Enteral Nutrition Case Study (20 points total): The remainin…
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: