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Why is hemоdynаmic stаbility in ICU pаtients impоrtant tо consider prior to beginning EN?
Mr. Sаnders, а 65 y.о. mаle, was emergently taken tо the OR fоr a CABG x 3 due to 70% vessel occlusion after being admitted to the hospital for a myocardial infarction. Today is hospital day #2 and he is currently in the coronary care ICU, ventilated and sedated. MIV is running at 125 mL/hour with D5W and 20 mEq of KCl. A nasogastric tube is drained 1500 mL in the past 24 hours. A nutrition consult is ordered. Height: 5’8” Current Weight: 225 lbs. Weight prior to admit: 212 lbs Past Medical History: Hypertension, dyslipidemia, obesity but has experienced an unintentional weight loss to 40 lbs. in the past 3 months as he just hasn’t been hungry Medications: Antibiotics, s.s. insulin, & propofol @ 10 mL/hr Nutrition-focused physical exam: large male sedated and ventilated; abdomen firm and distended; 3+ bilateral lower extremity pitting edema Laboratory data: Na++: 134 (135-145) K: 4 (3.5-5) Cl: 97 (96-106) Phosphorus: 2.2 (2.5-4.5) HCO3: 25 (20-29) BUN: 20 (7-21) Cr: 1.5 (0.6-1.2) Magnesium: 1.5 (1.5-2.5) Gluc: 150 (70-99) Ca++: 7.5 (8.5-10.2) Alb: 2.9 (3.5-5.5) WBC: 11,000 (5,000-10,000) I/O: 2700 mL/2400 mL MAP: 59, 57, 57 Temp: 99.3° Write a nutrition assessment for Mr. Sanders based on the data above: (5 points) Calculate a nutrition prescription for Mr Sanders: (5 points) Write one PES statement for Mr. Sanders based on the above data and assessment: (5 pts) What would you recommend and why? Discuss your rationale for your recommendation, show your work, and COMPLETE the appropriate order form if necessary. If you are choosing an order form, make sure to submit to the Final Exam Folder. (15 points)