Question

nutriton question, answer if you really know it.

Shannon is a 29 year old female currently intubated and sedated in the ICU due to domestic abuse Today is hospital day #3. She had surgery after being admitted from the emergency department to repair her small bowel, colon, liver and spleen due to multiple abdominal stab wounds. Her abdomen is currently firm and distended with negative bowel sounds. She has a nasogastric tube in place which has drained 1800 mL out in the past 24 hours. A triple lumen has been inserted into the superior vena saya. Patient reportedly had been having some health issues prior to admission. She is employed as a lab tech at a local university and told her Mom that she had lost 10 lbs. in the last 2 months due to work-related stress. She was having lots of abdominal cramps and had really lost her appetite. She has two children aged 4 and 6. IV fluids are running at 100 mL/hr with D5W and ½ normal saline with 20 mEq/d of KCl. A nutrition support consult has been ordered to start parenteral nutrition. Current Wt: 125 lbs. (-57 kg) Usual Wt: 130 lbs. (2 months ago) Ht: 5'7" Nutrition-focused physical exam: patient appears thin but no overt signs of nutritional deficiencies; abdomen is firm and distended with negative bowel sounds Current medications: meds for sedation and pain control; antibiotics to decrease infectious complications Labs: Sodium: 135 (135-145) Potassium: 4.0 (3.5-5.5) Chloride: 99 (99-112) Bicarb: 26 (22-29) Glucose: 91 (65-99) BUN: 10 (8-24) Creatinine: 0.8 (0.6-1.1) Albumin: 2.8 (3.5-5.5) WBC: 11 (4-11) Hemoglobin: 12 (11-15.8) Vital Signs: Temp: 100° MAP: 59, 60, 59, 58, 57 IOs for the past 2 days: hospital day #1 : 32402500 mL hospital day #22800/2300 mL

Answer 1

1. List the potential complications associated with parenteral nutrition to Mrs.Shannon?

Here Mrs.Shannon is on nutritional support with parenteral nutrition, due to the parenteral nutrition she is suffered from electrolyte imbalance such as (Hypokalemia and Hypomagnesemia) high blood sugars (Hyperglycemia) and infection and as well as dehydration.

2. Mrs Shannon who is a victim of domestic violence is on total parenteral nutrition and she develops the complications of parenteral nutrition.

She is having high WBC count and hyperthermia indicates some infection and suffering with hypokalemia, hypomagnesemia and hypoalbuminaemia and or hypoproteinemia.

She needs the IV fluid should be included with some more electrolytes to prevent dehydration and other electrolytes imbalance

We have to add an IV infusion with amino acids or proteins

I think she needs vitamins/multivitamin supplementation

3. Today she is on 10 the day and her abdomen appears soft and non-distended instead of hard and distended and her parenteral nutrition is running at a goal rate indicates that she is feeling better than her previous stage and she is maintaining a mean arterial pressure of 65 indicates it as normal and she is not having any signs of dehydration.

We have to follow the present nutrition plan and as well as we have to check her frequently for her status that whether she is functioning as normal or not.