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Diet for malnourished person

Hello Experts!
Background: My husband is 28 y/o and was recently admitted to the hospital with a DX of Malnutrition, Ketoacidosis, and Anxiety. For the past couple years he has been dealing with anxiety issues and frequent panic attacks. Many times following a bad attack he gets severe nausea and vomiting. His diet has been minimal/poor due to this nausea and work schedule combined. He has always been skinny (140-145 lbs) but seemingly healthy with no prior DX. While on deployment and alone, he was a panic attack (angina, palpitations, & sweating with nausea and vomiting). He hadn't eaten anything for the previous day or more. He called 911 (a huge deal for him, considering I couldn't get him to make a routine Dr appt). They admitted him to the hospital. His UA showed ketones at 150 and high protein levels. Also, a BUN of 5 and glucose of 186 (concerning since he hadn't eaten in so long). He also reacted positive for ethanol at a small amount, caused either by actual consumption or high ketones. On admission, it was found that he had lost about 20 lbs over the past couple months, putting him at 121 lbs. He has since been sent home because of this and I am not impressed, to say the least, with the visit or testing done by the MD. Now, I am a CNA in a hospital and currently studying nursing so I know a little about the field. In the end, my two main concerns here are: 1. Follow-ups with his primary care manager here. I feel that an A1 glucose test and thyroid level labs should be done... are there others you feel he would benefit from? I definately feel there is an underlying cause of symptoms here, not just an acute episode. And 2. Diet plan. The current goal is 3000cal/day with high protein. He has been doing fairly well with this and is steadily gaining his weight back. I am having a hard time keeping up with this plan though: planning and counting and logging. Are there suggestions or maybe a specific diet plan that can help shape this for us?
Thank you so much!
1 Responses
267079 tn?1195146570
MEDICAL PROFESSIONAL
From your measurements he is underweight for his height. If you want additional tests, then ask your Doctor, Ketosis is when the body does not have enough glucose (food) and it starts breaking down fat and protein; and ketones are the by-products which can become a dangerous state if too high. 2800-3000 calories is what he should eat. Try to eat a Heart Healthy diet which will give you the nutrients, vitamins and minerals your body needs, not strain the heart with too much fat, and help with possibly preventing future disease states. Heart Healthy diet which is a moderate fat diet and a moderate fat diet means = using polyunsaturated (omega 3, corn oil, nuts, etc) fats and monounsaturated (olive oil, canola oil, peanut oil, etc) fats, no saturated fats (high fat snack foods, butter, fat spreads) and no trans fats. Eat low fat meats (chicken, fish, loin of pork) or non-meat sources (soy products, nuts), low fat vegetarian combinations (rice & beans, pasta & beans, low fat cheese & pasta), low fat and substitute dairy products (1% milk, low fat/fat free yogurts, low fat soy milk/soy yogurt), use plant oils, non trans-fat margarines, and eat a lot of fruits and vegetables. Eat daily high fiber breads and cereals (oatmeal). Try nutrient dense drinks 1-2 a day, either purchase them, such as Ensure or Boost, or make your own yogurt smoothies - yogurt, milk, and frozen fruit blended together for additional calories, protein and nutrients to help increase your weight. Hoped that helped you.
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