What is different from inpatient and outpatient counseling?

Case Studies

A 56 year old male, E.O, is present in the hospital for dilation of the esophagus due to severe gastroesophageal reflux (GERD). Patient has a past medical history of diabetes, cardiovascular disease and hypertension. Patient indicates that over the past month he has not been able to eat much food and what he does eat keeps coming back on him. He reports that he has lost approximately 10 pounds within the past month and cannot stand to drink any supplements like Ensure. He wants to know what he can eat after the surgery.

Height: 6’0” Weight: 200 pounds Weight history: 215 pounds (4/5/09) Labs: Bedside glucose- 150-200 mg/dL, Albumin 2.5 mg/dL Meds: Humalog, Lantus, HCTZ, Simvastatin

A 75 year old female, S. H., is present in the hospital for open heart surgery. Patient has a past medical history of angina and high cholesterol. She reports that she generally eats a well balanced diet by including fruits and vegetables and higher fiber foods, but thinks because her husband and her go out to eat frequently the salt content is too high. She reports she walks 5 days per week rain or shine for about 1-2 miles and was feeling very good and is pretty shocked she had this surgery.

Height: 5’4” Weight: 130 pounds Labs: Cholesterol 240 mg/dL, LDL 150 mg/dL, HDL 45 mg/dL, Triglycerides 120 mg/dL Meds: Lisinopril, Tricor, Multivitamin, Vitamin E

A 6 year old female, R. F., is present in the hospital with nausea and vomiting. Patient has a past medical history of asthma. Mom reports that daughter has not been eating well in the past week and thinks she has lost some weight, but does not weigh her. She reports daughter has only had ½ piece of toast with butter and jelly and 1 cup of juice this morning for breakfast. Patient has agreed to have a milkshake in the afternoon.

Height: 120 cm Weight: 55 pounds Previous weight in chart 1 year ago: 40 pounds

Meds: Inhaler