Re: May 2010 Case Study focusing on initial MDS completion

[Guest guest]

I have not had time to compose the results to the first case study. I will

be doing this tonight or tomorrow evening. As some have suggested, I will

be sending the results via email format AS WELL AS archiving in blog format.

FYI, a little off subject, but I have been a little distracted. A good

friend of mine (who had ridden her motorcycle all over the country and has

also completed police officer motorcycle ridiing course) was riding home

from Rolling Thunder in Washington DC. She lives in NYC. she was almost

home and she was hit head on. She is in Stony Brook University Hospital in

Stony Brook, NY. If there are any dietitians or dietetic technicans that

work at Stony Brook, please email me. I just would like to make she

receives a little extra TLC. Her injuries are not life threatening.

Thanks

Carol

On Mon, May 24, 2010 at 10:53 AM, Carol S. Casey wrote:

> This is based on the MDS 2.0

>

> This case study is solely based on how you would complete the MDS based

> on the information presented. There is no need to address what you might

> recommend for interventions – remember everyone’s clinical judgement might

> not be the same. You just have to look at the information as if you were

> assessing this patient and how would you complete the MDS. Please try to

> not get off track and remember to focus on MDS completing skills. Thank

> you.

>

>

>

> How would you complete the initial MDS based on this patient information.

>

>

> Admission Date: 5/17/2010

>

> Assessment Reference Date: 5/22/2010

>

>

>

> Female patient was admitted from the hospital. Height 66 inches, 110 lbs.

> Diagnosis includes: HTN, Failure to Thrive, Barrett’s Esophagus, History

> of Alcohol Abuse, and Stage 3 pressure wound on her coccyx.

>

> While in the hospital she received:

>

> 1) D5NS @ 100 ml per hour with end date of 5/16/2010.

>

> 2) The IV site was KVO and received NS 250 ml every shift.

>

> 3) TPN 8.5% Amino acids 500ml, 10% Dextrose 500 ml running at 75

> ml/hr and 20% Lipids 250 ml 3 times weekly. The TPN was discontinued

> 5/14/2010.

> 4) Heparin 25,000 units with 500 ml D5W IV drip with end date of

> 5/15/2010

>

>

> Patient was also receiving a Dysphasia 3 diet with nectar thick liquids due

> to esophageal strictures. The diet was advanced to Regular texture with

> nectar thick liquids on 5/14/2010. On 5/15/2010 a nutrition supplement

> was added – Magic cup with lunch and dinner to help with bolus formation and

> boost calories

> .

> The patient was admitted with a NAS regular texture, nectar thick liquids

> and Magic Cup at Lunch and Dinner. The Speech Therapist is following the

> patient and also has determined she can receive Two Cal HN without any

> thickening, therefore she is receiving 60 ml QID with med pass.

>

>

> The patient has multiple food preferences and does not like the facility

> food, she feels she is a much better cook than the facility cook. She has

> an extensive list of food likes and dislikes. She also is receiving

> regular sized portions, but she states she is not getting enough food. She

> did not eat much at home, she would defer her nutrition intake to when she

> was drinking her cocktails. She stated she lives with her nephew and they

> would drink cocktails starting at noon every day. She would get out of

> bed, he would help her to her chair after getting dressed, and they would

> watch television all day long. Her nephew reports she wears Depends

> because it was too difficult to get her up to go to the bathroom when they

> had been watching television for several hours and had several cocktails,

> cheese, and crackers.

>

> Her medications include B-Complex, Ativan, MVI with minerals, Vitamin C,

> Zinc, Lasix.

>

>

> --

> " It is better to fail in originality than to succeed in imitation. "

> Herman Melville

>

> http://www.carolscasey.com

>

--

" It is better to fail in originality than to succeed in imitation. "

Herman Melville

http://www.carolscasey.com