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    Nutrition Care Plan - Dr. Dominguez

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    Monique Angela Turingan Gangan
    This document outlines the components and process for developing a nutrition care plan, including assessing nutritional requirements, formulating nutrient delivery, and monitoring strategies. It provides guidelines for determining total caloric requirement, protein requirement, non-protein calories, carbohydrate and fat composition based on condition. Enteral and parenteral delivery methods and access routes are discussed. An example case demonstrates how to calculate the total caloric requirement, protein requirement, non-protein calories, carbohydrate and fat amounts, and fluid requirements for a patient.

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    Nutrition Care Plan - Dr. Dominguez

    Uploaded by

    Monique Angela Turingan Gangan
    195 views2 pages
    This document outlines the components and process for developing a nutrition care plan, including assessing nutritional requirements, formulating nutrient delivery, and monitoring strategies. It provides guidelines for determining total caloric requirement, protein requirement, non-protein calories, carbohydrate and fat composition based on condition. Enteral and parenteral delivery methods and access routes are discussed. An example case demonstrates how to calculate the total caloric requirement, protein requirement, non-protein calories, carbohydrate and fat amounts, and fluid requirements for a patient.

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    Nutrition Care Plan- Dr. Dominguez

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    This document outlines the components and process for developing a nutrition care plan, including assessing nutritional requirements, formulating nutrient delivery, and monitoring strategies. It provides guidelines for determining total caloric requirement, protein requirement, non-protein calories, carbohydrate and fat composition based on condition. Enteral and parenteral delivery methods and access routes are discussed. An example case demonstrates how to calculate the total caloric requirement, protein requirement, non-protein calories, carbohydrate and fat amounts, and fluid requirements for a patient.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    195 views2 pages

    Nutrition Care Plan - Dr. Dominguez

    Uploaded by

    Monique Angela Turingan Gangan
    This document outlines the components and process for developing a nutrition care plan, including assessing nutritional requirements, formulating nutrient delivery, and monitoring strategies. It provides guidelines for determining total caloric requirement, protein requirement, non-protein calories, carbohydrate and fat composition based on condition. Enteral and parenteral delivery methods and access routes are discussed. An example case demonstrates how to calculate the total caloric requirement, protein requirement, non-protein calories, carbohydrate and fat amounts, and fluid requirements for a patient.

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    Nutrition Care Plan Dr.

    Dominguez November 14, 2013


    Condition Protein Requirement
    Nutrition Care Plan  Non- critically ill 0.8-2 gm/kg/day
     How much and what type of nutrient to give (nutrient formulation)  Critically ill, normal
     Nutrient delivery process and monitoring determine the outcome or problem
    success of the management process.  Critically ill, with CKD
    or dialysis
    Components of Nutrition Care Plan  Critically ill with CKD, 0.6-0.8 gm/kg/day
     Nutritional assessment no dialysis
     Nutritional requirements  Burns 2.5 gm/kg/day
    ** Convert the TPR to kcal by multiplying TPR by 4 kcal/gm.
    Nutritional Requirement **in the computation- use upper reference value (2, 0.8, 2.5)
     Total Caloric Requirement
     Total Protein Requirement Non- Protein Calories (NPC)
     Non- Protein Calories  NPC= TCR-TPR in calories
     Electrolytes, vitamins, and trace elements
    Condition CHO Fat
    Total Caloric Requirement (TCR)
     Usual 60-70% (70%) 30-40% (30%)
    Condition Energy Factor
    Critically ill (initial phase) 15-20 kcal/ kg/ day  Critically ill 50% 50%
    **in the computation- use 70% for CHO, and 30% for fat (usual condition), 50%
    Critically ill (follow up phase) 20-25 kcal/ kg/ day CHO and 50% fat for critically ill

    Non critically ill 25-30 kcal/ kg/ day

    **in the computation- use upper reference value (20, 25, 30)

    Body Composition Weight Reference to Use


    Non- obese including ACTUAL/IDEAL/ESTIMATED
    underweight body weight
    Obese (BMI >/=30) IDEAL body weight

    *IBW Formula
     IBW for a woman may be estimated as 100 pounds for the first 5 feet plus
    an additional 5 pounds for every inch over 5 feet. The IBW for a man is 106
    pounds for the 5 feet plus an additional 6 pounds for every inch over 5
    feet.

    Total Protein Requirement (TPR)

    Medical Nutrition Prelims Page 1


    Nutrition Care Plan Dr. Dominguez November 14, 2013
    1. CHO Formulation= NPCx % requirement divided by 4 kcal/ gm Nutrient Delivery
    2. Fat Formulation= NPC x % requirement divided by 9 kcal/ gm  Oral
     Gastric feeding
    Fluid Requirements: o Bolus (manual or gravity tube)
     Usual complication: 30 ml/kg body wt o Intermittent or continuous using enteral pumps
     Mostly dependent on fluid balance records  Small intestine feeding
     Critical care set up: include insensible water loss in the fluid balance o Intermittent or continuous using gravity drip
    which is about 800- 1000ml/day o Enteral pumps

    Access Monitoring Strategies


     Oral  Calorie count
     Enteral  Regular weight determinations (once a week)
    o NGT  Fluid balance
    o PEG/ gastrostomy  Complete blood count
    o Jejunostomy  Total lymphocyte count
     Parenteral Nutrition  Serum albumin
    o Peripheral
    o Central Case:
     68- year old female
    Nutrient Formulation  Admission weight: 30kgs
     Regular or special diet  BMI: 12 kg/ m2
     Oral supplements
     Enteral Nutrition  Dx: esophageal tumor
    o Standard formulations: Pre- mixed solutions  High risk/ severe malnutrition
    o Modular formulations: Custom built- for the patients
    o Special (elemental or semi- elemental) Nutrition Care Plan
     Parenteral Nutrition
    o Individual (amino acids, fat, dextrose) or 3 in 1 combinations TCR= 30 kgs x 20 kcal 600 kcal/ day
    o Formulations for peripheral or central route
    TPR= 30 kgs x 2 gm 60 gm/ day x 4 kcal/
    g= 240 kcal/ day
    NPC= 600 kcal- 240 kcal 360 kcal/ day
    CHO= 360 kcal x 0.5/ 4 gm 45 gm/ day
    Fat= 360 kcal x 0.5/ 9 gm 20 gm/ day
    Fluid requirement= 30 ml x 30kg 900 ml/ day

    Access
     *PEG/ gastrostomy, jejunostomy, or Parenteral nutrition (Central)

    Medical Nutrition Prelims Page 2

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