TBI case study

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TBI case study
2013-10-10 22:39:04
TBI case study

TBI case study
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  1. What info will help you assess pt's nutritional status?
    • new swallow eval
    • current weight
    • gastric tolerance to TF (n/v, c/d; abd distention/residuals)
    • physical evidence of muscle/fat wasting
    • labs
  2. TBI nutrition needs (not acute)
    • Kcal:  harris benedict x 140% OR 30-35 kcal/kg actual weight
    • Protein:  1.5-2.0 g/kg ACTUAL bw
    • Fluid:  1.0 mL/kcal
  3. What to include in tube feeding recs?
    • What formula
    • Method of delivery (bolus, intermittent, continuous pump)
    • Amount
    • Free water
    • ---Any protein supplements
  4. Monitor and goals categories
    • Anthropometrics
    • Behavior
    • Knowledge/Beliefs
    • Intake
    • Physical
  5. Interventions (4)
    • Nutrition education- content, application (ex:  educated pt on importance of vit K consistency) (ex: educated pt on how to administer bolus feeds, flushes, and stoma hygiene)
    • Nutrition counseling
    • Coordination of care:  (ex:-nursing text order to weigh pt)
    • Meals and snacks:  (ex: add fresh fruit, add snack, etc)
  6. What would you want to educate pt/pt's wife on?
    • Increased needs due to TBI due to hypermetabolism, hypercatabolism and importance of meeting nutritional needs during post-acute care
    • -Importance of optimal nutrition and hydration
    • -Once PO, importance of well-balanced, adequate meals and snacks
    • -How to care for stoma
    • -How to properly feed pt with bolus feedings