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Comprehensive Care Plan for an 86-Year-Old Man with Nutritional Challenges

This case study explores the management of an 86-year-old man facing acute health issues, including significant weight loss, a stage 3 pressure ulcer, and swallowing difficulties. Initially, nasogastric tube feeding was employed to meet his nutritional and hydration needs. However, due to tube complications and a significant decline in nutritional intake, discussions for gastrostomy (PEG) placement are initiated. This assessment focuses on his nutritional needs, monitoring strategies, and considerations for long-term care alternatives, ensuring his well-being through tailored interventions.

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Comprehensive Care Plan for an 86-Year-Old Man with Nutritional Challenges

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Presentation Transcript

  1. What would you do ? • Elderly 86 yr. old man • Lives on his own • Widow • No Hx from GP re weight changes • Acute Haemorrhagic • Weight o/a 58kg • BMI 19 • Grade 3 Pressure Ulcer • Low K, Mg, PO4

  2. Phase 2 • Naso- gastric tube placement sucessful • Advised to hydrate and feed to protein and energy requirements • What monitoring or evaluation needs to occur ?

  3. Phase 3 • Seen by S.A.L.T. • Assessment shows can start puree and custard • What do you do with the N.G and what do you monitor?

  4. Phase 4 • On thickened fluids, managing 500mls • Food record charts show eating ½ puree meals and custards • What is your nutrition plan ?

  5. Phase 5 • N.G ‘fell’ out! Can’t replace • Not meeting nutrition / hydration requirements • Pressure ulcer has healed • 2kg weight loss • S.A.L.T r/v predicts that swallow function unlikely to improve • What are the options to meet requirement ?s

  6. Phase 6 • Discussions for Gastrostomy ( P.E.G. ) • What things do we need to assess / consider for this ?

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