This patient has end stage liver disease due to chronic alcoholism. He has a history of gastrointestinal bleeding from esophageal varices. He was admitted with edema, ascites, and weight gain. His medications and conditions require careful management of nutrients. Tube feedings were started but caused intolerance, so a soft diet was ordered to prevent further bleeding. Nutrition interventions focus on managing malnutrition and gastrointestinal symptoms while supporting organ function and transition to an oral diet.
This patient was admitted with symptoms of nausea, vomiting, abdominal pain and black stools. He has a history of hypertension, gallbladder removal and GERD. Diagnosis includes GERD, GI bleeding and cirrhosis of the liver. A jejunostomy tube was placed for nutrition due to malabsorption from liver disease. The patient was started on TPN and stabilized. TPN was tapered and the patient advanced to a clear liquid diet and then oral diet as tolerated. He was discharged on a soft diet restricted to 2000ml fluids per day with sodium and protein recommendations.
This document provides information on chronic kidney disease (CKD) and its treatment with dialysis. It discusses the physiological functions of the kidneys, causes of CKD including diabetes, stages of CKD and associated signs/symptoms. It also describes different treatment options for stage 5 CKD including kidney transplantation and dialysis (hemodialysis and peritoneal dialysis). The document outlines components of Mrs. Joaquin's medical nutrition therapy and assesses her weight and calculates her edema-free weight.
This document discusses dietary guidelines for kidney health. It notes that kidneys play a key role in nutrient homeostasis and that loss of kidney function disrupts this. For chronic kidney disease (CKD) patients, guidelines recommend a daily protein intake of 0.6-0.8g/kg, limiting fat intake to 30% of calories, and restricting sodium and phosphorus intake. While protein restriction may slow CKD progression, large trials like MDRD found little overall benefit. A plant-based, low-protein diet that is low in phosphorus and sodium may be most suitable for CKD patients. Focusing on overall dietary patterns like the DASH diet may be more practical than individual nutrient restrictions.
This document discusses carbohydrate counting for managing diabetes. Carb counting involves following a meal plan that specifies grams of carbs per meal and snack, and using an insulin-to-carb ratio to determine insulin dosage. For those with type 1 diabetes, carb counting helps control blood sugar levels. Those with type 2 diabetes also need to count carbs to control portions and support weight loss through a balanced, limited sugar diet with regular physical activity. Common carb foods are listed along with serving size guidelines to estimate grams of carbohydrates from labels.
This document discusses medical nutrition therapy for diabetes, including nutrition assessment goals, recommendations, considerations for special populations like those who are overweight or have type 1, type 2, or gestational diabetes. It covers assessing nutrition needs, monitoring carbohydrates, meal planning strategies like portion control and carbohydrate counting, and basic follow-up nutrition advice and resources for patients. The conclusion questions if a perfect eating plan exists for diabetes management.
This patient was admitted with symptoms of nausea, vomiting, abdominal pain and black stools. He has a history of hypertension, gallbladder removal and GERD. Diagnosis includes GERD, GI bleeding and cirrhosis of the liver. A jejunostomy tube was placed for nutrition due to malabsorption from liver disease. The patient was started on TPN and stabilized. TPN was tapered and the patient advanced to a clear liquid diet and then oral diet as tolerated. He was discharged on a soft diet restricted to 2000ml fluids per day with sodium and protein recommendations.
This document provides information on chronic kidney disease (CKD) and its treatment with dialysis. It discusses the physiological functions of the kidneys, causes of CKD including diabetes, stages of CKD and associated signs/symptoms. It also describes different treatment options for stage 5 CKD including kidney transplantation and dialysis (hemodialysis and peritoneal dialysis). The document outlines components of Mrs. Joaquin's medical nutrition therapy and assesses her weight and calculates her edema-free weight.
This document discusses dietary guidelines for kidney health. It notes that kidneys play a key role in nutrient homeostasis and that loss of kidney function disrupts this. For chronic kidney disease (CKD) patients, guidelines recommend a daily protein intake of 0.6-0.8g/kg, limiting fat intake to 30% of calories, and restricting sodium and phosphorus intake. While protein restriction may slow CKD progression, large trials like MDRD found little overall benefit. A plant-based, low-protein diet that is low in phosphorus and sodium may be most suitable for CKD patients. Focusing on overall dietary patterns like the DASH diet may be more practical than individual nutrient restrictions.
This document discusses carbohydrate counting for managing diabetes. Carb counting involves following a meal plan that specifies grams of carbs per meal and snack, and using an insulin-to-carb ratio to determine insulin dosage. For those with type 1 diabetes, carb counting helps control blood sugar levels. Those with type 2 diabetes also need to count carbs to control portions and support weight loss through a balanced, limited sugar diet with regular physical activity. Common carb foods are listed along with serving size guidelines to estimate grams of carbohydrates from labels.
This document discusses medical nutrition therapy for diabetes, including nutrition assessment goals, recommendations, considerations for special populations like those who are overweight or have type 1, type 2, or gestational diabetes. It covers assessing nutrition needs, monitoring carbohydrates, meal planning strategies like portion control and carbohydrate counting, and basic follow-up nutrition advice and resources for patients. The conclusion questions if a perfect eating plan exists for diabetes management.
The document discusses medical nutrition therapy (MNT) for diabetes. It provides guidelines on who should receive MNT, how counseling should be conducted, and what messages to emphasize for MNT in barangay health stations. These include choosing foods from the plate method and using hand sizes as guides for portion control. The document also outlines goals and approaches for MNT, including setting behavioral goals, assessing patients' views on food and willingness to change, and enhancing adherence through mobile phone interventions.
http://www.our-diabetic-life.com Intake of large amount of carbohydrates can spike your blood glucose level. Right amount of carbohydrate can make your glucose level under control.
The patient has chronic kidney disease and is on hemodialysis 3 times per week. He has secondary hyperparathyroidism due to low calcium levels from his kidney disease. This causes overproduction of parathyroid hormone which can lead to bone and cardiovascular problems if not managed. The patient is at risk due to his low calcium levels. His secondary hyperparathyroidism is managed through a low phosphorus diet, phosphate binders, vitamin D, and potentially parathyroidectomy for severe cases. Controlling serum phosphorus and parathyroid hormone levels is important to prevent complications.
This document discusses cirrhosis of the liver and its dietary management. It begins with defining cirrhosis as a diffuse process characterized by liver necrosis, fibrosis and conversion of normal liver architecture into abnormal nodules. It then outlines the common causes of cirrhosis including chronic alcoholism, hepatitis B/C, autoimmune diseases and others. The document discusses the pathophysiology of cirrhosis and its clinical manifestations. It also covers nutritional assessment of patients with cirrhosis and recommendations for their dietary management including adequate caloric, protein and fiber intake as well as supplementation of vitamins, minerals and branched-chain amino acids.
