Nutrition for Wound Repair

Question 1

Key indicators of nutritional compromise

Answer 1

involuntary weight lost of 10% in last 6 months or >5% in 30 days
Protein depletion: albumin/tranferrin/prealbumin
Clinical S: SQ loss, muscle wasting, edema, dry pluckable hair, itchy dry skin, cracked mucous membranes, delayed wound healing

Question 2

Calculate patient’s current weight as percentage of actual weight and interpret the significance

Answer 2

current weight
—————— x 100 = % usual weight
usual weight

<18.5 - underweight
25-29.9 - overweight

Question 3

Calculate a patient’s caloric needs, protein needs, and fluid needs given the pt’s current weight

Answer 3

2.2 lbs = 1 Kg
CALORIES: pt weight x 30 or 35
PROTEIN: pt weight x 1.2-1.5gm/day
FLUID: pt weight x 30cc/day

Question 4

Identify common causes of diarrhea in tube-fed patients and implications for prevention and management

Answer 4

not usually caused by tube feeds
r/t impaction, sorbitol, C-diff, reduced absorption (villi atrophy > 7days, low albumin decreases absorption r/t bowel edema)
Treatment:
a.  kaopectate or peptoBismol
b.  Lomotil/Imodium (antiperistaltic)
c.  Fiber-based formula
d.  Probiotics (for pts on Abx)