Nutrition in Hospitalized Flashcards
When to feed?
Normal not sick
10-14 days
When to feed?
Normal pretty sick
Nutritionally depleted and not sick
5-7 days
When to feed?
Nutritionally depleted and sick
3-5 days
How much to feed?
Sick-o-meter?
25-35 kcal/kg/day, the sicker the person the greater the energy the requirement - the bigger the person the greater the energy requirement
What route to feed?
Enteral if possible - feed the GI tract and the body
If you are getting 1.2L/day D5 how many calories is that?
5% = 5g/100ml x 12 = 60g x 4kcal = 240kcal glucose
Position in NG feeding?
Elevate head of bed
Right lateral decubitus - help stomach contents empty
Which aa is a precursor for NO
Arginine
If patient has respiratory failure, what kind of nutrition may be beneficial
Higher fat and less calories
If patient has liver disease, what kind of diet may be beneficial
lower in aromatic AA
higher in branched AA
Renal failure concern in feeding?
Volume overload (Na and water)
Burn patients
Increased energy rq. may be as high as 30-35 kcal/kg/day
May have increased protein rq. 1-1.5 g/kg/day
Refeeding
complications
hypophosphatemia
hypokalemia
diarrhea
Wernicke’s encephalopathe (acute thiamine deficiency)
Refeeding
approach
begin with thiamin, folate, and multivitamin solution intravenously
Cardiac diets
Consider nutritional consult in cardiac patients - good timing :)
