Nutrition Flashcards
In stable patients, the most accurate serum nutritional marker is … ?
Serum albumin
What serum marker is typically used in assessing nutritional status?
Serum albumin
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Reflects long-term protein status and chronic malnutrition.
What factors can impact serum albumin?
Low levels (<3.5 g/dL) indicate protein-energy malnutrition but can also be affected by hydration, inflammation, liver function, and acute illness.
What does prealbumin indicate in nutritional assessment?
Prealbumin reflects short-term protein status due to its shorter half-life (2–3 days).
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Serum prealbumin is sometimes followed as a nutritional marker, but it is also prone to degradation in proinflammatory states.
What is the practicality of using prealbumin to assess nutritional status?
It monitors acute changes in nutritional status
Preablumin can be altered by …. ?
Prealbumin is influenced by inflammation and liver function.
How is serum transferrin used in nutritional assessment?
Serum transferrin reflects both iron and protein status. Levels decrease in protein malnutrition but are also affected by iron stores and inflammation, making it less specific.
Serum transferrin has a half-life of … ?
8 days (much shorter).
Serum transferrin levels are influenced by …?
Serum transferrin levels are prone to degradation during proinflammatory states.
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Patients who are in disease states where the level is most critical are also the ones who are most likely to have confounded levels due to inflammation.
Transferrin levels will __________ in iron deficiency
Transferrin levels will increase in iron deficiency.
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Conversely levels will decrease in iron overload.
Why is hemoglobin a poor candidate to assess a patient’s nutritional status?
Serum hemoglobin may be low in malnutrition, but it is not a good nutritional marker because patients who are malnourished may have normal hemoglobin, and hemoglobin can drop due to both bleeding and micronutrient deficiencies that do not reflect the overall nutritional status well.
What is the significance of retinol-binding protein (RBP) in nutrition?
RBP reflects short-term protein status with a half-life of 12 hours. It is rarely used in clinical practice due to limited availability and specificity.
Why is C-reactive protein (CRP) important in nutritional assessment?
CRP is not a direct nutritional marker but is used alongside albumin or prealbumin to assess the effect of inflammation. Elevated CRP can indicate that low albumin or prealbumin is due to inflammation, not malnutrition.
What does Body Mass Index (BMI) measure in nutritional assessment?
BMI is a widely used measure of overall nutritional status but does not differentiate between fat and lean mass.
What does serum total protein indicate in nutrition?
Serum total protein measures all circulating proteins but is less specific for malnutrition compared to albumin or prealbumin.
What does nitrogen balance reflect in nutritional assessment?
Nitrogen balance reflects protein intake versus protein loss, often used in hospitalized patients on nutrition support.
Dividing the amount of protein consumed per day by _____ gives the amount of nitrogen.
6.25
Nitrogen loss is determined by …. ?
urinary urea nitrogen (UUN), which is measured in a 24-hour urine sample
To account for the insensible nitrogen losses what must be done to the nitrogen loss?
To account for additional nitrogen losses (e.g., from feces, sweat, and skin), add a constant (commonly 4 g/day) to the UUN
What is the overall (final) nitrogen balance calculation?
The overall nitrogen intake (protein in per day/6.25) minus urinary urea with an additional 4 added for insensible nitrogen loss.
What are the normal dietary requirements to met a patient’s nutritional needs?
Normal dietary requirements are 1 g/kg/d of protein and 25 kcal/kg/d for calories
What is the recommended nutrition for an obese patient?
2.0 g/kg/d of protein + 20 kcal/kg/d of calories
Obesity compounds the metabolic response to critical illness and increases the risk of overfeeding complications because of its comorbidities. Hypocaloric, high-protein nutrition therapy affords the hospitalized patient with obesity the opportunity to achieve net protein anabolism with a reduced risk of overfeeding complications. Most obese patients are sarcopenic and need higher protein requirements.
Should an obese patient obtain “nonfat calories”?
There is no association between providing nonfat calories and complication rates in obese patients.
For patients with significant gastroesophageal reflux, what would be the key method for placement of a enteral feeding tube?
Advance the feeding tube beyond the ligament of Treitz (post-pyloric placement) is preferred to reduce the risk of aspiration.
