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Maisey Hospital
Nutrition Department
Lillie
70 years old
11/10/2018
Nutrition Assessment:
This is a 30 minute face to face Medical Nutrition Therapy visit. Patient is a 70 year old female
referred for dietary counseling by her doctor.
Weight History:
Height: 5’1’’; Current weight: 146lbs; current BMI is 27.6 (Overweight)
Usual body weight 173lbs; % usual body weight: 84.4%
Ideal body weight: 105lbs; % ideal body weight: 139%
Adjusted Body weight: 115.3lbs; % ABW: 126.6%
Has lost 27lbs in the last 1 month
Social history:
Use to be an active member of her community
Has a son and a friend caring for her
Nurses she used to work with are also willing to help out
Current Meds:
Ibranz (chemotherapy agent)
Constipation medications
Heartburn medications
Pain medications
Cancer medications
Nutrition Diagnosis:
Poor nutrition quality of life (NB-2.5) related to inability to chew and swallow foods, constant
fatigue, and calorie consumption of 100-200 a day as evidenced by muscle and fat deficit,
weight loss, and being bed ridden.
Nutrition Intervention:
Nutrition Prescription
1. Recommended energy needs for a malnourished cancer hypermetabolism patient-
35kcals/kg
• 66kg * 35= 2,310kcals
2. High protein diet suggested for malnourished cancer patients- 1.2-1.5g/kg
• 66kg * 1.2-1.5= 99-132g of protein/d
3. 66* 20-40= 1,320-2,640mL/kg
4. From formula:
1500mL
6 cartons
2250kcals
102g of protein
Flushes (water)- 720 mL (60 before and after each feeding)
Total fluids: 2,888mL
5. Start at 50% of needs first day, 75% the second, and 100% every day on
Day one:
o Fluid: 750 ml, 3 cartons, 95mL from formula, 720mL from flushing
o Energy: 1125 kcal
o Protein: 51 g
Day two:
o Fluid: 1,125mL, 4.5 cartons,143mL from formula
o Energy: 1,678kcals
o Protein: 76.5g
Implementation of Intervention
6 feedings a day of event distribution of the formula (1 carton)
Have son or friend help administer the fluids
Have a motivation change towards completing feedings and understanding of how enteral
feeding works
Maintain Weight
Have more energy to be able to get out of bed
Get small household chores done
Be able to see friends or family for one hour without getting too fatigued
Medical Nutrition Therapy provided using the 2018 evidence based practice guidelines from the
American Academy of Nutrition and Dietetics.
Tessa Vojtik