JB is a 53 yo male who was recently divorced. He has experienced periods of depression and decreased appetite. Family reports history of heavy drinking habits and 15# weight lost. He was previously diagnosed with cirrhosis and portal hypertension and paracentesis and TIPS procedures were performed. Mr. JB's condition seems to have worsened; he c/o stomach pains, nausea, and vomiting at times. His
abdomen is sore to touch and feels swollen. Mr. JB has developed ascites and pedal edema; his urinary output has decreased and he continues to lose weight. Mr. JB also c/o pain when swallowing food. Because of JB's persistent symptoms, he's been admitted to the hospital. A referral to the SLP for a MBS was also ordered and resulted in dysphagia, pureed diet recommended. By day 2 Mr. JB still c/o of nausea and no po intake has been reported. The MD prescribed dietary consult: RD to assess patient and recommend alternate means of nutrition support, currently NPO. Ht: 5'11'' Wt: 145 # UBW: 163# Dx: End-stage liver cirrhosis, dysphagia PMH: alcoholic cirrhosis, portal hypertension Labs: Na: 134 Cl: 101 BUN: 4 Alb: 2.3 TG: 305 Transferrin: 101 NH4: 53 Glu: 139 AST: 45 ALT 48 Alk Phos: 40 Bilirubin: 2.1 K: 5.2 CO2: 25 Cr: 1.8 H/H: 11/35 Diet: NPO Meds: Neomycin, Aldactone, Lasix, Reglan Because of JB's history of alcohol abuse, he is most likely at risk of which nutrient deficiency?
a. potassium
b. vitamin A
c. sodium
d. vitamin B6
e. vitamin E
d
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