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Meal Plan—May 24, 2016

Patient Body Mass Index: 15.1

Normal BMI range: 18.5–24.9

Other symptoms: Bradycardia, arrhythmias, osteopenia, unstable vital signs.

Treatment Objective: Weight gain and restoration of patient BMI to within normal range.

Meal Plan:

Patient will consume three meals and three snacks at two-to-three-hour intervals daily.

Initial caloric value set at 2,100 calories per day, to be increased by 250–300 calories every forty-eight hours to seventy-two hours.

Patient will be monitored for symptoms of refeeding syndrome and other medical complications, including but not limited to: heart failure, arrhythmias, respiratory failure, muscle breakdown, sudden death.

Calorie Guidelines (to be revised as needed)

Breakfast: 400 calories (to be increased to 800 calories)

Lunch: 550 calories (to be increased to 800–1,000 calories)

Dinner: 550 calories (to be increased to 800–1,000 calories)

Midmorning snack: 200 calories (to be increased to 400 calories)

Afternoon snack: 200 calories (to be increased to 400 calories)

Evening snack: 200 calories (to be increased to 400 calories)

Meal Plan may be complemented by a liquid nutritional supplement to increase calorie density. Value: 350 calories per 8 fl. oz. Liquid supplement must be administered immediately if meals are skipped, refused, or unfinished.