Concept notebook Nutrition
CASE STUDY
Please relate castudy to the Concept of nutriton
You assume care for Mr. Bowden and receive a report from the charge nurse who has started the admissions process. She mentions the labs tests were drawn, and radiology has been notified to transport Mr. Bowden when they are ready to perform the MRI. The nurse tells you she is concerned that the admitting provider might be unaware of the patient’s withdrawal symptoms.
You enter Mr. Bowden’s room to perform a head-to-toe assessment. You find an obese, unkempt, unshaven man. You verify his identification with double identifiers. Mr. Bowden is alert but repeatedly asks where he is and what time it is. He appears slightly agitated and answers your questions curtly. He complains that the unit is “very loud and irritating” and asks whether you could turn off the lights as they are “really bright.”
…Vital Signs…
Temperature: 99.0 degrees Fahrenheit (37.2 degrees Celsius), tympanic…
Heart rate: 100, radial
Blood pressure 140/72 mmHg, right arm, sitting…
Respirations: 20…
Oxygen saturation: 93% via room air per finger probe…
Height: 6 ft 1 in…
Weight: 268 lbs, patient statement…
You hear S1S2 in a regular rhythm with no murmur. Peripheral pulses in the femoral, popliteal, right anterior tibial, right dorsalis pedis, brachial, and radial areas are normal. Left anterior tibial and left dorsalis pedis are nonpalpable. His extremities are generally cool and pale. Capillary refill is normal in upper extremities and right foot but greater than 3 seconds in the left foot. Mucous membranes are pink and moist. Left foot with 4-plus pitting edema and reddened.
No cardiac problems are found. Mr. Bowden’s breathing pattern is even and unlabored, and lung fields are clear bilaterally in all fields but slightly diminished in the lower posterior fields. You note the presence of a dry, nonproductive cough that the patient describes as a “smoker’s cough” during examination.
