Determining Needs Working knowledge of fluid and electrolyte requirements. Have working knowledge of methods of assessing nutrition status.

Determining Needs Collect pertinent information for comprehensive nutrition assessment.

Determining Needs What are the factors that affect total energy needs?

What weight to use? Energy needs –obese use actual wt. Protein needs –obese use IBW –under 120% IBW use actual

What weight to use? Fluid needs –obese use IBW –under 120% IBW use actual

Harris Benedict Formula Men –kcal/day –66 + (13.8 x W) + (5 x H) - (6.8 x A)

Harris Benedict Formula Women –655 + (9.6 x W) + (1.8 x H) - (4.7 x A) W = wt in kg A = ht in cm A = age in years

Total Daily Energy TDE = BEE x AF x IF AF - activity factors IF - injury factors

Rule of Thumb Men –106 lb for 5 ft plus 6 lb per inch over 5 ft –106 lb minus 6 lb per inch under 5 ft

Rule of Thumb Women –100 lb for 5 ft plus 5 lb per inch over 5 ft –100 lb minus 5 lb per inch under 5 ft

Energy/kg wt wt in kg x kcal/kg = kcal need

Fever & Energy Needs Normal body temperature –98.6 degrees F BEE increases 7% for each degree F above normal

Protein Needs What is normal? What is maximum?

Fat Needs How do you determine g fat if have a target of % kcal from fat?

Fat Needs Need 4% of total daily kcal provided by linoleic acid to prevent EFA deficiency

CHO Needs Usually be difference

Fluid Needs 1 ml/kcal consumed - adult 1.5 ml/kcal consumed - infant ml/kg body wt Conduct an I&O also

Fluid Needs Dx of concern?

Vitamin & Mineral Needs Conduct a through diet hx Look at current food intake Know what diseases & dx may result in vitamin & mineral deficiencies Keep RDA & DRI in mind

END NEEDS Questions?