This document provides information on a 40-year-old female patient admitted for J-tube placement due to severe protein-energy malnutrition. She has a complex surgical history including gastrectomy and small bowel resections which has resulted in nutritional deficiencies. Laboratory results show low albumin, prealbumin, calcium and magnesium levels indicative of her malnutrition. The patient is started on continuous tube feedings which are advanced gradually, however her blood sugars remain difficult to control when eating orally in addition to the tube feedings.
This presentation deals with the various approaches of medical nutrition therapy in Diabetes, comparison of the ADA, RSSDI and ICMR guidelines. It also talks about the various calorie counting apps as well.
This document summarizes medical nutrition therapy for chronic kidney disease and end-stage renal disease. It discusses the pathophysiology and stages of chronic kidney disease, complications that can arise at different levels of kidney function, and nutritional management strategies and guidelines for protein, fluid, electrolyte, and energy intake at various stages of kidney disease and on different types of dialysis.
Chapter 20 Nutrition and Diabetes Mellitus KellyGCDET
The document discusses diabetes mellitus, including types, symptoms, diagnosis, and treatment. It notes that 12.3% of US adults have diabetes, making it a leading cause of death. There are two main types - type 1 is caused by autoimmune destruction of insulin-producing cells, while type 2 involves insulin resistance and relative insulin deficiency. Treatment involves lifestyle changes like diet, exercise and medication or insulin therapy to control blood sugar and prevent complications affecting major organs. The goal is to maintain blood glucose levels in a target range through a combination of nutrition, medication, self-monitoring and medical care.
This document provides an overview of nutritional assessment. It discusses the goals of assessment as identifying malnutrition, obesity, and devising treatment plans. Assessment includes clinical history, physical exam, screening tools, anthropometrics, lab tests, and body composition analysis. Specific assessment measures are described in detail such as the subjective global assessment screening tool, body mass index, serum proteins, and creatinine tests. The document provides reference values and factors that influence various assessment markers.
The document discusses liver disease and nutrition. It begins by reviewing the functions of the liver and various liver diseases. It then discusses nutritional features of end-stage liver disease and nutritional assessment and management guidelines. Specific topics covered include neurological symptoms associated with liver disease, nutritional assessment tools for patients with end-stage liver disease, daily energy expenditure calculation methods, progression of liver disease, and ESPEN guidelines on enteral and parenteral nutrition for various liver diseases.
Mrs. Joaquin has stage 5 chronic kidney disease and is preparing for renal replacement therapy. Her GFR is 4, indicating severe loss of kidney function. She has several signs and symptoms of kidney disease including edema, anemia, and electrolyte imbalances. She will need to start hemodialysis or peritoneal dialysis to replace kidney function and improve her symptoms. Her medical nutrition therapy plan aims to control her intake of protein, sodium, potassium, phosphorus and fluids to manage her condition.
Chapter 22 Nutrition and Renal Diseases KellyGCDET
The document discusses various kidney diseases and conditions. It begins by describing the anatomy and functions of the kidney, including filtering waste from the blood and regulating fluid, electrolytes, and acid-base balance. It then covers specific conditions like nephrotic syndrome, acute kidney injury, chronic kidney disease, and kidney stones. For each, it discusses causes, consequences, diagnostic assessments, and treatment approaches including nutrition therapy. Nutrition interventions aim to address issues like fluid balance, electrolyte levels, protein-energy status, and dietary modifications for related diseases.
Medical Nutrition Therapy for Cardiovascular Diseases, Krause Book 14th editionBatoul Ghosn
Prepared from the chapter of MNT of CVD from Krause's book 14 the edition 2017 as well as some part from " Modern Nutrition in health and disease" 11th edition.
Applied nutrition 3 rd presentation - diseases of liver, gall bladder, and ...MD Specialclass
The document provides detailed information about diseases of the liver, gallbladder, and pancreas. It discusses the anatomy and functions of the liver, signs and symptoms of various hepatitis types, cirrhosis, and hepatic coma. It also covers cholecystitis, including causes, clinical manifestations, and dietary management for related conditions.
This document discusses medical nutrition therapy for diabetes mellitus using a case study. It provides an overview of diabetes, outlines the nutrition care process used for a patient with uncontrolled type 2 diabetes and a foot infection. Key interventions included education on carbohydrate counting and menu planning. Evaluation found improved intake and understanding of carbohydrate counting concepts. The summary emphasizes uncontrolled diabetes can lead to complications and the importance of nutrition therapy like carbohydrate counting to help manage blood glucose levels.
The document describes the Nutrition Care Process, which is a standardized process for providing nutrition care. It involves 5 steps: nutrition screening, assessment, diagnosis, intervention, and monitoring and evaluation. Nutrition screening is used to quickly identify patients at nutritional risk and determine if a full assessment is needed. Hospitals are required to conduct nutrition screening within 24 hours of admission according to Joint Commission standards. Nutrition assessments gather comprehensive dietary, medical, and social data on patients to identify nutrition problems. This leads to developing a nutrition diagnosis, then creating and implementing a nutrition intervention plan to address the problem. Progress is monitored and outcomes are evaluated.
This document discusses medical nutrition therapy for diabetes. It outlines the major components of diabetes treatment as management of diabetes through nutrition recommendations and interventions. It describes expected outcomes of medical nutrition therapy for diabetes such as reductions in A1C and LDL-C. The document discusses nutrition therapy strategies for type 1 and type 2 diabetes, including carbohydrate intake, fiber, sweeteners, and glycemic index. It provides guidelines on integrating insulin therapy with dietary and activity patterns and adjusting insulin doses based on carbohydrate intake.
The document discusses the importance of nutrition in diabetes management. It states that diabetes treatment involves controlling factors like diet, drugs, and daily activity. Proper nutrition therapy is an integral part of diabetes management. The document then compares the effects of high-carbohydrate and high-fat diets on various health markers in diabetics. It proceeds to describe Balance-D diabetes medical nutrition therapy, highlighting its balanced macronutrient profile, glycemic control benefits, improved compliance, and other advantages.
Cirrhosis is a chronic liver disease caused by conditions like alcoholism, hepatitis B and C, and fatty liver disease. It involves scarring and regeneration of the liver leading to loss of function. For patients with cirrhosis, dietary modifications are important and include a high protein, high carbohydrate diet with moderate or restricted fat intake providing 2000-2200 calories per day. The diet should also restrict sodium if ascites is present, provide adequate vitamins and minerals which may be malabsorbed, and restrict protein if hepatic encephalopathy is present.
