Author Question: On a separate sheet of paper assume that Mr. N will go home on a diet and estimate what that diet ... (Read 197 times)

abern · **on:** Aug 2, 2018

On a separate sheet of paper assume that Mr. N will go home on a diet and estimate what that diet will be. Include in your estimate the number of kcals he should have, the grams and percent of protein, the grams and percent of carbohydrate, the grams and percent of fat, the cc of fluid, the grams of Na, and any other restrictions or supplements that you feel are necessary.

Question 2

Describe the mechanism of action and possible nutritional complications of furosemide.

mjenn52 · **Reply #1 on:** Aug 2, 2018

Answer to Question 1

The kcals should be about the same, more if he can tolerate them to gain wt. Assume a kcal intake of 2500
Protein will vary according to his degree of recovery; 0.8 - 1.0 g/kg may be his tolerance level. 1.0 g/kg = 68 g. 68 4 = 272 kcals or 272/2500 = 10.8

The protein would be increased as tolerated. Fat as tolerated. Initially try 30 and gradually increase to 40 if tolerated. 40 of 2500 = 1000 kcals; 1000/9 = 111 g of fat.

With 1000 kcals coming from fat, and 272 from protein, this is 1272 kcals and leaves 1228 to come from CHO. 1228/2500 = 49 or 1228/4 = 307 g.

Fluid as tolerated, probably between 1 and 1.5 L. Na would be between 1 and 2 g. A good vitamin and mineral supplement per day would be in order.

Answer to Question 2

furosemide (Lasix): inhibits reabsorption of sodium and chloride at the proximal portion of the ascending loop of Henle. Possible nutritional complications include abdominal discomfort and pain, diarrhea (with oral solutions). Hypokalemia, fluid and electrolyte imbalances, hypocalcemia, hypomagnesemia, hyperglycemia and impairment of glucose tolerance, dehydration.