Learning Issues: Group 1 and 2 combined

The learning issues were distributed initially when there were two groups.  Since there is only one group now, many of the learning issues overlapped.  Here they are combined: 

What is CVA (Kathy) CVA is cerebrovascular accident, or a stroke.  This often results in death of certain neurons and effects the functioning of the body.  (From Martini's Anatomy and Physiology Textbook)

What does S/P stand for? (Kathy) S/P stands for status post-operative.  (from advanced clinical web page). 

What is hydrochlorothiazide (Kathy, Mary Beth) It is a diuretic and it is a potassium wasting medicine.  Magnesium is also at risk of over excretion.  It should be avoided with natural licorice and should be avoided with Calcium supplements because this diuretic causes reabsorption of calcium.  

What kind of IV fluids were used (Beryl, Kathy) The D5W is a dextrose solution and it provides some kilocalories to the patient, but the patient is in need of nutrition support.  

What is ETOH? (Susan) It is ethanol or alcohol.  This patient has a history of alcohol abuse, but it does not seem to be an issue right now.  (class website)

Implications of Dysphagia Diet (Susan, Mary Beth) The patient is on the dysphagia diet because of difficulty in swallowing.  This means that she is asked to have thickened liquids and foods that are soft and easy to swallow.  Since the patient is refusing to eat foods that fit this description, the patient is severely malnourished.  (Therapeutic Notes)

What is temporal wasting? (Susan)  Temporal wasting is wasting around the temporal bone and the muscles/tissues located near the temporal bone.  

Interosseus wasting? (Susan) Interosseous refers to the bones in the feet and legs.  They refer to the bones that move the feet.  The wasting is occurring around the bones of the feet and legs. This is important since this could have been a result of why the patient fell down.  (From Martini's Anatomy and Physiology Textbook)

What are percentiles for TSF, UAMA, UAFA? (Susan) The percentiles were listed under facts under the different hypothesis.  

What does SBO stand for? (Amena)  SBO is short bowel obstruction.  We see this as being constipation.  

What is skin turgor?  (Amena) Water content of the skin is what helps maintain the flexibility of the skin and also resilience.  Dehydration causes decline in flexibility.  We test this by pushing down on the skin with a finger and seeing if the skin bounces back up.  If it does not, it means there is poor skin turgor and is usually a result of dehydration.  

What is risk of aspiration? (Amena) Aspiration, as we knew previously, is when food or foreign objects go into the lungs.  We were concerned whether this patient had this problem but found by reading through the case that the speech pathologist ruled out the risk of aspiration.  

Route of Nutrition Support (Amena) This learning issue was written down to research if there was a risk of aspiration and if this would affect the route of administration. Different articles state that if there is no risk of aspiration, a nasogastric tube can be used.  

How will Alzheimer's affect the case? (Amena, Beryl)  Alzheimer's disease is when the patient starts forgetting things.  This patient is forgetting her name and losing orientation. She doesn't know where she is, etc.  Using the Therapeutic Textbook, we found that Alzheimer's patients usually suffer from having elevated fasting blood sugar. They often forget to eat because they do not feel that they are hungry, or thirsty.  They also may suffer from pica, which means they might eat non-food items.  When patients start pacing, they may need increased nutritional requirement.  This is not the case while the patient is in the hospital, since she is confined to her bed.  

What does the high Chloride and Sodium mean? (Beryl) Chlorine and sodium both help to maintain water balance and osmotic pressure.  These both are electrolytes and since the patient was dehydrated when she was first admitted into the hospital, her chlorine and sodium were a little high initially.  

Impact on Hematocrit. (Mary Beth) the hematocrit value increases when the body is dehydrated because there is a decrease in plasma volume.  (Martini Anatomy and Physiology Textbook).  

What does BUN signify? (Kathy, Amena) The BUN means blood urea nitrogen and if it is high, as it was when the patient is admitted, it means that the patient is dehydrated.