Needs Assessment
Patient info, weight status, and estimated calorie / protein / fluid needs — the same core assessment workflow, now with side-by-side equations.
Patient Info
Editable — used throughout the rest of the app.
Weight Status
Hamwi ideal body weight, %IBW, %UBW, weight-change significance, and BMI.
Weight-change significance reference table
| Time frame | Significant loss | Severe loss |
|---|---|---|
| 1 week | 1–2% | >2% |
| 1 month | 5% | >5% |
| 3 months | 7.5% | >7.5% |
| 6 months | 10% | >10% |
Blackburn GL et al., JPEN 1977; corroborated by the AND/ASPEN Consensus Characteristics for malnutrition (White JV et al., J Acad Nutr Diet 2012).
Calorie Needs
Three common equations, side by side — pick the one that fits your patient population.
Advanced: Penn State (2010b) for ventilated / critically ill adults
Frankenfield D. JPEN 2011 — Mifflin(actual wt) × 0.96 + Tmax × 167 + VE × 31 − 6212.
Protein Needs
Fluid Needs
Three reference methods based on actual weight and today's calorie estimate.
Amputation-Adjusted BMI
A limb amputation lowers measured body weight without changing adiposity — this estimates pre-amputation body weight so BMI reflects the patient accurately.
Patient Measurements
Amputation Level, Per Limb
Select the highest level present on each side. Percentages are % of total (pre-amputation) body weight.
Result
EN / TPN Calculator
Ported from your existing EN/TPN workbook — same formula database and math, now with live totals as you type.
EN Formula Reference
21 adult formulas, Abbott + Nestlé. Edit values in code to match your facility's current formulary.
| Product | Category | Cal/mL | Protein g/L | Carb g/L | Fat g/L | Fiber g/L | Free H₂O% | Osm. |
|---|
Continuous Feed
Rate finder (optional)
Daily Totals
Bolus Feed
Dose finder (optional)
Daily Totals
TPN Calculator
Does not calculate final compounded osmolarity — that depends on your pharmacy's exact compounding. Confirm peripheral-vs-central line choice with pharmacy (commonly cited safe-peripheral threshold: <900 mOsm/L).
Totals & Dosing
Electrolyte Additives
| Additive | Ordered amount | Vol. needed (mL) | Standard concentration |
|---|---|---|---|
| Sodium chloride 23.4% (mEq) | — | 4 mEq/mL | |
| Potassium chloride (mEq) | — | 2 mEq/mL | |
| Sodium phosphate (mmol phos) | — | 3 mmol/mL, 4 mEq Na/mL | |
| Potassium phosphate (mmol phos) | — | 3 mmol/mL, ~4.4 mEq K/mL | |
| Magnesium sulfate 50% (mEq) | — | ~4 mEq/mL | |
| Calcium gluconate 10% (mEq) | — | ~0.465 mEq/mL |
Summary & Print
Pulls the current values from every module into one clean page you can print or copy into the chart.
Sources & Clinical Notes
This is a calculation aid, not a clinical decision or verified order. Values below should be checked against current facility protocol and, for TPN, pharmacy verification before use.
Needs Assessment
- Ideal Body Weight (Hamwi): Hamwi GJ. "Therapy: Changing Dietary Concepts." In: Diabetes Mellitus: Diagnosis and Treatment, Vol. 1. American Diabetes Association, 1964. Frame-size adjustment (±10%) is standard clinical convention.
- Adjusted Body Weight: IBW + 0.25 × (actual − IBW), applied when actual weight exceeds ~125% IBW — widely used clinical convention referenced across Academy of Nutrition and Dietetics and ASPEN materials.
- Weight-change significance: Blackburn GL, Bistrian BR, et al. "Nutritional and metabolic assessment of the hospitalized patient." JPEN J Parenter Enteral Nutr. 1977;1(1):11-22; corroborated by White JV et al. (Academy/ASPEN malnutrition characteristics consensus), J Acad Nutr Diet. 2012;112(5):730-738.
- Mifflin-St Jeor: Mifflin MD, St Jeor ST, et al. "A new predictive equation for resting energy expenditure in healthy individuals." Am J Clin Nutr. 1990;51(2):241-247.
- Harris-Benedict: Roza AM, Shizgal HM. "The Harris Benedict equation reevaluated." Am J Clin Nutr. 1984;40(1):168-182 (revised coefficients used here).
- Penn State 2010b: Frankenfield D. "Validation of an equation for resting metabolic rate in older obese, critically ill patients." JPEN. 2011;35(2):264-269.
- Protein needs by condition: General ranges reflect Academy of Nutrition and Dietetics Nutrition Care Manual and ASPEN adult nutrition support guidance; obesity dosing per ASPEN/SCCM Guidelines for Critically Ill Obese (McClave SA et al., JPEN 2016).
- Fluid — Holliday-Segar: Holliday MA, Segar WE. "The maintenance need for water in parenteral fluid therapy." Pediatrics. 1957;19(5):823-832 (originally pediatric; commonly cross-applied clinically). 30–35 mL/kg and 1 mL/kcal are standard adult reference conventions.
Amputation-Adjusted BMI
- Formula: Estimated total body weight = observed weight ÷ (1 − proportion removed). Osterkamp LK. "Current perspective on assessment of human body proportions of relevance to amputees." J Am Diet Assoc. 1995;95(2):215-218.
- Segment percentages: composited from multiple independent clinical-calculator implementations citing the Osterkamp table, since the original journal table wasn't directly retrievable in this session. Cross-source variance was noted on entire-arm (5.0–6.1%) and foot (1.5–1.8%) values — flagged in the Amputation BMI tab. Verify against the primary article or facility protocol before clinical use.
EN / TPN Calculator
- Enteral formula composition: Abbott Nutrition product spec sheets and Nestlé Health Science HCP product pages, cross-checked against distributor-hosted reprints where available. Formulas are reformulated over time — verify against current manufacturer literature.
- Dextrose kcal/g (3.4, hydrous) and stock-solution osmolarity: FDA drug labeling via DailyMed and Baxter product inserts.
- Amino acid / lipid data: FDA-approved prescribing information (Travasol, Clinisol, SMOFlipid, Intralipid).
- GIR formula: standard clinical/pharmacy formula (mg dextrose/kg/min).
- Electrolyte concentrations: DailyMed labeling for sodium chloride, potassium chloride, sodium phosphate; potassium phosphate, magnesium sulfate, and calcium gluconate concentrations are standard reference values not individually re-confirmed against a package insert.
- 900 mOsm/L threshold: widely cited in clinical nutrition support practice, commonly attributed to ASPEN's Safe Practices for Parenteral Nutrition (Mirtallo et al., JPEN 2004) — sourced here via secondary summary; confirm against the primary guideline.