Chapter 10 - Nutrition Flashcards
What is the approximate daily caloric need?
25 kcal/kg/day
How many kcal/gram of fat?
9
How many kcal/gram of protein?
4
How many kcal/gram of oral carbohydrates?
4
How many kcal/gram of Dextrose?
3.4
How many kcal/cc is there in a 10% lipid solution?
1.1
How many kcal/cc are there in a 20% lipid solution?
2
What are the nutritional requirements of a healthy adult male?
1g/kg/day protein (20% essential AA); 30% fat calories; rest as carbs
How much does trauma, surgery, or sepsis stress increase the k/cal requirements?
20-30%
How much does pregnancy increase the kcal requirements?
300 kcal/day
How much does lactation increase kcal requirements?
500kcal/day
How do you calculate the calories required in a burn?
25kcal/kg/day + (30 kcal/day x % of burn)
How do you calculate protein required in a burn?
1-1.5 g/kg/day + (3g x % of burn)
How much does the basal metabolic rate rise in fever?
10% for each degree above 38.0
Central line TPN is based on what?
glucose. Max glucose administration is 3g/kg/hr
Peripheral line parenteral nutrition is based on what?
fat
What is the fuel for colonocytes?
short chain fatty acids
What is the fuel for small bowel enterocytes?
Glutamine
What is the most common AA in bloodstream and tissue?
Glutamine
What does Glutamine do in kidney?
Releases NH4, helping with nitrogen excretion (can also be used for gluconeogenesis)
What is the primary fuel for neoplastic cells?
Glutamine
What is the half life of albumin?
20 days
What is the half life of Transferrin?
10 days
What is the half life of Pre-albumin?
2 days
What is the normal protein level?
6.0-8.5
What is the normal albumin level?
3.5-5.5
What are acute indicators of nutritional status?
retinal binding protein, pre-albumin, transferrin, total lymphocyte count
What is the Ideal Body Weight calculation?
Men: 106 + 6 for every inch over 5ft
Women: 100 + 5 for every inch over 5ft
What are 3 preoperative signs of poor nutrition?
- Weight loss >10% in 6 months
- Weight <3.0 (strong M&M risk)
What is the respiratory quotient?
ratio of CO2 produced to O2 consumed
An RQ of >1 means what?
lipogenesis- overfeeding. decrease carbs and caloric intake. Can lead to ventilator problems for CO2 buildup
An RQ of <0.7 means what?
ketosis and fat oxidation (starving). Increase carbs and caloric intake
Pure fat metabolism has an RQ of?
0.7
Pure protein metabolism has an RQ of?
0.8
Pure carbohydrate metabolism has an RQ of?
1.0
Postoperative diuresis phase occurs when?
days 2-5
Postoperative catabolic phase occurs when?
days 0-3 (negative nitrogen balance)
Postoperative Anabolic phase occurs when?
days 3-6 (positive nitrogen balance)
How long before glycogen stores are depleted?
24-36 hours of starvation (2/3 in skeletal muscle, 1/3 in liver)
What do skeletal muscles lack that is found in the liver in regards to glycogen metabolism?
Glucose-6-phosphatase