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In addition to the above information regarding K.R., the physician has ordered an exploratory laparoscopy of the upper gastrointestinal. The findings indicate K.R. has extensive gastric ulcers, and a biopsy has been done.K.R. was placed on a TPN ordered by the admitting physician to allow for gut rest. The RDN completed the NFPE and found K.R. had 2+ pitting edema and moderate muscle wasting.Based on ALL the information provided, what indications does K.R. have for a malnutrition diagnosis?

Utilizing the previous exam case study- complete additional questions about the case. K.R. is a 60 y/o African American male who was admitted through the ER due to blood loss from a deep laceration on the arm. K.R. has a history of cardiovascular disease and hypertension. He is currently taking Coumadin and Lisinopril. K.R. arrived to the E.R. with complaints of shortness of breath and indicated he had cut his arm on the lawn mower blade. He could not stop bleeding and he became weak. K.R. received a blood transfusion and stitches in the E.R. and then was transferred to the floor for monitoring. K.R. was noted to have a current body weight of 155 lbs. and is 6’0”. K.R. states he has started losing weight over the last 3 months. He has noticed his pants are not fitting correctly and he is tightening his belt. K.R. states he is not hungry and usually weighs around 190 lbs. K.R. reports his bowel movements have changed and are very dark, blackish in color no matter what he eats. A Nutrition consult has been ordered by the admitting physician for a Coumadin education. 

Chronic liver disease due to diffuse necrosis and abnormal regenerative capability results in a fibrous tissue formation called _____.

For this question, you will write a case. You can pick any problem we have every covered the entire semester. The initial problem must overlap into at least two other organ systems. (think xyz 2/2 abc, 2/2 rst)   Tell me about your patient: How did they present? What is their medical/surgical history? (1 point)   What are their presenting VS (consistent with their problem) What is their physical exam? Only report pertinent negatives. (consistent with their problem)  (1 point)   What labs and tests are you asking for to rule in/rule out? (1 point)   What are the results of the labs and tests you asked for? You needs to write out the labs and the actual numbers/results/findings. (consistent with their problem) (2 points)   What treatment do you anticipate? (2 points)   What could go wrong? What other organ systems will this problem effect? How? (2 points)   If this patient were to decompensate, how would it likely happen? (1 point)   White blood cell (WBC) count: 4,000–10,000 cells/mcL  Hemoglobin: 11 – 16 gm/dL  Hematocrit: 35 – 50%  Platelet count: 150,000–450,000 platelets/mc Serum sodium: 136–144 mEq/L  Serum potassium: 3.7–5.2 mEq/L  Serum chloride: 96–106 mmol/L  Carbon dioxide (CO2): 23–29 mmol/L  Serum calcium: 8.5–10.2 mg/dL BUN: 6–20 mg/dL  Creatinine: 0.6–1.3 mg/dL  Glucose: 70–100 mg/dL  pH: 7.35–7.45 PaO2: 75–100 mmHg PaCO2: 35–45 mmHg HCO3: 22–26 mEq/L *If there is a lab that helps your case that is not listed here, you are fine to note “high/low”

K.R.’s biopsy returned 3 days post-op and he does not have any signs of cancer. However, he does have Barrett’s Esophagus and extensive peptic ulcer disease. The ulcers are limited to his lower stomach and upper duodenum. He has a PEJ placed to allow for the esophagus to fully heal along with his extensive ulcers. The TPN will be discontinued in 4 to 5 days and K.R. will begin enteral feeding upon discharge from the hospital. K.R. is estimated to be on enteral nutrition for 6 weeks and then will transition to an oral diet. The RDN recommends K.R.’s enteral nutrition order to be Jevity 1.5 @ 55 ml/hour x 22 hours (1.5 kcals/ml; 63.8 g Pro/L; and 760 ml Free water per Liter). Calculate the TF order and type in the steps used to calculate the order to obtain total kcals and protein. Does the order meet K.R.’s current needs? Why or Why not?

63M admitted for hemorrhagic shock. 92 kg, PMHx HTN, DM, remote MI. Pt suffered AKI and is recovering after volume resuscitation. The RN knows that adequate urine output for this patient is:

The medium or media of choice used to recover Legionella is:

Isolates from CSF that are gram-negative coccobacilli, grow on chocolate agar in CO2 but not blood agar, require factor V but not X, and are nonhemolytic on rabbit or horse blood may be identified as:

Organisms belonging to the genus Legionella are:

The commensal Neisseria spp. are often confused with pathogenic gram-negative diplococci. A simple test utilizing a blood agar plate and an antibiotic disk resulting in elongation of the cells assists in the differentiation of these organisms. Which antibiotic disk is utilized in this application?