You are meeting with Mr. Adams in the medical oncology outpatient clinic today. Mr. Adams is a 49-year-old Hispanic male who is currently receiving chemotherapy and radiation for lung cancer. He received a PEG for tube feedings when diagnosed 6 weeks ago because of dysphagia as the tumor was pressing on his esophagus. He has had 3 weeks of radiation and 2 rounds of chemo, which has resulted in the tumor shrinking enough for Mr. Adams to start taking some oral nutrition. He and his wife have an appointment with you today because they would like to know how to best manage his nutrition now. He will have radiation for at least 3 more weeks and will have his last chemo treatment in 4 days – he has been tolerating chemo well. He reports tolerating his tube feedings ok; no problems with nausea, diarrhea or constipation. He doesn’t really get hungry in between feedings. Ht: 5′ 7″ Current Wt: 125 lb. Wt before starting treatment: 148 lb. (2 months ago) Labs: reportedly WNLs Meds: none besides the chemo. PEG feedings: 4 cans per day providing ~1420 calories & 50 grams of protein; he flushes his feeding tube with 60 mL of water before and after each feeding. The formula is 76% free water. He also drinks about 3-4 oz. of juice in the morning without too much difficulty – it just takes him about 10 minutes to get it all down. He is not experiencing any coughing or difficulties with swallowing when he drinks the juice. He is just cautious because if he drinks it too fast he thinks he might aspirate. Labs: not available but reportedly WNLs. What are your MNT recommendations (formatted in SMART goal format) and plan for follow-up? (10 points)
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Put the code/comments in order. —> represents an indention
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