Do you have any evidence that Mrs. Maney may be malnourished? ...

[newyorker26]

Do you have any evidence that Mrs. Maney may be malnourished? Identify factors that may support a diagnosis of malnutrition using the latest AND/ASPEN proposed guidelines for malnutrition diagnosis.
 
  What will be an ideal response?

Question 2

Determine Mrs. McCormick's energy and protein requirements. Explain the rationale for the method you used to calculate these requirements.
 
  What will be an ideal response?

[guyanai]

Answer to Question 1

 Yes, there is evidence that Mrs. Maney is malnourished
 Muscle loss at her temporal region
 Fluid accumulation is present: ascites, 2+ pedal edema (though, her heart failure complicates this clinical evidence for malnutrition) and would be difficult to interpret.
 Weak grip strength
 < 27 energy intake (per 2 cans of Boost daily)

Answer to Question 2

 EER: 28-33 kcal/kg x 50 kg = 1400-1700 kcal/day
Because of this patient's recent weight loss and underweight status, she will require more calories than needed to maintain weight (goal is to gain weight back to usual body weight)
 EPR: 1.2-1.5 g protein/kg x 50 kg = 60-75 g protein/day
Because of the clinical and laboratory evidence of protein malnutrition, her needs over the long term are increased in order to see an improvement to these signs and symptoms

[newyorker26]

Thanks for the timely response, appreciate it

[mohan]

Excellent