TBI case study
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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
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
What to include in tube feeding recs?
- What formula
- Method of delivery (bolus, intermittent, continuous pump)
- Free water
- ---Any protein supplements
Monitor and goals categories
- 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)
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
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