Hesi Case Study Mariana

1. Mariana’s microbiology results have led to the ruling out of any urinary tract infection (UTI), Gastroenteritis and malnutrition. The results show that her red and white cell count are within the normal range and also the epithelial cells found in the urine sample are of a moderate amount and there were no significant bacterial growth. Abnormalities in this results would have indicated to a UTI but the results were normal. According to Roche (2011), presence of bacteria, in addition to a high white blood count or epithelial cells in a fresh urine sample is a diagnostic of UTI, meaning Mariana is in the clear of any UTI. Additionally, Mariana’s faeces sample result were clear of any bacteria growth especially Salmonella and E.coli. Several species of microorganism such as …show more content…
Mariana’s biochemistry results were requested by her GP because of suspicions she might be suffering from a liver disorder. The results showed some normalities such as the serum albumin which was within the lesser normal range of 30-50g/L. However, the level of serum bilirubin which is elevated compared to the normal range which could have been caused by a liver dysfunction. According to Thepa (2007), serum bilirubin is elevated when there is an impairment in the excretion of conjugated bilirubin from hepatocytes of bile ducts. The results also showed elevation of two of the liver’s enzymes, alanine aminotransferase (ALT) and aspartate aminotransferase (AST), these elevation could be caused by impaired liver function (Pratt et al, 2000). Mariana’s serum ALT levels is higher than the serum AST which could be caused by a form of viral hepatitis, drug or toxin induced liver injury (Limdi et al, 2003). The alterations in Mariana’s biochemistry results all seem to have been caused by a probable liver dysfunction. Fig 1: Graph showing the probability of a hepatocellular disease based on AST/ALT ratio (Kaplan, 2007).Mariana’s AT/ALT ratio is low, below 1 hinting she has viral