Answer to Question 1
American Chest Physician's equation 30-35 kcal/kg: 30x 54.1 = 1623 kcal- 35x 54.1=1893 kcal
EPR (1.2-1.5 g/kg/day) = 65-81 g/day
Most patients with COPD have some degree of hypermetabolism.
This may result in part from the increased work of breathing.
In Mrs. Hoffman's case, she also has an infection, which may also increase her energy requirements.
Answer to Question 2
Ht. 63; Admission wt: 119; UBW (5 years ago) 145-150; last recorded weight 12 months ago = 139; UBW 86 (based on weight 1 year ago)
BMI: 21.1
- Mrs. Hoffman's BMI is within a healthy range but this alone would not give an accurate view of her weight status.
- The most important risk factor is that she is 86 of her usual body weight, having lost 14 in one year's time.
- Any unexplained weight loss of >10 within a 12-month period places her at nutritional risk.
Presence of pitting edema indicates her actual (dry) weight is slightly less than her current weight of 119 (suggesting her UBW is lower than calculated, placing her at a greater nutritional risk).
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