Nutrition Support

Question 1

events that are bypassed during IV feeding

Answer 1

• stimulation of mucosal cells by luminal nutrients
• stimulation of GI hormone response
• direct transport of nutrients to the liver (first pass)
• packaging of lipids in chlyomicrons

Question 2

definition of enteral feeding

Answer 2

• delivery of nutrients to the GI tract through a feeding tube into the stomach or the small intestine

Question 3

definition of parental feeding

Answer 3

• delivery of nutrients into the vascular system

- requires nutrients miscible with blood and components that are not immunogenic

Question 4

indicator of muscle mass

Answer 4

• urinary creatinine

Question 5

effect of fever on metabolic rate

Answer 5

• metabolic rate increases by approximately 10% for every degree above 37C

Question 6

pathophysiology of refeeding syndrome

Answer 6

• triggered by aggressive oral, enteral, or parental carb feeding following a period of nutritional deprivation
• sudden influx of glucose into cells adapted to low glucose metabolism
• jump in glucose metabolism strains intracellular and extracellular reserves of phosphorus, magnesium, and potassium
• the shift from extracellular to intracellular can abruptly lower blood concentrations of these minerals
• severe mineral and fluid imbalances that occur with refeeding can lead to cardiac arrest, neuromuscular complications, and respiratory dysfunction

Question 7

short bowel syndrome

Answer 7

• initially there is malabsorption due to a decrease in the absorptive surface and due to decreased transit time
• parental nutrition support is necessary until the intestines are able to adapt and absorb the adequate amounts of nutrients and fluids

Question 8

complications of long-term TPN

Answer 8

• catheter related infection
• liver disease
• metabolic bone disease
• micronutrient deficiencies

Question 9

complications of enteral feeding

Answer 9

• reflux of stomach contents into the lungs