Question

Case: Review Medical Nutrition Therapy: A Case Study Approach - Case 6 Heart Failure with Resulting Cardiac Cachexia. Reviewing chapter 13 of Nutrition Therapy and Pathophysiology will also help you to understand the disease and pathophysiology of this case. 1. Calculate Mrs. Maney's energy and protein requirements. Show your calculations and explain your rationale for the formula you chose for your calculations. (15 points) 2. The MD consults the RDN for nutrition assessment and enteral feeding recommendations. Do you feel that Mrs. Maney may benefit from enteral feeding? What data would you use to make this decision? (10 points) 3. Outline a nutrition therapy regimen for her that includes formula choice, total volume and goal rate. (can use the UAB Enteral Formulary for information about formulas) (25 points)

Answer 1

1. Energy required by Mr Mandy as he is a great failure patient ,his energy expenditure is 20%to 30%more than the basal body requirement .

Weight = 105lbs = 105×0.45= 47.25kg

Height = 5foot 2inch = 157.4cm

His BMI = WEIGHT IN KG /HEIGHT IN METERS SQUARE

= 47.25/1.57 ×1.57

= 19.6 kg / meter square ( adequate BMI)

For adequate BMI cardiac failure patient , calories requirement is = 28- 32 kcal / kg

= 28× 47.2 to 32× 47.2

= 1321.6 kcal to 1510.4 kcal

Protein requirement is 1.1- 2g/ kg/ day

= 51.92 gm to 94.4gm per day

2. Yes, Mr.Maney will be benefited by enteral feeding because in enteral feeding Many will get only the required amount of feed not more than that and not less than that . As he is a heart failure patient ,his heart can be overloaded because it can't pump efficiently hence to decrease load on the heart enteral feeding is the best . It will provide adequate amount of macronutrients and micronutrients according to the requirement of Mr Mandy .

3. If a person requires 1,500 kcal from tube feeds they will need 4 cans or 1,000 mL of a 2.0 kcal/mL formula. To determine the rate, divide the total volume of tube feeding by 24 hours. The rate would be 42 mL/hr.