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What would you do ?. Elderly 86 yr. old man Lives on his own Widow No Hx from GP re weight changes Acute Haemorrhagic Weight o/a 58kg BMI 19 Grade 3 Pressure Ulcer Low K, Mg, PO4. Phase 2. Naso - gastric tube placement sucessful

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What would you do
What would you do ?

  • Elderly 86 yr. old man

  • Lives on his own

  • Widow

  • No Hx from GP re weight changes

  • Acute Haemorrhagic

  • Weight o/a 58kg

  • BMI 19

  • Grade 3 Pressure Ulcer

  • Low K, Mg, PO4


Phase 2
Phase 2

  • Naso- gastric tube placement sucessful

  • Advised to hydrate and feed to protein and energy requirements

  • What monitoring or evaluation needs to occur ?


Phase 3
Phase 3

  • Seen by S.A.L.T.

  • Assessment shows can start puree and custard

  • What do you do with the N.G and what do you monitor?


Phase 4
Phase 4

  • On thickened fluids, managing 500mls

  • Food record charts show eating ½ puree meals and custards

  • What is your nutrition plan ?


Phase 5
Phase 5

  • N.G ‘fell’ out! Can’t replace

  • Not meeting nutrition / hydration requirements

  • Pressure ulcer has healed

  • 2kg weight loss

  • S.A.L.T r/v predicts that swallow function unlikely to improve

  • What are the options to meet requirement ?s


Phase 6
Phase 6

  • Discussions for Gastrostomy ( P.E.G. )

  • What things do we need to assess / consider for this ?


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