CASE STUDY
Steven is a 44-year-old male who is 5 ft 11 in tall and weighs 182 pounds. Over the last
month, he has lost approximately 10 pounds, which he blames on loss of appetite and
fatigue. When he went to his family doctor with flu-like symptoms, a blood test revealed a
very high white blood cell count, low platelet count, and low hemoglobin. The doctor told
him to proceed to the hospital for admission to rule out acute leukemia. Further laboratory
tests are pending. Admitting orders include a regular diet. Steven does not have a significant
medical history. He is married, has three children, and enjoys a successful career.
Calculate and evaluate Steven’s weight according to the following standards:
■ BMI
■ Percent weight change
■ Based on Steven’s weight and weight change, is he at nutritional risk?
■ Does Steven’s possible diagnosis place him at nutritional risk?
■ What other criteria would help determine his level of risk?
■ Calculate his estimated calorie requirements. Calculate his Recommended Dietary
Allowance (RDA) for protein.
■ If he is treated for leukemia, his protein need may increase to approximately 1.2 g protein/kg.
How much would he then require?
■ The hospital’s diet manual says that, on average, a regular diet provides 2400 calories
and 90 g of protein. Is this diet adequate to meet his needs?