Nutrition Flashcards
The typical postnatal weight loss in the term infant is…..?
5% to 10% of birth weight
preterm infants, this postnatal weight loss can be as much as……..?
15% of birth weight, with the nadir by 4 to 6 postnatal days and a regain to birth weight by 14 to 21days
Goals for weight gain in term and preterm…??
15 to 20 g/kg/day for infants <2 kg
and 20 to 30 g/day for larger infants.
Protein(g/kg/day) requirement…..?
3.5–4.5
Human milk - 1.4
Carbohydrate (g/kg/day )
10-14
Energy. Estimates suggest that preterm infants in a thermoneutral environment require approximately ….?
40 to 60 kcal/kg/day
AAP has recommended that peripheral solutions maintain an osmolarity between …….?
300 and 900 mOsm/L
Dextrose concentration administered through peripheral veins be limited to…?
≤12.5% dextros
Infants with renal failure and those receiving extracorporeal membrane oxygenation (ECMO) therapy may require as high as dextrose …?
50% dextrose due to fluid restriction
Protein source in PN …?
Crystalline amino acid solutions provide the nitrogen source in PN
Dose of aminoven in PN ….
Infants with a birth weight <1,500 g are provided with 2 to 3 g/kg/day of amino acids shortly after birth.
The IV fat emulsion used in neonates is a …?
soybean oil–based lipid emulsion with egg phospholipids (Intralipid 20)
The soybean oil it also contains…………, which have been associated with the development of PN-associated cholestasis (PNAC)
phytosterols
What is smog …?
SMOF lipid 20% (Fresenius Kabi), a combination of soy, medium-chain triglycerides (MCTs), and olive and fish oils (Omegaven), has been tried,
but there is no definite decrease in PNAC.
SMOF has replaced Intralipid in India.
A recent recommendation suggests that lipid be given at…….?
1 to 2 g/kg/day during the first 4 days of life and then increased by 0.5 to 1 g/kg/day to a maintenance range of 3 to 4 g/kg/day.
Requirement of sodium and potassium …?
Maintenance requirements are estimated at approximately 2 to 4 mEq/kg.
Dose of vitamins for PN ??…?
No pediatric vitamin is available in India. Adult multivitamin (MVI) dose of 0.5 to 1 mL/kg is used
Calcium-to-phosphorus ratios of approximately for PN. …?
1.3:1 to 1.7:1 by weight (1:1 to 1.3:1 M) are suggested
Which minerals routinely reduced or omitted if impaired biliary excretion and/or cholestatic liver disease is present…?
As copper and manganese
are excreted in bile
Which Trace elements Additional supplementation may be indicated in osteomyelitis outputs …?
zinc and copper
When to give carnitine supplements in PN …?
infants requiring prolonged (e.g., >2 to 4 weeks) PN, a parenteral source of carnitine may be provided 10 mg/kg/day until enteral nutrition can be established.
About cystine in PN …?
Cysteine is not a component of current crystalline amino acid solutions because it is unstable over time and will form a precipitate
Supplementation with l-cysteine hydrochloride lowers the pH of the PN solution and may necessitate the use of additional acetate to prevent acidosis.
However, the lower pH also enhances the solubility of calcium and phosphorus and allows for improved mineral intake.
Cysteine is routinely supplemented in PN at a rate of approximately 30 to 40 mg/g protein.
Vitamin A supplements during PN …?
In some units, infants weighing <1,000 g at birth are supplemented with 5,000 IU vitamin A intramuscularly three times per week for the first 4 postnatal weeks, beginning in the first 72 hours
Triglycerides Schedule for Nutrition Laboratory Monitoring during PN …?
Consider during initiation and/or advancement for extremely low-gestational-age or growth-restricted infants receiving parenteral lipid nutrition
