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Chronic Respiratory Failure Case Study

This case study describes a 71-year-old male patient with several chronic conditions including respiratory and gastrointestinal issues who has lost weight. He has an abdominal wound being treated with a wound VAC and receives nutrition through a gastrostomy tube and regular diet. The assessment calculates his estimated calorie and protein needs and finds that his current tube feeding prescription provides adequate calories and protein to support healing and weight stability.

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511 views2 pages

Chronic Respiratory Failure Case Study

This case study describes a 71-year-old male patient with several chronic conditions including respiratory and gastrointestinal issues who has lost weight. He has an abdominal wound being treated with a wound VAC and receives nutrition through a gastrostomy tube and regular diet. The assessment calculates his estimated calorie and protein needs and finds that his current tube feeding prescription provides adequate calories and protein to support healing and weight stability.

Uploaded by

api-434982019
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Case Study​:

71yr old male. Alert w/ confusion

Dx:​ Chronic Repertory Failure w/ hypercapnia, emphysema, oropharyngeal phase


dysphagia, COPD, Severe PCM, MRSA, Gastrostomy, HTN, GERD, Malignant
neoplasm of upper lobe/R-Bronchus or lung; Malignant neoplasm of hypo
pharynx, Disorders of Peritoneum.

Medications​: prilosec 20mg, tramadol 50mg, magnesium oxide- 400mg BID,


thermo tabs 2 tablets w/ meals., prochlorperazine maleate 10mg-prn, potassium
chloride ER 20MEQ q 12hrs, Megace 625mg, furosemide 40mg, folic acid 1mg,
famotidine 20mg

NKFA

Diet​- Regular, Pureed w/ Honey Thick liquids

Tube Feeds​- Jevity 1.5 @ 110cc/hr x 12hrs 7pm-7am; Flush 100cc H2O q 4 hrs

- GJ Tube (lower than PEG tube due to the abdominal surgery)

Consuming 0-25% of meals.

Weights​: 107.6lbs 11/9/2020

109.4lbs 10/29/2020

120lbs 9/28/2020

Height​: 69"

BMI ​= 15.9

Skin​- Abdominal wound w/ wound VAC 13cm (L)x8cm (W)x0.5 depth in size

wound VAC - vacuum that sucks out bad stuff to help new tissue form without
issues

serous ​drainage = clear, watery (ideal)


95% granulation - this means the new tissue is growing

slough ​- greyish discharge

escar ​- dark in color - necrotic

margins - shape of the wound (should not be odd)

● Do reassessment on the nutrition support patient (weights)


● Wound - want more granulation, less sloth or dead skin
○ Abdominal wound from the surgery the pt had
○ Wound VAC (vacuum) incision wound -
○ Gastrostomy was performed

***​Assessment:
Estimated calorie needs:  

IBW: 5’9= 106 + 6 x 9 = 160lbs 

AJBW: IBW + .4(ABW - IBW) = 160 + .4(-53) = 160 - -21.2 = 138.8lbs or 63kg 

Men: (10 × w
​ eight​ in kg) + (6.25 × h
​ eight​ in cm) - (5 × age in years) + 5. 

- (10 x 63) + (6.25 x 175.3) - (5 x 71) + 5 


- 630 + 1,095 - 355 + 5 = 1,365 x 1.2AF = 1,638 or​ 1,650 calories  

Protein:  

(1.25-1.5g/kg) 

- 1.25 x 63kg = 78.8 grams 


- 1.5 x 63kg = 94.5 grams  

Tube Feed Provides: 

110cc/hr x 12 hrs = 1,320cc x 1.5kcals =​ 1,980 calories  

63.8g per 1,000mL = 1,320 / 1,000 = 1.32 x 63.8 =​ 84.2 grams protein  

- The tube feeding prescription seems to be providing enough calories and protein 
for this individual to promote healing and weight stabilization.  

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