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CNC Zero Hour

The old days

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# 41IronEagle May 6 2010, 23:26 PM
you're never to old to bump.

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# 42FakeReviT Jun 9 2010, 23:06 PM
Im alive ohmy.gif

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# 43HuNTeR Jun 14 2010, 12:28 PM
ohmy.gif

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# 44PlayBoy89 Oct 3 2010, 03:01 AM
LMAO hi hi, danggg, Iron eagle, techno dewb making the same sigs XD, JEDI BENJI!!! hahahah madddd old skool yo! I can't remember if ur aussie or brit been soo long XD,

oh and this has to be my personal fav post sig
|
V

-Playboy89St0rm

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# 45ModestGod Jan 12 2011, 15:19 PM
bump

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# 46IronEagle Jan 24 2011, 16:24 PM
QUOTE(ModestGod @ Jan 12 2011, 17:19 PM) *

bump


what he said

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# 47TeKnO_CaLiTY Jan 26 2011, 05:27 AM
triple bump

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# 48Arson Mar 4 2011, 15:53 PM
. Do you have any difficulty in feeding self, eating, chewing, or swallowing? Yes, I have only difficulty holding utensils. Therefore, I needs help being fed. Have you experienced any nausea, vomiting or diarrhea? No. Do you ever have constipation? No. What is your food likes or dislikes? Swedish pea soup, fried chicken. I don’t like hospital foods. Do you eat alone or with a family group? At home, I eat with my husband. Do you take any vitamins or supplements? (liquid diets) Yes, I take Iron supplements, and multi-vitamins. Do you follow a particular diet? No. (At the hospital she is on a 1800 ADA diet). Do you have any especially strong craving? No. Do you have any familial risk factors such as obesity, high cholesterol, diabetes mellitus, hypertension, Coronary artery disease, cerebrovascular accident or cancer? Yes, I have DM. What nutritional concerns would you like to discuss? None. Ms. W.S states that she enjoys every food but is having difficulty cooking food because of hands tremor. Therefore, she relies on her husband. Geri Nutritional Assessment3 Twenty-four hour diet history '' (A typical day at home): |Food Eaten |Amount |Method of |Where eaten | | | |Preparation | | |Breakfast: | | | | |Coffee with 1 tsp of sugar |A large mug of coffee |Brewed |At home in the dining | |Eggs |2 eggs |Scrambled eggs |Room | |Oatmeal |1.5 cups |Stove top slow cook | | |Bagel |1 item |Store brought package | | |Cream cheeses |2 tablespoons |Store brought package | | |Strawberry jam |1 tablespoon |Store brought package | | | | | | | | | | | | |Lunch: | | | | |Coffee with 2 tsp of sugar |1 cup |Boiled |Dining room | |Swedish pea soup |1 cup |Boiled | | | | | | | |Sometimes, skips Lunch | | | | | | | | | |Dinner: | | | | |Steak |10 ounces |Grill on the iron skillets |Dining room | |Rice |2 cups |Steamed | | |Asparagus |1 cup |Steamed | | |Broccoli |1 cup |Store brought package | | |Salad |1 tomato |Slice | | | |1/8 carrot |Slice | | | |1/8 cucumber |Slice | | | |3-4 tablespoon |Store brought bottle | | | |Ranch Dressing. | | | |Snack: | | | | |Pumpkin pie |3 pieces |Baked |Dining room | |Ice cream |2 cups |Frozen | | |Fried chicken |5 drum sticks |Store brought package | | | | | | | Geri Nutritional Assessment 4 Medical Diagnosis Ms. W.B was admitted to the hospital with Urinary Tract Infection. She is a 71- year-old Swedish-American woman with a history of DM. She was experiencing a severe headache and her temperature had reached 101.8 F. Her husband reports that she was confused and disoriented. At the hospital, through lab and observations, it was discovered that Ms. W.B was suffering from acute renal failure and Parkinson’s Dementia. Urinary Tract Infections: UTIs are the most common hospital-acquired (nosocomial) infections in the United States, accounting for 40 % of the total. Although several different microorganisms may cause UTIs, Escherichia coli remain the most common causative pathogen. Bacteria in the urine (bacteriuria) may lead to the spread of organisms into the kidneys and bloodstream, leading to urosepsis. Poor perineal hygiene is a common cause of UTIs in women. Inadequate hand washing, failure to wipe from front to back after voiding or defecating, and frequent sexual intercourse predispose women to infection (Potter, A., Perry, A, 2005 p328). Diabetes Mellitus: This is a disorder in which blood sugar (glucose) levels are abnormally high because the body dose not produce enough insulin. There are two types of DM: Type 1, Type 2. In type 1 diabetes (insulin-dependent diabetes), more than 90 % of the insulin-producing cells of the pancreas are permanently destroyed. The pancreas, therefore, produces little or no insulin. In type 2 diabetes (non-insulin-dependent diabetes), the pancreas continues to produce insulin, sometimes even at higher-than-normal levels. However, the body develops resistance to the effects of insulin, so there is not enough insulin to meet the body’s need (Beers, M, 2003 p962). Acute Kidney failure: Kidney Failure, also known as renal failure may occur in severe forms. Depending on cause, AKF is classified as prerenal, intrarenal, or postrenal. The major AKF is infection. AKF is an abrupt decline in kidney function manifested by increase in BUN and plasma creatine levels. About 55% to 70% of cases of AKF are due to prerenal factors such as intravascular volume depletion, decreased cardiac output, and vascular failure secondary to vasodilation or obstruction. Intrarenal causes account for 25% to 40% of cases of AKF. It is caused by damage to the kidney tissue and structure and included tubular necrosis, Geri Nutritional Assessment 5 nephrotoxicity, and alterations in renal blood flow. Acute tubular necrosis is responsible for approximately 90% of all cases of intrarenal AKF. Postrenal failure is generally caused by obstruction of urine flow between the kidney and the urethral meatus (Monahan, F.D., Sands, J.K., Neighbors, M., Marek, J.F and Green, C.J 2007 p 1003-1004). Parkinson’s Disease Dementia: Parkinson disease (PD) is a disabling, progressive condition. In 1817, when James Parkinson originally described the "shaking palsy," he stated that cognitive changes are not evident until the later stages of the disease but that the disorder is often complicated by a spectrum of cognitive deficits that range from isolated cognitive impairment to severe dementia. Cognitive deficits are due to the interruption of frontal-subcortical loops that facilitate cognition and that parallel the motor loop. Fibers from various areas of the cortex (eg, posterior parietal, premotor) converge on the striatum (particularly the head of the caudate) and project to the prefrontal cortex via nigral, pallidal, and thalamic structures. Different areas of the caudate project to different areas of the prefrontal cortex. Damage to any of the structures of the circuit can elicit the frontal-like cognitive deficits that characterize cognitive dysfunction in PD. Dementia is likely due to a dopamine deficiency caused by nigral degeneration compounded by the loss of inputs from noradrenergic and cholinergic nuclei (locus coeruleus and nucleus basalis of Meynert, respectively). The prevalence of AD pathology increases with age. AD changes are more common in the brains of patients with PD than in those of healthy controls, and prevalence of plaques and tangles in the cortex increases as the severity of PD dementia increases (eMedicine 2004). Medications |Tylenol (acetaminophen) |This drug is given for treatment of mild | |325mg tab 650mg 2 tabs PO q4h PRN |Pain and prn headache. | | | | |Levaquin (levoflaxin) |This drug is an anti-infective. It is being used for | |500mg PO daily |Treatment of UTI on Ms. W.B. | |Aricept (donepezil) |This helps treat mild to moderate dementia. | |10mg 1 tab PO qam | | |Lantus Insulin |This drug is given for treatment of | |10 units/0.1ml SubQ bedtime |Diabetes Mellitus. It lowers blood glucose | | |By stimulating glucose uptake in skeletal | | |Muscle and fat, inhibiting hepatic glucose | | |production. | |Zoloft (sertraline) |This drug is an antidepressant. | |50mg PO daily | | | | | |Keflex (cephalexin) |This is an anti-infective to treat UTIs. | |250 mg PO qid | | Geri Nutritional Assessment 6 Physical Assessment Height: 5’6” = 165cm Weight: 183.4 lbs = 83.4 kg General Appearance: overweight, disheveled; depressed Skin: Dry, poor skin turgor, scaly Nails: On hands, pink and rough; on feet, thick and brittle Hair: thin hair Mouth: dry, light pink, intact mucous membrane, dentures not present Eyes: PERRLA Head and Neck: Normal size head, no bruise, no distention of jugular vein Heart and Peripheral Vasculture: Blood pressure 120/83, Pulse 78, Respiration 22, Capillary refill>3 seconds and peripheral pulses strong Abdomen: concave, soft, a little bit distended, last BM on 11/1/07, normal bowel sounds in all four quadrants. Musculoskeletal System: Tremors on hands, strong muscle strength in hands and both feet, needs assistance with getting up and eating, easily fatigued, lacks energy Neurological system: Alert and oriented x 2, responsive to verbal and physical stimuli Respiratory System: Normal rhythm, no cough, normal breath sounds, no Hx of smoke Female menstrual cycle: No menstrual cycle Anthropometrics Measurements Triceps Skin: 25 mm Mid-Arm Circumference (MAC): 32 cm Geri Nutritional Assessment 7 Mid-Arm Muscle Circumference: 24 cm MAMC (cm) = MAC (32 cm) '' [3.14 x TSF (2.5 cm)] = 24.15 Body Mass Index (BMI) (use normogram): 31 (overweight) Body shape (Pear, Apple, or Normal): Apple shape Laboratory Data Hematocrit (HCT): 29.5 % Hemoglobin (HGB): 9.9 % (low) Cholesterol: less than 200 mg/dl (desirable) 200-239 mg/dl (borderline- High Risk) 240 mg/dl and over (high risk) LDL: less than 100 mg/dl (optimal) 129. (near optimal/above optimal) 130-159 (borderline high) 160-189 (high) 190 and above (very high) HDL: >40 mg/100 ml (low HDL cholesterol puts you at higher risk for heart disease) Triglycerides: less than 150 mg/dl (normal) 150-199 (borderline-high) 200-499 (high) 500 mg/dl (very high) TIBC: Normal value for adult 250-400 microgram/dl Iron: its deficiency cause an anemia Pre-Albumin: Normal value 23-43 mg/ dl Albumin: Normal value 3.5-5.5 g/dl Total Protein: Normal value 6.4-8.5 g/dl Glucose Trend: 168 mg/dl (high) Summary and conclusions The role of nutrition in elderly people is very important because it protects health and makes disease progression slow. In reality, many elderly are at nutritional risk. Nutritionally inadequate diets can delay recovery from illnesses. Eating a healthy diet can reduce the risk for many conditions associated with aging, such as anemia, confusion, and infection. In addition, when combined with Geri Nutrition Assessment 8 regular physical activity it can reduce the risk of many chronic diseases like type 2 diabetes and heart disease. As is examined in the case of Ms. W.B, whose dietary history revealed that she especially liked sweet and fried foods, her daily diet does not have enough consumption of fiber, fruit and vegetable groups. To manage type 2 diabetes, Ms. W.B needs a diet which helps to control body weight, has adequate fiber, is moderate in added sugars, has control of total carbohydrate, and is low in saturated fat with adequate but not-too-high protein (Sizer, F., Whitney, E, 2006 p123). Well-planned diet concepts in the Food Guide Pyramid are balanced with regard to food types, moderate in unwanted constituents, and a variety of nutritious foods. Ms. W.B’s dietary history did not match these concepts. She eats almost 90% of her meals while in the hospital, but she puts sweetener on every food. Currently, Ms. W.B is having an 1800 ADA diet. Also, she has a self-deficit related to stiffened muscle as evidenced by hand tremors. Therefore, she has lack of ability to eat independently. If the nurses neglect feeding her, she will have a high risk for malnutrition. Above all, she has gained 10 lbs recently. The major factor is due to sedentary life and excessive intake of fats. To control her weight, she needs a short walk a day or strength and flexibility exercise while seated, as well as a low fat diet. Dementia may also contribute to her poor diet due to severe deterioration and motor functioning resulting in loss of coordination and tremors, which makes her feeding herself difficult. Drugs and medication may affect nutritional status by charging one’s ability to taste, altering appetite, or absorption, distribution, metabolism, and excretion of nutrients. Most drugs, Keflex, Aricept, and Zoloft, which Ms. W.S is taking currently, bother her nutrition because they have side effects such as nausea, vomiting, and diarrhea. She is also taking multivitamin and iron supplement daily. The iron consumption can be made from clams, beans, spinach, and enriched cereal. Geri Nutritional Assessment 9 The physical assessment of her BMI is 31. A BMI of 18.5 and 24.9 is considered a “healthy” or “normal” weight; that is, a weight with low risk of health problems related to weight (Dudek, S, 2006 p376). Her BMI indicates obesity. Many factors--an increasing consumption of snack, fast foods, and inactive life style-- contribute to overweight. The laboratory results show that her Hematocrit level is 29.5 % and Hemoglobin level is 9.9 %. Hemoglobin is below normal which indicates signs of anemia. Above all, her glucose level is high which 168 mg/dl is. This number means Ms. W.B should pay attention to quantity and variety of foods to manage diabetes. Nursing Diagnosis for her medical problem is Impaired Urinary elimination r/t UTI, sensory motor impairment, immobility aeb incontinence, retention, and pain on urination, and elevated WBC count, low back pain, cognitive changes. The goal for her is that she will free of UTI as evidenced by clear, non-foul-smelling urine; pain free urination; normal WBC; absence of fever, chills, back pain until discharge. The following nursing interventions are applicable. First, monitor lab data including BUN, WBC level regularly. Record intake and output because this enables the care provider to determine adequate fluid balance. Second, encourage Ms. W.S to drink extra fluid. If the urine is kept dilute, calcium particles are less likely to precipitate and stasis with resultant infection is less likely. Lastly, suggest cranberry or prune juice because it contains an ingredient that may prevent bacteria from adhering to the lining of the urinary tract, thereby prompting their excretion. However, not all bacteria are sensitive to the juice, and protection lasts only as long as the juice is consumed regularly (Dudek, S, 2006 p631). In conclusion, all the data presented indicates that MS. W.B is not meeting her ingestive needs. I would conclude that she has an impaired urinary elimination, self-care deficit: feeding r/t alteration in Geri Nutritional Assessment 10 cognition, disorientation aeb requires assistance with feeding, dressing, and oral hygiene, which present an obstacle in her immune system and preventing a healthy life. The health advice for her is to lose some weight and to consume moderate carbs, high proteins and fluids frequently.

