Dietitian nutrition assessment

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Reference no: EM133820599

Question

Dietitian Nutrition Assessment: Pt. is 29 yo male admitted to trauma ICU with gunshot wound to abdomen with gastric, duodenal and jejunal injuries, liver laceration, and left pleural effusion. After stabilization upon admission, pt was mechanically ventilated and gastric injury was repaired, liver laceration was controlled, and pt had a resection of proximal jejunum. On admit day 2, pt had bowel reconnected, surgical packs removed, abdominal vac placed, abdomen was left open with 3 drains; on admit day 3 pt had an anastomotic leak with a gastro-jejunostomy tube. Plan is to return to OR in am for wound wash out, wound vac replacement, placement of jejunostomy tube. Pt presents at high risk for malnutrition due to critically ill and hypermetabolic status despite high BMI. Pt currently weighs 102.7kg (136% IBW) and has a BMI of 32.4 (class I obesity); wt history not provided. PMHx and FPE findings noted as unremarkable. Pt is a tobacco user. Pt currently on Propofol at 35 mL/hr - will need to account for 1.1 kcals/mL. Labs reflect low Alb, hematocrit and elevated CRP, WBCs, BUN, Cr indicating inflammation and metabolic stress due.

Reference no: EM133820599

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