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Case 3
Case 3
Case 3
Case 3
Case 3
Case 3
Case 3
Case 3
Case 3
Case 3
Case 3
Case 3
Case 3
Case 3
Case 3
Case 3
Case 3
Case 3
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Case 3

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  • -Family history is unknown-People exposed to ionizing radiation have increased risk of brain tumors-We do not know his employment history but people working in certain industries have increased risk; including: agriculture, electrical, health care, and oil refineries-Age: the majority of brain tumors occur in people 45 and older-brain tumors more common in white people than other races
  • -Occur in hospitals or other health care settings, such as nursing homes and dialysis centers-It is known health care-associated MRSA or HA-MRSA
  • -Acute kidney failure is common in people that are already hospitalized, particularly those in intensive care
  • Cannot tell whether blood potassium is high because it is removed during the dialysisThere is no indication of urine output amount
  • Transcript

    • 1. Case 3 <br />60 year old male<br />Caucasian<br />Presents with:<br />Low grade fever (99.8)<br />Mild low back pain<br />Extremity weakness<br />Has been on steroids & antibiotics<br />Not a surgical candidate<br />Has borderline lung function<br />
    • 2.
    • 3.
    • 4. Atherosclerosis<br />Less <br />No constriction<br />More permeable<br />
    • 5.
    • 6. HTN<br />Atherosclerosis<br />MI<br />Stroke<br />
    • 7. MRSA<br />Metastases<br />
    • 8. MRSA: Methicillin-resistant Staphylococcus aureus<br />
    • 9.
    • 10. Pulmonaryedema<br />
    • 11.
    • 12.
    • 13. Corticosteroids<br />Include prednisone & cortisone<br />Anti-inflammatory medication<br />Used to treat diseases such as asthma, eczema, allergies, arthritis, colitis, and kidney disease, IBD, lupus, and MS<br />Intended use for 1 to 2 weeks<br />
    • 14. Long-term Use of Corticosteroids<br />Cataracts<br />Inc. blood sugar<br />Inc. risk of infections<br />Calcium loss from bones<br />Suppressed adrenal gland hormone production<br />Easy bruising & slower wound healing<br />Weight gain<br />Stomach ulcers<br /><ul><li>Not recommended with active infection</li></li></ul><li>Temador<br />Anti-cancer chemotherapy drug <br />For treatment of anaplasticastrocytoma and glioblastomamultiforme (GBM) brain tumors<br />Low blood counts may occur:<br />White & red blood cells and platelets may temporarily decrease<br />This may increase risk for infection, anemia, and bleeding<br />
    • 15. Delayed Effects of Temodar<br />Swelling/edema<br />Central neurotoxicity<br />Diarrhea<br />Weakness<br />Skin rash<br />Itching<br />
    • 16. Diet Prescription<br />It is recommended that you supply 45-55 kcal per kg BW to avoid catabolism<br />45*97 kg= 4,300 kcals<br />Patient is obese so with this consideration<br />Mifflin St. Jeor equation= 1,800 kcals<br />Recommended that patient receive ~ 3000 kcals per day<br />
    • 17. Diet Prescription<br />Protein is a main focus: 0.55 g/kg<br />0.55 (97kg)= 53 grams per day<br />Fluid needs based on urine output<br />Want to watch BUN, creatinine, and electrolyte levels<br />

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