Debate sobre el acuerdo final entre el gobierno y las farc. 2016Edgar Devia Góngora
El documento resume un debate sobre un acuerdo de paz entre el gobierno colombiano y las FARC que será votado el 2 de octubre de 2016. Propone estudiar el acuerdo en clases de ética y pensamiento cristiano para que los estudiantes puedan participar en el debate público y tomar una decisión informada, especialmente sobre temas como la teoría de género. Los dos temas principales del acuerdo son la suspensión de la guerra y las armas, y la adopción de un enfoque de género para lograr una sociedad más
Este documento presenta diferentes herramientas para explicar conceptos relacionados con el presupuesto como mapas mentales, mapas conceptuales, caligramas y acrósticos. Incluye información sobre el presupuesto de producción, presupuesto de ventas, entrada de caja, desembolso de efectivo y presupuesto de caja. Fue elaborado por tres estudiantes de la Universidad Fermín Toro para una cátedra de presupuesto.
The document discusses medical nutrition therapy (MNT) for diabetes. It provides guidelines on who should receive MNT, how counseling should be conducted, and what messages to emphasize for MNT in barangay health stations. These include choosing foods from the plate method and using hand sizes as guides for portion control. The document also outlines goals and approaches for MNT, including setting behavioral goals, assessing patients' views on food and willingness to change, and enhancing adherence through mobile phone interventions.
http://www.our-diabetic-life.com Intake of large amount of carbohydrates can spike your blood glucose level. Right amount of carbohydrate can make your glucose level under control.
The patient has chronic kidney disease and is on hemodialysis 3 times per week. He has secondary hyperparathyroidism due to low calcium levels from his kidney disease. This causes overproduction of parathyroid hormone which can lead to bone and cardiovascular problems if not managed. The patient is at risk due to his low calcium levels. His secondary hyperparathyroidism is managed through a low phosphorus diet, phosphate binders, vitamin D, and potentially parathyroidectomy for severe cases. Controlling serum phosphorus and parathyroid hormone levels is important to prevent complications.
This document discusses cirrhosis of the liver and its dietary management. It begins with defining cirrhosis as a diffuse process characterized by liver necrosis, fibrosis and conversion of normal liver architecture into abnormal nodules. It then outlines the common causes of cirrhosis including chronic alcoholism, hepatitis B/C, autoimmune diseases and others. The document discusses the pathophysiology of cirrhosis and its clinical manifestations. It also covers nutritional assessment of patients with cirrhosis and recommendations for their dietary management including adequate caloric, protein and fiber intake as well as supplementation of vitamins, minerals and branched-chain amino acids.
This document provides information on a 40-year-old female patient admitted for J-tube placement due to severe protein-energy malnutrition. She has a complex surgical history including gastrectomy and small bowel resections which has resulted in nutritional deficiencies. Laboratory results show low albumin, prealbumin, calcium and magnesium levels indicative of her malnutrition. The patient is started on continuous tube feedings which are advanced gradually, however her blood sugars remain difficult to control when eating orally in addition to the tube feedings.
This presentation deals with the various approaches of medical nutrition therapy in Diabetes, comparison of the ADA, RSSDI and ICMR guidelines. It also talks about the various calorie counting apps as well.
This document summarizes medical nutrition therapy for chronic kidney disease and end-stage renal disease. It discusses the pathophysiology and stages of chronic kidney disease, complications that can arise at different levels of kidney function, and nutritional management strategies and guidelines for protein, fluid, electrolyte, and energy intake at various stages of kidney disease and on different types of dialysis.
Chapter 20 Nutrition and Diabetes Mellitus KellyGCDET
The document discusses diabetes mellitus, including types, symptoms, diagnosis, and treatment. It notes that 12.3% of US adults have diabetes, making it a leading cause of death. There are two main types - type 1 is caused by autoimmune destruction of insulin-producing cells, while type 2 involves insulin resistance and relative insulin deficiency. Treatment involves lifestyle changes like diet, exercise and medication or insulin therapy to control blood sugar and prevent complications affecting major organs. The goal is to maintain blood glucose levels in a target range through a combination of nutrition, medication, self-monitoring and medical care.
This document provides an overview of nutritional assessment. It discusses the goals of assessment as identifying malnutrition, obesity, and devising treatment plans. Assessment includes clinical history, physical exam, screening tools, anthropometrics, lab tests, and body composition analysis. Specific assessment measures are described in detail such as the subjective global assessment screening tool, body mass index, serum proteins, and creatinine tests. The document provides reference values and factors that influence various assessment markers.
The document discusses liver disease and nutrition. It begins by reviewing the functions of the liver and various liver diseases. It then discusses nutritional features of end-stage liver disease and nutritional assessment and management guidelines. Specific topics covered include neurological symptoms associated with liver disease, nutritional assessment tools for patients with end-stage liver disease, daily energy expenditure calculation methods, progression of liver disease, and ESPEN guidelines on enteral and parenteral nutrition for various liver diseases.
Mrs. Joaquin has stage 5 chronic kidney disease and is preparing for renal replacement therapy. Her GFR is 4, indicating severe loss of kidney function. She has several signs and symptoms of kidney disease including edema, anemia, and electrolyte imbalances. She will need to start hemodialysis or peritoneal dialysis to replace kidney function and improve her symptoms. Her medical nutrition therapy plan aims to control her intake of protein, sodium, potassium, phosphorus and fluids to manage her condition.
Chapter 22 Nutrition and Renal Diseases KellyGCDET
The document discusses various kidney diseases and conditions. It begins by describing the anatomy and functions of the kidney, including filtering waste from the blood and regulating fluid, electrolytes, and acid-base balance. It then covers specific conditions like nephrotic syndrome, acute kidney injury, chronic kidney disease, and kidney stones. For each, it discusses causes, consequences, diagnostic assessments, and treatment approaches including nutrition therapy. Nutrition interventions aim to address issues like fluid balance, electrolyte levels, protein-energy status, and dietary modifications for related diseases.
Medical Nutrition Therapy for Cardiovascular Diseases, Krause Book 14th editionBatoul Ghosn
Prepared from the chapter of MNT of CVD from Krause's book 14 the edition 2017 as well as some part from " Modern Nutrition in health and disease" 11th edition.
