Determining Needs

1. Determining Needs • Working knowledge of fluid and electrolyte requirements. • Have working knowledge of methods of assessing nutrition status.

2. Determining Needs • Collect pertinent information for comprehensive nutrition assessment.

3. Determining Needs • What are the factors that affect total energy needs?

4. What weight to use? • Energy needs • obese use actual wt. • Protein needs • obese use IBW • under 120% IBW use actual

5. What weight to use? • Fluid needs • obese use IBW • under 120% IBW use actual

6. Harris Benedict Formula • Men • kcal/day • 66 + (13.8 x W) + (5 x H) - (6.8 x A)

7. 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

8. Total Daily Energy • TDE = BEE x AF x IF • AF - activity factors • IF - injury factors

9. 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

10. 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

11. Energy/kg wt • wt in kg x kcal/kg = kcal need

12. Fever & Energy Needs • Normal body temperature • 98.6 degrees F • BEE increases 7% for each degree F above normal

13. Protein Needs • What is normal? • What is maximum?

14. Fat Needs • How do you determine g fat if have a target of % kcal from fat?

15. Fat Needs • Need 4% of total daily kcal provided by linoleic acid to prevent EFA deficiency

16. CHO Needs • Usually be difference

17. Fluid Needs • 1 ml/kcal consumed - adult • 1.5 ml/kcal consumed - infant • 25-40 ml/kg body wt • Conduct an I&O also

18. Fluid Needs • Dx of concern?

19. 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

20. END NEEDS • Questions?