Answer to Question 1
Pivot 25 mL/hr = 900 kcal and 56 g protein. At initial rate of 25 mL/hr, the patient's needs are not met.
Goal = 54 mL/hr, which provides 1944 kcal and 122 g protein
Answer to Question 2
Mrs. Hoffman has a low albumin, prealbumin, total protein, RBC, hemoglobin, and hematocrit.
Her CO2, HCO3-,WBC, Lymph and Segs are elevated
Additionally, her O2 is low - due to COPD and dysfunctional respiratory status
Albumin and total protein can be assessed as a measurement of chronic visceral protein status when there is no inflammation present.
The elevated CO2 and HCO3- levels are related to her compensated (low end of normal pH) respiratory acidosis.
The elevated WBC, Lymph, and Segs are related to her upper respiratory infection.