Free Opening Brief in Support - District Court of Delaware - Delaware

Case 1 :04-cv-01250-SLR Document 12-Z _ Filed 06/29/2005 _ __Page 1 _ _ __ __ _ _ _ _'
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C Nutritional Assessment
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____ ____ _____§ub'ecti’ve Date: -
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- t {)b’ective Data: ~ -
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. Amhrc meterics Hgb :5.3 Glueese Q { 7 ;3/(qc
Gender: Fcmaée HCT {_h,*2_ godgum N,-L__
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Estimated Piutritinnalbieed : — 1; W
Basal Energy Expenditure {BEE): {a 2% ·* if ?°{"6} 7* z’S·(q I) 3
Male: BEE=*66+(23.7x ‘·'···"""""`)+{5i0x ·~—····-- }—(6.8x*·")=-Z C*$.Kc-als
wi/kg htfcm age
Female: BEE=665+(9.60x —-···"""` }+(l.7x hy }—{4.7x`“““'""" 1* ‘*····· Kcals
Wtikg 0121 agi}
Estimated Energy Needs (EEN):
EEN= ——·—··*1{BEH)x····‘""‘ (activity fectmjx ""““ (i1zjuz·yfectory)+/— £6"*° kcais furiossfgairi 17 h'Y¤l·:c1ls
neimaea ?r0te%Needs (EPN)= Qi x , *3*-1 I e 73* ‘it gmpmein
· Protein Requirement Factors: (gm/'lcg/day) ~— Norma.! = 0.08 ~» 1.0
. ...... ..\. Q -..· .. _.._ . .... . ...-.. _ . .._. . .. .
¤¤¤¤¤1—=.;*¤“¢1ff¤i¤F(56°F1s¢s§ 1 _ 1 1 1 `smgeiii 1.3-.:2.4gm _
Us cc: Slgzcc HHid(<55 WS} gigimnmz MMI-om Smgew 1.5-mgm
20 25 mm 2 8-3.5 1.0-1.2 gm Re1zaIDisea.se Prerenel 0.641.8 gm
* * ¤°=~.".:.7...°€ * 21-2.7 1,2-Lsyn Hcmodiaiysis 1.8—I.2gm
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t . . Fxmifeetioes: 2.5 ~ 2.0 gm
lnnmeiiauea Number: _ l lasiiwtiun:
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MR IOM - Pane `I 0{"2

Case 1 :04-cv—O1250-SLR Document 12-7 Filed 06/29/20135- Page 2 012 I s
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_1 Plan: _ 1
I ` A. Diet Changes: -
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‘ BB. Lifestyle Changes: I
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Education: Dune: ` 7`BS ‘·*·*···*·—‘""‘““““““““"“*""—·
Handouts Given: ` :- “ *"""""““““"”"""‘·
Discussed: Yes No
Appetite Eating Diff ________
Calories K
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Family Health Hx gf
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