Author Question: Before his bleeding, what diet would have been appropriate for Mr. N? Be specific for protein, ... (Read 15 times)

cabate · **on:** Aug 2, 2018

Before his bleeding, what diet would have been appropriate for Mr. N? Be specific for protein, carbohydrate, fat, total energy, Na, fluid, and vitamins and minerals.

Question 2

Why would Mr. Y not be allowed to have any hot or cold liquids with his meals?

Liddy · **Reply #1 on:** Aug 2, 2018

Answer to Question 1

If Mr. N had been taking oral food prior to his severe bleeding, he should have been taking about 0.5 - 0.7 g/kg of dry body wt, moderate CHO in actual practice, the patient will probably not eat enough CHO and the goal would be just trying to get him to eat enough, fat as tolerated (evaluated by steatorrhea and elevated triglycerides); energy = 35-40 kcals/kg of body wt but it will be difficult to get this much into him; 1g Na or possibly less; 700 1000 cc fluid + urinary output; and a good multivitamin and mineral supplement.

Answer to Question 2

The hot or cold liquids could stimulate nerve endings of the vagus nerve that are in close proximity to the esophagus. It is remote, but possible, that this stimulation could be sufficient to affect heart muscle contraction and could possibly result in arrhythmias.