Assignment 5: Assessing Needs for Critically Ill and Wound Patients

Calculate the energy and protein needs based on the patient information provided. See Tables 6.14, 6.15, and 7.7 to help calculate the needs of the following patients.

**Note: 2.54 cm = 1 in. and 2.2 lbs = 1 kg**
**Note: Don’t forget to use activity and stress factors found in Ch.5 in your calculations**

1. Carl is a 70-year-old male who suffered a heart attack and needed an emergency coronary artery bypass graft surgery. He is currently sedated and intubated s/p his surgery but the plan is to wean off ventilation within 24-48 hours. Pt is 70" and weighs 195 lbs. His maximum temperature is 37 degrees C and current ventilation status is 4.5 L/min.
- a. Calculate Carl’s energy needs.
- Age: 70
- Height: 1.778 meters
- Weight: 88.63 kg
- E = 662 – (9.53 x 70) + 1 x ((15.91 x 88.63) + (539.6 x 177.8))
- E = 2,364.51 kcal
- b. Calculate Carl’s protein needs.
- P = 195 x 0.36
- P = 70.2 grams
- c. Would you recommend enteral nutrition for this patient at this time? Why or why not?
- Since Carl is sedated and on ventilation, he needs a feeding tube to fulfill his daily nutritional and energy requirements. He cannot eat the food by himself so he will need to be provided with enteral feeding.

2. Karen is a 61-year-old female who was admitted to the ICU s/p complications with bowel surgery and currently has sepsis. Pt is alert and not on a ventilator. She is 63" tall and weighs 205 lbs.
- a. Calculate Karen’s energy needs.
- b. Calculate Karen’s protein needs.
- c. Would you recommend enteral nutrition for this patient at this time? Why or why not?

3. Mrs. Jones is an 82-year-old woman admitted to the hospital d/t stage 3 wound on her buttock. Two years ago she suffered from a stroke and is non-ambulatory. She is 62" and weighs 112 lbs. All labs are normal.
- a. Calculate Mrs. Jones’ energy needs.
- b. Calculate Mrs. Jones’ protein needs.

4. After further investigation, Mrs. Jones’ caregiver reported that she has been eating less than 50% of most of her meals and has to be handfed. At this point, you recommend that the patient would benefit from enteral nutrition.
- a. What EN route would you recommend at this time and how would you transition the patient back to her home?
- b. Based on her energy and protein needs, provide an enteral nutrition prescription to include formula type, total formula volume, formula rate, and bolus rate. See Chapter 3 for information on enteral nutrition calculations.

**Please help with question 2 (all of question 2 a/c)**