Professional Documents
Culture Documents
o Pathophysiology: Likelihood of developing sepsis is higher for individuals who are alcoholics [2]
o Inferred lung tissue is being exposed to oxidative damage
o Glutathione concentrations in epithelial lining fluid decreases
o Etiology: Unclear
Disease Background: Pneumonia of Both
Upper Lobes
o Pathophysiology: Common lung infection caused by germs, such as bacteria, viruses, and fungi
o Etiology: Infectious organism
o Community acquired pneumonia can be the leading cause for respiratory failure [2]
o Pneumonia or sepsis?
Disease Background: Treatment of
Respiratory Failure
o Supplement with oxygen
o Medications for the infections causing acute failure
o Antibiotics or bronchodilators
o Little information on nutrition treatment and interventions for respiratory failure [6]
o Decrease risk for aspiration
o Glycemic control
o Hydration [11]
o Pharmacological Interventions
Disease Background: Prognosis
o Poor
o Noncompliance to previous medical advice
o Worsening receptiveness to treatments
o Lack of ability to stay off the ventilator
o Ineffective interventions
o Feeding tolerance
o Bowel movements
o Mental status
Current Admission
DIAGNOSIS o Patient transported via ambulance
o Admitted with worsening shortness of breath in
Chronic hepatitis combination of cough with sputum
Acute respiratory failure with hypoxia o Unable to talk but could shake head
o 3/23 Nuclear medicine gastric emptying o 4/4 Single view abdominal KUB
study o Unremarkable bowel gas pattern
o Small calcification/calculi right upper quadrant
o Severely delayed gastric emptying consistent cholelithiasis
o NG tube extending to the gastric antral level
o 4/2 Renal Ultrasound o No bowel intramural gas evident
o Acute kidney injury
o3/30, 3/31, 4/1, 4/2, 4/3, 4/4, 4/5 AP portable
o 4/4 CT head w/o contrast chest
o Endotracheal tube NG tube and right IJ central
o No acute intracranial abnormality venous catheter remain in place
o Heart size is normal
o No change in bilateral airspace disease with
effusions
Current Admission
TREATMENTS, INCLUDING MEDICAL, SURGICAL, THERAPIES
norepinephrine (LEVOPHED) In dextrose solution so provides extra calories and may effect blood sugar levels.
PRN Medications
albuterol (PROVENTIL) N/A
Nutrition Care Process
NUTRITION ASSESSMENT ANTHROPOMETRICS
Process Sodium 131 (L) 132 (L) 133(L) 135(L) 137 138 140 142
Carbon Dioxide 27 27 25 24 21 21 22 23
BIOCHEMICAL LABS
Calcium 8.3 8.4 8.3 8.4 8.6 8.3 8.4 8.6
Anion Gap 12
Albumin 2.5 (L) 2.1 (L) 1.9 (L) 2.0 (L) 1.8 (L) 1.8 (L) 2.1 (L)
Total Protein 5.3 (L) 5.4 (L) 5.4 (L) 5.8 (L) 5.4 (L) 5.4 (L) 5.6 (L)
SGOT-AST 28 25 26 24 23 26 25
SGPT-ALT 13 (L) 12 (L) 14 (L) 13 (L) 14 (L) 17 18
Alkaline 56 68 62 73 75 78 78
Phosphatase
Total Bilirubin 4.42 (H) 2.16 (H) 2.20 (H) 2.28 (H) 2.06 (H) 2.10 (H) 2.37 (H)
o Daughter reported patient's refrigerator o Congestive Heart Failure and heart healthy
being empty diet
o Seemed interested
o No money in his account
o Admitted poor access to food at home
o Bring food over, place in refrigerator and
show him where it was o No education during recent admission
o Still wouldn’t fix own meals
Nutrition Care Process
EVALUATION OF INTAKE, CURRENT ASSESSMENT OF LEVEL OF RISK
o Failed spontaneous breathing trial this AM o Tube feed was at goal rate
o Continue on tube feed o Placed on hold 1900cc of emesis
o Severely malnourished
o Wt loss, muscle wasting, cachectic