Theresa Admitted With Question & Answer Guide (With Explanation)
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Key Explanation
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Original Question
Theresa, age 35, is admitted with microcytic anemia. Her medical history indicates that she underwent a total gastrectomy 2 years ago to treat bleeding ulcers. On admission she weighs 120 pounds, and she is 5 feet 9 inches tall. She has lost 30 pounds since the surgery. She has been taking ferrous sulfate and monthly injections of vitamin B12 . On admission, her laboratory findings are as follows: hemoglobin 8 g/dL, hematocrit 26%, and serum albumin 2.7 g/dL. Her typical dietary intake is as follows: Breakfast 1 egg scrambled in 1 teaspoon margarine 1 2 cup cream of wheat with 1 teaspoon margarine 1 slice white toast with 1 teaspoon margarine 1 cup black coffee 10 AM 6 saltine crackers 12-ounce can diet cola Lunch 2 baked chicken wings 1 cup cooked carrots 1 medium boiled red potato 1 medium banana 12 ounces diet lemon-lime soda 3 PM 1 2 bagel with 1 tablespoon cream cheese 8 ounces chocolate milk Dinner 1 broiled chicken breast 1 2 cup steamed broccoli 1 cup hot tea with artificial sweetener 9 PM 6 saltine crackers 1 tablespoon peanut butter 1 cup black coffee 1. What are common nutrition problems found in patients who have gastrectomies? 2. Which of these problems has Theresa experienced? 3. What factors explain the iron-deficiency anemia that develops after a gas-trectomy? What is used to treat this anemia? 4. How do Theresa’s laboratory values compare with normal values? What do they indicate? 5. Why is Theresa receiving monthly injections of vitamin B12 ? Explain your rationale. her to eat more foods high in B12 6. Review Theresa’s usual dietary intake; what food groups and/or nutrients are lacking in her diet? 7. What suggestions would you offer Theresa concerning her dietary habits? 8. Should Theresa continue to consume six smaller meals and snacks? Why or why not?
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