Nutrition Flashcards
Glucose is essential to metabolism in which 3 places
Brian
renal medulla
red cell metabolism
What is the main glucose regulatory hormone
Insulin
Where is glucose converted to glycogen
In the liver
A decrease in insulin secretion prompts what 3 things
glycogenolysis
glyoneogenesis
lipolysis
Where does glycogenolysis occur
in the liver
How do lipids enter the circulation
As chylomicrons
How much of hospital patients are undernourished
30%
What does MUST stand for
Malnutrition Universal Screening Tool
What does nutritional dupport refer to
The provision of nutrition above and beyond the normal diet and includes food fortification, oral nutritional supplementation, tube feeding and parenteral nutrition
What is the preferred method of feeding out of oral and enteral
Oral
What is the preferred method of feeding out of enteral and parenteral
Enteral
What 5 factors need consideration in deciding the replacement schedule
Calorie requiredment Nutrogen (protein) balance Minerals and vitamins Fluid and electrolytes Fibre
Malabsorption of what causes gum hypertrophy, bleeding and poor wound healing
Vitamin C
How long is nasogastric feeding appropriate for
4 weeks
What effect do soluble fibres have
Prebiotic effect
What does less soluble fibre act as
A bulking agent, increasing stool output and frequency
Patients with complete, irreversible intestinal failure require what type of feeding
Parenteral
What are the 2 general types of complications for parenteral nutrition
Line-related
metabolic
What are 3 early line-related complications
Local haematoma
Arterial puncture
pneumothroax
What are 3 early line-related complications
Local haematoma
Arterial puncture
pneumothrthorax
What is the main metabolic risk of parenteral feeding
Refeeding syndrome
Patients receiving long term PN have an increased risk of what
Cholestasis
Metabolic bone disease
micronutrient deficiencies
When is enteral tube feeding indicated
If supplemetns are insufficient to ensure an adequate intake and recovery
Where oral intake is unsafe and contraindicated
What should a NG aspirate pH be
5 or less
What should a NG aspirate pH be
5 or less
During starvation, what does the body utilise to form glucose
Liver glycogen stores as well as gluconeogenesis
What is gluconeogenesis
Glucose synthesis using breakdown products of lipid and protein
What causes loss of lean body mass
Catabolism of adipose tissue and muscle
What is the refeeding syndrome
A syndrome consisting of metabolic disturbances that occur as a result of reinstitution of nutrition to patients who are starved or severely malnourished
What 6 types of patients are at risk of the refeeding syndrome
Anorexia nervosa
chronic alcoholism
prolonged fasting
following duodenal switch operation for obesity
oncology patients receiving prolonged chemotherapy
postoperative patients
What does intestinal failure result from
Loss of absorption due to obstruction, dysmotility, surgical resection, congenital defect or disease
What is intestinal failure characterised by
Inability to maintain protein energy, fluid, electrolyte or micronutrient balance
What is SBS
Intestinal failure resulting from the loss of small intestinal absorptive capacity for anatomical reasons
What length of small bowel would a patient at risk of SBS have
What is type 2 intestinal failure
In severely ill patients with major resections of the bowel and septic
