Calculate Mrs. Maney's energy and protein requirements. Explain ...

[vicotolentino]

Calculate Mrs. Maney's energy and protein requirements. Explain your rationale for the weight you have used in your calculation.
 
  What will be an ideal response?

Question 2

Evaluate Mrs. McCormick's laboratory values. List all abnormal values and explain the likely cause for each abnormal value.
 
  What will be an ideal response?

[FergA]

Answer to Question 1

 Mrs. Maney's IBW (50 kg) is used for calculations as her current weight is masked by fluid retention. This is within 10 of her current weight.
 Energy: energy needs for cardiac cachexia may be calculated using the American Chest Physician's nomogram. 50 x 25 = 1250 kcal 50 x 35= 1750 kcal Range: 1250-1750 kcal

 Protein: AND EAL recommends 1.37 g/kg for heart failure patients.
47.7 kg x 1.37 = 65 g/day

Answer to Question 2

 Calcium (L): Low protein levels, especially albumin, which causes the bound calcium to be low; dietary calcium deficiency, malnutrition, possible hypoparathyroidism
 Protein (L): Malnutrition  decreased visceral protein stores
 Albumin (L): Malnutrition  decreased visceral protein stores
 Prealbumin (L): Malnutrition  decreased visceral protein stores
 Cholesterol (L): PEM, starvation
 HDL (L): Family history of CAD, low physical activity
 RBC (L): Anemia, iron deficiency
 Hgb/Hct/MCV/MCH/MCHC (L): Prolonged iron deficiency/anemia
 Transferrin (H): Chronic iron deficiency (body is trying to allocate iron to put into stores)
 Ferritin (L): Iron deficiency (low iron stores)
 WBC (H): Consistent with infection and possible pneumonia

[vicotolentino]

Thank you!

[FergA]

Always glad to help...