Question

Elaine, an 82-year-old woman, has been hospitalized for pneumonia. Her medical history is positive for hypertension, diabetes, coronary artery disease, and heart failure. During her initial examination, she appears frail, alert, and cooperative, and is able to answer questions appropriately. Her daughter states that she has been slowly losing weight over the last 6 months. Her chief complaints are fatigue, poor appetite, leg weakness, and nonproductive cough.

Laboratory test results:

Test Results Reference Interval Glucose (mg/dL) 130 70–99 BUN (mg/dL) 45 6–20 Creatinine (mg/dL) 3.3 0.6–1.1 Albumin (g/dL) 2.9 3.5–5.0 eGFR (mL/min) 36 >60 TSH (mIU/L) 2.05 0.4–4.2 Vitamin B12B12 (pg/mL) 318 200–900 Vitamin D hydroxyl (ng/mL) 18 20–40 Zinc (μg/dL) 55 80–120

Issues and Questions to Consider

1. What test results are abnormal?

2. Based on Elaine’s laboratory findings, what are probable diagnoses?

3. What are the findings that indicate the state of her nutritional status?

4. What other test(s) could be ordered to evaluate her nutritional status?

5. What test results point to kidney disease?

Answer 1

with the above test results, following are abnormal: o Glucose - high (2) BUN - high | (3) creatinine high | (A) GIFR - hess Lo Zinc- less Based on above results patient may I be suffering the renal failure. - BUN and creatinine is very high and GIFR is less which indicato Pt is going to renul failure stage - For Nutrition, Iron, Nat, ke cl should be ordered to pt.