Need to study! Flashcards
What is included in the SGA? 8 items
wt history, dietary intake, functions status, metabolic demand, GI symptoms; fat stores, muscle stores, and edema
What is included in the Comprehensive Geriatric Tool?
anthropometrics, biochemical markers, and medications. NOT exercise level
Nitrogen end product waste is removed by ___ and ___.
alanine and glutamine
Total body water distribution for extracellular and intracellular? Interstitial and intravascular?
33% and 66% respectively. 75% and 25% respectively
Normal Anion Gap
12 +/- 4
What acid-base disorder is seen with overfeeding?
Respiratory Acidosis
What acid-base disorder is seen in AKIs?
metabolic acidosis
What is the relationship with hyperglycemia and sodium?
Hyperglycemia causes shift of water to outside the cell, leading to dilutional hyponatremia
Which micronutrients are involved in converting homocystine to methionine?
B12, folate, and choline
What inhibits Calcium absorption?
phosphate and oxalates
Vit D supplementation in adults? Pediatrics?
800-1000 IU. 400 IU in Pediatrics
What is a low 25OH-D value?
<20ng/dL
Which vitamin is surprisingly involved in prevention of osteoporosis?
Vitamin K
What is choline used for?
fatty acid transport and metabolism. Low levels seen in hepatic steatosis
Chromium helps with this medication’s action.
Insulin
What is the relationship between Zn, Cu, and Fe?
Zn inhibits copper absorption. Low copper leads to low iron value since it is needed for activation.
Symptoms of low zinc
dysgusia, loss of appetite, poor wound healing
___ and ____ are primarily absorbed in the duodenum.
Iron and Calcium
Folate absorption is decreased with ___ deficiency
Zinc. Folate is absorbed via enterohepatic system.
Cardiomyopathy may be due to deficiency of which micronutrients?
carnitine, Co Q10, thiamine, taurine, selenium, niacin
Methotrexate side affects and main nutrient interaction
can lead to mucocitis, osteoporosis. Needs folate supplementation
Cisplatin- monitor for which electrolyte abnormalities?
Hypokalemia and hypomagnesemia
Tacrolimus is associated with what electrolyte and lab alterations?
low Mg, low K, high gluc; Nephrotoxic
Sirolimus has what effect on lab values?
hypertriglyceridema
Which medications interact with divalent and trivalent minerals, resulting in poor absorption of the medication?
Tetracycline and ciprofloxacin (fluroquinolones)
Valporic acid can lead to a ___ deficiency.
Carnitine (used for transports long-chain fatty acids into the mitochondria so they can be oxidized)
Lab alterations from cyclosporin
hyperkalemia, hypomagnesemia, hyperglycemia, and hypercholesterol
Which medications can have an anorexic affect?
narcotics, histamine receptor antagonists, and antihypertensives
Zinc drug interactions
Floxacins, phos binders, corticosteroids, HCTz; propofol increases Zn losses
Magnesium drug interactions
diuretics, PPI, cyclosporin and cisplatin
What tube materials for TFs have a higher risk of clogging?
silicone
Pros and cons of balloon bolster vs. solid?
Balloon bolster is more comfortable, can be changes at home, but has a shorter life
Goal UOP
1ml/kg/hr
Acetate Cloride ratio goal for PN
1:1
Do not exceed ___ lipid infusion
0.11g/kg/hr; 2.5g/kg/d
What increases Ca Phos solubility in PN?
increase AA, use of CaGluc, lower temp, lower pH.
Lower pH is not suitable for lipids, use a 2 in 1 then
Daily electrolyte requirements in PN
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