Experiment: Hemoglobin/Hematocrit

Ana Maria Pelcastre

I.

Date: February 8, 2013

Recorder:

Nutrition Assessment
a. Diagnosis: Energy requirement
b. Age, gender: 22, female
c. Dietary Intake: PO intake
d. Symptoms: constant fatigue
e. Anthropometric Measurements

Ht./wt.: 54(163 cm) / 108# (48.9kg.).

BMI: 18.5

IBW: 120#/54.43kg, %IBW: 90%

d. Energy, protein and fluid needs

Ranges
o Total energy: 2590.1-2911.6 kcal/d
o Protein: 51.12-60.9g/d
o Fluid: 1236.7ml/day

Include basis for Estimations (Based on an ABW of 48.9kg).

o For energy, used Mifflin-St. Jeor formula to determine REE
then multiplied by Activity factor (1.3) & injury Factor (1.31.5) plus 500 kcals extra for lactation condition.
o For protein used stress factor for non-stressed state 0.8
1.0 g PRO/Kg plus 12gr of PRO extra for lactation
condition.
o For fluid needs, used 1 ml/kcal multiplied by Estimated
required Kcal.
e. Labs/tests (can indicate high or low).
Hemoglobin: Low, (<11 g/dL).
Hematocrit: Low, ( <37%).

II.

Nutrition Diagnosis: PES Format

Food and Nutrition related knowledge deficit R/T constant fatigue caused by
breast feeding AEB mild malnutrition <95% IBW, low hemoglobin serum &
low hematocrit.

III.

Nutrition Intervention
a. Meals & Snacks
o To add fortified iron beverages and iron high foods in the diet.
o Examples: fortified iron juice, oysters, enriched-fortified iron
cereals, green leafy vegetables, tomato sauce, lean beef,
prunes, raisins, beans, lentils, chick peas, artichokes etc.
b. Nutrition related Medication Management
o REC nutrition Education/management.
c. Goals:

o
o
o
IV.

To increase total iron and hematocrit levels to within normal

ranges.
To increase Energy levels
Dietary intake to meet percentage of estimated energy needs
for breast feeding woman.

Monitoring and Evaluation

o Follow up phone call
o Ask the patient to attend Nutrition education classes and to
develop a meal plan according to her needs.
o Ask the patient to do a 3 day food record and bring it to clinic to
reassess hemoglobin and hematocrit tests.
o Reassess hemoglobin serum and hematocrit levels in 4 weeks to
determine if they are within normal ranges.
o Consult MD if fatigue persists and hemoglobin and hematocrit
levels are within range.