Rewritten on days 1, 2, 4 and 8, the plan in this NS490 Unit 7 critical care case study follows a composite ventilated woman whose sedation and fever move her requirements. Searches like "ns 490 unit 7 assignment example", "ns490 unit 7 sample" and "ns490 unit 7 example" land here.
What a finished NS490 Unit 7 critical care case study looks like
Four dated panels follow a short case summary, about eight pages in all. Day 1 gives weight [70] kg, height [165] cm, minute ventilation [11] L/min and a maximum temperature of [38.6] C, then works the Penn State 2003b equation to 1,852 kcal, with Mifflin-St Jeor inside it. Propofol at [20] mL an hour is converted to 528 kcal. Day 2 starts trophic feeding once vasopressors are weaning. Day 4 recalculates after sedation drops to [12] mL an hour, 317 kcal, and fever settles, giving about 1,590 kcal, and switches to a very high protein formula so protein can rise without overfeeding. Day 8 follows extubation, a failed swallow screen and a revised route. Each panel ends with delivered versus prescribed figures.
How a NS490 Unit 7 example is structured
Time organizes the paper rather than topic, because the unit tests whether a paper grasps that a critical care plan ages in days. Each panel runs the same four moves: new data, recalculated needs, the change to the regimen, and what was actually delivered against what was ordered. The energy method is named and defended once, Penn State for a ventilated adult with its inputs listed, and reused in each panel with the new values. Propofol is converted to energy in every panel where it runs, since unrecognized lipid calories are the classic overfeeding route. Targets follow current ASPEN critical care guidance for the first week, 12 to 25 kcal/kg and 1.2 to 2.0 g/kg protein, which the paper quotes as a range rather than a single figure. A closing discussion compares the four plans and names the monitoring that justified each change.
Four panels, four dates
Days 1, 2, 4 and 8 each get a panel with the same headings. A marker can compare any two panels directly and see which input changed and what that change did to the regimen.
Penn State, worked once in full
Mifflin-St Jeor at 1,330 kcal enters the 2003b equation with minute ventilation and maximum temperature. The full substitution is shown on day 1; later panels change only the inputs that moved.
Sedation counted as food
Propofol's lipid carrier supplies 1.1 kcal/mL. At [20] mL an hour that is 528 kcal; at [12], 317 kcal. Each panel subtracts it before setting the formula rate.
Protein raised without extra energy
With propofol supplying fat calories, the day 4 panel moves to a very high protein formula so protein can approach 1.2 to 2.0 g/kg while total energy stays inside the early-phase range.
Prescribed versus delivered
Holds for proning and procedures mean delivered volume trails the order. Every panel reports both, and the discussion treats the gap as data rather than a failure to hide.
Extubation changes the route
A failed swallow screen after extubation on day 8 moves feeding to a small-bore tube while speech-language pathology assesses. The panel recalculates for a patient no longer ventilated.
Where marks go in NS490 Unit 7
Choosing and applying an energy method for ventilated patients heads most critical care rubrics, followed by attention to non-nutritional energy sources, guideline-based targets, responsiveness to change and documentation. Penn State is used where it applies, and the paper says when it stops applying. Propofol is counted every time. Early-phase targets are quoted in the guideline's own terms. Responsiveness is the heart of the paper: four recalculations, each triggered by a named change. Submissions for this unit commonly lose points by applying Mifflin-St Jeor with a stress factor to a ventilated patient without comment, by ignoring propofol altogether, by prescribing full goal feeding on day 1, by reporting what was ordered as if it were delivered, and by writing one plan for a patient whose picture changed four times.
Get a NS490 Unit 7 example written to your instructions
Trauma, sepsis or pancreatitis may replace respiratory failure in your NS490 Unit 7 case, with different days and data. Pass along every dated value in the case, the energy method your section expects and the rubric. Each day's plan is recalculated from its own inputs with sedation counted, back within 24-48h, and a first custom sample carries no cost.
NS490 Unit 7 questions, answered
Why not use Mifflin-St Jeor with a stress factor for a ventilated patient?
Because validation studies found the Penn State equations more accurate in ventilated adults, and they build in the ventilation and fever that a stress factor only guesses at. If your case offers indirect calorimetry, that replaces any equation. If your course text names a different method, use it and cite why it applies.
Should the case study aim for full energy needs in the first week?
Current critical care guidance generally favors lower energy delivery in the first several days, within a stated range, while protein is pushed toward its target. The exact figures differ between ASPEN and ESPEN, so quote the one your course uses and cite it. Full goal feeding from day 1 in someone at risk of refeeding will usually draw a comment.
How are propofol calories calculated?
Multiply the hourly rate in milliliters by 1.1 kcal per milliliter, the energy of its lipid carrier, then by the hours infused. The result is subtracted from the energy goal before the formula rate is set. Rates change often in intensive care, so recalculate whenever the case gives a new rate.