Kapitel 8 - Metabolism and nutrition Flashcards
How is blood glucose levels maintain during brief periods of uncomplicated starvation?
by hepatic glycogenolysis and gluconeogenesis.
… However, glycogen stores are rapidly depleted, and fatty acids become the primary energy source
Which tissues in the body are glucose dependent?
Brain and erythrocytes
What causes death due to uncomplicated starvation?
Cardia and respiratory failure and bronchopneumonia
what are the effects of food deprivation on ill/injured patients?
Metabolic rate is increased, and protein conservation does not occur.
Increases in metabolic rate and protein catabolism are approximately proportional to the severity of the insult
What neuroendocrine changes occurs in food deprivation on ill/injured patients?
sympathetic nervous system activation;
- increased production of catecholamines, glucagon, and glucocorticoids
- increased production of antidiuretic hormone
- and activation of the renin-angiotensin-aldosterone system.
These neuroendocrine changes result in decreased cardiac output, increased peripheral vascular resistance, relative insulin resistance, increased protein catabolism and nitrogen loss, increased mediators of inflammation, increased metabolic rate, and rapid development of malnutrition
What are the structural components of the epithelial barrier
- single layer of epithelial cells
- tight junction proteins
- a layer of mucins composed of glycoproteins
- Paneth cell–derived antimicrobial factors,
- secretory immunoglobulin A produced by gut-associated lymphoid tissue
(Many of these attributes of the intestinal epithelial barrier are compromised with starvation)
What level of serum albumin concentration are associated with increased postoperative complications?
Serum albumin concentrations less than 2 g/dL
How does the entry requirement change in severely patients?
The energy requirements may exceed two times the estimated resting energy requirements (RER)
Likewise, protein requirements may exceed that required for maintenance to facilitate recovery, immune function, and wound healing. With trauma or strenuous exercise, protein requirements may exceed maintenance amounts by 50% to 100%
Total body water is divided into four compartments, what are those 4 compartments and how much of the total water content does each one contain?
- 64% being intracellular
- 22% in interstitial spaces
- 7% in plasma
- and the remaining 7% transcellular.
How do you calculate the resting energy requirement (RER)?
What is daily energy requirement (DER)?
It is based on the resting energy requirement (RER) multiplied by a factor for life stage or disease.
for example se picture
What is a Polymeric diets?
Diets containing high-molecular-weight protein, carbohydrates, and fats and require digestion before absorption can occur
(vanligt torrfoder)
What are Monomeric diets?
Monomeric diets are liquid and tend to be hyperosmolar.
Monomeric diets are used with enterostomy feeding tubes but can be used with any feeding tube.
Monomeric diets do not require digestion before absorption.
Give examples of parenteral nutritional products
- Dextrose
- Amino acids (with or without electrolytes)
- Lipid emulsions
- and multivitamin and mineral supplements
How should dextrose solution of grater than 10% be administered?
dextrose solutions of greater than 10% are hyperosmotic, they should be administered in a central vein such as the cranial or caudal vena cava
(the same applies for amino acid solutions of greater than 6.5%)
