PX NAME: Dionne V. Poquiz ROOM NO.

302 TYPE OF DIET:

HEIGHT: 165cm WEIGHT: 48kg PHYSICIAN:
AGE: 45 DBW: 59kg DIAGNOSIS: Malignant Pleural effusion
BMI REMARKS: 17.64 Underweight SEX: MALE FEMALE Dx: 1900 kcal; 285 g CHO ; 95 g CHON; 40 g FAT

Bmi: 48kg (1.65 m²) = 48(2.72) TER: 59 x 27.5 = 1622.5 x .15 = 243 + 1622.5 = 1865.5 / 1900 kcal
= 17.64 – UNDERWEIGHT C- 1900 x .60= 1140 /4= 285 g
DBW: 165-100-10% P- 1900 x .20= 380 /4 = 95g
= 65-6.5 F- 1900 x .20=380 / 9= 42.2 / 40 g
= 58.5/59kg
DX: 1900 kcal, 285g CHO, 95g CHON, 40g FAT

Food Exchange EXCHANGES CHO g CHON g Fat g Energy (kcal) MEAL DISTRIBUTION
Group B L D AM Snack PM Midnight Snack
Snack
VEGETABLE 7 21 7 112 1 2½ 2½ ½ ½
FRUIT 6 60 240 1 1½ 1½ 1 1
MILK
Whole
Low fat 1 12 8 5 125 1
Non-fat/Skim

RICE A (LP) 2 46 184 1 1

RICE B (MP) 4 92 8 400 1 1 1 ½ ½
RICE C (HP) 2 46 8 216 1 1
MEAT
Low fat 6 48 6 246 2 2 2
Medium Fat 2 16 12 172 1 1
High Fat
FAT 3 15 135 ½ 1½ ½ ½
 SUGAR 2 10 40 1 1
TOTAL 287 95 38 1870 5½ 9 6½ 6½ 4 2

PX NAME: Ruffa Ubando Solomon ROOM NO. 308 TYPE OF DIET:

HEIGHT: 5’ (152.4cm) WEIGHT: 48kg PHYSICIAN:
AGE: 32 DBW: 47kg DIAGNOSIS: ATP
BMI REMARKS: 20.96 Normal SEX: MALE FEMALE Dx: 1300 kcal; 195 g CHO ; 65g CHON; 30g FAT

Bmi: 48kg (1.514 m²) = 48(2.29) Ter: 48x 27.5=1320 /1300kcal

=1320/ 1300kcal C- 1300 x .60= 780/4= 195g
= 20.96 -NORMAL P- 1300 x .20= 260 /4 = 65g
DBW: 152.4-100-10% F- 1300 x .20= 260/ 9= 28.88/30g
= 52.4 - 5.24
= 47.16 / 47kg
DX: 1300kcal, 195g CHO, 65g CHON, 30g FAT
Food Exchange EXCHANGES CHO g CHON g Fat g Energy (kcal) MEAL DISTRIBUTION
Group B L D AM Snack PM Midnight Snack
Snack
VEGETABLE 4 12 4 64 1 1½ 1½
FRUIT 3 30 120 1 1 1
MILK
Whole
Low fat 1 12 8 5 125 1
Non-fat/Skim

RICE A (LP) 2 46 184 1 1

RICE B (MP) 4 92 8 400 1 1 1 ½ ½
RICE C (HP)
MEAT
Low fat 6 48 6 246 2 2 2
 Medium Fat
High Fat
FAT 4 20 180 1 1 1 ½ ½
SUGAR 1 5 20 ½ ½
TOTAL 197 68 31 1339 6 7 7 2 1½ 1½

PX NAME: Juanito M. Garcia ROOM NO. 318 TYPE OF DIET:

HEIGHT: 157cm WEIGHT: 48kg PHYSICIAN:
AGE: 74 DBW: 51kg DIAGNOSIS: HPN 2
BMI REMARKS: 19.51 Normal SEX: MALE FEMALE Dx: 1300 kcal; 195 g CHO ; 65 g CHON; 30 g FAT

