Question

Nutrition Support (Enteral and Parenteral Feeding)

Case Study

Patient Summary: 75 y/o, Female

Weight: 90kg Height: 155cm UBW: 87kg BMI: __________

Medical Diagnosis: acute heart failure, chronic kidney failure.

Reason for Admission: shortness of breath, chest pain, bradycardia, extreme edema in

lower extremities, ascites, and reduced urine output.

Medical history: hypertension, acute heart failure, impaction of intestine, stage 3 chronic kidney disease, and chorionic kidney failure.

Medication before nutrition support: Apixaban 2.5 mg, Furosemide 40 mg, Pantoprazole 40 mg.

History of NPO: myocardial infarction; patient suffers prominent chest pain and shortness of breath for a long time therefore not able to eat properly.

Sedation & ventilation status: patient is incubated and sedated on mechanical ventilation. No eye opening, verbal responses, and motor responses. Glasgow coma scale is 3. Bilateral air entry, ventilation mode is synchronized intermittent mandatory ventilation/pressure control. FiO2 50%.

Which type of nutrition support is best suited for this patient?

Answer 1

Parenteral type of nutrition support is best suited for this patient as she is diagnosed with acute heart failure and has a history of intestinal impaction. She has a history of prominent chest pain and shortness of breath for a long time and is not able to eat properly. She is incubated and sedated on mechanical ventilation. Glasgow coma scale is 3 with no eye opening, verbal responses, and motor responses. She has blateral air entry, ventilation mode is synchronized intermittent mandatory ventilation/pressure control. In such cases, TPN or total parenteral nutrition is capable of providing the required nutrition support until the patient's condition improves as this provides the required nutrition directly into the blood stream without going through the GI tract through an IV cather.