TF: how high of calories is safe
New pt in LTC.
Severe PCM, stage 4 pressure injury, h/o larynx cancer/cachexia, CKD (GFR has been in 40s)
Current wt 89# BMI 14.8.
UBW 116#
Facility wt hx: 6/30 89#, 6/28 92#, 6/21 99#, 6/5 111# (2+ pedal edema on 6/5)
Prior wt hx: 5/29 96#, 5/10 95#, 12/22 119#
Have gone from 1500kcal, to 1800kcal to now 2000kcal. Has been tolerating all feedings. Started with continuous and now on bolus feedings, has tolerated all. Past week no interruptions noted, confirmed correct formula and volumes being given. Nurse and pt confirm have been receiving boluses as ordered. Resident currently constipated.
Current feeding providing 50kcal/kg and 2g protein/kg. I would usually never go this high but she continues to lose wt. Has anyone needed to go higher than this for your pts? Do you feel it would be safe?