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EN:
Goal Rate: 320 mL/bolus at 5 bolus feedings per day
Nutrition prescription: Begin Osmolite 1.5 at 160 mL per bolus; if gastric residuals <250
mL and no nausea, vomiting, or distention are presenting, then increase by 20 mL per
bolus feeding until goal rate is met. Flush with 217 mL water after each bolus.
Total volume: 1600 mL/day
Energy: 2400 kcal
Protein: 100 g
Fat: 79 g
CHO: 326 g
Free water: 1219
Water with flushes: 2304 mL
Nutrition Intervention:
1. FOOD AND/OR NUTRIENT DELIVERY: (1)Enteral Nutrition; Inserted J-tube for enteral
feeding. (2) Meals and Snacks; Implemented increased protein diet via nutrition
support to address increased protein needs due to cancer diagnosis and treatment.
(3) Meals and Snacks; Implemented increased/consistent energy diet via nutrition
support to maintain weight status and prevent further weight loss.
2. NUTRITION EDUCATION: (1) Content; Discussed nutritional needs as they relate to
maintaining current weight and increasing protein intake as required due to patient
receiving cancer treatment. (2) Content; Discussed need for enteral nutrition, how
EN works, and desired outcomes following implementation of EN. (3) Application;
Worked on developing skills related to administering bolus feedings.
Goal: Meet goal feeding rate within 8 bolus feedings and maintain current weight by next
appointment in one week.
Monitor/Evaluate:
1. Enteral Nutrition Intake: Enteral nutrition formula/solution (amount prescribed and
amount administered), volume and frequency of feeding tube flush, gastric
residuals, signs of nausea/vomiting/abdominal distension
2. Nutrition Related Physical Findings: Gastric residuals, signs of
nausea/vomiting/abdominal distension
3. Anthropometrics: Weight, weight change
4. Biochemical: Pre-albumin, vitamin profile, mineral profile, electrolyte profile (to
ensure that nutrition support is adequately addressing needs)
5. Knowledge/Beliefs/Attitudes: Level of knowledge/skill related to administering bolus
feedings