determining needs

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?