Applied nutrition 3 rd presentation - diseases of liver, gall bladder, and ...MD Specialclass
The document provides detailed information about diseases of the liver, gallbladder, and pancreas. It discusses the anatomy and functions of the liver, signs and symptoms of various hepatitis types, cirrhosis, and hepatic coma. It also covers cholecystitis, including causes, clinical manifestations, and dietary management for related conditions.
This document discusses medical nutrition therapy for diabetes mellitus using a case study. It provides an overview of diabetes, outlines the nutrition care process used for a patient with uncontrolled type 2 diabetes and a foot infection. Key interventions included education on carbohydrate counting and menu planning. Evaluation found improved intake and understanding of carbohydrate counting concepts. The summary emphasizes uncontrolled diabetes can lead to complications and the importance of nutrition therapy like carbohydrate counting to help manage blood glucose levels.
The document describes the Nutrition Care Process, which is a standardized process for providing nutrition care. It involves 5 steps: nutrition screening, assessment, diagnosis, intervention, and monitoring and evaluation. Nutrition screening is used to quickly identify patients at nutritional risk and determine if a full assessment is needed. Hospitals are required to conduct nutrition screening within 24 hours of admission according to Joint Commission standards. Nutrition assessments gather comprehensive dietary, medical, and social data on patients to identify nutrition problems. This leads to developing a nutrition diagnosis, then creating and implementing a nutrition intervention plan to address the problem. Progress is monitored and outcomes are evaluated.
This document discusses medical nutrition therapy for diabetes. It outlines the major components of diabetes treatment as management of diabetes through nutrition recommendations and interventions. It describes expected outcomes of medical nutrition therapy for diabetes such as reductions in A1C and LDL-C. The document discusses nutrition therapy strategies for type 1 and type 2 diabetes, including carbohydrate intake, fiber, sweeteners, and glycemic index. It provides guidelines on integrating insulin therapy with dietary and activity patterns and adjusting insulin doses based on carbohydrate intake.
The document discusses the importance of nutrition in diabetes management. It states that diabetes treatment involves controlling factors like diet, drugs, and daily activity. Proper nutrition therapy is an integral part of diabetes management. The document then compares the effects of high-carbohydrate and high-fat diets on various health markers in diabetics. It proceeds to describe Balance-D diabetes medical nutrition therapy, highlighting its balanced macronutrient profile, glycemic control benefits, improved compliance, and other advantages.
Cirrhosis is a chronic liver disease caused by conditions like alcoholism, hepatitis B and C, and fatty liver disease. It involves scarring and regeneration of the liver leading to loss of function. For patients with cirrhosis, dietary modifications are important and include a high protein, high carbohydrate diet with moderate or restricted fat intake providing 2000-2200 calories per day. The diet should also restrict sodium if ascites is present, provide adequate vitamins and minerals which may be malabsorbed, and restrict protein if hepatic encephalopathy is present.
Debate sobre el acuerdo final entre el gobierno y las farc. 2016Edgar Devia Góngora
El documento resume un debate sobre un acuerdo de paz entre el gobierno colombiano y las FARC que será votado el 2 de octubre de 2016. Propone estudiar el acuerdo en clases de ética y pensamiento cristiano para que los estudiantes puedan participar en el debate público y tomar una decisión informada, especialmente sobre temas como la teoría de género. Los dos temas principales del acuerdo son la suspensión de la guerra y las armas, y la adopción de un enfoque de género para lograr una sociedad más
Este documento presenta diferentes herramientas para explicar conceptos relacionados con el presupuesto como mapas mentales, mapas conceptuales, caligramas y acrósticos. Incluye información sobre el presupuesto de producción, presupuesto de ventas, entrada de caja, desembolso de efectivo y presupuesto de caja. Fue elaborado por tres estudiantes de la Universidad Fermín Toro para una cátedra de presupuesto.
The document discusses improving student outcomes through data dashboards. It describes a Higher Education Compact in Greater Cleveland that uses data to track the educational journeys of Cleveland Metropolitan School District (CMSD) students. The Compact aims to increase CMSD student college readiness, access, and persistence. Student-level data is collected from 17 higher education institutions to identify factors impacting student success, such as high school GPA, ACT scores, and first semester college GPA. The Compact seeks to increase CMSD student graduation rates and prepare more students for college and careers.
The document discusses Michigan's efforts to streamline data usage across schools through the implementation of statewide data hubs. It outlines how the data hub solution is designed to integrate different education systems like student information, special education, food services, and transportation systems. The data hubs use the Ed-Fi open source framework and are being piloted in 5 regions. The goals are to eliminate redundant data entry, improve data accuracy, and provide a single source of actionable data and reporting. The timeline outlines a phased statewide rollout through 2016-2017 with all districts connected to their regional data hub and using state reporting capabilities.
RiseUp redefines the way parents & coaches interact and prepare, develop and promote our youth for tomorrow's challenges. With our innovative use of cognitive, semantic and web technologies we provide the best available tools for personal development, coaching and recruiting anywhere.
RiseUp is currently in the process of raising it's seed round to complete its product development, launch program and a series of field marketing events.
Este documento describe el juego heurístico, un tipo de actividad diseñada para niños de 1 a 2 años. Consiste en darles materiales cotidianos como corchos, pelotas o rollos de papel para que exploren y experimenten libremente. Tiene tres fases: preparación del espacio y materiales, juego sin interrupciones de los niños, y recogida final. El objetivo es que los niños descubran por sí mismos y desarrollen su concentración y habilidades motoras en un ambiente tranquilo.
Romania's success in software outsourcingComputaris
Romania ranks highly in Europe for IT specialists and engineers per capita. It has the fastest growing IT market in the EU, expected to reach EUR 4 billion by 2020. Romania is considered one of the top nearshore and offshore destinations for custom software outsourcing, offering competitive prices and high standards of professionalism across all subsectors of information and communications technology.
The document discusses nutrition and liver diseases, including fatty liver, hepatitis, and cirrhosis. It covers the following key points:
1) Fatty liver is caused by an accumulation of fat in the liver and affects 20% of the US adult population. It is often asymptomatic but can lead to inflammation and liver damage over time. Treatment focuses on eliminating the underlying cause like obesity.
2) Hepatitis is liver inflammation that can be caused by viruses, alcohol, drugs, or autoimmune disease. Viral hepatitis A-E are discussed along with their transmission routes. Symptoms range from mild to chronic liver damage.
