NCP #1

Experiment: Albumin
Maria Pelcastre
I.

Date: Feb. 1 2013

Recorder: Ana

Nutrition Assessment:

Diagnosis: Bladder cancer

Age, gender: 55, female

Dietary Intake: PO intake

Symptoms: Decreased appetite since chemo N/V WHEN TRIES TO EAT.

Anthropometric measurements
o Ht./wt. 55/ 165.1 cm and 112#/ 50.9 kg.
o MBI: 18.7
o IBW: 125#/56.8 Kg %IBM: 89.6%
o UBW: 123#/ 55.9 Kg, %UBW: 91%
o % Weight loss: 8/9% (mild degree of malnutrition).
Energy, protein & fluid needs

Give a range

Total energy: 1998-2306 kcal/d

Protein: 50.9-63.6 g/d

Fluid: 1782
Basis for Estimations (based on ABW OF 50.9 Kg)
Energy Needs:

II.

III.

REE: 307.5
Protein, used stress factor for tumor 1-1.25g PRO/Kg
For fluid needs, used 35 ml/kg/day

Lab tests:
Total PRO: 5.5g/dL
Serum Albumin: 2.8g/dL
Nutrition Diagnosis:
Problem: Inadequate protein intake
Etiology (cause): R/T poor appetite and N/V caused by chemotherapy
Sign/symptom: AEB <90%, IBW 8.9% wt. loss, low total PRO and low serum
albumin.
Nutrition Intervention

Meals and Snacks : short frequent meals with mini shakes with PRO
o Supplemental protein drinks TID between meals
o Examples of protein rich food: nuts, asparagus, beef fillet steak,
cheese, deer meat, soya beans, Tilapia fish, pumpkin seeds.

Nutrition-related medication management:

o REC Appetite stimulant

Goals:
o Dietary intake to meet >75% of estimated energy needs.

Weight gain of 1#/wk. until pt. reaches BW/IBW

Protein need: 50.9-63.6 g/d
Increase total protein and serum albumin to within normal
ranges in 4 wks.
Monitoring and evaluation
o Follow up phone call
o Ask the patient to do 3 day food record and bring it to
clinic to reassess BW protein intake have increased from
previous visit.
o Re-assess total protein and serum albumin in 4 wks. to
determine if within normal ranges .
o Consult MD if the patient need a TPN in case the patient
has still low blood albumin and loss body weight.
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