Metabolic Stress

Question 1

Metabolic changes in stress

Answer 1

Metabolic rate increases
Ebb phase: decreased O2 consumption, hypothermia, lethargy
Flow phase: increased O2 consumption, hyperthermia, increased nitrogen excretion and catabolism

Question 2

Stress hormones that affect blood glucose levels

Answer 2

Cortisol increases blood glucose

Question 3

Metabolic and immunological changes in starvation

Answer 3

liver glycogen depleted within 24 hours, lipid stores used, muscle protein is catabolized, fatty acids hydrolyzed, ketone bodies produced, immune system compromised, GI microbiome spreads out

Question 4

Difference between metabolic changes in starvation vs stress

Answer 4

metabolic rate decreases in starvation but increases rapidly in severe stress

Question 5

Nutritional needs for patient experiencing severe metabolic stress

Answer 5

• 1.5-2g/kg body weight of protein
• Vitamin A, C, Zinc
  Fluids (by age)
• 55+ 35-40mL/kg
• 55-65 30mL/kg
• 65+ 25mL/kg

Question 6

Nutritional Care for patients with burns

Answer 6

Fluid and electrolyte replacement first!!!
Once hydrated enteral feedings (high calorie, high protein, especially Vitamin A & C)

Question 7

Rule of Nines

Answer 7

One side: Head 4.5%, Arms 4.5% each, Trunk 18%, Peri area 1%, Legs 9% each