Clinical Case Study The long road back to eating. Birgit Humpert , KSC Dietetic Intern 2012-2013. Dartmouth-Hitchcock Medical Center. Our mission
Birgit Humpert, KSC Dietetic Intern 2012-2013
We advance health through research, education, clinical practice and community partnerships, providing each person the best care, in the right place, at the right time, every time.
Achieve the healthiest population possible, leading the transformation of health care in our region and setting the standard for our nation.
Children’s Hospital at Dartmouth –CHaD
Norris Cotton Cancer Center
Image: retrieved from National Cancer Institute
Diagnosis: malnutrition in intraabdominal disease, postoperative ileus
NI-5.2 Malnutrition related to alterations in gastrointestinal tract structure/function AEB inability to eat sufficient energy and protein.
176 g dextrose, 135 g AA, 40 g lipids
Source: Practical Gastroenterology
Parrish, C.R., Quatrara, B. (2010). Reinfusion of Intestinal Secretions: A viable Option for Select Patients. Nutrition Issues in Gastroenterology, Series #83, April 2010
S: Why do I have to get so much tube feeding?
O: Meds: dulcolax supp. Ordered
Labs: phos 1.1
A: TF: average daily intake 231 ml (goal 804 ml) with steady increase, 29%
P: TPN increased, phos provided
“It was great to eat, it’s been months. I had cereal for breakfast.”
800-900 kcal, 35-40 g protein
Needs: 1700 kcal, 105 g protein
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Parrish, C.R., Quatrara, B. (2010). Reinfusion of Intestinal Secretions: A viable
Option for Select Patients. Nutrition Issues in Gastroenterology, Series #83, April 2010.