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    Mr. J.O. is a 74-year-old man with a T5-T6 spinal cord injury who has been admitted for wound evaluation and management of pressure ulcers. He is overweight at 240 pounds and has increased nutritional needs due to his hypermetabolic state from his spinal cord injury. His lab work shows low albumin, pre-albumin, potassium, calcium, hemoglobin, hematocrit, and MCV, indicating nutritional deficiencies. The nutrition care plan is to continue his regular diet with supplemental shakes and drinks to meet his increased calorie and protein needs and support wound healing.

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    Mr. J.O. is a 74-year-old man with a T5-T6 spinal cord injury who has been admitted for wound evaluation and management of pressure ulcers. He is overweight at 240 pounds and has increased nutritional needs due to his hypermetabolic state from his spinal cord injury. His lab work shows low albumin, pre-albumin, potassium, calcium, hemoglobin, hematocrit, and MCV, indicating nutritional deficiencies. The nutrition care plan is to continue his regular diet with supplemental shakes and drinks to meet his increased calorie and protein needs and support wound healing.

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    23 views12 pages

    Sci Rotation

    Uploaded by

    api-284781536
    Mr. J.O. is a 74-year-old man with a T5-T6 spinal cord injury who has been admitted for wound evaluation and management of pressure ulcers. He is overweight at 240 pounds and has increased nutritional needs due to his hypermetabolic state from his spinal cord injury. His lab work shows low albumin, pre-albumin, potassium, calcium, hemoglobin, hematocrit, and MCV, indicating nutritional deficiencies. The nutrition care plan is to continue his regular diet with supplemental shakes and drinks to meet his increased calorie and protein needs and support wound healing.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    of 12

    SCI ROTATION

    Allana Boone
    Preceptor:
    Lisa Plungas MS, RD,
    LD

    NUTRITION ASSESSMENT:
    PATIENT INFORMATION
    Patient: Mr. J.O.
    Ward: W6B (SCI)
    Attending: Dr. Krupkin
    Past Occupation: Dentist
    PMH: Complete T5-6 Asia A, Endocarditis, Sleep Apnea, GERD,
    Incontinence, Pressure ulcer of buttox, BPH
    Admitting Dx: Wound Eval
    Chart reviewed: 74YO WM T4 ASIA A paraplegic with nonhealing wounds and deconditioning

    NUTRITION ASSESSMENT:
    MEDICATIONS
    Ascorbic Acid
    Cholecalciferol
    Cyanocobalamin
    Multi Vit/Min
    Trazadone
    Zinc Oxide
    Potassium Chloride
    Pantoprazole
    HCTZ
    Docusate Na
    Finasteride

    NUTRITION ASSESSMENT:
    ANTHROPOMETRICS
    Height: 5 11
    Weight: 240#
    Target Weight: 176-182.5# (80-83 kg)
    Adj for SCI , obesity

    % Target Weight: 131-136%

    NUTRITION ASSESSMENT:
    BIOCHEMICAL DATA
    Albumin 2.0 L
    Pre-albumin 10 L
    CRP 113 H
    K 3.3 L
    Ca 7.9 L
    HGB 7.1 L
    HCT 25.6 L
    MCV 69.2 L

    WOUND VAC

    NUTRITION ASSESSMENT:
    COMPARATIVE STANDARDS
    Energy Needs: 2490 kcal

    Calculated based on 30 kcal/kg and Adj TBW

    Protein Needs: 149 gm

    Calculated based on Adj TBW and 1.8

    Fluid Needs: 2990 ml/d

    Calculated based on kcal needs +500 ml

    NUTRITION DIAGNOSIS
    NUTRIENT
    Increased nutrient needs kcal, PRO
    Related to: hypermetabolism
    As evidenced by: increased kcal ad protein needs,
    need for
    nutrn suppl

    NUTRITION INTERVENTION
    FOOD/NUTRIENT DELIVERY:
    Continue Regular Diet
    Continue to provide JUVEN BID
    Providing 80 kcal, 7g arginine, 7g glutamine
    Provide MagicCup ]1x/d
    Providing 290 kcal, 9 g PRO

    COORDINATION OF NUTRITION CARE:


    Consider drawing pre-alb, CRP
    Consider drawing iron panel and ferritin
    NUTRITION EDUCATION:
    Encouraged adequate intake: kcal, PRO

    NUTRITION
    MONITORING/EVALUATION
    NUTRITIONAL GOALS:
    1.) Adequate PO Intake greater than or equal to 75% of
    meals/supplements (MET)
    2.) Weight maintenance without documented significant
    weight gain/loss (NOT MET)
    Weight range (updated): 235-245#

    3.) Uptrending prealbumin towards > or equal to 15 with


    a downtrending CRP.
    (unable to assess, no new labs since last ntrn note)

    REFERENCES
    Up To Date
    V.A.C Manual
    Images:
    http://
    waittfoundation.org/wp-content/blogs.dir/9/files/misc/clipboard.jpg
    https://tanyagrove.files.wordpress.com/2011/05/test-tubes.jpg

    ANY QUESTIONS?

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