Day 219 - Poppin Collars
Friday, August 6th, 2021 James had OT and a bunch of stop-ins with their clinical notes below from the hospital portal. No issues overnight. Tolerated LTV x8hr x2 yesterday and overnight. Remains on same respiratory medications. No changed to methadone and clonidine. WAT scores reported as 0. Fluid balance +289mL. 1BM. Tolerated feeding regimen. No changed to calories/protein as of yet. Update Notes from Nutrition, GI, and ENT Nutrition Designation : Pt meets severe PCM criteria for length z-score. However, per pt's length history, pt has always been in this range. Stunting vs h/o rickets and bone fractures Nutrition Recommendation : 1. Recommend change to previous feeding regimen of EBM 20 kcal/oz with 2 daytime feeds of Neosure 22 kcal/oz. This will provide additional protein 0.3 g/kg for growth and provide additional calcium and phos due to continued rickets --Neosure 22 kcal/oz, 120 mL over 45 min at 12pm and 4 pm, and then continuous feeds of EBM 20 kcal/oz at 35 mL...