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

2. Determining Needs Collect pertinent information for comprehensive nutrition assessment.

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

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

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

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

7. 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

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

9. 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

10. 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

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

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

13. Protein Needs What is normal? What is maximum?

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

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

16. CHO Needs Usually be difference

17. Fluid Needs 1 ml/kcal consumed - adult 1.5 ml/kcal consumed - infant 25-40 ml/kg body wt Conduct an I&O also

18. Fluid Needs Dx of concern?

19. 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

20. END NEEDS Questions?