Nutrition Flashcards
how many kcal/ounce is breast milk?
20 kcal/oz
1 oz= 30 mL
what are the parameters for a pediatric patient to be considered faltering (failure to thrive)?
falling by 2 major percentiles or weight <3-5% percentile
What supplements are recommended for all breastfed babies?
vitamin D3 (400 IU or 10 mcg)
premature neonates may require iron supplementation (2mg/kg/day)
may require zinc supplementation
How do you calculate fluid requirements in pediatric patients?
Holliday-Segar Method
100mL/kg for 1st 10 kg
1000 mL + 50 mL/kg for 10-20 kg
1500 mL + 20 mL/kg for >20 kg
What are the caloric requirements for pediatric patients?
preterm infant 100-120+ kcal/kg/day
<6 months = 85-105
6-12 months 80-100
What are the protein requirements for pediatric patients?
3-4g/day for low birth weight/preterm neonate
2-3g/day for infant
What are the caloric needs per day for an ICU/surgery patient?
25-30 kcal/kg/day
how many kcal is 1 g of protein?
4 kcal
how many mL of fluid is required for ICU/surgery patients?
30-40 mL/kg/day MIVF
What are the positive IONs that need to be balanced?
sodium
potassium
What are the negative IONs that need to be balanced?
Chloride
acetate
Phos
What are the additives in the TPN?
MVI - 10 mL
Multi-trace elements - 1 mL
What monitoring parameters are used in PN?
vitals, I/O’s, CMP, weight, CBC, Mg, Phos, Ca, Prealbumin/CRP
weekly- triglycerides, nitrogen balance, PT/INR, transferrin
What is the conversion factor for mMol and mEq of phos?
1 mMol phos= 1.4 mEq phos
how much phos do you need in PN?
0.3 mMol/kg
how much potassium do you need in PN?
0.5-1 mEq/kg
how much calcium do you need in PN?
10 mEq/day (if Ca normal)
how much magnesium do you need in PN?
8 mEq/day (if Mg normal)
how much sodium do you need in PN?
aim for 1/2 NS (77 mEq/L) titrate to L amt
What is the NBW equation?
IBW + 0.25(wt-IBW)
What is the IBW equation?
(males) 50 kg + (2.3 x inches over 60”)
(females) 45.5 kg + (2.3 x inches over 60”)
What is the TEE equation?
TEE= REE x 1.2
What is the RQ goal?
0.85-0.95
1-1.2 = overfeeding
0.67-0.82 = underfeeding
What is the normal prealbumin range? and how does CRP affect it?
15-40 mg/dL
if CRP high and prealbumin is decreased then its due to inflammation
if CRP normal AND prealbumin is decreased then its due to malnutrition
How do you prevent refeeding syndrome?
limit carbs to 100-150 gm
limit fluids to 800 mL/day
what are the clinical findings if refeeding syndrome is suspected?
Hypophosphatemia, hypomagnesemia, hypokalemia
What is the nitrogen balance equation?
N(in)= 24 hr protein intake / 6.25
N(out)= 24 hours UUN = factor (4g)
Nitrogen balance = N(in) - (N)out
What is the 70/30 rule?
70% of non protein calories need to be carbohydrates
30% of non protein calories need to be lipids
