Nutrition Flashcards
what things should be looked for on examination regarding nutrition ?
Cheilitis is inflammation of the lips skin fat dry hair pressure sores weight and BMI arm circumference skin fold thickness
- these can suggest vitamin deficiencies
what blood tests should be done to assess nutrition ?
albumin
phosphate
transthyretin
state three different feeds which can be oral supplements ?
polymeric - intact proteins, starches and long chain FAs
disease specific
elemental - simple AAs and monosaccharides requiring minimal digestion
for what conditions can elemental feeds be used?
crohns, UC
state some complications of enteral nutrition ?
NGT - nasal trauma, malposition feed intolerance electrolyte imbalance aspiration referring syndrome
what is refeeding syndrome ?
life threatening metabolic complication of refeeding via any route after a prolonged period of starvation
what is the pathophysiology of refeeding syndrome ?
decrease in carbs
results in catabolic state with reduced insulin
depletion of intracellular phosphate
refeeding increases insulin and increases intracellular uptake of phosphate which can lead to hypophosphataemia
what are some symptoms of hypophosphataemia?
rhabdomyolysis respiratory insufficiency arrhythmias shock seizures
what is rhabdomyolysis ?
breakdown of damaged skeletal muscle. Muscle breakdown causes the release of myoglobin into the bloodstream. Myoglobin is the protein that stores oxygen in your muscles. If you have too much myoglobin in your blood, it can cause kidney damage
what patients are at risk of refeeding syndrome?
malignancy anorexia alcoholism GI surgery starvation
what is the management of refeeding syndrome ?
supplement phosphate
refer to dietician
what is parenteral feeding ?
via IV
what are some indication for parenteral feeding?
prolonged obstruction high output fistula short bowel syndrome severe crohns severe malnutrition severe pancreatitis unable to shallow
what are some complications of parenteral feeding ?
lined related
- cardiac arrhythmias
- pneumothorax
- line sepsis
- central venous thrombus
feed related
- vilious atrophy of GIT
- electrolyte imbalance
- vitamin deficiencies
