50 Y M presents to the ER with anorexia, fatigue, nausea & vomiting & an uninten

Question

50 Y M presents to the ER with anorexia, fatigue, nausea & vomiting & an unintentional weight loss of 60lbs over the past year. Has only been eating small amounts of scrambled eggs, oatmeal, apple juice, canned peaches, and soup each day. He is currently undergoing medical tests to diagnose his illness You are asked to assess his nutritional status using anthropometric standards. Current Body Wt= 130 lbs, Ht= 6'1", Usual body weight 1 year ago= 190 lbs.

1) Calculate his BMI, IBW, %IBW, %Weight Loss and summarize results.

2) Estimate his energy (kcal/kg method) & protein requirements.

3) Write a PES statement based on findings.

Explanation / Answer

1. ANS: BMI Categories:
Underweight = <18.5
Normal weight = 18.5–24.9
Overweight = 25–29.9
Obesity = BMI of 30 or greater

BMI = Weight in kilograms / (Height in meters) 2

Height: 6 feet, 1 inch

Weight: 130 pounds

Age: 50Years

Gender: Male

Calculation

The calculation of the body mass index is based on a height of 6 feet 1 inch (185 cm) and a weight of 130 pounds (59.0 kilograms) is 17 (BMI = 17)

Ideal Body Weight (IBW):

MEN: IBW (kgs) = 22 x (height in meters)2

Based on the BMI range formula his ideal weight is between 140.22 lbs and 189.49 lbs.

Weight loss:

1. Height - 6 feet 1 inch

2. Initial Weight - 190 lb 86 kgs

3. Present Weight - 130 lb 59 kgs

So the weight loss is 27 kgs or 60 lbs

2. ANS: Basal Energy Expenditure:

Estimate basal energy expenditure using the Harris-Benedict equations.

Height: 6 feet, 1 inch

Weight: 130 pounds

Age: 50Years

Gender: Male

Activity Factor: Bed rest

B. E. E calculation For men:
B.E.E. = 66.5 + (13.75 x kg) + (5.003 x cm) - (6.775 x age)

B.E.E = 618 kcal/day

Caloric Requirement = 742 kcal/day

Protein calculation:

Formula: Weight in kg x 0.8-1.8 gm/kg = protein gm

Based on the weight, American Dietetic Association (ADA) recommends taking at least 59 - 106 grams of protein per day.

Based on the conditions, Centers for Disease Control and Prevention (CDC) recommend taking 50 - 176 grams of protein per day, which is 10% - 35% of his daily Calorie intake.

PES statement: The patient weight is at a very low level and it may lead to serious health problems. According to the WHO classification he is present in underweight.

Possible causes

Undernourishment

Maldigestion

Slimming caused by a disease

Possible measures

Set a weight target

Nutritional

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