Answer to Question 1
Standard calculations for Mrs. Williams' needs can be used. For energy requirements, a 25-30 kcal/kg nomogram or the Harris-Benedict equation for females can be used. For protein requirements, a 0.8-1.0 g/kg nomogram would be appropriate. A physical activity factor of 1.3 should be used considering her relatively low-active work environment and assumptions based upon her ailment/symptoms and age.
Energy Requirements:
REE = 655.1 + 9.6 W (kg) + 1.9 S (cm) - 4.7 A (yrs)
REE = 655.1 + 9.6 x 57.3 kg + 1.9 x 167.64 cm - 4.7 x 49 yrs
REE = 1283.8 1300 kcal
TEE = 1283.8 x 1.3 (PA) = 1668.9 1700 kcal; range of 1600-1800 kcal/day
57.3 kg x 25-30 kcal/kg = 1432.5-1719 kcal 1450 - 1700 kcal/day
Protein Requirements:
57.3 kg x 0.8 g/kg = 46-57 g/day
Answer to Question 2
Olivia's reported intake is meeting approximately 58 of her estimated energy needs. Her protein intake is adequate at 1.7 g/kg/d. She is meeting around 70 of her estimated fluid requirement.
Olivia's 24 hour recall indicates insufficient intake of the following micronutrients: vitamin D, vitamin E, thiamin, niacin, calcium, iron, zinc, phosphorus, and potassium.
Vitamins Patient's Intake DRI for age
Vitamin D 240 IU/d 600 IU/d
Vitamin E 3 mg/d 11 mg/d
Thiamin 0.7 mg/d 0.9 mg/d
Niacin 5 mg/d 12 mg/d
Minerals
Calcium 1000 mg/d 1300 mg/d
Iron 7 mg/d 8 mg/d
Zinc 6 mg/d 8 mg/d
Phosphorus 1000 mg/d 1250 mg/d
Potassium 2300 mg/d 4500 mg/d
The patient also takes a pediatric complete gummy multivitamin, 2x/day, though this does not contain calcium or iron.
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