Question

Adam is a 68-year-old male admitted to the hospital with a 1-month history of nausea, vomiting, and diarrhea resulting in weight loss and fatigue. He presents tachycardic with abdominal pain, fever, and chills. Adam is a retired engineer and lives at home with his wifeIt is now postoperative day 6/HD 12 and Adam remains in the ICU. He is currently receiving enteral nutrition support since postop day 3, which provides him with 1,700 calories and 100 g protein.

Anthropometric Data:
Weight: 76 kg (167 lbs)
Last Weight: 77 kg (169 lbs) postop day 1/HD 7
Admit weight 75 kg (165 lbs)

Biochemical Data:
Albumin 2.1 g/dL (3.5 to 5.0 g/dL)
Prealbumin 14 g/dL (17-36 g/dL)
Urine urea nitrogen (UUN) 10 g/24 hours

Questions
1. How do you interpret Adam’s current albumin and prealbumin levels? What information does this provide to your assessment of Adam’s nutritional status?






2. Calculate Adam’s nitrogen balance. Is he in positive or negative nitrogen balance?






3. Based on this information, how would you assess Adam’s current nutrition plan?





4. What biochemical indices can you monitor to further assess nutritional adequacy

Answer 1

Answer :

Q. No 1 answer :interpretation of albumin and pre albumin level : albumin 2.1 gm / dl. It is low.

Pre albumin 14 gm/ dl. It is also low.

* he is on enteral nutrition , and he needs albumin containing diet.

* through protein rich diet he will improve albumin levels.

* as already he is receiving proteins, so still more we need to increase by rules tube by giving milk, daily.

* and meat eggs also can improve albumin.

* so by crushing egg we can give through nasogastric tube.

Q. No 2 answer :

Adams nitrogen balance is positive, because normal urea nitrogen balance is 12-20 gm/24 hrs.

* so here only 10 gm in 24 hrs .

* Low urea nitrogen indicates malnutrition.

Q no 3 answer :

Based on urea nitrogen volume patient is on malnutrition.

* so the nutritional requirements are very essential to clients.

* nutrientional requirements like proteins containing diet like milk, meat, eggs, by liquid forms we can give through nasogastric tube.

* along with enteral feeding we can give this also.

Q. No 4. Answer :

* by vitamins and minerals levals assessment also we can monitor the further nutritional adequacy.

* micro elements also essential for recovery of the client.

* and to absorption of the all nutrients in the body.