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2.1.1: Employ various techniques to calculate patients' nutritional needs and the content of nutrient sources

BI is a 72-year-old man with hypertension, diabetes, and COPD. He is currently hospitalized and on a ventilator for community-acquired pneumonia. Which of the following regimens would be the most appropriate dietary therapy?

(A) 55% carbohydrate, 25% fat, 20% protein

(B) 65% carbohydrate, 30% fat, 35% protein

(C) 35% carbohydrate, 25% fat, 40% protein

(D) 35% carbohydrate, 50% fat, 15% protein

The correct answer is (D).

A low carbohydrate diet has been supplemented by a higher fat content, which will help decrease the CO 2 load while providing adequate calories (D).

Patients with pulmonary disease should be given a low carbohydrate diet to decrease CO 2 production, as well as to decrease the risk of hyperglycemia in a diabetic patient (A and B). A low carbohydrate load is appropriate, but the caloric deficit should be replaced with fat (C).

FT is a 57-year-old woman with type 2 diabetes and end stage renal disease who requires enteral nutrition. She was recently placed on hemodialysis therapy 3 times/wk. What is the most appropriate nutrition combination for this patient?

(A) Low protein, high carbohydrate

(B) Low protein, low carbohydrate

(C) Moderate protein, moderate carbohydrate

(D) High protein, high lipid

The correct answer is (C).

A moderate protein diet in a hemodialysis patient decreases the risk of protein malnutrition; there is no risk of further renal deterioration. A low carbohydrate diet may also prove beneficial for patients with diabetes (C).

A low-protein diet in a hemodialysis patient may lead to protein malnutrition, due to increased protein loss (A and B). Furthermore, a high carbohydrate diet is likely to lead to loss of glycemic control. High-protein diets have not been proven to be beneficial in preventing protein malnutrition, and high lipid diets may increase the risk for pancreatitis and would not be appropriate (D).

Which of the following daily calorie counts would be most appropriate for DR?

(A) 1,600 kcal

(B) 1,800 kcal

(C) 2,500 kcal

(D) 3,200 kcal

The correct answer is (C).

Adult patients on bed rest require an average of 30 to 35 kcal/kg of body weight per day. The calculations for calorie intake are from 78 kg × 30 to 78 kg × 35 ...

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