3) Cirrhosis is an advanced scarring of the liver that impairs its
Culture Summit 2016 - How to Scale Culture with Janelle Gale, VP of HR at Fac...Culture Summit
Janelle Gale introduces herself as working in Facebook People & Culture. She outlines Facebook's mission to make the world more open and connected through sharing on its family of apps and technologies. She lists five principles that guide Facebook: building social value, moving fast, being bold, being open, and focusing on impact. The document also lists many employee resource groups at Facebook and emphasizes that the company is social and strengths-based, embracing innovation.
1. El documento describe las medidas de prevención de adicciones en el ámbito laboral, incluyendo la sensibilización, detección temprana, y limitación del acceso a sustancias adictivas.
2. Se enfatiza la coordinación entre empresas, sindicatos y el gobierno para desarrollar protocolos y apoyar a trabajadores con problemas de adicción.
3. Se resumen los datos clave de la encuesta Euskadi y Drogas 2012, mostrando descensos en el consumo de alcohol, tabaco y cannabis, especialmente entre
ClassMarker allows users to easily create online tests and assessments for free. It provides tools to embed tests on websites, send tests to groups, collect and analyze assessment data, and give students instant feedback and the ability to track their progress. Creating an account is simple and the dashboard makes it easy to view test results, edit questions, and have students print certificates of completion. The platform offers different types of customizable tests and assessments as well as options for assigning tests and providing feedback.
This career summary outlines the skills and experience of a resourceful administrative assistant seeking a suitable position. The individual has over 3 years of experience providing efficient administrative support and office management. Key skills include proficiency with MS Office, organization, multi-tasking, problem solving, and the ability to work well independently and as part of a team. Prior roles include time and attendance clerk, data entry, and accounts reconciliation. Formal education includes a diploma in electronics and computer training.
Top 10 security risks for mobile backend developersJiri Danihelka
The document outlines the top 10 security risks for mobile backend developers. These include: 1) SQL injection, 2) cross-site scripting and JavaScript injection, 3) broken authentication and session management, 4) insecure direct object references, 5) cross-site request forgery, 6) security misconfiguration, 7) insecure cryptographic storage, 8) failure to restrict URL access, 9) insufficient transport layer protection, and 10) unvalidated redirects and forwards. For each risk, the document provides recommendations on how to mitigate those risks.
This document provides an overview of studying animals, including vertebrates and invertebrates. It outlines that the key points to cover are the 5 groups that make up vertebrates, the main characteristics of each vertebrate group, what invertebrates are, naming the different invertebrate groups, and naming characteristics of mollusks and arthropods.
A 57-year-old male was admitted with nausea, vomiting and abdominal pain due to cirrhosis and bleeding esophageal varices. He has a history of alcoholism. Initial labs showed hyponatremia and low albumin. A jejunostomy tube was placed for nutrition but caused intolerance. He was started on TPN with Hepatamine which was later tapered as he transitioned to an oral soft diet.
Obesidad: nutrientes moduladores de neuropeptidos y neurotransmisoresNutriline SRL
This document discusses ketogenic enteral nutrition (KEN) as a treatment for obesity. It describes a study of over 19,000 obese patients who underwent 10-day cycles of receiving 50-65 grams of protein per day via continuous nasogastric tube infusion, without any carbohydrates. This protocol resulted in an average weight loss of 10.2 kg over 2.5 cycles, with 57% of the loss being fat mass. No significant adverse effects occurred. KEN is concluded to be a safe, fast, and inexpensive treatment that provides good long-term weight maintenance results.
This document presents a case study of a 41-year-old male patient (SW) with chronic kidney disease who is undergoing hemodialysis 3 times per week. It provides details on his medical history, social history, physical exam findings, laboratory values, current diet, and medication regimen. It finds that his current diet is low in calories and protein and high in phosphorus and potassium. It develops an intervention plan focused on increasing calorie intake, reducing phosphorus intake, and educating on limiting high potassium and phosphorus foods given his chronic kidney disease and medications. It discusses how the patient is at risk for secondary hyperparathyroidism due to low calcium levels and provides a recent literature reference on managing this condition in
Mrs. Douglas, a 76-year-old female, presented with shortness of breath, weakness, and fatigue. She has a history of type 2 diabetes, hypertension, obesity, and a previous myocardial infarction. Laboratory tests revealed abnormalities including high triglycerides, cholesterol, LDL, HbA1c, and low HDL. Her diet contains high sodium and added sugars from processed foods. The patient was diagnosed with congestive heart failure, diabetes, and obesity. She was prescribed a 1,500 calorie cardiac diet to manage her conditions.
This document provides a case study on a 41-year-old male patient with chronic kidney disease who is undergoing hemodialysis 3 times per week. It includes his medical history, social history, physical assessment, laboratory results, current diet, medication regimen, and recommendations for improving his diet. A registered dietitian provides an analysis of his current intake compared to goals, recommends an appropriate dietary pattern to meet his needs, and includes an ADIME note with interventions and monitoring plans.
The patient, a 57-year-old male with a history of alcoholism and cirrhosis, was admitted with upper GI bleeding and esophageal varices. He underwent placement of a surgical jejunostomy tube due to his bleeding varices. His condition deteriorated, requiring transfer to the ICU and initiation of TPN using Hepatamine to provide nutrition support and manage his liver disease. He was later transitioned to a clear liquid diet and discharged on a soft diet with fluid restrictions and electrolyte management.
This case study describes a 41-year-old male patient with chronic kidney disease who is undergoing hemodialysis treatment. His medical history, social history, physical exam findings, laboratory results, medications, and dietary intake are presented. The patient's lab results show abnormalities including high phosphorus and potassium levels. His current diet does not meet the nutritional recommendations for dialysis patients. The case study involves assessing the patient's diet, creating a sample meal plan meeting his needs, and addressing risks such as secondary hyperparathyroidism resulting from his chronic kidney disease.
This case study describes a 57-year-old male patient with a diagnosis of cirrhosis of the liver and a history of alcoholism, hypertension, and cholecystectomy. Laboratory tests show abnormalities indicative of liver disease including elevated creatinine, PTT, triglycerides, and cholesterol as well as low albumin, glucose, sodium, and chloride levels. After admission, the patient's weight increased to 194 pounds due to fluid accumulation in the abdomen. A jejunostomy tube was placed for nutrition due to risk of esophageal bleeding from varices and impaired nutrient absorption from liver disease. Tube feedings were later not well tolerated. The patient was started on TPN but concerns included potential edema and
In the changing scenario of pharmacy practice in India, for successful practice of
Hospital Pharmacy, the students are required to learn various skills like drug distribution,
drug dispensing, manufacturing of parenteral preparations, drug information, patient
counselling, and therapeutic drug monitoring for improved patient care
Nutritional management of renal diseasesWajid Rather
The document discusses the major roles of the kidney in metabolic regulation including water-electrolyte homeostasis, calcium-phosphate balance, waste product removal, acid-base balance, erythropoietin production, and blood pressure regulation. It then summarizes the goals of nutritional therapy in renal failure and discusses nutritional problems patients with renal failure often experience like anorexia and metabolic abnormalities. Guidelines for protein intake, energy intake, fluid intake, sodium intake, and potassium intake are provided for non-dialysis patients, patients undergoing hemodialysis, and patients undergoing peritoneal dialysis.
