Fluid and Energy Requirements

A patient has severe trauma, is intubated, and completely immobile.
Choose the most appropriate stress and activity factor combo:

• A) 1.2 stress / 1.2 activity
  

• B) 1.5 stress / 1.2 activity
  

• C) 1.3 stress / 1.3 activity
  

• D) 1.6 stress / 1.4 activity

Answer explanation

• Stress factor for trauma = 1.5–1.6

• Activity factor for bedridden/intubated = 1.2

✅ Correct answer: B) 1.5 / 1.2
Answer: B

What is the daily fluid requirement for a 65 kg adult patient?

Answer explanation

1500 mL + 20 mL/kg for every kg >20
= 1500 + (20 × 45)
= 1500 + 900 = 2400 mL/day ✅
Answer: 2400

A 70 kg, 175 cm, 45-year-old male patient needs a TPN.
What is his Basal Energy Expenditure (BEE) using the Harris-Benedict equation?

Answer explanation

📌 Harris-Benedict for Males:
66.47 + 13.75 × W + 5 × H – 6.76 × A
= 66.47 + 962.5 + 875 – 304.2
= 1599.77 kcal/day → 1600 kcal/day ✅
Answer: 1600

A 58-year-old female weighs 60 kg and is 165 cm tall.
What is her BEE?

Answer explanation

📌 Harris-Benedict for Females:
655.1 + 9.56 × W + 1.85 × H – 4.68 × A
= 655.1 + 573.6 + 305.25 – 271.44
= 1262.51 kcal/day → 1263 kcal/day ✅
Answer: 1263

Using the male from Q2 (BEE calculated), what is his Total Energy Expenditure (TEE) if he is ambulatory and recovering from major surgery?
Use: Stress factor = 1.4, Activity factor = 1.3
Round to nearest whole number

Answer explanation

(From Q2 BEE = 1600 kcal)

📌 TEE = BEE × stress × activity
= 1600 × 1.4 × 1.3
= 1600 × 1.82 = 2912 kcal/day ✅
Answer: 2912