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    This document summarizes the medical history and nutrition care plan for a 39-year-old male patient admitted with pancreatitis caused by high triglyceride levels. The patient has a history of alcohol dependence, chronic back pain, diabetes, and a previous episode of pancreatitis in his teens. His current symptoms include abdominal pain and weight loss. The nutrition care plan focuses on advancing the patient to a low-fat, diabetic diet while monitoring for weight stabilization and improvement in triglyceride and glucose levels. Due to worsening condition, the patient was transferred to the ICU for concerns of metabolic acidosis, pancreatitis complications, and need for intubation.

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    This document summarizes the medical history and nutrition care plan for a 39-year-old male patient admitted with pancreatitis caused by high triglyceride levels. The patient has a history of alcohol dependence, chronic back pain, diabetes, and a previous episode of pancreatitis in his teens. His current symptoms include abdominal pain and weight loss. The nutrition care plan focuses on advancing the patient to a low-fat, diabetic diet while monitoring for weight stabilization and improvement in triglyceride and glucose levels. Due to worsening condition, the patient was transferred to the ICU for concerns of metabolic acidosis, pancreatitis complications, and need for intubation.

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    40 views15 pages

    Med I Boone 12 12 14

    Uploaded by

    api-284781536
    This document summarizes the medical history and nutrition care plan for a 39-year-old male patient admitted with pancreatitis caused by high triglyceride levels. The patient has a history of alcohol dependence, chronic back pain, diabetes, and a previous episode of pancreatitis in his teens. His current symptoms include abdominal pain and weight loss. The nutrition care plan focuses on advancing the patient to a low-fat, diabetic diet while monitoring for weight stabilization and improvement in triglyceride and glucose levels. Due to worsening condition, the patient was transferred to the ICU for concerns of metabolic acidosis, pancreatitis complications, and need for intubation.

    Copyright:

    © All Rights Reserved
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    of 15

    MED I

    Allana Boone
    Preceptor: Debra Haarburger, RD, LD

    BACKGROUND: PANCREATITIS
    Pancreas function
    Digestion
    Insulin and glucagon regulation

    Pancreatitis
    Inflammation of the pancreas
    Bleeding
    Infection
    Permanent tissue damage
    Necrosis

    BACKGROUND CONTD
    Signs and Symptoms
    Abdominal pain/tenderness
    Nausea
    Vomiting

    In chronic pancreatitis:
    Unintentional weight loss
    Oily, smelly stools (steatorrhea)

    BACKGROUND: CONTD
    Causes
    ETOH use
    Gallstones
    Hypertriglyceridemia
    Genetic abnormalities
    Abdominal trauma
    Medications
    Infections
    Tumors

    PATIENT HX
    D.G. 39 Y.O Caucasian Male
    PCP: Alexander Miranda
    Attending Phys: Elliott Dasenbrook
    Ward: 4B (moved to WMIC 2D)
    PMH: ETOH dependence, chronic LBP, DM2, DLD,

    lumbar post-laminectomy synd, epigastric pain,


    pancreatitis (early teens)

    Chief complaint: Pancreatitis 2 high TG

    ANTHROPOMETRICS
    Height: 5 9 (175 cm)
    Weight: 187.3 lbs (85.1 kg)
    BMI: 27.7 (overweight)

    UBW: 200 lbs (90.9 kg)

    Significant Wt Change: 13.6#, 6.7% wt loss x


    %UBW: 94%
    2d
    IBW: 160 lbs (72.7 kg)
    %IBW: 117%

    MEDICATIONS
    Hydromorphone Inj
    Heparin
    Dextrose
    Glucagon Inj
    Insulin, Aspart
    Ondansetron
    Nicotine Transdermal Patch

    LABORATORY DATA

    COMPARATIVE STANDARDS
    Energy requirement: 2554 Kcal/day
    Based on actual body weight and 30 kcal/ kg
    Protein requirement: 85 gm/day
    Based on actual body weight, protein level of 1.0
    Fluid requirement: 2554 ml/day

    FOOD/NUTRITION-RELATED HX
    Diet recall:
    Inconsistent CHO
    High CHO
    High Fat

    NUTRITION DX
    Weight

    Unintentional weight loss


    Related to: Pancreatitis, poor po intake, loss of appetite,
    N/V, abd pain
    As evidenced by: 13.6#, 6.7% sig weight loss x 2 days

    Biochemical

    NUTRITION INTERVENTIONS
    Diet Order
    Slowly advance diet to 50 g

    fat, CC DM diet

    Nutritional Supplements
    Currently receiving Breeze on CL LIQ Diet
    Per serving: 250 kcal, 9 g PRO

    Nutrition Education
    Educated Veteran and his wife on Low Fat, CC DM diet
    Coordination of Nutrition Care
    HgbA1C pending
    Diabetes Education
    Recommend prescribing lipid lowering medication

    NUTRITION MONITORING AND


    EVALUATION
    Followed up with Veteran during meal rounds
    Monitored lab values and adjust nutrition care as needed

    Weight maintenance
    Tolerance of CL LIQ diet no N/V, abd distention
    HgbA1c <7%
    TG downtrending towards <500 mg/dL

    UPDATE
    Currently in the MICU
    Metabolic acidosis possibly 2 lipolysis
    Acute pancreatitis - concern for necrosis/sepsis
    Severe hypertriglyceridemia
    Receiving DM Education
    Intubation per pt

    REFERENCES
    Krauses Food & the Nutrition Care Process, Mahan,

    2012

    UpToDate

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