Mr. Lew was transported to the emergency room (ER) by emergency transport. City police officers called an ambulance after finding Mr. Lew lying in an alley with apparent unconsciousness. The emergency medical team started an intravenous (IV), and upon arriving at the ER, Mr. Lew had regained consciousness but is now unconscious again. Physical data collected included the following:
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Physical appearance is unkempt and dirty.
Odor suggests consumption of alcohol is likely.
T 96, P 124, R 36, B/P 90/40
Very emaciated appearance
Legs and arms very dry and flaky
Mottled purplish areas to lower extremities
Edema 3+ in ankles and lower legs
Abdomen tight and distended
Facial color and nail beds pale
No response to painful or verbal stimuli
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After physician examination, Mr. Lew was admitted to the hospital with malnutrition, R/O pancreatitis, and cirrhosis of the liver due to ETOH abuse.
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Identify goals for Mr. Lew, relating to nutrition. Be specific as to protein needs.
Mr. Lew will stabilize fluid and electrolyte balance within 24-48 hours; receive adequate nutrients to meet nutritional needs (typically 30-35 calories per kilogram of body weight); gain 0.25-0.5 lb/kg a week. Protein needs are greater in those recovering from alcoholism. Goal would be to consume 1-2 grams per kilogram of body weight daily. The extra protein is needed for cell growth and muscle and tissue repair. He will need to have protein added to meals as well as one to three snacks per day with added protein.
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Resource: Academy of Nutrition and Dietetics Nutrition Care Manual?
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A) ?It is efficiently converted to storage fat. B) ?It spares oxidation of body fat and dietary fat. C) ?It stimulates glucagon release, resulting in inhibition of fatty acid oxidation. D) ?It stimulates pancreatic lipase secretion, which results in higher dietary fat absorption.
Insufficient insulin causes
a. increased lipoprotein lipase synthesis and triglyceride uptake in adipose tissue. b. decreased triglyceride synthesis in adipose tissue. c. decreased triglyceride breakdown in adipose tissue and unrestrained release of fatty acids into the blood. d. decreased production of ketone bodies and very-low-density lipoproteins (VLDL) in the liver.
The coenzyme TPP plays a critical role in the breakdown of glucose for energy. Which water-soluble vitamin is part of the TPP complex?
A) niacin B) biotin C) riboflavin D) thiamin
Which food below provides a source of both protein and carbohydrate??
A)Egg? B) Chicken C) Olive oil D) Broccoli E) Orange