Nutrition Flashcards
How long is a prolonged air leak?
Next step in management?
> 4 days
VATS and pleurodesis
How many calories are in carbs?
protein?
fat?
Carbs = 3.4kcal/g Protein = 4kcal/g Fat = 9kcal/g
What is the equation for nitrogen balance?
What is a positive and negative balance?
Nitrogen balance = (Protein/6.25) - (24hr urine N + 4g)
Positive balance = anabolic
Negative balance = catabolic
~1g of Nitrogen needed for every __ kcal?
150 kcal
What is an elemental diet?
What condition is it good for?
free amino acids / small chain peptides. Low in fat.
mal-absorptive conditions
What makes up the following?
Maltose
Sucrose
Lactose
Maltose = 2 glucose molecules
Sucrose = glucose + fructose
Lactose = glucose + galactose
What is fuel for the following?
Colonocytes
Enterocytes
Disaccharides and trisaccharides cannot be broken down by what?
Short-chain fatty acids
Glutamine
Amylase
What can become conditionally essential amino acids during stress?
Glutamine and Arginine
What can help wound healing in patients with chronic steroid use?
Vitamin A supplementation
Malabsorption of Vit D leads to?
Osteomalacia. Not osteoporosis.
What does Vit E deficiency lead to?
peripherial neuropathy, spinocerebellar ataxia, thrombocytosis, and hemolytic anemia
Zinc deficiency leads to?
poor healing, wasting, and rash
Niacin deficiency leads to?
pellagra with Diarrhea, Dementia, Dermatitis
Chromium deficiency leads to?
hyperglycemia, confusion and peripheral neuropathy
Copper deficiency leads to?
PANcytopenia, neuropathy with ataxia
Selenium deficiency leads to?
cardiomyopathy, hypothyroidism, and neuro changes
What are BCAA’s?
Where are they metabolized?
LIV - Leucine, isoleucine, valine
Metabolized in muscle
Are also essential amino acids
Non-essential amino acids start with …? And also include?
C, A, or G + serine, tyrosine, and proline
High nutrient levels of ___ trigger ___
Arginine - enhances immune function
Leucine - muscle protein synthesis
Glutamine - citric acid cycle
Tyrosine - used in signal transduction
Pulmonary formulas have low __ ? Why can this be problematic?
Hepatic formulas have low __ ?
Diabetic diet starts with what kind of diet? What if glycemic control is needed?
carbs - can be a disadvantage when weaning from vents tho, depleted glycogen
Aromatic amino acids and high BCAA’s - catabolism has increased BCAA utilization
Regular diet then if glycemic control is needed a diabetic formula is used.
Hypotensive ICU patients on pressors are at risk for what with early enteral feedings?
If severe malnutrition in this setting then use what kind of nutrition?
Intestinal ischemia
Parenteral nutrition
What is the only essential fatty acid?
What symptoms do you see in deficiency?
LinolEIC
A cis-polyUNsaturated 18 carbon fatty acid.
Scaly dermatitis, heart dysfunction, and increased risk of infections.
What’s the most accurate method for calculating energy needs in a patient?
Indirect calorimetry is the gold standard.
O2 & CO2 inhaled and exhaled is measured
Not reliable when inhaled O2 is above 60%
What’s a simple but effective formula for calculating calorie requirements for a patient?
What about in an obese patient?
REE in kcal/day = 25 * kg.
If obese then use adjusted weight which =
ideal weight + 25% of excess weight
