Calculate carmines energy and protein needs

Reference no: EM133463362

Assignment:

Carmine is a 34-year-old mother of three young children. She was admitted to the hospital with multiple enterocutaneous fistulas 3 weeks ago, at which time she weighed 52 kg (116 lbs). She is 165 cm (5 ft 5 in) tall. Carmine has a history of recurrent cervical cancer for which she had a hysterectomy four months before admission. During chemotherapy that followed, she had regular bouts with nausea and anorexia. Surgery was performed again. Her fistulas continued to drain for 2 weeks postoperatively, during which she tolerated clear liquids only. An intravenous drip of 10% glucose and 45% normal saline was ordered to supplement fluids and kcal.

This week she developed peritonitis and has had a fever with a maximum temperature of 39 C (102 F) over the past 24 hours. Her weight has dropped to 41 kg (90 lbs); drainage from the fistulas has become odorous. The patient was placed in isolation today and was advised by her physician that he intended to start her on total parenteral nutrition (TPN) and conduct some more tests to determine her progress.

Questions for Analysis

1. What types of nutrition assessment procedures would be used by the TPN team for planning Carmine's nutrition therapy? Explain the purpose of each.

2. Calculate Carmine's energy and protein needs, and account for increased needs.

3. Why did Carmine develop nausea and anorexia during chemotherapy? What are the implications of this for recovery?

4. Outline a plan for evaluating and controlling nausea and vomiting in patients undergoing chemotherapy.

5. What personal concerns would you expect Carmine to have? What resources would you use to help her obtain the personal and physical support she probably needs?

Reference no: EM133463362

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