Marlene is an 86-year-old white female resident in a skilled nursing facility with unintentional weight loss. She was admitted 3 months ago from the hospital after a hip fracture. She had been residing in an independent living facility for several years. She reports she has been eating poorly because of difficulty moving around being generally uncomfortable and states If I am not active I dont need to eat so much. Intake is less than 50% of regular diet. No problems chewing or swallowing are noted after a speech language pathologists evaluation. Admission weight was 112 pounds; current weight is 95 pounds. Self-reported height is 5 3; Hgb/Hct is normal; total cholesterol is 135; and Mini Nutrition Assessment score is 5. Hip scans show slow fracture healing and no improvement in bone density; currently she is being supplemented with calcium 1000 mg/day and vitamin D 600 IU/day. Blood pressure is 128/80 with furosemide (Lasix); other medications are lorazepam (Ativan) fentanyl transdermal patch (Duragesic) senna (Senokot-S) docusate (Colace) and mirtazapine (Remeron)here are sutable reference to answer this question Kunreuther, H. 2008. Reducing Losses from Catastrophic Risks Through Long-Term Insurance and Mitigation. Philadelphia: Risk Management and Decision Processes Center, The Wharton School, University of Pennsylvania.;Krueger, A. B. 2009. Measuring the Subjective Well-Being of Nations. Chicago: University of Chicago Press.;Knowles, N., M. D. Dettinger, and D. R. Cayan. 2006. Trends in snowfall versus rainfall in the western United States. Journal of Climate 19(18):4545-4559.;Kirllenko, A. and R. Sedjo. 2007. Climate change impacts on forestry. Proceedings of the National Academy of Sciences of the United States of America 104(50):19697-19702.;Kim, H., S. Kim, and B. E. Dale. 2009. Biofuels, land use change, and greenhouse gas emissions: Some unexplored variables. Environmental Science and Technology 43:961-967.;Khagram, S. 2004. Dams and Development: Transnational Struggles for Water and Power. Ithaca, NY: Cornell University Press.;Keith, D. W., J. F. Decarolis, D. C. Denkenberger, D. H. Lenschow, S. L. Malyshev, S. Pacala, and P. J. Rasch. 2004. The influence of large-scale wind power on global climate. Proceedings of the National Academy of Sciences of the United States of America 101(46):16115-16120.;Kaufman, D. S., D. P. Schneider, N. P. Mckay, C. M. Ammann, R. S. Bradley, K. R. Briffa, G. H. Miller, B. L. Otto-Bliesner, J. T. Overpeck, B. M. Vinther, and Arctic Lakes 2k Project Members. 2009. Recent warming reverses long-term Arctic cooling. Science 325(5945):1236-1239.;Kates, R. W., C. E. Colten, S. Laska, and S. P. Leatherman. 2006. Reconstruction of New Orleans after Hurricane Katrina: A research perspective. Proceedings of the National Academy of Sciences of the United States of America 103(40):14653-14660.;Kalnay, E., M. Kanamitsu, R. Kistler, W. Collins, D. Deaven, L. Gandin, M. Iredell, S. Saha, G. White, J. Woollen, Y. Zhu, A. Leetmaa, B. Reynolds, M. Chelliah, W. Ebisuzaki, W. Higgins, J. Janowiak, K. C. Mo, C. Ropelewski, J. Wang, R. Jenne, and D. Joseph. 1996. The NCEP/NCAR 40-year reanalysis project. Bulletin of the American Meteorological Society 77(3):437-471.
