Mr. B, a 70 year old male, h/o of alcohol abuse, has been diagnosed with cirrhosis with signs of impending hepatic coma. His condition has also been aggravated by ascites with hyponatremia (Na+ mg/dl). At 5'11" tall Mr. B. who once weighed 190 pounds now weighs 160 pounds. An 80 gram protein, 2000 milligram sodium, 1500 cc fluid restriction diet has been prescribed for Mr. B.
1. What is the rationale for this type of diet?
2. What problems may Mr. B encounter while following this diet since he has always eaten what and when he desired?
3. Using the sodium/diabetic exchange lists of foods, write a diet for Mr. B allowing for 80 grams of protein, 2000 milligrams of sodium, 1500 cc fluid restriction.
4. Since he is not restricted on total kcalories, can fats and sugars be added freely?
5. Why would they be valuable food sources?
6. What potential nutrient deficiencies could arise?
7. PO intake has been poor with continual weight loss. Hypponatremia has improved and sodium levels are normal. Current weight is now recorded at 152 lbs. An MD order has been received for a diet consult to initiate a tube feeding schedule. Determine a formula and continuous TF schedule x 20 hours that would meet Mr. B's nutritional requirement.