A 57-year-old male with a history of alcoholism and cirrhosis was admitted with upper GI bleeding and black stools. Evaluation found esophageal varices and laboratory abnormalities including low sodium and albumin. He was started on medications and tube feeding but developed intolerance. A TPN was started but also not well tolerated. He was placed on a soft diet low in sodium as he prepared for discharge with a diagnosis of chronic alcoholic cirrhosis and esophageal varices.
Nutrition therapy work shop dawly second part 2017FarragBahbah
This document provides information on nutrition for patients with chronic kidney disease (CKD) and those undergoing dialysis. It discusses recommendations for calories, protein, carbohydrates, fat, sodium, fluids, phosphorus, calcium, potassium and micronutrients. It notes that dialysis can impact nutrition by causing losses of certain nutrients and affecting appetite and food intake. Dietary goals for patients on dialysis include managing blood pressure and glucose as well as intake of minerals and fluids.
This document contains a case study and renal diet calculation for a patient with chronic kidney failure undergoing hemodialysis. It evaluates the patient's laboratory values compared to goals and assesses their current dietary intake. Recommendations are provided for calorie, protein, phosphorus, potassium, sodium and fluid intake. A sample one-day renal diet is created meeting the recommendations. Two PES statements are written, one in the clinical domain addressing altered laboratory values and one in the behavioral domain addressing undesirable food choices. Interventions, monitoring and evaluations are proposed for each.
This document discusses nutrition and fasting in chronic liver disease. It outlines several metabolic changes that occur in chronic liver disease, including decreased glycogen stores and glucose intolerance. It provides general nutrition guidelines for patients with liver disease, recommending adequate calories, proteins, vitamins and minerals. It discusses the benefits of fasting, including detoxification, reduced inflammation, blood sugar and weight loss. However, it notes fasting can worsen conditions in some patients and is not advised for all cases of liver disease.
This document provides a case study presentation on Anorexia Nervosa. It outlines the diagnostic criteria for Anorexia Nervosa and describes the physical findings, prognosis, and care team involved in treatment. It then provides details of a specific 25-year-old female patient's history, including her medical history, social history, laboratory results, nutrition interventions and monitoring over time. The summary highlights the patient's low weight and BMI, medical complications including infections and renal failure, and challenges with refeeding and following the treatment plan.
This document provides guidance on calculating nutritional requirements and formulations for enteral and parenteral nutrition. It discusses factors to consider such as a patient's caloric needs, protein and fluid requirements, and osmolality of formulas. Commercial formulas are available for enteral or parenteral use, and can be modified as needed to meet a specific patient's nutritional needs. Proper administration of enteral and parenteral nutrition requires calculating appropriate formula volume, infusion rates, and timing of delivery.
This document provides information on cystic fibrosis including signs and symptoms, nutrition implications, and treatment. It then presents a case study on a 9.8 month old female patient with CF who was admitted for metabolic insufficiencies. Initial assessment found the patient was underweight. Recommendations included increasing formula intake and supplements. Follow up found weight gain and increased intake meeting goals. Further advancement of formula was recommended.
This document provides recommendations for seasonings to use with different vegetables and meats. It suggests herbs and spices that complement the flavors of various foods like asparagus, broccoli, brussel sprouts, cabbage, carrots, cauliflower, corn, eggplant, green beans, mushrooms, peas, potatoes, sweet potatoes, tomatoes, and winter squash. For meats, it lists herbs that work well with beef, eggs, fish, lamb, and poultry. The document also includes some helpful hints for grocery shopping such as making a list before shopping, checking expiration dates, watching for specials on seafood and meat, avoiding dented cans, and checking for cracks in egg cartons.
The document provides recipes for several salads and main dishes:
1) Egg salad, chicken salad, and tuna salad recipes that include chopped hard boiled eggs, chicken or tuna mixed with yogurt and mustard.
2) A chicken with green peppers recipe that involves baking chicken breasts with soy sauce and peppers.
3) A honey-mustard garlic chicken recipe that coats chicken breasts with a honey and mustard mixture before baking.
4) A chicken pesto pasta recipe that involves making a basil pesto sauce to toss with cooked pasta and sautéed chicken strips.
The student completed a counseling practicum at the KANC where she was able to apply what she learned in classes and gain experience. She enjoyed sharing basic nutrition information with community members in Healthy You classes and observing different counseling styles. The variety of clients seen, from those with pre-diabetes to athletes, provided a unique learning experience. A favorite opportunity was researching and creating a meal plan independently for a client with Huntington's disease. The practicum was a valuable learning experience that reinforced the student's passion for community nutrition and teaching others.
POSTER Influence of breastfeeding on infant allergy development (1)Marissa Uhlhorn
This document discusses the influence of breastfeeding on infant allergy development. It finds that exclusive breastfeeding for 6 months reduces the risk of food allergies, as components in breast milk like antibodies and cytokines provide immunoprotection. The duration of breastfeeding is positively correlated with decreased allergy development, up to at least 6 months of exclusive breastfeeding and 1 year of any breastfeeding. Maternal diet and nutrition, family history, and environmental factors can also impact the protective effects received through breastfeeding.
Post-survey
(Appendix 2)
will be given
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using the
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assess
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Marissa Uhlhorn wrote a case study on celiac disease. The patient, BR, has symptoms including diarrhea, abdominal pain, weight loss, and an itchy rash. Testing showed BR has antibodies associated with celiac disease and biopsy showed damage to the small intestine. A nutrition assessment found BR was consuming gluten and may be lactose intolerant. The assessment recommends a gluten-free diet to address malnutrition from malabsorption and weight loss. Interventions include education on a gluten-free diet and monitoring symptoms, weight, and lab values.
The document summarizes a consumer news article and primary research journal article on the relationship between human milk oligosaccharides (HMOs) found in breast milk and infant body composition. The consumer article provided a brief overview of a study that found associations between specific HMOs and increased or decreased infant fat mass at 6 months. The journal article described a study that analyzed breast milk from 37 mothers and found that higher levels of certain HMOs correlated with lower infant weight and fat mass, while others correlated with higher fat mass. The implications are that nutrition professionals may educate mothers on HMO sources, and consumers may be intrigued but find the information inconclusive due to need for more research.
