Textbooks and Resources: Introduction to Critical Care Nursing (Case Study Sample)
Textbooks and Resources: Introduction to Critical Care Nursing
A) Ch 6 Nutrition
Mr H. is at post-op day 7 after coronary artery bypass graft surgery. He has not eaten any significant calories since the operation. He does not like hospital food and has trouble chewing because of poor dentition. Objective data include the following:
Height 6 ft
Wgt 135 lbs with a history of a 20 lb wgt loss in the last month.
Prealbumin < 7.4 g/dl
Albumin < 1.6 g/dl
Urine output adequate
Hypoactive bowel sounds
What combination of assessment findings determines the patient
Acute Kidney Failure
Date of submission
Case Study 1
1 What combination of assessment findings determines the patient?
The anthropometric results of Mr. H are some of the best findings to determine the nutritional status of the patients. The Body Mass Index of the Mr. H can be determined from height and weight measurement. The BMI results of Mr. H would determine whether Mr. H is severely, moderately malnourished or normal nutrition status (Sole et al., 2009). For instance, the height of 6.0 ft or 1.83 metres and weight of 135 lbs or 61 kg. The BMI of Mr. H would be (61/1.83*1.83))= 18.21kg/M2. This BMI indicates that Mr. H is at risk of since it is slightly below the borderline. Normal nutritional status should range from (18.5- 24.9). Immediate nutritional intervention should be done to enable MR. H improve his nutritional status.
The second assessment findings to determine the nutritional disorders of Mr. H is biochemical test results. One of the important biochemical results is the albumin level. The albumin measures can be used to diagnose and watch kidney or livers problems. A healthy individual should have Albumin level ranging from 3.5 to 5.5 g/dL. However, chronic or acute kidney failure may contribute to the leaking of Albumin into the urine thus leading to low albumin level in the blood. For instance, Mr. H has low albumin level less 1.6 g/dl. This indicates that there is severely kidney problem leading to loss of albumin from the blood into the urine (Hartshorn, Lamborn, & Noll, 1993). Similarly, the prealbumin findings may also indicate the nutritional complications that the patient may be suffering. Normal prealbumin ranges from 1.5g/dL to 3.6 g/dL. However, high prealbumin findings may indicate the presence of chronic kidney disease.
Lastly, clinical signs and symptoms findings can effectively be used to determine the nutritional status of Mr. H. The urine output measurement and bowel sounds can efficiently determine the nutrition of the patient. Adequate urine output and hypoactive bowel sounds can be used to diagnose acute kidney failure.
2 Would you suggest enteral feeding or parenteral feeding and why?
Enteral feeding is the best nutrition support for Mr. H. This is because he has got functional gastrointestinal tract which can enhance the absorption of nutrients into the blood. Secondly, this feeding support for Mr. H is anticipated to be on the nutrition support for short term and not long term. Enteral nutrition support is always preferred when the patients is anticipated to be on the feeding support for short duration of time. Lastly, Mr. H is complaining about the hospital food. In actual sense, he did not have appetite for hospital meals but he has got functional gastrointestinal tract. Patients who has lost appetite but has functional gastrointestinal tract can be fed successfully through tube or enteral feeding. In regards to this, the best feeding support for Mr. H is enteral feeding since he got minor complications s...
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