Medical Nutrition Therapy II

please fill in the worksheet
but dont use very complex terminology
use these formulas to help with calculation
yi 0.25 yi 0.25
yi 0.25 Formula Characteristics
yi Macronutrient Composition:
yi 0.25 50% CHO (40-60%); 30% Fat (30-40%); 20% Protein (12-20%) yi 0.25 Protein needs are higher in stress, and lower in kidney disease
yi Energy Density:
yi 0.25 Normally ranges from 1 a 2 kcal/ml
yi 0.25 High- for those that need high Energy or fluid restrictions yi 0.25 Low-for those with high fluid needs, or can give water via tube or IV
yi 0.25 yi 0.25 2009 Cengage – Wadsworth
yi 0.25 yi 0.25
yi 0.25 Formula Characteristics
yi Fiber: for treating diarrhea/constipation & maintaining blood glucose yi Osmolality:
yi 0.25 Istotonic: is the formula with osmolality similar to that of the blood (300 mosm/kg) versus hypertonic: formula with higher osmolality
if needed

Chapter 20 – Enteral Nutrition Support
Assignment

Name: ___________________________________________ Grade: /15

Please answer the following 4 case studies.

1. Worksheet 1: Comparison of Nutritional Supplements (2 points)

Directions: Using the comparison sheet below, write down information from three types of nutritional supplements—search for the information online or at a drugstore. Once you have recorded the information, answer the questions about the supplements at the bottom of the sheet.

Factor Standard Formula #1 (e.g. Boost®, Ensure®) Standard Formula #2 (with fiber) Disease-Specific Formula (e.g. Pulmocare®)
Calories/mL
Cost/100 kcal
Protein (grams/mL)
Source of protein
Fat (grams/mL)
Source of fat
Carbohydrate (grams/mL)
Source of carbohydrate
Fiber (grams/mL)
Source of fiber
Lactose-free?
Gluten-free?

2. If the patient has high protein and kcalorie needs, which one would be the best choice? Why?

3. If the client has high fiber needs, which one would be the best choice? Why?

2. Worksheet 2: Planning a Tube-Feeding Administration Schedule (5.5 points)

Hint: Use the box “How to Plan a Tube Feeding Schedule” in the chapter to help you complete this activity.

The registered dietitian (RD) has completed a nutrition assessment for Ms. Brown and has determined she will need a total of 2500 kcal daily to meet her nutrient needs. The RD plans to leave recommendations for three tube feeding delivery options in the medical chart for the physician to select from as it hasn’t been determined yet which option Ms. Brown will tolerate the best.

A tube feeding formula that contains 1.0 kcal/mL has been selected.

Ms. Brown is home-bound, but she does receive physical therapy once a day at home.

Instructions: Be sure to show how you obtained your answers to the following questions:

1. How many milliliters of enteral formula will Ms. Brown need per day to meet her calorie needs?

2. If Ms. Brown was to receive continuous tube feeding for 24 hours, what would her rate per hour be using this formula?

3. If Ms. Brown were to receive intermittent feedings eight times a day, how many milliliters of formula would she need at each feeding? If the formula is packaged in 250-mL cans, how many cans of formula would be required per day? Per feeding?

4. If Ms. Brown were to receive bolus feedings 5 times a day, how many milliliters of formula would she need at each feeding? How many 250-mL cans of formula would be administered per feeding?