1. Marissa Uhlhorn
End Stage Liver Disease with GERD and Bleeding Esophageal Varices
FSHN 450
Fall 2015
Due Date: November 6, 2015
I have not given or received any unauthorized assistance on this assignment
_______________________________________________________
2. End Stage Liver Disease with GERD and Bleeding Esophageal Varices
FSHN 450
Fall 2015
Due Date: November 6, 2015
What was the cause of the weight gain?
The cause of the patient's weight gain is most likely due to edema, which is from water retention
and swelling of extremities. This is indicative of his low serum albumin levels. He was also
admitted with ascites as seen with fluid accumulation in his abdomen.
His weight gain could also be attributed to the diet he consumes. A large number of calories come
from his 7 shots of bourbon and 6 cans of beer he is consuming each day. This patient also
consumes highly processed foods, which typically are high in saturated fats and sodium.
What is the purpose of each of the patient’s medications? List any important drug/nutrient
interactions.
TUMS
o Purpose: Antacid, phosphate binder, antidiarrheal
o Diet: insure adequate fluid intake/hydration, take separately from large amounts of high
fiber, high oxalate or high phytate foods
Zantac
o Purpose: Antiulcer, anti-GERD, antisecretory
o Nutrient interaction: decreased FE & Vit B12 absorption, Mg or Al/Mg antacids
decreased drug absorption
Lisinopril
o Purpose: Antihypertensive, CHF treatment, post MI treatment
o Nutrient interaction: insure adequate fluid intake, decreased Na and cal may be
recommended. Caution with K supplements, avoid natural licorice, decreased weight
reported (anorexia)
Lactulose
o Purpose: laxative to treat increased ammonia levels
o Nutrient interactions: High fiber (with 1500-2000 ml fluid/day) to prevent constipation,
not with lactose or galactose restricted diet. Do not take concomitantly with antacids, Ca
or Mg supplements. Drug increased absorption of Ca & Mg
Octreotide
o Purpose: Antidiarrheal, also used for acute bleeding esophageal varices treatment
o Nutrient Interactions: May cause fat and fat-soluble vitamin malabsorption and delay
gastric emptying. Alters insulin, growth hormone, thyroid hormone and glucagon levels
Vitamin K
o Purpose: Treat hypoprothrobinemia and increase blood clotting
o Nutrient Interactions: Maintain consistent Vit K intake if taking anticoagulant, adequate
intake for males: 120 micrograms/day, no documented toxicity.
3. Compazine
o Purpose: Antipyschotic, antiemetic, antianxiety
o Nutrient interactions: limit caffeine, increased appetite, increased weight, and increased
need for Rib. May decrease absorption of Vit B12.
Morphine
o Purpose: Analgesic, narcotic, opioid
o Nutrient interactions: anorexia (decreased weight), increased thirst, dehydration
Albumin iv
o Purpose: Can be used to treat edema, hypovolemia, hypoalbuminemia in critically ill or
bleeding patients
Furosamide iv
o Purpose: Antihypertensive and diuretic.
o Nutrient interaction: May deplete potassium levels, can lead to anorexia and increased
thirst.
Why was a surgical jejeunostomy tube placed?
Due to the patient's history of alcoholism, his intestinal mucosa is most likely severely damaged.
This would impair digestion and absorption of nutrients, resulting in malnutrition. He would also
most likely have B1 deficiency and poor iron and folate absorption. In addition, the cirrhosis has
caused esophageal varicies causing esophageal veins to bleed easily and become swollen or weak.
Because of all of these severe factors, the patient needs a surgical jejeunostomy tube so that he
can properly absorb nutrients and avoid further malnutrition.
Evaluate the patient’s nutrient needs and prescribe a tube feeding including type and
brand name, total volume and rate. Include a start rate and progression. Include ONLY
the Assessment section of the ADIME at this point.
Energy Needs: 30-35 kcal/kg BW/day
30-35 kcal * 88.2 kg= 2,646- 3,087 kcal/kg BW/day
Fat: Moderate- as tolerated: 25-35-en%
RANGE:
0.25*2,646= 661.5kcal/9g=73.5 g fat/day
0.25 * 3,087=771.8kcal/9g=85.8 g fat/day
0.35*2,646=926.1 kcal/9g=102.9 g fat/day
0.35* 3,087=1,080.5kcal/9g= 120.0 g fat/day
4. Protein Needs (clinically stable): 1.0-1.2 g/Kg BW/day
1.0-1.2g * 88.2 kg= 88.2-105.8 g/Kg BW/day
Other Vitamins/Minerals:
B12, B6, Niacin, Folic Acid for alcoholism
Iron with anemia??
Zinc and Magnesium for alcoholism
Nutrihep
1.5 kcal/ml
Total volume: 2,646-3,087kcal/1.5= 1,764 ml-2,058ml
Rate: 1,764ml-2,058ml/24 hr= 73.5ml/hr-85.8ml/hr
Start Rate: ¼ goal rate: 73.5ml/hr-85.8ml/hr *0.25=18.4 ml/hr-21.45ml/hr
Progression: Advance by 20 ml every 8-12 hrs until final volume is reached.
Assessment:
Current diagnosis: Upper GI Bleed, Cirrhosis
• Anthropometrics
◦ 57 year old male
◦ 5' 7”, 194 # (BMI: 30.4- obese)- gained 4 pounds in past 11 days
◦ BP 128/80- slightly high
◦ Pulse 90-normal
◦ RR 16- higher end of normal
◦ Temp 98.9- normal
Biochemical Indicators
◦ Na (low), Cl (low), CO2 (low), Creatinine (high), PTT (high), Hgb (low), Hct (low),
Albumin (low), TG (high), Total Cholesterol (high risk)
• Physical
◦ N&V
◦ Abdominal pain radiating to Rt side
◦ Presented with scleral icterus (possible jaundice)
◦ Increased abdominal girth
◦ Ascites- accumulation of fluid causing abdominal swelling
◦ Black stools
◦ Gained 4 pounds in 11 days (upon next visit)
• Medical History
◦ Hypertension
◦ Cholecystectomy
◦ Alcoholism
◦ Medications at home: TUMS, Zantac, Lisinopril
5. • Hospital medications: Lactulose, Octreotide, Vitamin K, Compazine, Morphine, albumin
iv, furosamide iv
• Social/Family History
◦ Divorced for 15 years.
