Question

Lab 8: Exercises EXERCISE 8.1 GM is a 20 y/o male who was admitted to the ICU for severe closed head injury and multiple fractures resulting from a fighting engagement at the bar on his birthday. According to his friends, his Ht is 178 cm. His measured Wt at admission is 76 kg. His lab values were normal except for low Hgb and Hct due to bleeding (which was well controlled). He was unconscious, thus was tube fed for one week using Jevity 1.0 at 10 mL/h with increases of 10 ml/hour q12 hours, till a goal rate of 95 mL/hour was met. Closed head injury: brain injury without any penetrating injury to the brain or skull fracture. 1. Calculate GM's IBW (Use Desirable BMI ranges for Specific Age Group). Is he within his IBW7 Should IBW or actual body weight be used to calculate his requirements? 2. Calculate GM's caloric and protein requirements at admission using HBE. 3. What is the issue with the initial enteral nutrition progression ordered for GM? 4. Does Jevity 1.0 at 95 mL/hour provide adequate calories and protein for GM? Show your calculations.

Answer 1

28 29 30 31 THURSDAY 0 3. Tube feed a 2 kaal 1 ul. using Huhren 2.0. Nutren 2. 0 has. 2000 kcal IL or a kcal/hul! GM needs 2755 kcal 1 day, so 2755 2 115 kcal/how. - 24 Using Nuhen 115 kcal the a Inl/hr. 2 kcal/ml

** Free wales Flashes should not be confused with wated Flushes, which is additional wadee peovided to a patient in their daily regimer to clear the Feeding tube Periodically throughout the day (may heas to som mired with medications and Pee Flush) infused in to the tube [also may be alw und 25 to som! pel Flush] The watel Flushes conteibude free watee as well, which also count toward the fluid requirement 250 ml q (evely) 4 hes happens 6 times in a day so the Flushes Plovides 1500 ml Feee wated toward the FR. This gives youe total 2593 ml Elle wadee peom the combined Feed watee and wated Flushes. CSS m I Scanned with CamScanner

LU20 21 U FRIDAY FRIDAY 27 28 8 Exercise 8.1 GM- Age - 204... Height - lits am - wt - t6 kg → 5.84 foot 167.5 pound. 12 1. IBW ( Ideal Body weight) formula. Male : 1BW 250 kg + 2.3kg for each 1 inch over s feet . - females : IBW = 45.5kg + 2-3 kg for each ?. Inch over s feet 3 The Bh and ABW are used to cakulte medication dosages when the patient is obese. 1BW of GM = 50 kg + 2.3 kg for each inch over 2 73.2 kg (with in 5.1. of BW) * He is within 5t. of IBW. BMI 2 Body Mass Index formula - kg/m² kg z pesson's weight in kilograms m2 a their height in metres square, A BMI & 25.0 or more is overweight, while healthy range is s. 5 to 24.9. CamScanner The time to repair the roof is when the sun is shining.

13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 SATURDAY SATURDAY U4 BMI of GM ² kg /m² 1782 2 24 kg (m ² (60t., Healthy weight) & Should Ibo or actual body eveight be used to calculate this requirement au Acording to his Bml he is healthy so there is no need to take Bw to calculate A al medication dosages. Actual weight can be used to calculate his requiranente • 2. ABE Harrisi Benedic Equation is a formula that ches your BMR (Bagal metsubisho rate) and then applics an achrity factor to dekonine your total daily eneegy expenditure Scanned with CamScanner

U MONDAY 27 28 " 12 How to dekomine the Harris - Benedict Equation for Sedentary - BMR X 1.2 4 Lightly active a oa BMRK 1.375 4 Modera y active - BMRX I.ss. "Very active - BMR + 1.725 4 Extra active - BMR t 1.9 So am's can be a moderately adare person. - HBG = BMR X 1.5.5. a Basal Body Metabolic Rate (BMR) a 3 for men, BMR = 10 x wt (kg) + 6.25xht et Com). .: Synon stage Cyn) ts. 6 for women BMR = 10 x wt (kg) + 6.25 X ht (cm) -stage (gos) - 16/ BMR for am a 10x 76 + 6.25 X 178 -SX20 +5 Scanned with CamScatter z 1777.5

HBB of am z BMR X 1.55 2 1775.5 * 1.55 z 2,755. 125 22155 Kaal (day • A. Jevety 1.0 at as well he. Jevety 1.0 las 1060 kcal / Lor I kcal lang. am needs 2755 kcal / day, uning Jevety 1.0. 2755 2 114.79 115 koal In 24 hous Scanned with are To have balance in all situations is the key to happiness