Question

based on laboratory test results, which types of nutritional supplementation should be enhanced?

CASE STUDY CYSTIC FIBROSIS Aerial For the Disease Summary for this case study see the CD-ROM. this PATIENT CASE ciente lent Patient's Chief Complaints Provided by patient's mother: "I noticed a let-down in T's exercise tolerance level a week ago and the last couple of days his cough and sputum production have gotten much worse. When he started having breathing problems, I brought him in immediately. T is normally a bubbly and lively little boy and it is obvious when he isn't feeling well. I think that he has another infection." HPI T.B. is a 6 yo Caucasian male with a history of CF. He was diagnosed with CF at 8 months of age. He had been doing well until five days ago, when his mother noticed that he became tired very easily while playing. She also reported an increasing cough productive of very dark-colored sputum but that he had no fever. The patient also has not had much of an appetite during the past week and has lost 2 pounds. His oxygen saturation is currently 87% and he was immediately placed on oxygen via nasal cannula. T.B. was born (74 months ago) a 6 lb-7 oz white male to a 23 yo mother. A normal vaginal delivery followed an uncomplicated pregnancy. The infant had Apgar scores of 8 and 9 at 1 and 5 minutes, respectively. The initial physical examination was unremarkable, but at 30 hours following delivery, the infant developed abdominal distension and began vomiting bile. No bowel movements had occurred since birth. A second physical exam disclosed an afebrile, well-developed infant with a tense abdomen from which only occasional faint bowel sounds were heard. The anus was patent, lungs were clear to auscultation, and the cardiac cam was unremarkable. There were no neurologic abnormalities. Radiography of the abdomen revealed distended loops of bowel without air. Both the CBC and serum chemistry panel were normal Exploratory laparotomy disclosed meconium ileus and atresia of the dis- leum. The narrowed segment of ileum was successfully resected and the infant recovered without complications. An attempt to collect a sweat sample for chloride analysis was unsuc- cessful. After discharge, the infant was lost to follow-up.

Answer 1

1.a. Patient has meconeum ilius soon after birth explains that patient may have CF

2.e. As patient has deficiency of macro and micro nutrients and energy is being consumed extra for breathing which makes him malnourished.

3. d. Postural drainage will help to loosen secretions and remove them from airways, thus facilitating gas exchange

4.e. Patient may have all three manifestations as there will be fluid accumulation in body because of right ventricle failure.