Reference no: EM133746659

Question

Pt is a 31 y/o male who presents as adequatley nourished as evidenced by a BMI of 29.6 and weighing outside IBW range (160-196). Pt was admitted for a thoracoabdominal gunshot wound resulting in injuries to his stomach, duodenum, jejunum and liver. Usual wt is 96kg but curent wt is 99kg. Weight gain possibly due to inflammationg and swelling from trauma. Labs show high WBC from inflammation, CRP from infection and inflammation, AST and ALT from liver damage, glucose from trauma and stress on the body, alkaline phosphate from liver damage, triglycerides from release of fats into the bloodstream from trauma, chloride from fluid loss and response to trauma. Low levels of GFR from decreased bloodflow to the kidneys, albumin from fluid shifts, bloodloss, or liver damage. Pt history is unknow but was known to abuse alcohol and occasionally use cocaine;reportedly was on a binge prior to admission. Nutrition-focused physical exam shows large male with 3 pitting edema; abdomen open and distended; wound vac in place. No diet history available. Recommend starting parental nutrition due to negative bowl sounds. A nutrition support consult has been ordered. What would you recommend at this point and why? Discuss your rationale for.