Enteral Nutrition Case Study
NSC 325
100 Points
Discuss the strengths and limitations associated with various enteral feeding routes by completing the table below (10 points):
You can make this table bigger or add more boxes if you need to in order to complete it:
Access Device | Indications | Advantages | Disadvantages |
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Describe the various administration methods available for infusing enteral nutrition including which methods can be used based on where the feeding tube is positioned (5 points).
A 55 y.o. male lives with his wife in an apartment in a large metropolitan city and has an appointment with you today because he “feels like” he is not tolerating his PEG feedings. He has a PEG in place due to severe dysphagia related to a neurologic disorder. The PEG was placed last month and he had been doing “fine” on his feedings until last week.
Ht: 6’ Current Wt: 166 lbs. (weight changed occurred in the past 3 weeks)
Weight 4 months ago: 172 lbs. (stable)
Labs: WNL
Physical activity: none as he is wheel chair bound
Challenges with PEG feeding: he reports that he infuses 2 cans of Osmolite at 8 am and 2 cans at 10 am (1.06 kcal/mL, 10 gms protein/can and 84% free water) and 1 can at 3 pm but he is too full to infuse any more for the rest of the day. He flushes his feeding tube before and after each infusion with 60 mL water. He also flushes the feeding tube in between feedings three times per day with 120 mL of water.
Calculate energy, pro, fluid the above regimen is providing. Is the EN provided meeting this patient’s needs? What % of energy, pro and fluid are being met? Is the EN volume meeting micronutrient needs? (5 pts)
Complete a nutrition assessment (10 points):
Design 1 PES statement (3 points):
P:
E:
S:
Nutrition Prescription (4 points):
Kcals:
Grams of protein:
Fluid requirements:
How will micronutrient needs be met:
Provide your specific recommendations, including whether you would recommend changing what he is currently doing, and how this patient can meet his estimated nutrient and hydration needs with his PEG feedings; be specific in terms of formula to use, infusion method and amount, and address meeting free water needs (10 points):
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