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Case Study 2 2010 - Lab values Albumin 2.5g/dL WBC 14...

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Case Study #2 Mr D is an 85 yowm who has lived with his son and daughter-in-law for the last 6 years. He broke his left femur a year ago and has not been able to get around well since then. His mental abilities have declined further over the past year. Mr. D had new dentures made that fit well so he no longer needs a soft pureed diet, but does not always eat well despite the new dentures. He is back in the hospital for a total hip replacement, a year after his initial left femur fracture. On post-op day 4, complications arise and Mr D develops sepsis and is transferred to the ICU. He was immediately placed on antibiotics to start treating the sepsis. However, as a result of the sepsis, Mr D develops an ileus and the nutrition support team has been consulted for recommendations for TPN (parenteral nutrition) feedings. Anthropometric Data: Height: 6’ 0” Current wt: 136 lbs Weight 1 year ago: 143 lbs TSF: <5 th percentile AMA: 10 th percentile Lab values:
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Unformatted text preview: Lab values: Albumin: 2.5g/dL WBC: 14 000/mm 3 Hgb: 12.6 g/dL Hct: 34% MCV: 76 μm TPN Order: 2000 mL of 25% dextrose and 5% amino acid solution 250 mL 10% fat emulsion 3 times a week MVI and trace elements According to the information provided above calculate how much protein and calories Mr D is receiving and state if it is sufficient to meet his nutrient and energy needs. It seems as though Mr D has been progressing well with the antibiotic treatment and has tolerated TPN well. His ileus has resolved and the attending physician has consulted nutrition support again to determine the best route to take at this stage. The nutrition support team decides to place him on Jevity 1.2. Calculate the amount of formula needed based on Mr D’s nutrient needs. Calculate the rate per hour for delivery of the formula. Calculate how much protein and fluid the formula will provide. Jevity 1.2 1.2 kcals/mL 22 g fiber/L 55.5g protein/L 805 mL water/L...
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