Re: elderly patient w/edema- current regimens?

[Guest guest]

Edema is best served with Lasix but then be sure to order at least K+ blood

levels. May need K+ supplements. Be sure adequate Kcal and hydration.

If wound care is not progressing after adequate protein (very few of my

elderly are taking adequate dietary protein so I supplement) then go to a

product like Juven.

>

>

> Colleagues:

>

> I have a 93 yr. old patient with edema and some mobility with a walker.

> Wound care is treating w/wraps. We are addressing protein and sodium intake

> but I would like to know if anyone has more specific recommendations with

> this population?

>

> Thanks in advance!

>

> <http://www.web-rd.com/> Web <http://www.web-rd.com/> RD

>

> America's Nutrition Coach

> 8343 Roswell Road, Suite 323 | Atlanta, Georgia 30350

> Office | Fax

>

> support@...

>

> www.facebook.com/WebRD

>

> www.Twitter.com/WebRD

>

>

[Guest guest]

How about 20,000 IU of Vitamin A, 500mg Vitamin c, and Zinsulfate if the wound

is oozing. Sometimes Pro-stat (Liquid protein) and Arginaid works well too.

Thanks

Jigna Mehta, RD

________________________________

To: SN ; rd-usa

Sent: Wed, March 16, 2011 10:43:23 AM

Subject: elderly patient w/edema- current regimens?

Colleagues:

I have a 93 yr. old patient with edema and some mobility with a walker.

Wound care is treating w/wraps. We are addressing protein and sodium intake

but I would like to know if anyone has more specific recommendations with

this population?

Thanks in advance!

<http://www.web-rd.com/> Web <http://www.web-rd.com/> RD

America's Nutrition Coach

8343 Roswell Road, Suite 323 | Atlanta, Georgia 30350

Office | Fax

support@...

www.facebook.com/WebRD

www.Twitter.com/WebRD

[Guest guest]

I usually recommend 250 mg vitamin C and 16 mg zinc. Why such a high dose

of Vitamin A - are you talking about beta-carotene or retinol?

>

>

> How about 20,000 IU of Vitamin A, 500mg Vitamin c, and Zinsulfate if the

> wound

> is oozing. Sometimes Pro-stat (Liquid protein) and Arginaid works well too.

>

> Thanks

> Jigna Mehta, RD

>

> ________________________________

>

> To: SN ; rd-usa

> Sent: Wed, March 16, 2011 10:43:23 AM

> Subject: elderly patient w/edema- current regimens?

>

>

> Colleagues:

>

> I have a 93 yr. old patient with edema and some mobility with a walker.

> Wound care is treating w/wraps. We are addressing protein and sodium intake

> but I would like to know if anyone has more specific recommendations with

> this population?

>

> Thanks in advance!

>

> <http://www.web-rd.com/> Web <http://www.web-rd.com/> RD

>

> America's Nutrition Coach

> 8343 Roswell Road, Suite 323 | Atlanta, Georgia 30350

> Office | Fax

>

> support@...

>

> www.facebook.com/WebRD

>

> www.Twitter.com/WebRD

>

>

[Guest guest]

Hello,

We recommend up to 500 mg vitamin c for stage 3 and 4. Vitamin A the same way.

Vitamin A has a well known role in modulating collagen production and

epithelialization. We do not mention specifics but i am sure it is retinol.

Jigna.

Sent from my iPhone

> I usually recommend 250 mg vitamin C and 16 mg zinc. Why such a high dose

> of Vitamin A - are you talking about beta-carotene or retinol?

>

>

>

>>

>>

>> How about 20,000 IU of Vitamin A, 500mg Vitamin c, and Zinsulfate if the

>> wound

>> is oozing. Sometimes Pro-stat (Liquid protein) and Arginaid works well too.

>>

>> Thanks

>> Jigna Mehta, RD

>>

>> ________________________________

>>

>> To: SN ; rd-usa

>> Sent: Wed, March 16, 2011 10:43:23 AM

>> Subject: elderly patient w/edema- current regimens?

>>

>>

>> Colleagues:

>>

>> I have a 93 yr. old patient with edema and some mobility with a walker.

>> Wound care is treating w/wraps. We are addressing protein and sodium intake

>> but I would like to know if anyone has more specific recommendations with

>> this population?

>>

>> Thanks in advance!

>>

>> <http://www.web-rd.com/> Web <http://www.web-rd.com/> RD

>>

>> America's Nutrition Coach

>> 8343 Roswell Road, Suite 323 | Atlanta, Georgia 30350

>> Office | Fax

>>

>> support@...

>>

>> www.facebook.com/WebRD

>>

>> www.Twitter.com/WebRD

>>

>>

[Guest guest]

There's no evidence that supplements of micronutrients help edema.

Before you supplement, please get a detailed diet history to determine

if intake is adequate (according to some evidence-based standard) and

then supplement only to that level. Otherwise you risk asking your

patient/client to spend money on supplements that are not helping. The

same goes for products like Juven that are hyped as healing all wounds

or would do anything for edema. If there is a wound, what heals wounds

is time, good nursing care, and adequate nutrition.

Sometimes it's not sexy to simply monitor and ensure adequate diet,

but it's not always in the patient's best interest to send in the big

(expensive) guns when they're not warranted.

Medical management of edema depends on the cause and underlying

factors. Talk to the patient's physician before recommending a

diuretic; you can't assess fluid status without a good history and

physical exam.

Pam Charney, PhD, RD

Affiliate Associate Professor

Pharmacy

MS Student

Clinical Informatics and Patient Centered Technology

School of Nursing

University of Washington

Seattle, WA

pcharney@...

http://www.linkedin.com/in/pamcharney

> How about 20,000 IU of Vitamin A, 500mg Vitamin c, and Zinsulfate if

> the wound

> is oozing. Sometimes Pro-stat (Liquid protein) and Arginaid works

> well too.

>

> Thanks

> Jigna Mehta, RD

>

> ________________________________

>

> To: SN ; rd-usa

> Sent: Wed, March 16, 2011 10:43:23 AM

> Subject: elderly patient w/edema- current regimens?

>

> Colleagues:

>

> I have a 93 yr. old patient with edema and some mobility with a

> walker.

> Wound care is treating w/wraps. We are addressing protein and sodium

> intake

> but I would like to know if anyone has more specific recommendations

> with

> this population?

>

> Thanks in advance!

>

> <http://www.web-rd.com/> Web <http://www.web-rd.com/> RD

>

> America's Nutrition Coach

> 8343 Roswell Road, Suite 323 | Atlanta, Georgia 30350

> Office | Fax

>

> support@...

>

> www.facebook.com/WebRD

>

> www.Twitter.com/WebRD

>

>