[Answered]: Nicholas Nevin is a 61 y/o male with a past…

Nicholas Nevin is a 61 y/o male with a past medical history of diverticulitis s/p laparoscopy, exploratory laparotomy, abdominal washout with 4 L, and with diverting loop ileostomy, who is seen at the request of hospitalist Dr. Harrison for evaluation and treatment of severe protein calorie malnutrition. He is doing okay and tolerating clear liquid diet. No distress and no issues with TPN. Was started on TPN by SNS team. Medical History: Hemorrhoids, BPH, Appendectomy, Colonoscopy, b/l THA Review of Systems: Constitutional: (-) fever chills sweats or weight loss Cardiovascular: (-) negative: no chest pain, dyspnea, syncope, or palpitations Pulmonary: (-) negative: no cough, wheezing, or shortness of breath Abdominal/GI: (+) abdominal pain and (-) dysphagia and (-) nausea Musculoskeletal: (-) negative: no pain Skin: (-) negative: no rash or new or changing moles Neurology: (-) negative: no focal neurologic defect Psychiatry: (-) negative: no depression or anxiety Review of systems otherwise negative. Vitals: Temperature: 98.6°F Pulse: 80 Respirations: 17 Blood Pressure: 120/60 SpO2: 98% on room air Physical Examination: Constitutional: no acute distress Eyes: sclera and conjunctiva normal Neck: JVP normal, normal carotid pulses without bruits CV: normal rate and rhythm, no murmur, gallops or rub Chest: normal respiratory effort, lungs clear to auscultation and percussion Abdomen: soft, no tenderness, no rebound or guarding, (+) ostomy functioning Musculoskeletal: (+) Muscle wasting: None (+) fat mass loss: None Extremities: no clubbing, cyanosis, (+) edema, Skin: warm, dry Neuro: alert, oriented to person, place, and time, normal mental status exam Psych: normal mood and affect, non-suicidal, judgement normal, memory normal Nutrition Requirement: Energy needs (Kcal/kg): 25-30 Weight Used (Energy): Ideal weight Kcal/day: 1858-2229 Protein (gm/kg): (1.2) Protein (gm/day): 89 Weight Used (Protein): Ideal weight CURRENT ORAL INTAKE: 25%