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# 49Norty Mar 6 2011, 04:45 AM
QUOTE(Calypso @ Jan 30 2010, 17:35 PM) *

Old Days?
What are that?
xD
Oh, and Hello, everyone. xD
@Tek
New Sig plox.
400x120 px
Dark Blue and Black
Grunge Style
I like the grid overlays like the one in the sig you made me before, if you dont remember, check my sig. Lol.
And.... Gla Style.
Just without the replay reviewing goddess thingy. xDD
I'll make you one, if you make me one. biggrin.gif


Christine.

Omfg.

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# 50ModestGod Jul 18 2011, 20:56 PM
old skool ftw

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# 51Spell Aug 22 2011, 13:18 PM
went on zhol today, posting this for Nostalgic reasons!


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# 52HuNTeR Aug 23 2011, 15:39 PM
nice smile.gif)

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# 53TeKnO_CaLiTY Aug 23 2011, 18:48 PM
-FaKe|FTW

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# 54Painbow Sep 25 2011, 21:00 PM
QUOTE(Carrex @ Mar 5 2011, 22:45 PM) *


Christine.

Omfg.


Dude that biatch was nuts.
>_>
Like, for real.
Medicine nuts.

Most of her reviews were my reviews, edited to be colorful and altered to the point where portions of them looked like the grammatical spawn of a high school student on crack.
Her, write a thought out article? Bahaha :-\


This post has been edited by Painbow: Sep 25 2011, 21:02 PM

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# 55TeKnO_CaLiTY Sep 26 2011, 01:42 AM
QUOTE(Painbow @ Sep 25 2011, 14:00 PM) *

Dude that biatch was nuts.
>_>
Like, for real.
Medicine nuts.

Most of her reviews were my reviews, edited to be colorful and altered to the point where portions of them looked like the grammatical spawn of a high school student on crack.
Her, write a thought out article? Bahaha :-\

LMAO yea she did like to write colorfully`

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# 56Painbow Sep 29 2011, 06:06 AM
Ahahaha no shit, I'll take a pic of my bedroom walls in the dark bro, that glow paint shit never comes off. I bleached it twice and there's still a huge glowing penor she drew on my wall.
LOL

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# 57Norty Nov 9 2011, 09:00 AM
Rise children. Anyhow, I've been playing SC2 all day everyday, it's super good.

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# 58Norty Nov 9 2011, 09:01 AM
*Shit, double post sad.gif

This post has been edited by Carrex: Nov 9 2011, 09:02 AM

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# 59TeKnO_CaLiTY Nov 10 2011, 01:13 AM
I LIKE TACOS!

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# 60IronEagle Nov 14 2011, 00:11 AM
I need to go to sleep.

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