An 84-year-old white female admitted with dehydration,...

Question An 84-year-old white female admitted with dehydration,… An 84-year-old white female admitted with dehydration, malnutrition, and late-state Alzheimer disease. The patient is not on medication for Alzheimer disease. She has had poor to no oral intake over the last several days, and her urine output within the last 15 hours prior to admission was 200 cubic centimeters. She is completely confused and disoriented. Her history is remarkable for occasional transient ischemic attacks.EKG on the day of admission was essentially normal. Chest x-ray showed a small area of infiltrate in the left upper lung field near the hilum consistent with acute pneumonia, approximately 2 centimeters in diameter. Repeat chest x-ray five days after admission showed clearing of the infiltrate. Electrolytes returned to normal range four days after admission with potassium 4 and sodium 140. Blood cultures were negative. Urine culture showed greater than 100,000 cfu/ml of StreptococcusHer fever came down 24 hours after admission, and she remained afebrile throughout the hospital course. Other vitals were within acceptable ranges. Appetite was very poor initially but then progressed to 50%-95% intake with all meals. Intravenous antibiotics were administered for pneumonia and urinary tract infection. The patient’s intake and outputs were followed; approximately 4,000 cubic centimeters were noted during the first three days, and then this began to stabilize. The patient’s mental status improved quite significantly over the course of the hospitalization, with increased alertness and responsiveness, although she remained confused and disoriented. She could sit in a chair without great difficulty and was eating quite well. She was discharged to the skilled nursing facility. Health Science Science Nursing HIM-2020 MISC Share QuestionEmailCopy link Comments (0)