Enteral Nutrition Case Study (20 points total): The remaining questions are related to the following case study.  Todd is a 39-year-old male on the neurology floor at a local medical center. He was admitted after going to the ER because of confusion, disorientation, and difficulty talking. He was diagnosed as having had a severe stroke. He is paralyzed on the right side. He is currently NPO with an IV running at 115 mL/hour. The speech pathologist has conducted a swallow study and is recommending that he remain NPO because he is at a high risk for aspiration and suggest alternate route of nutrition. Today is hospital day 5. A nutrition support consult is ordered because he will be going to a rehab center in 3 days.   Ht: 5’ 8”           Current Wt: 180 lbs. (200 lbs. 5 months ago – intentional weight loss)         Vital signs:  Blood pressure: 125/82       Temperature: 98.6°   Past Medical History: hypertension, hernia surgery Labs: Na+: 138 (135-145)   K+: 3.9 (3.5-5.5)   Cl: 98 (95-105)    Glucose: 120 (70-99)   BUN: 12 (8-18)          Creatinine: 0.8 (0.6-1.2)                    WBC:  11 (3.5-10)     GFR: 120 (>90)         Hemoglobin: 14 (13.5-17.5)   Nutrition history: B: coffee (~10 oz) with ~2 tbsp. whole milk. 2 whole grain waffles with fresh fruit. L: large salad (1 c of mixed lettuce, cucumbers, tomatoes, artichokes & carrots) with ~4 ounces of chicken, salmon or shrimp. 1 Tbsp dressing. Salad has lots of colorful veggies. Large unsweetened iced tea to drink (32 oz). Snack: Large apple or pear; large unsweetened iced tea (32 oz). D: ~6 oz. of grilled chicken, fish or lean meat; large salad w/lots of veggies (tomatoes, cucumber, carrots, broccoli, asparagus; 1 Tbsp dressing; small baked potato and large unsweetened iced tea to drink (12 oz). Evening snack: Typically will have 3 cups of fat-free popcorn and large unsweetened ice tea (20 oz).  1. Would you start enteral nutrition support at this time – state why or why not? (5 points) 2. Complete a nutrition assessment paragraph (6 points)  3. Complete a nutrition prescription (8 points). Record your answer so you have it accessible for questions to follow.       Energy requirements:      Protein requirements:      Fluid requirements:      Any micronutrient concerns: 4. Complete 2 PES statements (6 points):  Refer to terminology sheet and use correct language P:   E: S: P: E: S:   

9. Which medication is most suitable for a patient with alcohol addiction and opioid dependence?

Which of the following lists items that are ALL part of the Seven Rights of Drug Administration?

Write a TF order to start and advance Todd’s EN feeding based on the nutrition goals you have calculated for him. (7.5 points) Choose from the following formulas: Glucerna 1.2  – 1.2 kcal per mL, 60 g protein/L, 81% free water, meets or exceeds RDIs for micronutrients in 1250mL Jevity 1.2  -1.2 kcal per mL, 55.5 g protein/L, 81% free water, meets or exceeds RDIs for micronutrients in 1250mL (contains 17g fiber per liter) Osmolite 1.2 – 1.2 kcal per mL, 55.5 g protein per 1.0 L, 82% free water, and meets or exceeds RDIs for micronutrients in 1200 mL  Nepro  – 1.8 kcal per mL, 81 g pro/L, 73% water and 12.6 g fiber/L. Low in sodium, potassium and magnesium (

8. If a nurse is caring for a patient who is taking bupropion, effective treatment is indicated when the patient no longer has which characteristic?

6. Which action describes a therapeutic communication technique? Select all that apply. 

Which of the following is primarily responsible for the sensation of hearing?

The structure indicated by the arrow is primarily involved with which of the following?

11. Which condition would the nurse suspect that a patient on lithium has been diagnosed with?

Select the best description of the sympathetic postganglionic neurons.