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CNSC Study > Calculations/Equations > Flashcards

Calculations/Equations Flashcards

1
Q

Nitrogen content of protein

A

Nitrogen content = g protein x .16
AKA 16% of protein is nitrogen

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2
Q

Holliday Segar Method

A

First 10kg = 100ml/kg
Second 10kg = 50ml/kg
>20kg = 20ml/kg
If over 50, 15ml/kg
Cant use in those <14 days

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3
Q

Free Water Deficit

A

TBW x 1-(140/measured Na)

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4
Q

Total Body Water

A

Weight in kg x .6

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5
Q

Fluid Distribution

A

ICF = 66% of TBW
ECF = 33% of TBW
-Intravascular = 25% of ECF
-Interstitial = 75% of ECF

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6
Q

Respiratory Quotient

A

.7 = lipid oxidation
.82 = amino acid
.85 = mixed substrate
1 = carb breakdown

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7
Q

Corrected Calcium

A

Measured Calcium + .8 x (4-alb)

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8
Q

Corrected Sodium

A

Measured Na + [.016 x (BG-100)]

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9
Q

Nutrients Absorbed in the Stomach

A

Fluoride
Iodine

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10
Q

Nutrients Absorbed in the Duodenum

A

Fat soluble ADEK
Water soluble B vits (thia, ribo, nia, bio, fol) , except B12/B5/B6
Minerals Fe,Ca, Phos, Mg, Cu, Se, Io
All except choline, Zn, Mang, Chrom, Moly

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11
Q

Nutrients Absorbed in the Jejunum

A

AA
Monosaccharides
Lipids - glycerol, FFA

Fat soluble ADEK
Water soluble B vits (thia, ribo, nia, panto, bio, fol, pyrid, Vit C
MInerals Ca, Phos, Mg, Fe, Zn, Chro , Mang

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12
Q

Nutrients Absorbed in the Ileum

A

Bile salts and acids

Fat soluble - Vit D, Vit K
Vit C, Folate, B12
Mg

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13
Q

Nutrients Excreted by Bile/Stool

A

Fat soluble vits
Fe
Zn
Cu
Mang
Se

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14
Q

Nutrients Excreted in Urine

A

Water soluble except B12/folic acid
Choline
Cu (very little)
Se
Chrom
Iodine
Fluoride
Moly

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15
Q

Nutrients recycled by enterohepatic circulation

A

B12
Folic acid/B9

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16
Q

Vit A deficiency/toxicity

A

Deficiency - night blindness, follicular hyperkaratosis, impaired wound healing
Cause - fat malabsorption
Nutrient interactions: low ZN reduces Vit A

Toxicity - Alopecia, Ataxia, Prutitus

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17
Q

Vitamin D Deficiency/Toxicity

A

Deficiency - Tetany, Osteomalacia, hypoCa
Cause - fat malabsorption, renal disease,** LT PN support,** meds (steroids, isonizid, phenytoin)
Nutrient interactions: Excess vit D = excretion of vit K

Toxicity - Soft tissue calcification, confusion, tremor

18
Q

Vitamin E Deficiency/Toxicity

A

Deficiency - Age spots, ataxia, hemolytic anemia
Causes - Fat malabsorption,** LT PN without supplementation**
Nutrient interactions: Excess supp interferes with Vit K and warfarin

Toxicity - Bruising, thrombocytopenia, cerebral hemorrhage

19
Q

Vitamin K Deficiency/Toxicity

A

Deficiency - Bruising, prolonged bleeding, decreased bone density
Causes - Fat malabsorption, ABX, LT PN without ILE
Nutrient interactions: Excess vit A/E decreased Vit K absorption, excess vit D increases excretion

Toxicity - no toxicity

20
Q

Vitamin C Deficiency/Toxicity

A

Deficiency - Capillary rupture, delated wound healing, corkscrew hairs
Causes - Older adults, cancer, alcohol/tobacco, hyper BG = less transport
Nutrient interactions: Vit C increases iron absorption

Toxicity - N/V/D, renal stone

21
Q

Vitamin B1 Deficiency/Toxicity

A

Thiamine
Dry beriberi - muscle weakness
Wet beriberi - reduced cardiac output, encephalopathy, nystagmus
Causes - alcoholism, **LT PN **or HD, refeding, hyperemesis
Nutrient interactions: repletion only possible if Mg WNL, needed to activate

Toxicity - no toxicity

22
Q

Vitamin B2 Deficiency/Toxicity

A

Riboflavin
Deficiency - dermatitis, cheilosis, normochromic normocytic anemia
Causes - critically ill
Nutrient interactions: Alcohol, Cu, Zn, Fe and mang can form chelates and prevent absorption

Toxicity - no toxicity

23
Q

Vitamin B3 Deficiency/Toxicity

A

Niacin
Deficiency - Pellagra: dermatitis, diarrhea, dementia
Causes - older adult, alcohol, isonizaid/mercaptopurine
Nutrient interactions: needed for activation of folate

Toxicity - flushing, heat, GI upset, glucose intolerance

24
Q

Vitamin B6 Deficiency/Toxicity

A

Pyridoxine
Deficiency - Microcytic anemia, seborrheic dermatitis, cheilosis
Causes - AUD, HD, older adults
Nutrient interactions: leads to alterations in AA

