This patient is receiving the medication propofol. Using the information that you listed in question #6, what changes will you make to your nutritional regimen and how will you assess tolerance to this medication?
What will be an ideal response?
Patient is on 25 mL/h of propofol, which will provide 660 kcal/day. Discuss with medical team and if plan is to continue with propofol will need daily monitoring of calorie intake and titration of tube feeding goal rate accordingly. With the 60 mL/hr rate of infusion of Impact with Glutamine and the 25 mL/hr of propofol, the patient is receiving 2532 kcal/day (vs. needs of 2700-2900 kcal/day). Given this, consider increasing the goal rate to 66 mL/hr with propofol or 87 mL/hr without the propofol. Since propofol is in a 10% IV fat emulsion, need to monitor triglyceride levels and liver enzymes as a possible marker for ability to metabolize triglycerides.
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