Each figure in the NS490 Unit 4 enteral regimen worksheet, from a 65 mL hourly rate to 125 mL water flushes, is derived on the page for one composite stroke patient. Searches like "ns 490 unit 4 assignment example", "ns490 unit 4 sample" and "ns490 unit 4 example" land here.
What a finished NS490 Unit 4 enteral regimen worksheet looks like
A four-page worksheet in numbered steps. Step one sets goal energy two ways: 26 kcal/kg on a weight of [60] kg gives 1,560 kcal, and Mifflin-St Jeor at 1,079 kcal times factors of 1.2 and 1.2 gives 1,554, close enough to confirm it. Step two names a standard polymeric formula at 1.2 kcal/mL with [55.5] g protein and [81] percent free water per liter, chosen on composition. Step three divides 1,560 by 1.2 for 1,300 mL a day, then by 20 hours for 65 mL an hour. Step four checks delivery: 72 g protein against a need of 60 to 72 g, and 1,053 mL of free water. Step five fills the water gap to 1,800 mL with 125 mL flushes every four hours. Advancement and monitoring close the sheet.
How a NS490 Unit 4 example is structured
The worksheet moves from requirement to regimen to verification, and each step uses only numbers produced by the steps above it. Energy is estimated twice so the goal rests on agreement rather than a single method. Formula choice is justified by properties, energy density, protein per liter, water content and fiber, not by a brand. The rate calculation states the infusion hours and why they are 20, not 24: therapy sessions and medication holds interrupt the pump, and a regimen that assumes 24 hours under-delivers. Verification recomputes protein and water from the final rate, which is the step that catches errors. The advancement schedule starts at 20 mL an hour and adds 10 every four hours to goal. A refeeding paragraph notes [five] days of poor intake before admission and schedules potassium, magnesium and phosphorus checks, with thiamine as an order to request.
Goal energy confirmed twice
Per-kilogram and Mifflin-St Jeor estimates land within 6 kcal of each other. The worksheet shows both and takes the agreement as its justification, instead of presenting one method as if no other existed.
Formula chosen on composition
A standard polymeric product at 1.2 kcal/mL fits a patient with normal digestion and no fluid restriction. Properties are listed with values in brackets, since the case leaves the exact product to the facility.
Twenty hours, not twenty-four
Therapy and medication holds cut real infusion time. Dividing 1,300 mL by 20 gives 65 mL an hour; dividing by 24 would give 54 and quietly deliver less than the goal.
Delivery recomputed from the rate
At 65 mL for 20 hours the regimen provides 1,560 kcal and about 72 g protein. Recomputing from the final rate rather than trusting the target is the check that catches arithmetic slips.
Water counted to the milliliter
Formula water of 1,053 mL leaves 747 mL toward an 1,800 mL need. Six flushes of 125 mL close it, and a note says medication flushes count toward the total.
Advancement and what would stop it
From 20 mL an hour, adding 10 every four hours, goal is reached in about 20 hours. Vomiting, abdominal distension or falling phosphorus pause advancement, each tied to a named response.
Where marks go in NS490 Unit 4
Shown working counts for as much as correct arithmetic on most regimen worksheets, alongside justified formula selection, attention to fluid and a safe advancement plan. The example shows every division and multiplication, so a marker can follow 1,560 kcal to 65 mL an hour without a gap. Formula selection is argued from composition. Fluid is treated as a calculation of its own rather than a line saying provide flushes. Advancement carries stopping criteria and refeeding checks. Regimens here commonly lose points for a correct rate with no working, for infusion hours assumed to be 24 when the case describes interruptions, for free water ignored or double-counted, for protein never checked against need, and for an advancement plan with no conditions for pausing it.
Get a NS490 Unit 4 example written to your instructions
A bolus or cyclic schedule, a fluid restriction or a set formulary may shape the tube feeding case issued for NS490 Unit 4. Include every value in the case, any formulary your section provides, and the rubric. In 24-48h each step arrives computed from the ones before it, with free water and advancement written out, and a first custom sample is free.
NS490 Unit 4 questions, answered
Should the worksheet use a specific formula brand?
Only if the prompt supplies a formulary or asks for one. Otherwise describe the formula by its properties and, if helpful, name one product that meets them, with its values taken from the manufacturer's current data. The marks sit in the justification, so a brand name without reasons earns less than a well-argued profile.
Are gastric residual volumes part of the monitoring?
Follow the case and the facility policy it describes. Current critical care guidance has moved away from routine residual checks, and some ward policies have followed, while others still require them. A worksheet that notes the policy it applies and acknowledges the debate shows judgment without contradicting the setting your case describes.
How is free water calculated from the formula?
Multiply the daily formula volume by the water fraction the product lists, typically around 80 percent for standard densities and less for concentrated ones. Subtract that from the fluid requirement, then divide the remainder into flushes on a schedule. Count medication flushes too, or the patient may receive more water than intended.