from a decrease in calcium from the AlternaGel medication. Secondly, her bilirubin total was also elevated at 0.6 mg/dl. An increased TBIL may also indicate liver damage if too much – bilirubin is produced or the liver is unable to remove bilirubin properly, blockage in the bile ducts and liver disease may develop; ultimately causing stomach pain. Lastly, her elevated Amylase level of 350U/L may indicate recent intake of alcohol, stomach ulcer, pancreatitis, – – blockage to intestines, gallstones, or kidney failure all of which may induce LUQ pain. – (Dugdale, Medline Plus, WebMD) In the second set of lab values, glu, BUN, Cr, ser alb, Na, K, Cl, hgb, and hct all c. Dehydrated when the first labs were dropped. This probably means that GG was: drawn. I believe is the correct answer because GG returned to her ways” of caffeine “C” “old and alcohol prior to returning to the hospital. Therefore, she would induce dehydration in her system prior to the ER visit. In the second set of lab values, serum amylase, AST, and ALT all dropped. This probably means that: a. enzymes were elevated due to alcohol. I believe is the correct “A” answer because her history indicated binge and drank too much” the evening before “another the ER visit. If she has an increased alcohol intake prior to blood testing, her lab values would be altered and elevated. Refer to the two lab tables again, and not that two days after admission, GG’s Alk Phos and CPK remained essentially unchanged. Why? a. These enzymes are not affected by alcohol or hydration. Although it is not recommended to consume food or beverages 10 hours prior to blood testing for Alk Phos, GG had passed the 10 hours mark when she went to the ER the next morning. Special pre-testing procedures are not required for CPK blood testing.
from a decrease in calcium from the AlternaGel medication. Secondly, her bilirubin total was also elevated at 0.6 mg/dl. An increased TBIL may also indicate liver damage – if too much bilirubin is produced or the liver is unable to remove bilirubin properly, blockage in the bile ducts and liver disease may develop; ultimately causing stomach pain. Lastly, her elevated Amylase level – of 350U/L – may indicate recent intake of alcohol, stomach ulcer, pancreatitis, blockage to intestines, gallstones, or kidney failure – all of which may induce LUQ pain. (Dugdale, Medline Plus, WebMD) In the second set of lab values, glu, BUN, Cr, ser alb, Na, K, Cl, hgb, and hct all dropped. This probably means that GG was: c. Dehydrated when the first labs were drawn. I believe “C” is the correct answer because GG returned to her “old ways” of caffeine and alcohol prior to returning to the hospital. Therefore, she would induce dehydration in her system prior to the ER visit. In the second set of lab values, serum amylase, AST, and ALT all dropped. This probably means that: a. enzymes were elevated due to alcohol. I believe “A” is the correct answer because her history indicated “another binge and drank too much” the evening before the ER visit. If she has an increased alcohol intake prior to blood testing, her lab values would be altered and elevated. Refer to the two lab tables again, and not that two days after admission, GG’s Alk Phos and CPK remained essentially unchanged. Why? a. These enzymes are not affected by alcohol or hydration. Although it is not recommended to consume food or beverages 10 hours prior to blood testing for Alk Phos, GG had passed the 10 hours mark when she went to the ER the next morning. Special pre-testing procedures are not required for CPK blood testing.
case_study_1_-_pud.docx