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Which of the following are risk factors for vitamin D deficiency?

Medications can have a significant impact on bone density. Which of the following meds can affect bone density (either reduce or increase)?

Case Study: Mrs. Renteria is a 56 year old female who moved into an Alzheimer’s unit 2 months ago because it became too difficult for her husband to care for her at home. She was diagnosed with Alzheimer’s disease 5 years ago. During her husband’s visit today, he mentioned to you, the facilities’ dietitian, that he thinks his wife is starting to look “skinny” and wonders if she is losing weight. When you check Mrs. Renteria’s medical record, you see she has lost 8 lbs since her admission 5 weeks ago. In discussing her case with the nursing staff you find that she is frequently too tired in the morning to eat, rarely finishes her lunch or dinner as she easily gets distracted by the activities in the dining room. Ht: 5’ 5”            Current weight:  117 lb. Laboratory data:     Sodium: 150 (135-145)      Potassium: 3.7 (3.5-5)    Chloride: 109 (98-106)   Glucose: 80 (70-99)  BUN: 14 (10-20)     Creatinine: 0.6 (0.6-1.2)    Albumin: 3.2         Calcium:  7.8   (8.2-10.6) Medications: none Nursing record of intake for the past 3 days: Breakfast: consumed 10%           Lunch: consumed 75%             Dinner: consumed  25% Typical breakfast: 1 scrambled egg, ½ of English muffin with 1 pad of butter, 4 oz OJ, hot tea Typical lunch: 4 oz of chicken noodle soup, ½ c tuna salad or chicken salad, 1 small whole wheat roll and 4 oz. of applesauce, pudding or fruit cocktail Typical dinner: 3 oz. of white fish, chicken breast or meat loaf, 4 oz. (1/2 c) of mash potatoes with gravy, ½ c (4 oz) of green peas, cooked carrots or asparagus Based on the above information, complete a nutrition assessment for Mrs. Renteria (20 points).

Sam is concerned about his risk for a stroke since his Dad died of a stroke at age 57. Based on the following information, what would you recommend to Sam to reduce his risk for a stroke? Ht:  6’    Wt: 175 lb (stable)     B.P.: 145/80    Lipids: T Chol: 160    LDL: 100   TG: 130     HDL: 50       Glucose:  97

Patients with neuro disorders typically require PEG feedings using bolus administration to meet their nutritional needs. List three common challenges that can arise with these types of feedings (5 points):

You have received a nutrition consult for Quinn, a 28 y.o. male, in the ICU sedated and intubated due to a complete spinal cord injury at L1 after an ATV accident yesterday; he is now a paraplegic due to his accident. Today is hospital day #1. Bowel sounds are negative but abdomen is soft and non-distended. A nutrition consult is requested. MIV w/20 mEq KCl running at 120 mL/hr through a central line. Ht: 6’2”            Current Wt. 202 lbs.          Wt. Prior to Admission: 202 lbs. Vitals: Temp: 99.9°           I/O: 3300/2920            MAP: 62                 PMH: broke ankle @ age 18; up to date on all immunizations Medications: sedation, pain meds, and antibiotics. Labs: Na: 137 (135-145)             K: 3.8 (3.6-5.5)             Cl: 102 (101-111)                HCO3: 26 (21-31)        BUN: 11 (5-20)                  Cr:  0.8 (0.6-1.2)          Glucose:  82 (70-99)            Alb: 2.9 (3.5-5)     GFR: 79 (>60)                   Phos: 2.9 (3-4.5)         Ca++: 7.3 (8.5-10.5)              Mg: 1.8 (1.5-2.5) H/H: 13.8/37 (14-17/40-54)           MCV: 85 (80-100) Complete a nutrition prescription for kcals, protein, fluids and include any micronutrients to focus on (10 points):

You have received a nutrition consult for Quinn, a 28 y.o. male, in the ICU sedated and intubated due to a complete spinal cord injury at L1 after an ATV accident yesterday; he is now a paraplegic due to his accident. Today is hospital day #1. Bowel sounds are negative but abdomen is soft and non-distended. A nutrition consult is requested. MIV w/20 mEq KCl running at 120 mL/hr through a central line. Ht: 6’2”            Current Wt. 202 lbs.          Wt. Prior to Admission: 202 lbs. Vitals: Temp: 99.9°           I/O: 3300/2920            MAP: 62                 PMH: broke ankle @ age 18; up to date on all immunizations Medications: sedation, pain meds, and antibiotics. Labs: Na: 137 (135-145)             K: 3.8 (3.6-5.5)             Cl: 102 (101-111)                HCO3: 26 (21-31)        BUN: 11 (5-20)                  Cr:  0.8 (0.6-1.2)          Glucose:  82 (70-99)            Alb: 2.9 (3.5-5)     GFR: 79 (>60)                   Phos: 2.9 (3-4.5)         Ca++: 7.3 (8.5-10.5)              Mg: 1.8 (1.5-2.5) H/H: 13.8/37 (14-17/40-54)           MCV: 85 (80-100) Based on his current clinical status, what MNT recommendations would you provide regarding intervention(s) (be specific in terms of goals to achieve), monitoring and evaluation while he is in the hospital? (20 points):

Which of the following would be a healthy long-term goal for body weight for an individual with quadriplegia?

Nick is admitted to the hospital for encephalopathy and dehydration. He has been drinking a bottle of scotch every 2 days for the last couple of months. Which of the following is he at the highest risk for developing?

Which process allows for genetic variation in bacteria through uptake of naked DNA from the environment?