◦ Mother living but father died at age 65 from CHF
◦ Living siblings: Brother 53 has atherosclerotic heart disease
▪ Brother 40 and sister 46 in apparent good health
▪ Sister age 48 is obese
• Diet History
◦ High calories coming from 7 shots of bourbon/day and 6 beers/day
◦ High calories, saturated fats, and sodium coming from processed foods (hot dog,
chips, condiments, pasta/macaroni and cheese
◦ Low intake (if at all) of fruits and vegetables
◦ Low protein consumption
List the probable reasons for the tube feeding intolerance in this patient?
Tube feeding intolerance is seen in this patient due to the damage of the intestinal mucosa, which
includes the jejunum. This could result in the patient’s malabsorption of key nutrients and overall
calorie consumption.
You do not need to calculate a TPN but you should reevaluate protein and Kcal needs.
This patient is most likely grade 3 of hepatic encephalopathy (due to being disoriented to
time/place, mild asterixis and edema), therefore his energy and protein needs must be adjusted.
Energy Needs: still 30-35kcal/kg BW/day
30-35 kcal * 88.2 kg= 2,646- 3,087 kcal/kg BW/day
Protein Needs: Grade 3 requires 0.5 g/kg for 2-3 day and increase by 0.25 g/kg
0.5g * 88.2 kg= 44.1 g/kg BW/day (for 2-3 days) than increase to 0.75 g * 88.2 kg= 66.15 g/kg
Why was Hepatamine® ordered and what at is the drawback to using this product?
This is given to patients with hepatic encephalopathy and cirrhosis. It also provides additional
nutrition support. A possible drawback would be that it may cause hyperglycemia which may
require insulin injections.
Why was a soft diet ordered?
A soft diet is recommended to avoid bleeding of the varicose veins. This would occur due to the
inability of the veins in the esophagus to drain, resulting in bulges that may tear or burst.
Conduct a follow-up nutrition assessment and report in ADIME format for transition to
6. oral diet (on 7/11) Develop three PES statements, one in each domain and plan an
itervention and follow-up for each nutrition diagnosis.
7/1 Laboratory
Na 122 mEq/L
K 4.1 mEq/L
Cl 98 mEq/L
CO2 10 mmol/L
Glu 93 mg/dl
BUN 18 mg/dl
Creat 1.6 mg/dl
PTT 43.1 seconds (reference: 23.7 - 32.7 seconds)
RBC 2.88 x106
/mm3
Hgb 9.1 g/dl
Hct 26.9 %
Albumin 2.6 g/dl
Assessment:
Admittance diagnosis: Upper GI Bleed, Cirrhosis
• Anthropometric:
◦ 57 year old male
◦ Previous visit (6/17) vitals:
▪ 5' 7”, 194 # (BMI: 30.4- obese)
▪ BP 128/80- slightly high
▪ Pulse 90-normal
▪ RR 16- higher end of normal
▪ Temp 98.9- normal
*No recorded 7/1 or 7/11 vitals
Biochemical Indicators
(7/1): Na (low), CO2 (low), Creatinine (high), PTT (high), Hgb (low), Hct (low), Albumin (low).
• Physical
◦ Stabilized
◦ Diagnosis: Chronic alcoholic cirrhosis with stable encephalopathy and esophageal
varices.
• Medical History
◦ Hypertension
◦ Cholecystectomy
◦ Alcoholism
◦ Medications at home: TUMS, Zantac, Lisinopril
• Hospital medications: Lactulose, Octreotide, Vitamin K, Compazine, Morphine, albumin
iv, furosamide iv
• (7/1): Tri-luminal catheter, TPN with Hepatamine® (limit 1500 ml).
• Social/Family History
◦ Divorced for 15 years.
◦ Mother living but father died at age 65 from CHF
7. ◦ Living siblings: Brother 53 has atherosclerotic heart disease
▪ Brother 40 and sister 46 in apparent good health
▪ Sister age 48 is obese
• Previous diet history
◦ 6/17:
▪ High calories coming from 7 shots of bourbon/day and 6 beers/day
▪ High calories, saturated fats, and sodium coming from processed foods (hot dog,
chips, condiments, pasta/macaroni and cheese
▪ Low intake (if at all) of fruits and vegetables
▪ Low protein consumption
◦ 7/1:
▪ Tri-luminal catheter, TPN with Hepatamine® (limit 1500 ml).
◦ 7/11- diet prescription:
▪ TPN tapered and patient diet order changed to clear liquid progressing to oral diet
as tolerated. Fluid restricted to 2000 ml/day, 2300 mg sodium, soft diet.
Diagnosis:
1) Intake Domain: Malnutrition R/T diagnosis of chronic alcoholic cirrhosis AEB increased
creatinine and albumin levels (on 7/1) and previous TPN administration
Intervention:
• Discuss with the patient the importance of a balanced diet (once tolerated)
• Educate the patient about the harmful effects of alcoholism on his body
• Have the client come up with healthy foods to incorporate into his day
• Encourage the client to keep a food/fluid record for future analysis
Follow-up:
• Analyze the patient's food and fluid record (see if it meets the fluid and sodium
recommendations)
• Monitor creatinine levels
• Assess patient's tolerance to transition to soft oral diet
2) Clinical Domain: Altered GI function R/T diagnosis of chronic alcoholic cirrhosis AEB
increased abdominal girth secondary to ascites.
Intervention:
• Encourage client to decrease alcohol consumption (or quit all together)
• Encourage client to consume a balanced diet (as tolerated) and to keep a
food/fluid diary
8. • Encourage client eat smaller more frequent meals to avoid further symptoms of
GERD.
Follow-up:
• Assess the client’s compliance to decreasing/quitting alcohol consumption
• Analyze food and fluid diary
• Monitor lab values of concern: (7/1): Na (low), CO2 (low), Creatinine (high), PTT
(high), Hgb (low), Hct (low), Albumin (low).
3) Behavioral Domain: Undesirable food choices R/T excessive alcohol consumption,
sodium, and fat intake AEB dietary recall provided in admittance.
Intervention:
• Educate client about the effects of alcoholism
• Encourage client to come up with healthy meal/snack choices
• Assess the client’s ability to cook and give ideas of unprocessed meals to make
• Encourage activities/hobbies to take the place of drinking during the day
Follow-up:
• Assess the client’s compliance in decreasing/quitting excessive alcohol
consumption
• Assess the client’s progress in making healthier unprocessed meals
• Assess the client’s knowledge about healthy food options to consume
• Assess the client’s progress in choosing activities to prevent excess alcohol
consumption.