannot afford medication due to unemployment. When S inquires about Ms. J., she says in fear that she will die due to diabetes since her mother also died with diabetes. S clarifies her, that the regular management of diabetes will not kill people. S also finds Ms. J a social worker who could find her a community health center nearer her home who support her with her diabetes, S asks the social worker to find employment resources for Ms. J so that she can manage her diabetes and find a healthy living.
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Chapter 9 Solutions
Fundamentals of Nursing, 9e
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- Module 4 - Interpreting Labs.pd X CB CastleBranch Login Merged-TDL-Files--2024103012280X pl Dietetic Practitic 6uo8tbjf.cloudfront.net/68f85c32-16e5-11ef-925e-aaa4f1cd8999?response-content-disposition-inline DaVita Dietitian Reference Manual - + 90% Module 4-Evaluating Laboratory Values Case 3 Ray dialyzes three times a week on 2 K+ bath. His appetite is fair and he takes ReGen (4 oz. TID) to supplement his intake. His medications include: Nephrovite RX, PhosLo (1 at breakfast, 1 at lunch, 2 at supper) Prilosec, Imdur, Zemplar and Epogen. He says he's been feeling weak and tired and has SOB (shortness of breath). He reports having diarrhea for 2 days. His blood pressure is low Date PreBUN PostBUN URR KUV Creat Alb CO2 K+ Ca PO4 PTH- Hgb intact 5.3 9.0 4.9 160 11.5 5.4 8.9 5.4 6.5 9.3 6.1 01/01 02/01 03/01 37 8 40 9 104 missed 78% 1.6 7.7 3.2 25 78% 1.6 3.5 22 3.0 21 7.5 7.6 10.8 8.4 What do you suspect is the reason for his change in lab values? Case 4 Margaret is a 78-year-old woman…arrow_forwardModule 4 - Interpreting Labs.pd X CB CastleBranch Login Merged-TDL-Files--2024103012280X 1k6uo8tbjf.cloudfront.net/68f85c32-16e5-11ef-925e-aaa4f1cd8999?response-content-disposition=inline DaVita Dietitian Reference Manual + 90% Module 4-Evaluating Laboratory Values CASE STUDIES Case 1 Steve has been on hemodialysis for 3 years. His medications include Nephrocaps, PhosLo (3 at breakfast, 2 at lunch, 3 at supper), Lisinopril, EPO and Venofer. Patient reports he has had the flu and not eaten much for the past 4-5 days, but has continued to take all medications as prescribed. Date PreBUN PostBUN URR KWV Creat Alb CO2 K+ Ca PO4 PTH- Hgb intact 12/01 54 01/02 55 02/02 40 18 17 12 68% 1.33 12.3 3.9 24 4.7 11.0 5.9 69% 1.39 12.2 4.0 23 4.8 11.0 5.2 70% 1.45 12.5 4.0 26 4.1 12.5 4.5 96 12.3 12.1 11.9 What are possible reasons for increasing hypercalcemia in February? Case 2 Barb has been on hemodialysis for 1½ years. She has diabetes, but is not currently taking an antiglycemic agent.…arrow_forwardzm Module 4 - Interpreting Labs.pd X CB CastleBranch Login X Merged-TDL-Files--2024103012280X marks Tools Window Help 100% E pl Dietetic Practitioners s://d3da1k6uo8tbjf.cloudfront.net/68f85c32-16e5-11ef-925e-aaa4f1cd8999?response-content-disposition=inline + 90% DaVita Dietitian Reference Manual Module 4-Evaluating Laboratory Values REVIEW QUESTIONS 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. True False A patient who has a low bicarbonate level will also have a low potassium level. Causes of low albumin include low protein intake, infection, proteinuria and severe liver disease. Inaccurate handling of the blood specimen can result in a falsely low PTH. In a patient on hemodialysis, a potassium level of 6.0 is acceptable. An excessive intake of meat will result in higher levels of BUN, phosphorus and potassium. In a patient without kidney function, hyperglycemia will be accompanied by hypokalemia. A patient with access problems is likely to have increased levels of potassium, BUN, creatinine…arrow_forward
- Tools Window Help zm Module 4 - Interpreting Labs.pd X CB CastleBranch Login x Merged-TDL-Files--2024103012280X pl Dietetic Prac Halk6uo8tbjf.cloudfront.net/68f85c32-16e5-11ef-925e-aaa4f1cd8999?response-content-disposition=inlin - + 90% CASE STUDIES-DISCUSSION Case 1 His lower BUN, K+ and phosphorus are consistent with his reported decrease in intake due to the flu. His high calcium level is a consequence of taking his prescribed amount of PhosLo while eating less food. Thus, he absorbed more calcium from his phosphate binder. In this patient, with adynamic bone disease (low PTH without IV vitamin D therapy), he is unable to deposit calcium in his bones, so serum level rose quickly. PhosLo was held and the next week his calcium was 11.0 and phosphorus 5.8. Other possibilities for a rise in calcium might be that patient took Tums (or another calcium-containing antacid) because of the flu or heartburn; took phosphate binders between meals rather than with meals; was consuming…arrow_forwardlast two please (3 and 4)arrow_forward08tbjf.cloudfront.net/68f85c32-16e5-11ef-925e-aaa4f1cd8999?response-content-disposition=inline DaVita Dietitian Reference Manual + 90% Module 4-Evaluating Laboratory Values DISCUSSION QUESTIONS 1. Why is hyperkalemia dangerous? 2. What are 3 possible causes of hyperkalemia? 3. How is hyperkalemia managed? 4. What are 3 reasons for hypoalbuminemia in hemodialysis patients? 5. What are the side effects of hypoalbuminemia? 6. What are 3 possible reasons for a patient to have a low BUN? A high BUN? FEB 5 tv MacBook Airarrow_forward
- As nursing students dealing with school age patients with anxiety or fear related to hospitalisation, identify relevant and credible resources and explains their significance.arrow_forwardDescribe which of the 4 biomolecules could be used as a source of carbon and energy in a microbial growth media?arrow_forwardHow to teach mock dialysis (HD) patients how to decrease phosphorus on his/her dietarrow_forward
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