Cardiovascular Disease Part II Flashcards
Protein requirement in CHF
1.1-1.4 g/kg of ACTUAL body weight
Sodium requirement in CHF
2,000 -3,000 mg.day (HIGHER than RDA)
Fluid requirements for CHF
1-2L/day (LOWER than AI)
Fluid restriction in mild CHF?
1-2L/day
Fluid restriction in more severe CHF or severe hyponatremia?
1-1.5L/day
What should be adjusted in foods to allow for adequate energy intake without discomfort?
Texture and timing
Alcohol in CHF?
Limit to 1 drink/day
When is abstinence from alcohol mandatory?
When alcohol is considered to be a causative factor in heart failure
What is difficult to asses in CHF?
BMI, as there may be fluid retention
How is energy assessed in CHD?
Individualize and estimate - use ACTUAL WEIGHT, and then titrate towards weight-loss/weight gain
Weight gain?
30-35 kcal/kg
Weight maintenance?
25-30 kcal/kg
Weight loss?
20-25 kcal/kg
Energy in advanced heart failure?
22-24kcal/kg
What is cardiac cachexia?
End result of heart failure, where weight loss occurs, sig loss of LBM including cardia muscle –> Heart is soft and flabby
What is the consequence of cardiac cahcexia?
Inadequate blood supply to GI tract, anorexia, nausea, feeling of fullness, constipation, abdominal pain, loss of normal bowel function
Identification of 2 out of what 6 factors will indicate adult malnutrition? (MS.WEFF)
- Loss of muscle mass
- Loss of subcutaneous fat
- Weight loss
- Insufficient energy intake
- localized/general fluid accumulation
- diminished functional status (measured by hand grip strength)
Acute illness or injury may result in?
Moderate or Acute Protein Calorie Malnutrition
How is energy intake indicative of MPCM in acute illness?
<75% of EEE in 7 days
How is weight loss indicative of MPCM and in acute illness?
1-2% in 1 wk
5% 1 month
1.5% 3 months
How is energy intake indicative of SPCM in acute illness?
<50% ofEE in > 5 days
How is weight loss indicative of SPCM in acute illness?
> 2% in 1 week
5% in 1 month
7.5% in 3 months
How is energy indicative of of MPCM in chronic illness?
<75% of EE > 1 month
How is weight loss indicative of MPCM and SPCM in chronic illness?
5% in 1 month
7.5% in 3 months
10% in 60 months
20% in 1 year
anything greater than = SPCM
If large abdomen, what should be monitored?
Watch for signs of muscle wasting in areas where fluid tends to NOT accumulate
What could a a large abdomen be due to?
Ascites
Which areas of muscle wasting may be problematic?
- Eyes
- Shoulders
- Clavicle
- Knees
