e of 24-hour recall, food history, calorie counts .as appropriate. Identifies imbalance between estimated nutritional requirements and actual intake. TPN @ 79cc / hr 24 hr infusion through PICC line in R forearm. TPN will be monitored through out shift. Pump and tube will remain patent and operational and patent.3. Assess gag reflex, ability to chew / swallow, and motor skills when progressing to transitional feedings. May require additional interventions, e.g., retraining by dysphagia expert (speech therapist) or long-term nutritional support. Pt’s gag reflex intake AEB ability to eat and swallow solid food without complication4. Allow adequate time for chewing, swallowing, savoring food: provide socialization and feeding assistance as indicated. Patients needs encouragement/assistance to overcome underlying problems such as anorexia, fatigue, muscular weakness. Pt. Is given time to eat meals. Pt does this with limited assistance5. Refer to nutritional team / registered dietitian.Aids in the identification of nutrient deficits and need for parenteral nutritional intervention. Caloric and nutritutional status calculated by dietitian on 9/18/96Calculate basal energy expenditure using formula based on sex, height, weight, age, and estimated energy requirements. Provides an estimation of calorie and protein needs. Total caloric intake prescribed @ `1500 qd with 40% fat content and amino acids @ 65%. TPN solution adjusted for proper electrolyte and vitamin balance.OUTCOME/GOAL STATEMENT: Short Term: Client will eat at least 75% of prescribed food at each meal. Long Term: Prior to discharge, Pt. will show stable and or increased weight gain and be free of signs of malnutrition.#5. NURSING DIAGNOSIS: Self care deficit R/T physical limitations, and frustration over loss of independence AEB in ability to maintain cleanliness of tube insertion site( right posterior chest), changing clothes Doenges , p. 383Intervention /Action...
