Chapter 37: Medical Nutrition Therapy in Critical Care

Question 1

sepsis

Answer 1

Infection

Question 2

ebb phase

Answer 2

Occurring immediately after injury, is associated with hypovolemia, shock, and tissue hypoxia

Question 3

flow phase

Answer 3

Follows fluid resuscitation, colloids, and restoration of oxygen transport

Question 4

catecholamines

Answer 4

Epinephrine and norepinephrine released by the adrenal medulla

Question 5

counterregulatory hormones

Answer 5

Are elevated after injury and sepsis, play a role in the accelerated proteolysis

Question 6

cortisol

Answer 6

Released from the adrenal cortex in response to stimulation by adrenocorticotropic hormone

Question 7

Adrenocorticotropic hormone

Answer 7

Secreted by the anterior pituitary gland, enhances skeletal muscle catabolism and promotes hepatic use of amino acids for gluconeogenesis, glycogenolysis, and acute-phase protein synthesis

Question 8

acute-phase proteins

Answer 8

Secretory proteins produced by the liver

Question 9

interleukin-1 (IL-1)

Answer 9

Released by phagocytic cells in response to tissue damage, infection, inflammation, and some medications

Question 10

cytokines

Answer 10

Proinflammatory proteins

Question 11

interleukin-6 (IL-6)

Answer 11

Released by phagocytic cells in response to tissue damage, infection, inflammation, and some medications

Question 12

tumor necrosis factor (TNF)

Answer 12

Released by phagocytic cells in response to tissue damage, infection, inflammation, and some medications

Question 13

systemic inflammatory response syndrome (SIRS)

Answer 13

Describes the widespread inflammation that can occur in infection, pancreatitis, ischemia, burns, multiple traumas, hemorrhagic shock, or immunologically mediated organ injury

Question 14

quick sequential organ failure assessment (qSOFA)

Answer 14

A practical scoring system to define organ dysfunction of a potentially septic patient

Question 15

multiple organ dysfunction syndrome (MODS)

Answer 15

The syndrome generally begins with lung failure and is followed by failure of the liver, intestines, and kidney in no particular order

Question 16

shock

Answer 16

A critical condition brought on by the sudden drop in blood flow through the body.

Question 17

ileus

Answer 17

Lack of peristalsis in the stomach and small bowel

Question 18

tight junctions

Answer 18

Junctions between the intraepithelial cells

Question 19

epithelial barrier function (EBF)

Answer 19

The barrier regulates nutrient absorption as well as prevents the invasion of pathogenic bacteria in the host

Question 20

nutrition support therapy

Answer 20

Incorporates early EN when feasible, appropriate macro- and micronutrient delivery, and glycemic control

Question 21

hemodynamic

Answer 21

Maintenance of airway and breathing, adequate circulating fluid volume and tissue oxygenation, and acid-base neutrality

Question 22

abdominal compartment syndrome

Answer 22

Occurs with increased intraabdominal pressure, often after major abdominal trauma or sepsis

Question 23

total body surface area (TBSA) burned

Answer 23

The extent of a burn injury