A 15-year-old female with 50 grams of protein provided by gastrostomy feeding tube and UUN = 15 grams.
Protein intake that is recommended by Dietary Reference Intake (DRI) is 0.36 grams per pound. The average weight of a 15-year-old female is 114 pounds. The Nitrogen Intake is 50g/ 6.25 equaling to 8 grams for this client. The urinary nitrogen output (UUN) of the client over the 24-hour period is 15 grams. Nitrogen Loss equals to 19 grams. Nitrogen Balance=Nitrogen Intake-Nitrogen Loss. Resulting amount is-11 g N.
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The calculation result is negative. Negative nitrogen balance means that the patient is consuming an inadequate amount of protein. Raise the protein quantity by a factor of multiplying the nitrogen balance amount by 6.25. In this case, an increment protein intake by 68.75 grams is a requirement. The amount of nitrogen excreted exceeding than the ingested amount.
There is a link between significant health conditions with a negative nitrogen balance. That includes tissue damage, burns, hyperthyroidism and wasting diseases (Rodriguez 2013). The client's health condition should be analyzed further to determine the cause of the outcome.
A 9-year-old male with gastrostomy feeding tube and parenteral nutrition feeding intravenously providing 40 grams of protein and UUN = 15 grams
Total Nitrogen of this client intake is 40 grams divided by 6.25 giving a value of 6.4 g N.
Total output is 15 grams plus 4 grams which accounts for other nitrogen losses apart from urine. The amount is 19 grams of Nitrogen.
Nitrogen Balance is -12.6 g N. this client is losing 12.6 x 6.25= 78.75 grams of proteins daily. The client is using body protein; therefore, the protein consumed should be increased by 78.75 grams per 24-hour period (Forbes 2014). The negative value indicates that the client is experiencing malnutrition because body protein requirement is not being met accurately. Another possibility is that there are more underlying health conditions such as hyperthyroidism and tissue destruction. Further diagnosis should be carried out to determine the cause of the occurrence.
Effects of negative nitrogen balance include reduction of fatty tissues and skeletal tissue in a patient. This result in reduced physical activity and negatively affect muscles' functioning. This observation might be present in the client.
References
Forbes, A. (2014). Parenteral nutrition: new advances and observations. Current opinion in gastroenterology , 20 (2), 114-118.
Rodriguez, N. R. (2013). Optimal quantity and composition of protein for growing children. Journal of the American College of Nutrition , 24 (2), 150S-154S.
