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CNS Modules > Need to study! > Flashcards

Need to study! Flashcards

1
Q

What is included in the SGA? 8 items

A

wt history, dietary intake, functions status, metabolic demand, GI symptoms; fat stores, muscle stores, and edema

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2
Q

What is included in the Comprehensive Geriatric Tool?

A

anthropometrics, biochemical markers, and medications. NOT exercise level

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3
Q

Nitrogen end product waste is removed by ___ and ___.

A

alanine and glutamine

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4
Q

Total body water distribution for extracellular and intracellular? Interstitial and intravascular?

A

33% and 66% respectively. 75% and 25% respectively

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5
Q

Normal Anion Gap

A

12 +/- 4

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6
Q

What acid-base disorder is seen with overfeeding?

A

Respiratory Acidosis

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7
Q

What acid-base disorder is seen in AKIs?

A

metabolic acidosis

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8
Q

What is the relationship with hyperglycemia and sodium?

A

Hyperglycemia causes shift of water to outside the cell, leading to dilutional hyponatremia

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9
Q

Which micronutrients are involved in converting homocystine to methionine?

A

B12, folate, and choline

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10
Q

What inhibits Calcium absorption?

A

phosphate and oxalates

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11
Q

Vit D supplementation in adults? Pediatrics?

A

800-1000 IU. 400 IU in Pediatrics

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12
Q

What is a low 25OH-D value?

A

<20ng/dL

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13
Q

Which vitamin is surprisingly involved in prevention of osteoporosis?

A

Vitamin K

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14
Q

What is choline used for?

A

fatty acid transport and metabolism. Low levels seen in hepatic steatosis

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15
Q

Chromium helps with this medication’s action.

A

Insulin

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16
Q

What is the relationship between Zn, Cu, and Fe?

A

Zn inhibits copper absorption. Low copper leads to low iron value since it is needed for activation.

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17
Q

Symptoms of low zinc

A

dysgusia, loss of appetite, poor wound healing

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18
Q

___ and ____ are primarily absorbed in the duodenum.

A

Iron and Calcium

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19
Q

Folate absorption is decreased with ___ deficiency

A

Zinc. Folate is absorbed via enterohepatic system.

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20
Q

Cardiomyopathy may be due to deficiency of which micronutrients?

A

carnitine, Co Q10, thiamine, taurine, selenium, niacin

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21
Q

Methotrexate side affects and main nutrient interaction

A

can lead to mucocitis, osteoporosis. Needs folate supplementation

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22
Q

Cisplatin- monitor for which electrolyte abnormalities?

A

Hypokalemia and hypomagnesemia

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23
Q

Tacrolimus is associated with what electrolyte and lab alterations?

A

low Mg, low K, high gluc; Nephrotoxic

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24
Q

Sirolimus has what effect on lab values?

A

hypertriglyceridema

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25
Q

Which medications interact with divalent and trivalent minerals, resulting in poor absorption of the medication?

A

Tetracycline and ciprofloxacin (fluroquinolones)

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26
Q

Valporic acid can lead to a ___ deficiency.

A

Carnitine (used for transports long-chain fatty acids into the mitochondria so they can be oxidized)

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27
Q

Lab alterations from cyclosporin

A

hyperkalemia, hypomagnesemia, hyperglycemia, and hypercholesterol

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28
Q

Which medications can have an anorexic affect?

A

narcotics, histamine receptor antagonists, and antihypertensives

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29
Q

Zinc drug interactions

A

Floxacins, phos binders, corticosteroids, HCTz; propofol increases Zn losses

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30
Q

Magnesium drug interactions

A

diuretics, PPI, cyclosporin and cisplatin

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31
Q

What tube materials for TFs have a higher risk of clogging?

A

silicone

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32
Q

Pros and cons of balloon bolster vs. solid?

A

Balloon bolster is more comfortable, can be changes at home, but has a shorter life

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33
Q

Goal UOP

A

1ml/kg/hr

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34
Q

Acetate Cloride ratio goal for PN

A

1:1

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35
Q

Do not exceed ___ lipid infusion

A

0.11g/kg/hr; 2.5g/kg/d

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36
Q

What increases Ca Phos solubility in PN?

A

increase AA, use of CaGluc, lower temp, lower pH.
Lower pH is not suitable for lipids, use a 2 in 1 then

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37
Q

Daily electrolyte requirements in PN

A

o 1-2mEq/kg Na
o 1-2mEq/kg K+ (goal of <40mEq/L)
o 10-15mEq/d Ca++ (goal of <5mEq/L)
o 8-20 mEq/d Mg
o 20-40 mmol/d Phos

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38
Q

Composition of parenteral vitamin

A

A: 1mg, D: 5mcg, E: 10mg, K: 150mg
Vitamin C 100mg-200mg

39
Q

What percent of macronutrients are needed in a PN for stability?

A

at least 10% dextrose, 4% AA, and 2% lipid

40
Q

Which drugs are compatible with PN?

A

Insulin and famotidine

41
Q

What is included in the Central Line Placement Bundle?

A

Hand hygiene, maximal barrier precautions, skin antisepsis with chlorhexidine gluconate, optimal catheter site selection, daily review of line necessity

42
Q

What action do you take if there is or isn’t purulence at the catheter exit site?

A

Topical antimicrobial agent can be used if there is no purulence from the catheter exit site and no clinical signs of sepsis.

Systemic antimicrobial treatment is used in the presence of purulent drainage

43
Q

Most common infections for tunneled and non tunneled CVCs?

