10, LNE ClaSSES OF INUUIIUE Ieee Ne ee a Nutrition screening Nutrition education Clinical Food and/or nutrient delivery Case Study #3: ‘An 89 yo female is admitted to the hospital with progressively worsening confusion, lethargy, and hypotension (low blood pressure). There is no height available and the patient is unable to stand in her current state. Her skin is dry with poor turgor and she has had very low urine output over the past 24 hours. She has had type 2 diabetes for many years and it is fairly well controlled. Her admission weight is 113 pounds. Usual weight reported by her daughter is 132 pounds, Her laboratory results (including partial data from CBC and urinalysis) are as follows: Test Reference range ‘Subject values Nat 135-145 mEq/L 152 H K+ 3.6-5 mEq/L 3.8 ce 101-111 mEq/L 1 HCO3- 21-31 mEq/L 29 Glucose 70-110 mg/dl 175H BUN 5-20 mg/dl 27H Creatinine (Cr) 0.6-1.2 mg/dl 08 Albumin 3.5-5 gidl 43 Osmolalit 280-320 mOsm/kg 327H Total cholesterol >150 mg/dl 193 Total bilirubin 0.1-1 mg/dl 0.6 RBC 3.5-5.9 x 10°/mm* 5.6 Hgb 12-15 g/dl 16 Het 33-43% 2 MCV 80-95 fL. 81 MCH 27-31 pg 28 MCHC 32-36 g/dl 33 WBC 5-10 x 10°/mm* 9 Urine specific gravity 1.010-1.025 mg/ml 1.039 H Urine nitrite Negative Positive Urine leukocyte esterase __| Negative Positive 17. What do you suspect is happening with this patient and which factors are clues in the diagnosis? (4 points) She is suffering from duydiation - This can be factored: From her igh Nak, Glucosy, BUN » OSmold hy, and Specific grawity 4548. In addition, Her diy skin, poor turgor, and {ow unnl ovtput Compre 49 th) s 9 Aiagnosicn The positive hitaky + Kulcooyty strap results additionally factor in THis Stvation,