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Determining Needs. Working knowledge of fluid and electrolyte requirements. Have working knowledge of methods of assessing nutrition status. Determining Needs. Collect pertinent information for comprehensive nutrition assessment. Determining Needs.
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Determining Needs • Working knowledge of fluid and electrolyte requirements. • Have working knowledge of methods of assessing nutrition status.
Determining Needs • Collect pertinent information for comprehensive nutrition assessment.
Determining Needs • What are the factors that affect total energy needs?
What weight to use? • Energy needs • obese use actual wt. • Protein needs • obese use IBW • under 120% IBW use actual
What weight to use? • Fluid needs • obese use IBW • under 120% IBW use actual
Harris Benedict Formula • Men • kcal/day • 66 + (13.8 x W) + (5 x H) - (6.8 x A)
Harris Benedict Formula • Women • 655 + (9.6 x W) + (1.8 x H) - (4.7 x A) • W = wt in kg • A = ht in cm • A = age in years
Total Daily Energy • TDE = BEE x AF x IF • AF - activity factors • IF - injury factors
Rule of Thumb • Men • 106 lb for 5 ft plus 6 lb per inch over 5 ft • 106 lb minus 6 lb per inch under 5 ft
Rule of Thumb • Women • 100 lb for 5 ft plus 5 lb per inch over 5 ft • 100 lb minus 5 lb per inch under 5 ft
Energy/kg wt • wt in kg x kcal/kg = kcal need
Fever & Energy Needs • Normal body temperature • 98.6 degrees F • BEE increases 7% for each degree F above normal
Protein Needs • What is normal? • What is maximum?
Fat Needs • How do you determine g fat if have a target of % kcal from fat?
Fat Needs • Need 4% of total daily kcal provided by linoleic acid to prevent EFA deficiency
CHO Needs • Usually be difference
Fluid Needs • 1 ml/kcal consumed - adult • 1.5 ml/kcal consumed - infant • 25-40 ml/kg body wt • Conduct an I&O also
Fluid Needs • Dx of concern?
Vitamin & Mineral Needs • Conduct a through diet hx • Look at current food intake • Know what diseases & dx may result in vitamin & mineral deficiencies • Keep RDA & DRI in mind
END NEEDS • Questions?