Esophageal Cancer with Enteral Nutrition- Case study
NUTR-UE 1185.001
Clinical Nutrition Assessment and Intervention
Spring 2020
Assignment #4: Enteral Feeding Practice
Use Emory Case 17, case description/background and nutritional assessment data to answer the following questions. Assume that because of placement of a feeding jejunostomy (j-tube) post operatively, that your primary reason for evaluating the patient is to formulate an enteral (tube feeding) nutrition care plan.
Part I
Question 1(30 points total)
Estimate the patient’s energy needs and indicate the method you used to do so. (15 points)-
Kcal/Kg method= 30-35 kcal/kg=
74.8(30-35)=2244-2618 kcal/day
Estimate the patient’s protein and fluid needs and document what you are basing this on. (15 points)=
Daily Protein requirements for adults= 1.2-1.5 g/kg= 74.8 (1.2-1.5)= 90-112.2 g/day protein
Daily Fluid Requirements for adults=
Question 2 (40 points total)
Using the NYP formulary, which formula is most appropriate for this patient? Why? (10 points)
Calculate the volume of feeding you would need to provide for your client’s fluid, energy and protein needs. Calculate an appropriate “flush” (in mL) to meet total fluid needs (and keep the j-tube clear). (10 points)
Choose the method of feeding [bolus/gravity drip/ intermittent/continuous] for your patient while in the hospital and explain why you made this choice. (10 points)
Write out the tube feeding regimen listing total mL of formulary, total kilocalories, protein, free fluids (flush), % RDI of vitamins and minerals you are providing and total volume of regimen. (10 points)
Part II
USE ADIME format to document your assessment of this patient, as it would appear in the medical record. Remember this is Narrative and you are NOT answering questions: (30 points total)
a. A: Use relevant information from nutritional assessment data, i.e. information that you will consider important to your assessment (5 points).
b. D: Nutrition diagnosis; write PES statement (5 points)
c. I: Intervention directed at the cause of the diagnosis. Plan of care including counseling, MNT, in this case enteral feeding regimen, including initiation, advance to goal and fluid adjustments (10 points)
d. M: What will you follow to monitor care. (5 points)
e. E: Evaluation; what outcome (s) will you use to evaluate your care plan (may be the same as your monitoring parameters, e.g., weight, intake, etc. (5 points)