Bmi: 48kg (1.57 m²) = 48(2.46) Ter: 48x 27.5=1320 /1300kcal

= 19.51 – NORMAL C- 1300 x .60= 780/4= 195g
DBW: 157-100-10% P- 1300 x .20= 260 /4 = 65g
= 57-5.7 F- 1300 x .20= 260/ 9= 28.88/30g
= 51.3/51kg
DX: 1300kcal, 195g CHO, 65g CHON, 30g FAT

Food Exchange EXCHANGES CHO g CHON g Fat g Energy (kcal) MEAL DISTRIBUTION
Group B L D AM Snack PM Snack Midnight
Snack
VEGETABLE 4 12 4 64 1 1½ 1½
FRUIT 3 30 120 1 1 1
MILK
Whole
Low fat 1 12 8 5 125 1
Non-fat/Skim

RICE A (LP) 2 46 184 1 1

 RICE B (MP) 4 92 8 400 1 1½ 1½
RICE C (HP)
MEAT
Low fat 6 46 6 246 1 2½ 2½
Medium Fat
High Fat
FAT 4 20 180 1 1 1 ½ ½
SUGAR
TOTAL 192 68 31 1319 4 7½ 7½ 2½ 1½ 1

PX NAME: Corazon E. Moreno ROOM NO. 320 TYPE OF DIET:

HEIGHT: 5’2 (157.48cm) WEIGHT: 50kg PHYSICIAN:

AGE: 60 DBW: 52kg DIAGNOSIS: Breast CA stage 4, Chronic calculus, cholecystitis
BMI REMARKS: 20 Normal SEX: MALE FEMALE Dx: 1400 kcal; 210 g CHO ; 70 g CHON; 30g FAT

Bmi: 50kg (1.574 m²) = 50(2.47) Ter: 50x 27.5 =1375/ 1400kcal

= 20 – NORMAL C- 1400 x .60= 840/4= 210g

DBW: 157.48-100-10% P- 1400 x .20= 280 /4 = 70g

= 57.48-5.748 F- 1400 x .20= 280/ 9= 31. 11 /30g

= 51.73/52kg

DX: 1400kcal, 210g CHO, 70g CHON, 30g FAT

Food Exchange EXCHANGES CHO g CHON g Fat g Energy (kcal) MEAL DISTRIBUTION
Group B L D AM PM Midnight Snack
Snack Snack
VEGETABLE 4 12 4 64 1 1½ 1½
FRUIT 4 40 160 1 1 1 ½ ½
MILK
Whole
Low fat
Non-fat/Skim 1 12 8 80 1
RICE A (LP) 2 46 184 1 1
RICE B (MP) 4 92 8 400 1 1 1 ½ ½
RICE C (HP)
MEAT
Low fat 5 40 5 205 2 2 1
Medium Fat 1 8 6 86 1
FAT 4 20 180 1 1 1 ½ ½
SUGAR 2 10 40 1 1
TOTAL 212 68 31 1399 5 6½ 6½ 4½ 2½ 2
 PX NAME: Felipe S. Salinas ROOM NO. 321_ TYPE OF DIET:

HEIGHT: 5'9(175.26cm) WEIGHT: 75kg PHYSICIAN:

AGE: 83 DBW: 68kg DIAGNOSIS: T/C CVA
BMI REMARKS: 24 Overweight SEX: MALE FEMALE Dx: 1600 kcal; 240 g CHO ; 80 g CHON; 35 g FAT

Bmi: 75kg (1.7526 m²) = 75(3.07) TER: 68 27.5 =1870 kcal ×.15 = 280 - 1870 = 1590 / 1600 kcal

= 24– OVERWEIGHT C= 1600 X.60= 960/4=240g

DBW: 175.26-100-10% P=1600 X .20=320/4= 80g

= 75.26-7.526 F=1600 X .20=320/9= 35g

= 67.73/68kg 27.5 =1870 kcal ×.15 = 280 - 1870 = 1540 / 1600 kcal C= 1600 X.60= 960/4=240g P=1600 X .20=320/4= 80g F=1600 X .20=320/9= 35g DX: 1600 kcal, 240g CHO,
DX: 1600 kcal, 240g CHO, 80g CHON, 35g FAT

