Nutrition support Flashcards
prevalece on malnutrition
30-50%
what are basic nutritional requirements
- carb fat protein
- vitmains and minerals
40 essential nutrients
3 levels of nutrient deficiency
- mild self selection (food avoidances)
- nutrient deficiency (malnutrition)
- dehydration/starvation
4 consquences of malnutrition
- wieght loss
- dehydration
- vit/mineral def
- decrease immune response/wound healing
what are ABCD of assessment
- anthropomorphics - BMI, speed of loss
- Biochem tests
- clinical Hx/exam
- Diet history - 24 recall, typical day
2 evaluations of body weight
- % ideal BW
2. % usual BW
6 areas to examine on physical exam
- skin
- nails
- hair
- eyes
- teeth
- tongue
what is goal of oral intake
> 75% of estimated requirements and minimum CFG requirements
key to biochem tests
look for trends over time
what is best way to determine energy requirments
cal/kg
avg requirement
30 cal/kg
2 overall types of feeds
- enteral
2. paraenteral
4 enteral feed sites
- oral
- NG
- gastric
- jejunum
5 things that need to be monitored in enteral nutrirtion
- weight trend
- physical assessment
- output (stool)
- lab data
- GI function changes
contraindications to enteral feeds
- mechanical obstruction
- major vomit.diarrhea
- severe short bowel
- paralytic illeau
- hig output fisutla
- severe GI bleed or malabsorption
- expected need ober 5-7 days
complications of paraenteral feeds
1/ infection
- thrombi
- pneumothorax
4 objectives of TPN
- maintain body mass
- maintain fluid and lytes
- monitor PT for tolerance/complication
- wean patient back to enteral
2 routes of TPN
- central - long term, meets requirements
2. peripheral - short term
7 compnoents of TPN
- AA
- dextrose
- lipids
- vits
- minerals
- trace elements
- water
what is refeeding syndrome assoc with
- hypophosphatemia
- hypoklemia
- hypomagnesemia
- fluid retention
- micronutrient def.
