Exam 2 - questions Flashcards
When do we use parenteral nutrition?
- Non functioning gut, or obstruction that can’t be bipassed
- GI fistula with high output that cannot be bypassed with EN
- Acute pancreatitis – only if EN not tolerated with feeding into jejunum
- Short bowel syndrome/massive bowel resection
- PEM prior to admission and EN not feasible, 5-7 d pre-op
Is acute pancreatitis an automatic indication for parenteral nutrition?
No
What is the formula for the glucose infusion rate?
(Grams dextrose x 1000 mg/g dextrose) ÷ (kg body weight) ÷ (1440 min/day)
What is refeeding syndrome? What do we monitor for it?
Sudden introduction of glucose into the bloodstream (after patient has mostly been using fat as energy source) that causes electrolyte shift
- monitor K, Mg, Phosphorus (PO3)
- patients can die from this quickly
what are 4-5 guidelines for GERD and esophagitis?
- Avoid large, high fat meals
- Avoid eating 2-3 hours before lying down
- Elevated the HOB (head of bed)
- Avoid smoking
- Avoid alcoholic beverages (#1 starting place)
- Avoid caffeine containing foods/beverages
- Wear loose fitting clothing around stomach
- Avoid acid and highly spiced foods
- Consume a healthy diet with adequate fiber
- Lose weight if overweight
what does IDDSI stand for?
International dysphagia diet standardization initiative
- Speech language pathologist will perform swallowing test, and patient will be placed on level of diet depending on the results of the test
what is the primary cause of gastric ulcer disease?
- H. Pylori
- Other longer term use causes: NSAIDs, corticosteroids, alcohol, smoking, stress
what are the protective foods for peptic ulcer disease (evidenced based related to H pylori, but still see positive health benefits for non H. pylori cases too)
- Cranberries, ginger
- Curcumin
- Sulfoaphane
- Kimchi
- Green tea
- Black current oil
- Probiotics
What is reglan?
- Prokinetic agent
- Enhances GI motility by increasing acetyl CoA concentrations in the gut
- Dietitians may make request for patient to be on this to help digestion move along
- Helps with gastric paresis
- Safe during pregnant
- Very safe medication with little harm
Give me an example of a gluten free lunch
- Salmon, rice, broccoli
- Buckwheat chicken broccoli
- Lentil pasta, chicken, asparagus
What does FODMAP stand for?
fermentable oligosaccharides, disaccharides, monosaccharides, and polyols
which patients benefit from FODMAP?
- Fructose malabsorption and IBS
- know foods they can’t eat
- Do it for 6-8 weeks and then slowly add foods back in
- Goes on a yes or no list completely individual to the patient
- Everything could also be dose dependent
true/false for diverticular disease, do you need to rid of foods that could get caught in the pockets?
- False, just want to start with a low fiber diet until inflammation is gone and then high fiber diet
is fatty liver reversible?
Yes, in early stages
Alcoholism causes malnutrition due to what?
- Prioritizing alcohol over food
- Pancreatic insufficiency
- Use of lipids and carbs is compromised
- Vitamin and mineral deficiencies (main players to know)
o Thiamin causes Wernicke’s encephalopathy
o Folate
o B6
