Answer to Question 1
Upon admission to the hospital:
BEE = 66 + 13.7 wt + 5 ht - 6.8 age
= 66 + 13.7 81.8 + 5 180 - 6.8 25
= 66 + 1120.7 + 900 - 170 = 1916
CHI usually requires a lot of kcals. Stress factor = 1.7 - 2.0 1916 1.8 = 3450 kcals
Upon transfer to the ward:
BEE = 66 + 13.7 61 + 5 180 - 6.8 25
= 66 + 835.7 + 900 - 170 = 1632
RK was transferred to a ward after he recovered from the initial trauma but was still suffering from the results of the trauma. That is, his BEE was probably normal or sub normal now with very little exercise. It would take less kcals to maintain RK now than it did prior to his accident. Therefore: Stress factor = 1.2 1632 = 1958
Much of RK's weight loss was muscle. Much of the weight he gained back was fat. With a smaller than normal amount of muscle mass and inactivity, he may continue to gain weight on this amount of kcals and his intake may have to be decreased.
Concerning his protein needs, upon admission: 81.8 1.7 = 139 g/d
Upon transfer to the ward: 61 .8 = 49 g/d
Answer to Question 2
pancrelipase (Viokase): a combination of digestive enzymes that replaces endogenous exocrine pancreatic enzymes and aids in digestion of starches, protein, and fat. Complications: nausea, diarrhea with high doses.
potassium iodide: increases production of respiratory tract fluids to help liquefy and reduce the viscosity of thick, tenacious secretions. Complications: nausea, gastrointestinal distress.
corticosteroid: a class of drugs that decreases inflammation, mainly by stabilizing leukocyte lysosomal membranes. Also suppresses the immune response. Complications: increased appetite, glucose, muscle breakdown, can cause growth suppression in children, possible hypokalemia, hyperglycemia, and depressed immune response.