List factors that you would monitor to assess the tolerance to ...

[Davideckstein7]

List factors that you would monitor to assess the tolerance to and adequacy of nutrition support.
 
  What will be an ideal response?

Question 2

Would you make any changes to his prescribed nutrition support? What should be monitored to ensure adequacy of his nutrition support? Explain. What recommendations would you make to transition to enteral feeding?
 
  What will be an ideal response?

[Bsand8]

Answer to Question 1

 Since feeding access is in jejunum, checking of gastric residual volumes is not indicated. Monitor for abdominal distention, pain, emesis, bowel movements.
 Weekly indirect calorimetry will be beneficial to assess under or over feeding.
 Monitor weekly CRP and prealbumin levels.
 Monitor weekly LFTs due to oxandrolone treatment.
 Monitor labs for electrolyte imbalance, renal function (e.g. BUN, creatinine), and glycemic control; 1-3 times daily.
 Daily I/O charts: tube feeding intake, bowel movements
 Wound healing assessment with burn team
 Nitrogen balance: UUN (weekly)

Answer to Question 2

It would be best to continue with the current regimen as it meets his measured energy requirements. Assess actual intake from intake/output records to ensure the prescription meets estimated nutrient needs. Obtaining nitrogen balance will help support current rationale for nutrition prescription.
When able, wean Mr. Page from the parenteral nutrition support to enteral nutrition support or an oral diet..

[Davideckstein7]

Thanks for the timely response, appreciate it

[recede]

Gracias!