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CNSC > Nutrition Support in Specific States > Flashcards

Nutrition Support in Specific States Flashcards

1
Q

Which 5 main vitamins/minerals are important for fetal growth?

A

Iron, folate, calcium, vit B12, zinc

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2
Q

What is the RDA (recommend dietary allowance) for CHO during pregnancy?

A

175g/day

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3
Q

The Institute of Medicine recommends what g/kg of protein during pregnancy?

A

1.1g/kg

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4
Q

What is the target BG of a pregnant woman on PN?

A

140mg/dL

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5
Q

Which vitamin protects neutrophils, fibroblasts, and collagen, allowing wound healing to transition from the inflammation to the proliferative phase?

A

Vit C

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6
Q

Deficiency of this mineral can adversely affect B and T lymphocyte production, leading to delayed wound healing

A

Zinc

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7
Q

Deficiency of this mineral can adversely affect B and T lymphocyte production, leading to delayed wound healing

A

Zinc

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8
Q

Which two amino acids are conditionally essential during wound healing?

A

Arginine and glutamine

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9
Q

Which amino acid improves pressure wound healing?

A

Arginine

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10
Q

How soon (hrs) after ICE addmission should EN be initiated in burn patients?

A

4 - 6 hrs

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11
Q

How many days should you wait to start supplemental PN if a patient is unable to meet 60% of their kcal and protein needs?

A

7 - 10 days

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12
Q

What are the kcal and protein requirements of a malnourished pt with stage 2 and 3 pressure wounds?

A

30-35kcal/kg, 1.2-1.5g/kg

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13
Q

In TBI, estimated energy requirements is 140% of which equation?

A

Harris Benedict

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14
Q

Supplementing with insulin-like growth factor 1 (IGF-1) and which trace mineral has been shown to improve outcomes in TBI?

A

Zinc

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15
Q

What is the primary treatment of syndrome of inappropriate antidiuresis (SIAD)?

A

Fluid restriction

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16
Q

TBI is a common cause of SIAD, which results in which type of hyponatremia?

A

Eurvolemic

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17
Q

What is the protein requirement range for TBI pts?

A

1.3-2.5g/kg

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18
Q

In TBI, estimated energy needs is 140% of which energy equation?

A

Harris Benedict

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19
Q

What is the protein requirement range immediately following a stroke?

A

1-1.5g/kg

20
Q

When is PEG tube placement recommended in pts with ALS?

A

When the pt has dysphagia; BMI <20; weight loss of 5-10% of UBW.

21
Q

What are the kcal and protein requirements for pts with ALS?

A

35kcal/kg, 0.8-1.2g/kg

22
Q

What are the four metabolites used for gluconeogenesis?

A

Lactate, pyruvate, alanine, and glycerol

23
Q

In sepsis, energy needs increases by what percentage range?

A

20-80%

24
Q

What is the general guideline for EN and PN lipid delivery amount?

A

1g/kg/day

25
Q

What length of fatty acids do not require carnitine for transport into the mitochondria?

A

Medium chain fatty acids

26
Q

What is the protein requirement range during sepsis?

A

1.5-2g/kg (possibly up to 2.5 in some cases)

27
Q

ASPEN guidelines recommend use of an arginine/fish oil formula in surgical ICU pts, but not in pts with ___________.

A

Sepsis

28
Q

Which two nutrition assessment scoring systems does ASPEN recommend in critical illness?

A

The Nutrition Risk Screening (NRS-2002) and the Nutrition Risk in Critically ill (NUTRIC)

29
Q

What type of EN formula is recommended by ASPEN in post-op and trauma ICU pts?

A

Immunonutrition formulas with supplemental Omega-3s and arginine

30
Q

The clinical manifestations of copper deficiency can be similar to what other micronutrient deficiency?

A

Vit B12

31
Q

Which low electrolyte in the blood is the hallmark for refeeding syndrome.

A

Hypophosphatemia

32
Q

What is the protein requirement range for crohn’s disease?

A

1-1.5

33
Q

Pts with frequent use of these types of meds are recommended to take 1500mg/day supplemental calcium and 800-1000IU of vit D/day.

A

Corticosteroids

34
Q

What type of EN formula is best for cystic fibrosis?

A

A concentrated formula, either 1.5kcal/ml or 2kcal/ml

35
Q

In chronic cholestatic diseases, supplementation of which vitamins may be necessary?

A

Fat soluble -ADEK

36
Q

What are the protein requirements for cirrhosis?

A

1-1.5 g/kg

37
Q

What are the kcal requirements for cirrhosis?

A

1.2-1.4 x REE

38
Q

What supplements should be given in alcoholic liver disease?

A

B1, B6, B12, folate, and zinc

39
Q

What anatomical variant of short bowel syndrome is the most difficult to manage in the most likely to require permanent TPN?

A

The end jejunostomy variant

40
Q

What part of the small bowel Is the primary site of carbohydrate protein and water soluble vitamin absorption?

A

The proximal 100cm of the jejunum

41
Q

What part of the small bowel is the primary site of carrier mediated absorption of vitamin B12 and enterohepatic recirculation of bile?

A

The terminal ileum

42
Q

To qualify for a diagnosis of short vowel syndrome, the patient must have how many feet or less of residual small bowel?

A

5 ft or less

43
Q

What is the normal PCO2 range?

A

35-45 mmHg

44
Q

What is the normal serum bicarbonate range?

A

22-26 mEq/L

45
Q

What is a acetate converted to in the liver?

A

Bicarbonate

46
Q

What are the protein needs in the acute organ post-transplant phase?

A

1.5-2g/kg

CNSC (4 decks)

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