# Nutritional Management and Adjustments for Sharyn Bartell
Sharyn Bartell, a 24-year-old student, suffered severe injuries, including multiple fractures and a small bowel resection after a fall. Due to her immobility and the significant loss of weight since the accident, her healthcare team has decided that she needs a feeding tube to prevent further nutritional deterioration.
## High Protein Formula for Tube Feeding
After researching high-protein formulas suitable for administration via feeding tube, one appropriate option is **Jevity 1.5 Cal**.
1. **Name of Formula**: Jevity 1.5 Cal
2. **Nutrient Composition**:
– **Calories**: 1.5 kcal/mL
– **Protein**: 18.5% of total calories (approximately 63 grams of protein per liter)
– **Fat**: 29.7% of total calories
– **Carbohydrates**: 51.8% of total calories
– **Fiber**: Contains dietary fiber to support bowel function
– **Vitamins and Minerals**: Provides a balanced mix of essential vitamins and minerals, including vitamins A, D, E, K, and B-complex, as well as minerals such as calcium, magnesium, and potassium.
3. **Indications for Use**:
– Designed for patients requiring long-term tube feeding
– Suitable for patients with increased protein needs due to injury or surgery
– Appropriate for individuals with impaired digestive or absorptive capacity, ensuring adequate nutrition delivery
## Effects of Small Bowel Resection on Fluid and Electrolyte Balance
The small bowel plays a critical role in nutrient absorption and fluid balance. Sharyn’s small bowel resection will significantly impact her fluid and electrolyte balance in the following ways:
1. **Fluid Absorption**: The small intestine is responsible for absorbing a substantial amount of the water and electrolytes from ingested food and secreted digestive fluids. With a reduced length of the small bowel, Sharyn’s body may struggle to absorb sufficient fluids, leading to an increased risk of dehydration. Dehydration can further complicate her recovery, affecting wound healing and overall bodily functions.
2. **Electrolyte Imbalance**: The small intestine is also crucial for the absorption of electrolytes such as sodium, potassium, and magnesium. Post-surgery, Sharyn may experience malabsorption of these electrolytes, resulting in imbalances that can manifest as muscle cramps, weakness, fatigue, and more severe complications like cardiac arrhythmias. Ensuring adequate electrolyte levels through her diet or supplementation will be vital in her nutritional management plan.
## Physical and Psychosocial Adjustments to Enteral Feeding
Living with a feeding tube necessitates significant adjustments both physically and psychosocially. Two key adjustments Sharyn will need to make include:
1. **Physical Adjustments**:
– **Routine and Maintenance**: Sharyn will need to incorporate routine care and maintenance of her feeding tube into her daily life. This includes regular cleaning of the tube and site, ensuring the feeding tube is correctly positioned and functioning, and managing the feeding schedule to avoid complications such as clogging or infections. The physical demands of tube maintenance may initially be challenging and require a period of adaptation.
2. **Psychosocial Adjustments**:
– **Body Image and Social Interactions**: Having a feeding tube can affect Sharyn’s body image and self-esteem, as it is a visible reminder of her health condition. She may feel self-conscious or anxious about her appearance and the practicalities of tube feeding in social settings. Additionally, Sharyn may face challenges in social interactions, such as dining out with friends or participating in group activities that involve food. She will need to find ways to manage these feelings and maintain her social life, potentially seeking support from counseling services or support groups.
In conclusion, Sharyn’s recovery and nutritional management will require careful planning and adjustment. The selection of an appropriate high-protein formula like Jevity 1.5 Cal will help meet her nutritional needs, while addressing the impacts of her small bowel resection on fluid and electrolyte balance is critical. Additionally, physical and psychosocial adjustments are necessary to ensure she can live comfortably and confidently with her feeding tube.
References
– Abbott Nutrition. (n.d.). Jevity 1.5 Cal. Retrieved from https://abbottnutrition.com/jevity-15-cal
– Oley Foundation. (n.d.). Dietary Recommendations for Patients with Intestinal Failure. Retrieved from https://oley.org/page/Dietary_Recs_Intestinal_Failure
– Oley Foundation. (n.d.). Living with Enteral Feeds. Retrieved from https://oley.org/page/Living_with_Enteral_Feeds
Vitamins are energy building nutrients that contribute to sound nutritional health. Water, on the other hand, is responsible for carrying necessary nutrients and removing waste products throughout our body. A human body is made out of mostly water and is critical to our health. Similarly, minerals and electrolytes are essential to human health and can be obtained in our diet from different foods. When humans are too sick to consume a regular diet, digestion and absorption may impact the supply of necessary nutrients, requiring specialized nutritional support to meet their nutritional needs.
After studying Module 4: Lecture Materials & Resources, read the case study and answer the prompts:
Sharyn Bartell is a 24-year-old student who suffered multiple fractures when she fell from a cliff when hiking. As a result of the accident, she is immobile, in traction, and had a small bowel resection. She is able to keep her head up to 45 degrees. Sharyn used to weigh 140 pounds but has lost 8 pounds since the accident. The healthcare team agrees that Sharyn will need a feeding tube before her nutritional status deteriorates any further.
- Navigate the web, research a high protein formula that can be administered via feeding tube and share 1) name of formula, 2) nutrient composition, and 3) indications for use.
- Navigate to the Oley Foundation: Dietary Recommendations for Patients with Intestinal Failure – Oley FoundationLinks to an external site., read “Physiological Considerations” and discuss in at least one paragraph with two (2) effects of the small bowel resection on Sharyn’s fluid and electrolyte balance.
- Navigate to the Oley Foundation: Living with Enteral Feeds – Oley FoundationLinks to an external site. and provide two (2) physical or psychosocial adjustments Sharyn will have to make when living with a feeding .
- At least 400 words, formatted, and cited in the current APA style with support from the textbook and sources provided.
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