Case Study JB is a 53 yo male who was recently divorced.He has experienced periods of depression and decreased appetite.Family reports history of heavy drinking habits and 15# weight lost.He was previously diagnosed with cirrhosis and portal hypertension and paracentesis and TIPS procedures were performed.Mr.JB's condition seems to have worsened; he c/o stomach pains, nausea, and vomiting at times.His abdomen is sore to touch and feels swollen.Mr.JB has developed ascites and pedal edema; his urinary output has decreased and he continues to lose weight.Mr.JB also c/o pain when swallowing food.Because of JB's persistent symptoms, he's been admitted to the hospital. A referral to the SLP for a MBS was also ordered and resulted in dysphagia, pureed diet recommended.By day 2 Mr.JB still c/o of nausea and no po intake has been reported.The MD rx'd dietary consult: RD to assess patient and recommend alternate means of nutrition support, currently NPO. Ht: 5'11'' Wt: 145# UBW: 163# Dx: End-stage liver cirrhosis, dysphagia PMH: alcoholic cirrhosis, portal hypertension Labs:

Na: 134 Cl: 101 BUN: 4 Alb: 2.3 TG: 305 Transferrin: 101 NH4: 53

Glu: 139 AST: 45 ALT 48 Alk Phos: 40 Billirubin: 2.1

K: 5.2 CO₂ Cr: 1.8 H/H: 11/35

Diet: NPO Meds: Neomycin, Aldactone, Lasix, Reglan -How will the registered dietitian determine JB's protein needs?

Question

Case Study
JB is a 53 yo male who was recently divorced.He has experienced periods of depression and decreased appetite.Family reports history of heavy drinking habits and 15# weight lost.He was previously diagnosed with cirrhosis and portal hypertension and paracentesis and TIPS procedures were performed.Mr.JB's condition seems to have worsened; he c/o stomach pains, nausea, and vomiting at times.His abdomen is sore to touch and feels swollen.Mr.JB has developed ascites and pedal edema; his urinary output has decreased and he continues to lose weight.Mr.JB also c/o pain when swallowing food.Because of JB's persistent symptoms, he's been admitted to the hospital.
A referral to the SLP for a MBS was also ordered and resulted in dysphagia, pureed diet recommended.By day 2 Mr.JB still c/o of nausea and no po intake has been reported.The MD rx'd dietary consult: RD to assess patient and recommend alternate means of nutrition support, currently NPO.
Ht: 5'11'' Wt: 145# UBW: 163#
Dx: End-stage liver cirrhosis, dysphagia
PMH: alcoholic cirrhosis, portal hypertension
Labs:

Na: 134	Cl: 101	BUN: 4	Alb: 2.3	TG: 305	Transferrin: 101	NH4: 53
Glu: 139	AST: 45	ALT 48	Alk Phos: 40	Billirubin: 2.1
K: 5.2	CO₂	Cr: 1.8	H/H: 11/35

Diet: NPO Meds: Neomycin, Aldactone, Lasix, Reglan -How will the registered dietitian determine JB's protein needs?

Quizplus · Accepted Answer

The registered dietitian will determine JB's protein needs based on his weight and condition. JB is currently 145# and has end-stage liver cirrhosis. The recommended protein intake for patients with end-stage liver cirrhosis is 1.4-1.6 g/kg.

Case Study JB Is a 53 Yo Male Who Was Recently Divorced.He