Explanation of Facts: PERTINENT FACTS NOT RELATED TO NUTRITIONAL HYPOTHESIS -Constipation/SBO- this is a pertinent fact because it may be a result of dehydration. The patient is suffering from dehydration and is not eating enough so this is important. -61.4 kg UBM- this is pertinent because we used this value to figure out her percent of ideal body weight. This also gives us an idea of how much weight she has lost as a cause of her diagnosis. -82 year old female- this is a pertinent fact because we used this information to determine her Anthropometric information. -5'6" height- this is also pertinent because we used it to determine Anthropometrics. -ETOH Abuse-this is a pertinent fact because she may have possibly abusing the use of alcohol when she was wondering the neighborhood or really disoriented. It was diagnosed that it was Alzheimer's disease, but it is something to be aware of in the future. -Patient Fell at Home- this is a pertinent fact because it happens to relate to the wasting in the various parts of the body and the wasting could have caused weakness in her legs (the Interosseous wasting) causing her to fall. -Increased Mental Confusion- This characteristic is important because this is what caused the doctors and nurses to call neurology and find out that the patient has Alzheimer's disease. -Hypertension- this is a pertinent fact because the patient is taking a diuretic as a result of this condition. -Hydrochlorothiazide- this is a pertinent fact because this is a diuretic and since the patient is dehydrated, we saw this as being a pertinent fact, especially since the Doctors put a hold on the medicine b/c of the dehydration. -CAD- this is a pertinent fact because according to her family, after her stroke, she had a hard time swallowing and was put on the dysphagia diet at that time. We felt that it is important to discuss this because her family said she was improving after the stroke, and is now moving in the reverse direction. PERTINENT FACTS RELATED TO MARASMUS -Dysphagia- this is a pertinent fact related to Marasmus because the patient does not want to eat the foods that have a consistency appropriate for having problems swallowing. This means that she is not eating properly and it is leading to her starvation state. -Normal serum protein- we chose to put this under Marasmus because it shows that the patient is not suffering from kwashiorkor. The patient has normal serum protein and albumin. -5th %ile of TSF- this is a pertinent fact because it shows that the patient is wasting. -5th %ile UAFA- this also shows that the patient is wasting and losing fat stores. -Standard for UAMA- this shows that there is not a decrease in protein and muscle stores, which also leads us to believe that the patient is not suffering from kwashiorkor. -151mEq/L of Na- this is a pertinent fact because this shows that the sodium was high upon admission and this is related to the patient having hypertension as well as being dehydrated. -40 mg/dL BUN at admission- this is pertinent because it shows that the patient was dehydrated at admission and not only was she not consuming enough fluids, but she was not getting adequate intake of food. -86% of IBW- this is a pertinent fact because it shows that the patient is below her Ideal body weight and is has lost a lot of weight since the onset of this condition. -Forgetfulness- this relates to Marasmus because the patient is often times forgetting to eat, which is leading to starvation. -Poor Skin Turgor- We decided to put this under Marasmus because this means that the patient is dehydrated. Dehydration is not necessarily a sign of Marasmus, but because the patient is completely malnourished, she is dehydrated because of the overall not eating. -Dehydration- This is related to the poor skin turgor and as stated earlier, we decided to put this under Marasmus since it shows that there is an overall negligence of P.O intake. -CVA is also a pertinent fact since it led to the initial problem of swallowing. This led to the patient being placed on the dysphagia diet, which she does not like and does not want to eat the mushy food. -Alzheimer's Disease- this is a pertinent fact because this is causing the patient to forget to eat and leading to starvation. -Decreased P.O. intake- this is related to Marasmus because it shows that the patient is not eating enough. There is an overall lack of food being consumed. -Interosseous and Temporal Wasting- these are pertinent facts because they show that there is wasting occurring and it is occurring because of the lack of foods. PERTINENT FACTS RELATED TO COMBINATION OF MARASMUS/KWASHIORKOR Forgetfulness, Poor skin-turgor, Interosseous and temporal wasting, and the 40 mg/dL BUN are all facts that were placed under Marasmus. We also put them under the combination, only because these characteristics may be noticed if there is a combination problem. However, since we found no facts to put under kwashiorkor, the rationale behind stating them as facts are the same as listed for kwashiorkor.