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Molly Selvidio - Distance Option

8/10/2017

 
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Hello! My name is Molly Selvidio and I am a Sodexo Distance intern working on my third month in my clinical rotation at Saint Josephs Hospital in Nashua, NH. I graduated from my undergrad 2 years ago and was nervous about starting this journey so starting my clinical rotations was exciting but also very overwhelming! I learned so many things within days of starting at the hospital, some refreshers on what I learned in school and some very new topics! Very quickly in my rotation I realized how many patients were suffering from COPD in the acute care setting. My CNM had also realized this pattern and spoke with the doctors about consulting the dietitians when a COPD patient is experiencing exacerbation. I found this topic particularly interesting because when you think of COPD you think of difficulty breathing; after doing more research on this disease you I found it is actually connected to increase energy expenditure and weight loss.

At Saint Josephs hospital we initiate nutritional supplements to patients who are experiencing COPD exacerbation to aid in oral intake for those who are unable to consume their estimated needs due to shortness of breath. This is found to increase their overall outcome and reduce their risk for extended stay! It is suggested 1.2 -1.3 x REE to provide additional energy intake and avoid weight loss. I do agree with this information, although I feel there should be more research and information on patients who are experiencing COPD exacerbation but are overweight and eating appropriate meals. My question would be do you give a patient who has adequate oral intake an additional supplement? The guidelines are unclear and could benefit from a stronger outline.

If you haven’t already I would strongly suggest checking out the Today’s Dietitian magazine. It is an awesome magazine that provides research articles on current new nutrition topics and trends that you may find patients are asking you about! Take a look at the following article on COPD exacerbation and weight loss; I am sure you will find this interesting as well!

http://www.todaysdietitian.com/newarchives/td_020909p54.shtml



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