Author Question: By using the information on the intake/output record, determine the energy and protein provided ... (Read 71 times)

biggirl4568 · **on:** Aug 21, 2018

By using the information on the intake/output record, determine the energy and protein provided during this time period. Compare the energy and protein provided by the enteral feeding to your estimation of Mr. Angelo's needs.

What will be an ideal response?

Question 2

Mr. Page was placed on parenteral nutrition immediately postoperatively, and a nutrition support consult was ordered. Initially, he was prescribed to receive 200 g dextrose/L, 42.5 g amino acids/L, and 30 g lipid/L.

His parenteral nutrition was initiated at 50 cc/hr with a goal rate of 85 cc/hr. Do you agree with the team's decision to initiate parenteral nutrition? Will this meet his estimated nutritional needs? Explain. Calculate: pro (g); CHO (g); lipid (g); and total kcal from his PN.

elizabethrperez · **Reply #1 on:** Aug 21, 2018

Answer to Question 1

Mr. Angelo received 565 mL of Impact Glutamine providing 734.5 kcal and 44.07 g protein. This provides approximately 25 of prescribed energy and 31 of prescribed protein requirements.

Answer to Question 2

Mr. Page was certainly malnourished prior to surgery.
His surgery places his gastrointestinal function at risk. Mr. Page will be NPO for some time.
The decision to use parenteral nutrition is correct.
This formula prescription provides 2346 kcal and 86.7 g protein.
This is slightly higher in both energy and protein than the lower calculated energy needs and will sufficiently nourish him.
Note: Calculations of parenteral nutrition are as follows:
2436 kcal : 64 kg = 36.7 kcal/kg
86.7 g amino acids : 64 kg = 1.4 g protein/kg
Dextrose: 200 x 3.4 = 680 kcal/L. Total volume is 2040 mL, which would provide 1387.2 kcal.
408 g dextrose x 64 kg = 6.375 g/kg/day x 1000 mg/g x 1 day/1440 min = 4.4 mg dextrose/min
(4.3-7.2 mg/kg/min guideline for critically ill/stressed patients)
Lipid: 30 g lipid/L 11 kcal/g: 673.2 kcal