AS is a 54-year-old business man who has a family history of lung cancer. AS started smoking at 15; years later, he got what he thought was a very bad cold that lasted for a week, started experiencing pain in his tongue, and was given ibuprofen for pain. He then noticed white sores that were getting bigger in his oral cavity near the tongue. He started feeling generally lousy and was unable to eat because of severe pain; he lost 30 lbs in a month. AS went to the clinic, where they did a biopsy that revealed squamous cell cancer of the tongue. AS has undergone radiation therapy (RT) and surgery to remove the cancer and a restorative surgery was scheduled. Because of the RT, AS has developed mucositis and xerostomia in his oral cavity. All his nodes that were sent to the laboratory tested negative for metastasis, and no further RT was needed. The surgeons felt confident that they had removed all the cancer.
HT: 5'11" UBW: 165 lbs WT: 135 lbs
Meds: Corticosteroids and antineoplastic (dexamethasone) to reduce inflammation, K depletion, Na retention; and morphine for pain.
-What values should be used to estimate AS's caloric requirements?

Question

Quizplus · Accepted Answer

AS has experienced significant weight loss (30 lbs in a month) due to the pain and inability to eat caused by the cancer and subsequent treatments. Therefore, it is appropriate to use his current body weight (135 lbs) to estimate his caloric needs. The recommended range for estimated caloric needs for malnourished individuals is 30-35 kcal/kg current body weight, which would translate to approximately 2,025-2,475 kcal/day for AS. Using his ideal body weight (IBW) would not be appropriate in this case, as it does not take into account his current state of malnutrition.

AS Is a 54-Year-Old Business Man Who Has a Family