Hospital Nutrition Flashcards
Factors influencing the decision of “when to feed” a hospitalized patient
preexisting nutritional status, level of illness, consequences to the patient of inadequate nutrition, risks of feeding them
How long can previously well-nourished adults with minimal acute illness go without food before serious nutritional deficiencies
10-14 days
How long can a previously undernourished adult with minimal medical illness/previously well-nourished individuals with serious acute medical illness go without food before developing serious nutritional deficiencies?
5-7 days
How long can a previously undernourished adult with serious illness go without food before developing serious nutritional deficiencies
3-5 days
risk of enteral feeding
aspiration
Risks of parenteral feeding
infection, placement of central venous catheter
sources of macronutrients in hospital standard liquid formula
corn oil, maltodextrin, casein
Range of total energy expenditure for sick people
22-25kcal/kg/day (not too sick) - 30-32kcal/kg/day (very sick)
How do you calculate daily energy needs?
weight in kg x necessary kcal/kg/d
How do you calculate infusion rate?
number of kcals/day = number of ml/day of enteral diet needed
hourly infusion rate = (ml/day)/24
Appropriate infusion rate for starting enteral feed
lower than will meet their total daily energy needs (may have trouble emptying stomach at full infusion rate –> aspiration) and increase gradually over a period of days
Minimal nutritional requirements
vitamins and micronutrients, especially thiamine and folate and multivitamin
Why is D5W (all carb) not sufficient as a replacement for a proper diet?
lacks vitamins, micronutrients, essential amino acids and essential fatty acids
result of overfeeding a patient
initially fine, but hyperglycemia develops after glycogen stores are filled. Insulin is less effective because the “cupboard is full”
result of underfeeding a patient
negative nitrogen/protein balance (breaking down muscle to donate amino acids to gluconeogenesis)