A

Tunneled- catheter hub and intraluminal
Nontunneled- extraluminal

44
Q

Increases risk of PN bone disease?

A

Aluminum toxicity, low Ca, hypercalciuria, Mg deficiency, high AA provision, Hypo/Hyper Vit D

45
Q

Signs and treatment of SIADH

A

euvolemic hyponatremic. Treat with fluid restriction

46
Q

Signs and treatment of Cerebral salt wasting

A

hypovolemic hyponatreima; treat with IV Na

47
Q

Treatment for diabeties insipidus

A

free water and vasopressin

48
Q

Ratio for ketogenic diet?

A

4 fat:1 CHO; monitor Bhydroxybutyrate levels

49
Q

____ is the most predictive for both severity and outcome of pancreatitis

50
Q

How long does intestinal adaptation take for SBS?

51
Q

What diet is recommended for oxalate stones? Why?

A

low oxalate, low fat, high Ca, increase fluids. Fat competes with oxalate to bind to calcium; unbound oxalate absorbed in colon and excreted in kidney; therefore increases risk for kidney stones

52
Q

Which micronutrients are of concern for gastric surgery?

A

B12, Vit C, Vit D; watch for anemia and bone disease

53
Q

Method to treat proctitis?

A

SCFA enemas

54
Q

What is a randomized control trial?

A

Most rigorous. Random allocation to groups with blinding and equal treatment

55
Q

What is a case control study?

A

studies that assess whether exposure is disproportionately distributed between cases and controls

56
Q

What is an observational study?

A

relies on studying variables as they naturally occur, without any manipulation from researcher

57
Q

What is a cohort study?

A

aka longitudinal study. Group participants have the dependent variable measured several times over time

58
Q

What is a cross over study?

A

longitudinal study in which subjects receive a sequence of different treatments. All participants receive the same treatments but differ groups in the order in which they receive them.

59
Q

What is reliability? Validity?

A

Reliability is measure of consistent data using the same method. Validity is accurately measures what is trying to be represented

60
Q

What is specificity vs sensitivity?

A

Ability of a test to correctly identify people without the disease vs those with the disease

Sensitivity (true positive rate). Specificity (true negative rate)

61
Q

Type I error?

A

Conclude a difference exists when it doesn’t. False Positive

62
Q

Type II error?

A

Conclude a difference doesn’t exist when it does. False Negative. As sample size increases, type II error decreases

63
Q

What is considered low birth wt?

64
Q

What is considered SGA?

65
Q

Which growth chart for which age?

A

Fenton: premature; WHO infant to 2yo; CDC 2yo and up

66
Q

When can you start using BMI in pediatrics

A

2 years old

67
Q

Which group has the highest growth velocity?

68
Q

What is the the best marker of nutritional status in pediatric liver disease?

A

Upper arm circumference

69
Q

When can kids start drinking cow’s milk?

70
Q

When start iron supplementation on exclusively breast fed infant?

A

4-6 months

71
Q

Protein needs in PICU/NICU?

A

1.5g/kg for peds; up to 3g/kg for neonates

72
Q

Neonate nutrition recommendation with chylothroax?

A

Skimmed HBM or MCT

73
Q

What is added to ped PN to decrease the pH to allow for more Ca and Phos?

74
Q

What AA is considered essential in infants?

75
Q

Zinc dose in PN

A

2.5-5 mg/d

76
Q

Selenium dose in PN

A

20-40 mcg/d for burns, malabsorption, and critically ill

77
Q

What percentage of fat needed in diet to prevent EFAD?

A

4-10%. Need 2-4% linoleic and 0.25-0.5% alpha linolenic

78
Q

Upper limit of TG for pedicatric pts on ILE

79
Q

Signs of thrombosis

A

chest pain, ear ache, jaw pain, swelling of arm, shoulder, neck or face

80
Q

Superior vena cava syndrome signs

A

SOB, dyspnea, cough, cynosis of face, neck shoulder, arm

81
Q

If a pt is on this medication and hypokalemic and hypomagenemic, there is a high risk of toxicity

A

Digoxin because depletion of K and Mg will sensitize the myocardium to digoxin

82
Q

What medication is associated with SIADH

A

Setraline (SSRI)

83
Q

Signs of Mg deficiency

A

twitches, tremors, cramps

84
Q

Signs of Vit A deficiency

A

night blindness

85
Q

Sulfasalazine drug nutrient interaction

A

inhibits folate absorption whereas iron inhibits drug absorption

86
Q

What do you need to supplement if a pt is on phenobarbitol?

87
Q

Phenytoin inhibits ___ absorption

88
Q

Loop diruetics can lead to ___ and ___ losses; and what acid base disorder

A

Ca and K+; metabolic alkalosis

89
Q

Digoxin toxicity watch for ___

A

hypercalcemia; recommend low K+ diet and folate supplementation

90
Q

Vanco is a ____ medication; if clog IV line need to use ___ to unclog

A

acidic; HCl acid

91
Q

Phenytoin is a ____ medication; if clog the IV line, need to use ____ to unclog

A

basic; NaBicarb

92
Q

Overfeeding leads to what acid base disorder

A

respiratory acidosis

93
Q

Renal failure is associated with what acid base disorder

A

metabolic acidosis

94
Q

Use of diuretics can lead to what acid base disorder

A

metabolic alkalosis from Cl losses

CNS Modules (14 decks)

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