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An 62kg pаtient w/ shоrt bоwel syndrоme is receiving PN (15%D, 7.5% AA) аt 65mL/hr + 250mL 20% lipid dаily (2-in-1). Lipid infusion rate in both g/kg/d AND g/kg/hr? (round to the nearest hundredth)
It is nоw hоspitаl dаy #12. Mr. Phillips hаs been transferred оut of the ICU. Mr. Phillips has been tolerating your tube feeding prescription at goal. The patient was extubated successfully, however, Speech Therapy found the patient to have severe dysphagia secondary to the traumatic brain injury (TBI) and will be NPO for an extended period of time. The patient is pending a PEG tube placement and the primary team has consulted you for bolus tube feeding recommendations. Height: 6’1” Current Weight: 186lbs. Admit Weight: 185lbs. No weight or diet history available Past Medical History: Unknown Medications: None (Propofol Discontinued) Nutrition-focused physical exam: Unremarkable. No edema. Abdomen is soft, non-tender, and non-distended. Laboratory data: Na++: 142 (135-145) K: 3.8 (3.5-5) Cl: 98 (96-106) Phosphorus: 3.8 (2.5-4.5) HCO3: 21 (20-29) BUN: 12 (7-21) Cr: 0.7 (0.6-1.2) Magnesium: 2.2 (1.5-2.5) Gluc: 142 (70-99) Ca++: 8.2 (8.5-10.2) Alb: 2.9(3.5-5.5) WBC: 9,000 (5,000-10,000) Step 1: Re-estimate the patients needs if needed (Protein, Kcals, and Fluid) Step 2: Provide tube feeding recommendations for the patient. Please make sure to include the formula, volume, number of cans, along with what the prescription provides (kcals, protein, and free water). The regimen needs to have a realistic schedule for feeding (e.g. 1 can at 0800, 1 can at 1100, etc.). Hint: 1 can of formula = 237mL Step 3: Provide free water flush recommendations *NOTE - I don't need any additional information. Simply provide me with your recommendations as outlined in steps 1 - 3. I don't need which labs you're going to monitor, additional supplementation, etc. This question is simply testing your ability to complete a bolus tube feeding prescription.