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POS - Box 3 > Feeding and Nutrition > Flashcards

Feeding and Nutrition Flashcards

1
Q

What are normal caloric requirements?

A

35cal/kg/day

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2
Q

What are normal protein requirements?

A
  1. 7g protein /kg/day

* 1g protein = 4 cals

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3
Q

What are normal carb requirements?

A

75-80% of non-protein calories
100g/day to suppress gluconeogenesis

Normal max  = 7g/kg/day
Stressed  = 7.2-8.6g
hypercapnia = <4g
hepatic steatosis = <4g
Hyperglycemia/gluc intolerance = <5/day

1g carbs = 4 cals **dextrose 3.4cal

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4
Q

Normal lipid requirements

A

20-25% non-protein cals
Max 2g/kg/day of fat emulsion (recommended 1g, kids 4g)

1g fat = 10cals

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5
Q

What are essential amino acids? (7)

A 
(body can't make these, need from diet)
Valine
Leucine
isoleucine
Methionine
Phenylalanine
Threonine
Tryptophan
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6
Q

What are non-essential amino acids (7)

A 
Alanine
Aspartic acid
asparagine
glutamic acid
glycine
proline
serine
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7
Q

Essential Vitamins

A 
Vit A
Vit  B1 (thiamine)
Vit B2 (riboflavin)
Vit B12
Vit C
Vit K
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8
Q

What are essential minerals?

A 
Copper
Chromium 
Zinc
Selenium
Folate
Biotin
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9
Q

What results from copper deficiency? (2)

A

Microcytic anemia

Delayed wound healing

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10
Q

What results from chromium deficiency? (2)

A

Impaired Glucose metabolism

Peripheral Neuropathy

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11
Q

What results from zinc deficiency? (5)

A 
Delayed wound healing
Decreased immunity
Hair loss
dermatitis
Decreased taste
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12
Q

What results from selenium deficiency? (3)

A

Cardiiomyopathy
weakness
Decreased energy

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13
Q

What results from fatty acid deficiency? (3)

A

Dry flakey skin
Alopecia
TCP

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14
Q

What results from vitA deficiency? (1)

A

Poor wound healing

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15
Q

What results from B12/folate deficiency? (1)

A

Macrocytic anemia (megaloblastic anemia)

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16
Q

What results from a biotin deficiency? (3)

A

Skin rash
EKG changes
Neuromuscular changes

17
Q

What results from vitamin C deficiency?

A

Poor wound healing (needing for collagen synthesis and assembly)

18
Q

What results from vitamin K deficiency?

A

Impaired hemostasis (needed for clotting factors 2, 7, 9, 10)

19
Q

What results from VitB6 deficiency?

A

Poor wound healing

20
Q

What results from vitamin B1 (thiamine) and Vitamin B6 (riboflavin) deficiency?

A

Poor wound repair

21
Q

What results from arginine deficiency?

A

Impaired wound healing

22
Q

What are benefits of TPN? (4)

A

Improved wound healing
Decreased catabolic response to injury
Improved GI structure and fucntion
Improved clinical outcomes

23
Q

Indications for TPN as primary therapy (5)

A 
GI-cutaneous fistula
Renal failure (ATN)
Short bowel syndrome
Acute burns
Hepatic failure
24
Q

What are indications for TPN as supportive therapy? (4)

A

Acute radiation enteritis
Acute chemotoxicity caused enteritis
Prolonged ileus > 7days
Weight loss before major surgery

25
Q

What are technical complications of TPN? (from line itself)

A 
Pneumothorax
Arterial lac
Hemothorax
Mediastinal hematoma
Brachial plexus injury
Hyrdothroax
Thoracic  duct injury
Air embolism
Catheter embolism
Sympathetic effusions, substernal pain, fever from mediastinal effusion
26
Q

What are late technical complications of TPN? (line itself)

A

Erosion of catheter into bronchus, right atrium, or other structurees
Subclavian vein thrombosis
Septic thrombosis

27
Q

What are metabolic complications of TPN?

A 
Deficiency states
hypo or hyperglycaemia
Hepatitis steatosis
Fat overload syndrome (fever, back pain, chills, pulmonary insufficiency, blockage of reticuloendothelial system)
Gut mucosal atrophy
Overfeeding
28
Q

What are septic complications of TPN?

A

Catheter infection
Aspiration
Bacterial colonization of stomach

29
Q

What is the management of suspected TPN catheter sepsis?

A

Remove catheter is positive skin cultures
If no skin cultures: Replace tubes and lines and feeds - send blood cultures
Fever >8hr = remove line and culture tip
No Abx needed unless fever >24hrs after removal

Do not change catheters over guide wire when sepsis suspected

If catheter is source then IV ABx, replace catheter after period of sterile blood cx

30
Q

What are some complications from enteral feeding?

A 
Malpositioning of catheterr
Aspiration
Solute overload = diarrhea, dehydration, lyte imbalance
Loss of K, Mg, other ions with diarrhea
Pneumatosis intestinalis w/  perf
Bowel necrosis
31
Q

When appropriate which is preferred, enteral or parenteral feeds?

A

ALWAYS USE THE GUT FIRST IF POSSIBLE

POS - Box 3 (6 decks)

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