Camilyn Jackson

NTR 341
Tues/Thurs 10:30-11:45
Chap. 15 Assessment: Lab Data
Clinical Scenario #2 pg. 430

1. Based on the health history, social history, fasting

laboratory report and medical profile, what risk factors does
he have for chronic diseases?

Uriel comes from a racial minority and is economically

disadvantaged. He works a high-risk, physically demanding job and
eats a poor diet with lots of fast food. He is under a lot of stress with
his recent relationships and drinks a significant amount of beer. He
reports high blood pressure, chest pains, fatigue and shortness of
breath. He also has a history of smoking. Consequently Uriel’s history
provides numerous risk factors for diseases such as cardiovascular
disease (from poor diet, high blood pressure), diabetes (from obesity,
poor diet), chronic respiratory diseases (from smoking, shortness of
breath). He also is at risk for cancer, such as lung (because of tobacco
use), and liver (from alcohol consumption).

2. Considering Uriel’s medical profile, what does his

laboratory report for glucose, BUN, sodium, potassium and
creatinine suggest?

Uriel has an extremely high glucose blood level with his lab value
of 155 mg/dl compared to the healthy range of 70-99 mg/dl. Since he
is above 125 mg/dl, we can say that he has diabetes mellitus, not just
insulin resistance.
Uriel’s blood urea nitrogen (BUN) level is also very high at 44 mg
compared to healthy values of 5-20 mg. Levels this high indicate an
increase in renal disease and excessive protein catabolism. Renal
disease could be caused by Uriel’s diabetes; the high glucose put a
strain on the kidneys.
Uriel’s sodium level is 140 mEq/L, which is unremarkable as it
lies within the normal range, or 135-145 mEq/L. His sodium levels
should be monitored though as he has renal disease and DM.
Uriel’s potassium level is 3.5 mEq/L compared to the normal
values of 3.6 – 5 mEq/L indicating he is slightly low in potassium. This
is likely because of poor nutrition or possibly his blood pressure
medication; however usually when a patient has renal disease, as does
Uriel, they have increased K+ levels. Consequently, Uriel’s potassium
levels should be monitored.
Uriel’s creatinine value is 2.6 mg/dl ,which is extremely above
the normal range of 0.6-1.2 mg/dl. This is expected because creatinine

1
values are increased in those with renal disease.

3. What does his laboratory report for ALP, AST and ALT
suggest?

Uriel’s ALP level is 88 IU/L which is within the reference range of

30-120 IU/L. His AST level is 22 IU/L and his ALT level is 24 IU/L, both
of which lie in the reference ranges, 0-35 IU/L and 4-36 IU/L
respectively. These results suggest that he is not reflecting risk for
malignant, muscle, bone, intestinal, or liver diseases or injuries.

4. What does his lipid profile and homocysteine suggest?

Uriel’s total serum cholesterol level is 205 mg/dl compared to the

reference range of recommended <200 mg/dl. His Triglyceride level
is 350 mg/dl compared to the range of 40-160 mg/dl indicating he is
extremely high in triglycerides. Thus corresponds with his DM because
increased triglyceride levels are usually displayed in those with glucose
intolerance. These results suggest hyperlipidemia.
Uriel’s homocysteine level is 18 µg/ml which indicates an
elevated level. High blood homocysteine is a risk factor for
cardiovascular disease.

5. Uriel’s physician orders a vertical ultracentrifugation test,

What additional information will this test provide his
physician.

A vertical ultracentrifugation test will provide more information

about Uriel’s HDL levels and help better predict his risk for Coronary
Heart Disease, one of the main diseases he is concerned about.