Food Exchange EXCHANGES CHO g CHON g Fat g Energy (kcal) MEAL DISTRIBUTION
Group B L D AM PM Midnight
Snack Snack Snack
VEGETABLE 5 15 5 80 1 1½ 1½ ½ ½
FRUIT 4 40 160 1 1½ 1½
MILK
Whole
Low fat 1 12 8 5 125 1
Non-fat/Skim

RICE A (LP) 2 46 184 1 1

RICE B (MP) 5 115 10 500 1 1 1 ½ ½
RICE C (HP)
MEAT
 Low fat 6 48 6 246 2 2 2
Medium Fat 1 8 6 86 1
FAT 4 20 180 ½ 1½ 1½ ½
SUGAR 2 10 40 ½ ½ 1
TOTAL 238 79 37 1601 5½ 7½ 7½ 4 2½ 2

PX NAME: Hidalgo Matt Ritzer Manaois ROOM NO. 311 TYPE OF DIET:

HEIGHT: 5’4 WEIGHT: 80kg PHYSICIAN:

AGE: 30 DBW: 58kg DIAGNOSIS: T/C SJS
BMI REMARKS: 30 Obese SEX: MALE FEMALE Dx: 1300 kcal; 195 g CHO ; 65 g CHON; 30 g FAT
BMI: 80/( 1.625(m²) = 80/ 2.64 TER: 56×27.5 = 1540×.15=232-1540=1309/1300kcal
=30- OBESE C=1300×.60=780/4=195g
DBW: 162.56-100-10% P=1300×.20=260/4=65g
=62.56-6.256 F=1300×.20=260/9=28.88/30g
=56.30/56kg

DX: 1300kcal, 195g CHO, 65g CHON, 30g FAT

Food Exchange EXCHANGES CHO g CHON g Fat g Energy (kcal) MEAL DISTRIBUTION
Group B L D AM PM Midnight
Snack Snack Snack
VEGETABLE 5 15 5 80 1 1½ 1½ ½ ½
FRUIT 5 50 200 1 1½ 1½ ½ ½
MILK
Whole
Low fat 1 12 8 5 125 1
Non-fat/Skim

RICE A (LP) 1 23 92 1
RICE B (MP) 3 69 6 300 1 1 1
RICE C (HP) 1 23 4 108 1
MEAT
Low fat 4 32 4 164 1 1½ 1½
Medium Fat 1 8 6 86 1
High Fat
FAT 3 15 135 ½ 1 ½ ½ ½
SUGAR 1 5 20 ½ ½
TOTAL 197 63 30 1310 4½ 6½ 6 4 3 1
 PX NAME: Natividad ESTRADA MANUEL ROOM NO. 319 TYPE OF DIET:

HEIGHT: 5’5 WEIGHT:71kg PHYSICIAN:

AGE: 74 DBW: 59kg DIAGNOSIS: AGE WITH SOME SIGN OF DEHYDRATION
BMI REMARKS: 26.10 overweight SEX: MALE FEMALE Dx: 1400 kcal; 210g CHO ; 70 g CHON; 30 g FAT

Bmi: 71kg (1.65 m²) = 71(2.72) TER: 59×27.5 = 1622.5 ×.15=243-1622.5=1379/1400kcal

= 26 – OVERWEIGHT C=1400×.60=840/4=210g
DBW: 165-100-10% P=1400×.20=280/4=70g
= 65.1-6.51 F=1400×.20=280/9=31.11/30g
= 58.59/ 59 kg
DX: 1400 kcal, 210g CHO, 70g CHON, 30g FAT

Food Exchange EXCHANGES CHO g CHON g Fat g Energy (kcal) MEAL DISTRIBUTION
Group B L D AM PM Midnight Snack
Snack Snack
VEGETABLE 4 12 4 64 1 1 1 ½ ½
FRUIT 4 40 160 1 1 1 ½ ½
MILK
Whole
Low fat
Non-fat/Skim 1 12 8 80 1

