Adult Nutrition Flashcards
Normal requirements for hospital pts
Energy: 30 kcal / kg / day
Protein: 0.8-1 g / kg / day
Fluid: 30-35 ml / kg / day
Assessing nutritional status
BMI
Hx
MUST score - BMI, weight loss, acute illnesses (0= low risk, 1 = medium risk - observe, 2 = high risk - tx)
Nutritional status exam
Bloods: Hb, electrolytes, LFTs, haematinics
Oral supplements
Nutritional drinks
Vitamin supplements
Electrolyte supplements
Enteric feeds - when oral intake is like to be absent for > 5 days and gut is functioning
Methods - NG tube, NJ tube, percutaneous gastrostomy / jejunostomy tube
Most feeds contain 1 kcal / ml
Types - polymeric feeds (most commonly used), pre-digested feeds, disease specific and pharmaco-nutrient feeds
Administration methods - boluses, intermittent infusion, continuous infusion
Parenteral nutrition
May be required in intestinal failure (acute or chronic) and is given via central venous line
PN if also feeding by other methods
TPN if only IV feeding
Re-feeding syndrome
Feeding malnourished pts can cause insulin surge and activation of cellular membrane pumps - drop in serum electrolytes
RF: low BMI, weight loss > 15% over 3-6 months, poor intake for > 10 days, low electrolytes, alcohol excess
Start feeding at 10kcal / kg / day and gradually increase. Monitor K, PO4 and Mg and replace if low