Determine Mr. Campbell's energy and protein requirements. Explain ...

[HCHenry]

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

Question 2

Mrs. Caldwell's laboratory values that you discussed previously in this case indicate she has anemia. Why do renal patients suffer from anemia? How is this typically treated in dialysis patients?
 
  What will be an ideal response?

[johnpizzaz]

Answer to Question 1

For the critically ill, mechanically ventilated patient, the Penn State equation would be most appropriate. Since Mr. Campbell is not mechanically ventilated, it is best to use a 25-35 kcal/kg American Chest Physician's nomogram.
25-35 kcal/kg: (25 x 70.9 kg) to (35 x 70.9 kg) = 1773-2482 kcal per day (approx. 1800-2400 kcal/day)
The Harris-Benedict with or without stress factors, Ireton-Jones, Fick, or Mifflin-St Jeor equations are NOT recommended for use with non-obese critically ill patients.
Estimated protein requirements in non-obese critically ill: 1.2-1.75 g/kg/day: (1.2 x 70.9) to (1.75 x 70.9) = 85-124 g protein per day

Answer to Question 2

The loss of the kidney's ability to synthesize erythropoietin decreases red blood cell production. The K/DOQI anemia guidelines recommend administration of rHuEPO. Additionally, oral and intravenous iron supplementation can be prescribed.

[HCHenry]

Excellent

[yeungji]

TYSM