RICE A (LP) 2 46 184 1 1

RICE B (MP) 4 92 8 400 1 1 1 ½ ½
RICE C (HP)
MEAT
Low fat 5 40 5 205 1 2 2
Medium Fat 1 8 6 86 1
FAT 4 20 180 1 1 1 ½ ½
SUGAR 2 10 40 ½ ½ 1
TOTAL 212 68 31 1399 5 6 6 4½ 3½ 2

PX NAME: TOMILLOSO HILARIO JOSUE ROOM NO. 317 TYPE OF DIET:

HEIGHT: 5’10 WEIGHT: 94kg PHYSICIAN:

AGE: 60 DBW: 70kg DIAGNOSIS: spinal cord injury
BMI REMARKS: 29 overweight SEX: MALE FEMALE Dx: 1600 kcal; 240 g CHO ; 80 g CHON; 35g FAT

BMI: 94/ 1.778 m²) = 94/ 3.16 = 29 OVERWEIGHT DBW: 177.8-100-10%

=77.8-7.78 = 1925 x.15 =288-1925 =1637/1600kcal
=70.02/70kg C=1600 x.60=960/4=240g
P=1600 x.20=320/4=80g
TER: 70 x 27.5 F=1600 x.20=320/9=35g
DX: 1600kcal, 240g CHO, 80g CHON, 35g FAT

Food Exchange EXCHANGES CHO g CHON g Fat g Energy (kcal) MEAL DISTRIBUTION
Group B L D AM Snack PM Midnight Snack
Snack
VEGETABLE 5 15 5 80 1 1½ 1½ ½ ½
FRUIT 5 50 200 1 2 1 ½ ½
MILK
Whole
Low fat
Non-fat/Skim 1 12 8 80 1

RICE A (LP) 2 46 184 1 1

RICE B (MP) 5 115 10 500 1 1½ 1½ ½ ½
RICE C (HP)
MEAT
Low fat 6 48 6 246 2 2 2
Medium Fat 1 8 6 86 1
FAT 5 25 225 1 1½ 1½ ½ ½
SUGAR 1 5 20 ½ ½
TOTAL 243 79 37 1621 6 8½ 7½ 4½ 3 1½
PX NAME: SIDNEY C. LOMBOY ROOM NO. 305 TYPE OF DIET:

HEIGHT: 5’7 WEIGHT: 90kg PHYSICIAN:

AGE: 46 DBW: 63kg DIAGNOSIS: T/C ACUTE APPENDICITIES
BMI REMARKS: 32 - OBESE SEX: MALE FEMALE Dx: 1500 kcal; _225 g CHO ; 74g CHON; 35 g FAT
TER: 63 x 27.5
BMI: 90/ 1.7018 m²) = 90/ 2.8 = 32 OBESE
= 1732 x.15 =259-1732 =1473/1500kcal
DBW: 170.18-100-10%
C=1500 x.60=900/4=225g
=70.18-7.018
P=1500 x.20=300/4=75g
=63.16/63kg
F=1500 x.20=300/9=35g

Food Exchange EXCHANGES CHO g CHON g Fat g Energy (kcal) MEAL DISTRIBUTION
Group B L D AM Snack PM Midnight
Snack Snack
VEGETABLE 5 15 5 80 1 1½ 1½ ½ ½
FRUIT 5 50 200 1 1½ 1½ ½ ½
MILK
Whole
Low fat 2 24 8 10 218 1 1
Non-fat/Skim

RICE A (LP) 1 23 92 1
RICE B (MP) 4 92 8 400 1 1 1 ½ ½
RICE C (HP) 1 23 4 108 1
MEAT
Low fat 5 40 5 205 1 2 2
Medium Fat 1 8 6 86 1
FAT 3 15 135 ½ 1 ½ ½ ½
SUGAR
TOTAL 227 73 36 1524 5½ 7 6½ 4 3 1