Reference no: EM133380849
Case Study: Mr. Blake is a 36-year-old white male with type 2 diabetes and albuminuria. He is here because his physician said something about "kidney damage." He states he does not eat breakfast or lunch; however, he stops every morning at a convenience store before work for snacks. He works construction, lives alone, and doesn't want to cook.
He does not monitor glucose and denies hypoglycemia. Reports frequent urination at night, thirst, fatigue and blurry vision at times. Takes diabetes medication in the morning only, misses second dose most days. He takes all 4 glyburide/metformin tablets at once when his vision is blurred. States blood pressure medication makes him cough and he doesn't always take it.
Physical exam: obese with mild edema to left leg. Left foot ulcer is healing. No obvious nutrient deficiencies. Reports one tooth is loose, located on upper left. It is painful to chew certain foods.
Weight: 241
Height: 68"
Questions:
1. What are your patient's current energy requirements? (Note - use the appropriate energy calculation for their diagnosis and BMI).
2. What are your patient's current protein requirements?
3. Calculate what your patient's energy needs will be if they progress to ESRD and need to begin hemodialysis.
4. Calculate what your patient's protein needs will be if they progress to ESRD and need to begin hemodialysis.