Question

James Roberts, a 72-year-old African American male, is admitted to University Hospital with dehydration and acute respiratory failure. Mr. Roberts’ past medical history includes hypertension and chronic obstructive pulmonary disease (COPD). His current medications include clonidine (anti-hypertensive), prednisone (corticosteroid), and albuterol (bronchodilator).

Since the death of his wife one year ago, Mr. Roberts lives alone and does not cook for himself. Per patient’s daughter, Mr. Roberts receives home-delivered meals from the food assistance program, Meals on Wheels. In addition to the one meal per day from Meals on Wheels, he relies on ready-to-eat foods, such as cereal, toast, canned fruit, cheese, processed deli meats (e.g. bologna), and snacks, such as potato chips and cookies. Due to ill-fitting dentures, Mr. Roberts does not eat fresh fruits and vegetables or unprocessed meats often.

Mr. Roberts has been placed on a mechanical ventilator due to his respiratory failure. Dr. Connors, the physician, wants to start nutrition support in the next 24 hours. As his nurse, you listen for bowel sounds and they are positive in all four quadrants of the abdomen.

The following information was recorded on admission:

Height: 5’10”                Weight: 155 lbs                      Usual weight (3 months ago): 170 lbs

Which of the following measures is most useful for assessing Mr. Roberts' current nutritional status?

%IBW

%UBW

BMI

Current Weight

Answer 1

Mr. Robert's current nutritional status:

Answer: BMI

Mr. Robert's current nutritional status is best measured by the calculation of BMI ( Body mass index)

Body Mass Index is a statistical measure of the weight of a person scaled according to height , used to measure, if a person is underweight or overweight .

BMI of Mr. Robert:

BMI = weight (kg)/ height ( m square)

= 70.30 kg/ (1.524)square (m)

( 155lbs= 70.30kg, 5'10"= 1.524)

= 70.30kg/ 2.322 m square

= 30.27

Mr. Robert's BMI is 30.27. He is an obese person. Ideal BMI should be in between 18.5 to 24.9. BMI 25 to 29.9 is coming under overweight range .

% IBW: Ideal body weight. it is difficult to calculate as the different algorithms are there to calculate IBW and these are complex in nature.

% UBW : Usual Body weight is the weight that client usually remembers and it may not be accurate

Current weight: only with current weight , it is not possible to measure a person's nutritional status.

Different studies have shown that BMI is more accurate in finding the nutritional status and body fat mass when comparing with the IBW, UBW and current weight.