Question

Patient Description

H C , 68 y.o., Male Height: 6’3” Current Weight: 156 lbs. (70.8 kg); UBW: 220 lbs. (99.8 kg), % Weight Change: 29.1%.

Admitted to acute care for possible dehydration, weight loss, generalized weakness, and malnutrition. Ordered a mechanical soft diet and started on I.V. fluids. Patient was diagnosed with squamous cell carcinoma of tongue five years ago. Patient previously treated with radiation therapy, but has had no treatment in the last 3 years. Five years ago, the patient had a partial glossectomy (removal of the tongue). The patient expressed feeling lethargic and appears cachectic and looks older than his actual age. Patient states he has lost over 60 lbs. in the past 1-2 year, but after completing radiation therapy 5 years ago his weight held steady at 220 lbs. He gets full easily and never feels hungry.

Patient’s Diagnosis Chronic-Disease Related Malnutrition Supported by: Patient’s energy intake of <75% of estimated energy requirements for >1 month.

Patient’s 29.1% weight change in the past 2 years.

Patient’s decrease muscle tone and loss of lean mass in his quadriceps and gastrocnemius.

Lab results indicating inflammation:

Elevated C-reactive protein level of 2.4 mg/dL

Low albumin (1.8 g/dL) and pre-albumin (9 mg/dL) levels

Other signs and symptoms include:

Patient expresses lack of energy and feels weak.

Patient appears cachetic and older in years. Temporal wasting.

Support of Dehydration

Patient feels lethargic

Skin turgor: TENT

Receiving only 360 mL of fluid orally

High Sodium and Chloride levels

Low Potassium Levels

Elevated BUN and Creatinine Serum levels

Slightly elevated specific gravity in urinalysis

• Calculate the nutritional requirements and write the Nutrition Care Process

In the nutrition diagnosis write more than 1 PES statement

Answer 1

Image 1 explain nutrition required for disease related malnourishment

Image 2 explain nutrition care process

Ist

In disease related malnutrition - In disease related malnutrition, the nutsertion requirments are explained as : plenty of fruits and vegetables, plenty of starchy food such as bread, rice, potatoes, Some milk and daily foods and non- diary foods. some sources of protein such as eggs and Beaus Measure weight of patient daily. As we know that patiend had undergone to glossectomy so patient is adviced to eat liquids and soft foods. Such as milkshakes, yogud, cereals, smooth soups, mashed potatoes, refried Beans, pudding and fruit smoothies and protein shakes

2nd

Nutrition Care Process :- Subjective Data pt. feel weakness and timed. lite lue to objective I data and Data (Assessment) Newese assess that pt: Has malnowrished Evaluation to shoolch i dom Diagnosis pt. is suffering from Malnoweishment - Patient feels Better - Level of a weakness decrease (Nutrition care e process) C hodhroits Implementation ro Intervention - To provide plenty of T h of liquid T - Fluid given protein rich diet taken soft diet given. a To advice reich protein sowices To take soft diet. To take funits