Toxicity - derm lesions, ataxia, sensory neuropathy

25
Q

Vitamin B12 Deficiency/Toxicity

A

Cyanocobalamin
Deficiency - Cognitive decline, megaloblastic anemia, thrombocytopenia, bone marrow
Causes - vegetarian diet, low HCl secretion
Nutrient interactions: excess vit C can temporarily impair/destroy B12

Toxicity - no toxicity

26
Q

Vitamin B9 Deficiency/Toxicity

A

Folic acid

Deficiency - Cheilosis, megaloblastic or macrocytic anemia, diarrhea
Causes - AUD, pregnancy, phenytoin/chlostyramine/sulfasalazine
Nutrient interactions: Zn can impair absorption

Toxicity - seizures

27
Q

Vitamin B7 Deficiency/Toxicity

A

Biotin

Deficiency - elevated cholesterol, leythargy, dementia, hypotonia
Causes - AUD, LT PN, partial gastrectomy

Toxicity - no toxicity

28
Q

Vitamin B5 Deficiency/Toxicity

A

Pantothenic Acid

Deficiency - poor wound healing, N/V/D, NM disturbances
Causes - in conjunction with other nutrient deficiencies, DM, ID, ethanol intake

Toxicicity - no toxicity

29
Q

Choline Deficiency/Toxicity

A

Deficiency - visual/verbal impairment, hepatic steatosis
Causes - pregnancy/lactation, hyper metabolic state, LT PN
Nutrient Interactions: Choline can replace B12 to form homocystein

Toxicity - sweating, salivation, hypotension, anorexia, fishy body odor, hepatotoxicity

30
Q

Iron Deficiency/Toxicity

A

Deficiency - pallor, hypochromic anemia, nausea
Causes - blood loss, decreased gastric acid, roux-en-y
Nutrient interactions: non-heme reduced by phytic acid, oxalic acid, polyphenols, Ca, Zn, mang. Chrom toxicity contributes to iron anemia

Toxicity - skin pigmentation, organ damage
Cause - hemochromatosis

31
Q

Zinc Deficiency/Toxicity

A

Deficiency - rash, smell/taste alterations, immune/wound, alopecia
Causes - older adults, postop, AUD, burns, renal disease
Nutrient interactions: Zn deficiency can cause vit A deficiency. High levels of Ca/Fe comepete. HIgh Zn completes with Cu

Toxicity - GI distress, N/V, decreased HDL

32
Q

Copper Deficiency/Toxicity

A

Deficiency - Hypopigmentation, hypochromic microcytic anemia, parasthesia
Causes - Undernutrition with chronic diarrhea
Nutrient Interactions: phytates, dietary fiber, large dose Zn, inron, large dose Ca gluc, excess moly = urindary loss, large dose Vit C andcopepr deficiency can reduce absorption

Toxicity - Kayser-Fleisher rings, metallic taste, blood in urine
Causes - Wilson’s disease, liver disease

33
Q

Manganese Deficiency/Toxicity

A

Deficiency - Rare - Ataxia, Growth retardation, defects in lipid/carb metabolism
Causes - hepatobiliary disease, LT PN with biliary duct obstruction
Nutrient Interaction: competes with iron

Toxicity - hyperirritability, Parkinson-like, immune/reproductive dysfunction

34
Q

Selenium Deficiency/Toxicity

A

Deficiency - N/V, cardiomyopathy/Keshan’s, altered thyroid
Causes - LT PN support without supplementation, thermal injury, statin
Nutrient Interaction: selenium deficiency reduces iodine function

Toxicity - skin lesions, hair/nail loss, peripheral neuropathy

35
Q

Iodine Deficiency/Toxicity

A

Deficiency - Decreased TSH, goiter, weight loss, tachy
Causes - low sodium diet, low levels in soil
Nutrient interactions: selenium deficiency reduces iodine function

Toxicity - Elevated TSH

36
Q

Chromium Deficiency/Toxicity

A

Deficiency - peripheral neuropathy, weight loss, increased BG, glycosuria, elevated FFA
Causes -** LT PN without supplementation,** T2DM/pregnancy
Nutrient interactions: Fe competes with binding

Toxicity - rhabdo, liver dysfunction, renal failure

37
Q

Fluoride Deficiency/Toxicity

A

Deficiency - increased risk of dental caries
Causes - Unfloridated water
Nutrient interactions: Ca and Mg form insoluble complexes when combined with fluoride

Toxicity - Lacrimation, excess salivation, fluorosis, arrythmias

38
Q

Molybdenum Deficiency/Toxicity

A

Deficiency - AMS, Tachy, N/V, altered vision
Causes - LT PN
Nutrient interactions: moderate doses associated with copper wasting in urine

Toxicity - hyperuricemia, gout-like symptoms

39
Q

Deficiencies that cause anemia

A

Vit E - Hemolytic anemia (infants)
Riboflavin/B2 - Normochromic normocytic anemia
Pyridoxine/B6 - Microcytic anemia
Cyanocobalamin/B12 - Megaloblastic anemia
Folic acid/B9 - Macrocytic anemia
Iron - Hypochromic anemia
Copper - Hypochromic microcytic anemia

40
Q

Osmolarity of TPN/PPN

A

Amino acid 1g = 10 mOsm
Dextrose 1g = 5 mOsm
Add these together and divide by total volume.
In our case:
Amino acid 75g = 750 mOsm
Dextrose 210g = 1050 mOsm
750 mOsm + 1050 mOsm = 1800 mOsm/3000mL = 600 mOsm/L

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