lilley ch 55 - nutritional supplements Flashcards
body’s nutritional needs are not met by nutrient intake
malnutrition
provision of food or nutrients through GI tract
enteral nutrition
delivery of nutrients directly into circulation by means of IV solution
parenteral nutrition
what patients could benefit from feeding tubes (4)
- abnormal esophageal or stomach peristalsis
- altered anatomy secondary to surgery
- depressed consciousness
- impaired digestive capacity
what meds interact with enteral nutrition (6)
- phenytoin
- tetracyclines
- quinolones
- nutrient formulas with calcium
- corticosteroids
- vitamins A or D
adverse effects of enteral nutrition (4)
- GI intolerance: diarrhea
- infants (allergies and digestive intolerances)
- dumping syndrome
- aspiration pneumonia
type of nutrition administration that completely bypasses GI system by going directly into the circulatory system
parenteral nutrition (through IV)
type of parenteral nutrition:
- temporary, short term (less than 2 weeks)
- max dextrose concentration: 12.5%
peripheral TPN
type of parenteral nutrition:
- long term use (over 2 weeks)
- max dextrose concentration: 50% (usually 25-30% is used)
central TPN
what patients could benefit from peripheral TPN (5)
- procedures that restrict oral feedings
- anorexia caused by chemotherapy or radiation treatments
- GI illnesses that prevent oral food intake
- postsurgical patients
- when nutrition deficits are minimal but oral nutrition will not be started for more than 5 days
most devastating adverse effect of peripheral TPN
phlebitis
what veins are commonly used for central TPN
subclavian
internal jugular
adverse effects of central TPN
- higher risk infection
- catheter-induced trauma
- greater chance for hyperglycemia
what patients could benefit from central TPN (3)
- patients with large nutritional requirements
- patients who need nutritional support for more than 7-10 days
- patients who are unable to tolerate large fluid loads
primary role of amino acids
protein synthesis
greatest source of calories in TPN
dextrose (carbohydrates)
- peripheral TPN: less than 10%
- central TPN: 10-50%
two functions of fats
- supplies essential fatty acids
- source of energy or calories
symptoms of essential fatty acid deficiency
- hair loss
- scaly dermatitis
- growth retardation
- reduced wound healing
- decreased platelet levels
- fatty liver
what oils are lipid emulsions made from
- soybean oil
- safflower oil
what is the max % of daily caloric intake that can be from fats
60%
4 signs of lactose intolerance
cramping
diarrhea
abdominal bloating
flatulence
3 signs hyperglycemia (blood glucose more than 200)
headache
dehydration
weakness
4 signs hypoglycemia (blood glucose less than 60)
- cold clammy skin
- dizziness
- tachycardia
- tingling of extremities
what can happen if TPN is discontinued abruptly
rebound hypoglycemia
6 signs fluid overload (hypervolemia) with TPN
- weak pulse
- hypertension
- tachycardia
- confusion
- decreased urine output
- generalized pitting edema
