Nutrition Support in Specific States Flashcards
Which 5 main vitamins/minerals are important for fetal growth?
Iron, folate, calcium, vit B12, zinc
What is the RDA (recommend dietary allowance) for CHO during pregnancy?
175g/day
The Institute of Medicine recommends what g/kg of protein during pregnancy?
1.1g/kg
What is the target BG of a pregnant woman on PN?
140mg/dL
Which vitamin protects neutrophils, fibroblasts, and collagen, allowing wound healing to transition from the inflammation to the proliferative phase?
Vit C
Deficiency of this mineral can adversely affect B and T lymphocyte production, leading to delayed wound healing
Zinc
Deficiency of this mineral can adversely affect B and T lymphocyte production, leading to delayed wound healing
Zinc
Which two amino acids are conditionally essential during wound healing?
Arginine and glutamine
Which amino acid improves pressure wound healing?
Arginine
How soon (hrs) after ICE addmission should EN be initiated in burn patients?
4 - 6 hrs
How many days should you wait to start supplemental PN if a patient is unable to meet 60% of their kcal and protein needs?
7 - 10 days
What are the kcal and protein requirements of a malnourished pt with stage 2 and 3 pressure wounds?
30-35kcal/kg, 1.2-1.5g/kg
In TBI, estimated energy requirements is 140% of which equation?
Harris Benedict
Supplementing with insulin-like growth factor 1 (IGF-1) and which trace mineral has been shown to improve outcomes in TBI?
Zinc
What is the primary treatment of syndrome of inappropriate antidiuresis (SIAD)?
Fluid restriction
TBI is a common cause of SIAD, which results in which type of hyponatremia?
Eurvolemic
What is the protein requirement range for TBI pts?
1.3-2.5g/kg
In TBI, estimated energy needs is 140% of which energy equation?
Harris Benedict
What is the protein requirement range immediately following a stroke?
1-1.5g/kg
When is PEG tube placement recommended in pts with ALS?
When the pt has dysphagia; BMI <20; weight loss of 5-10% of UBW.
What are the kcal and protein requirements for pts with ALS?
35kcal/kg, 0.8-1.2g/kg
What are the four metabolites used for gluconeogenesis?
Lactate, pyruvate, alanine, and glycerol
In sepsis, energy needs increases by what percentage range?
20-80%
What is the general guideline for EN and PN lipid delivery amount?
1g/kg/day
What length of fatty acids do not require carnitine for transport into the mitochondria?
Medium chain fatty acids
What is the protein requirement range during sepsis?
1.5-2g/kg (possibly up to 2.5 in some cases)
ASPEN guidelines recommend use of an arginine/fish oil formula in surgical ICU pts, but not in pts with ___________.
Sepsis
Which two nutrition assessment scoring systems does ASPEN recommend in critical illness?
The Nutrition Risk Screening (NRS-2002) and the Nutrition Risk in Critically ill (NUTRIC)
What type of EN formula is recommended by ASPEN in post-op and trauma ICU pts?
Immunonutrition formulas with supplemental Omega-3s and arginine
The clinical manifestations of copper deficiency can be similar to what other micronutrient deficiency?
Vit B12
Which low electrolyte in the blood is the hallmark for refeeding syndrome.
Hypophosphatemia
What is the protein requirement range for crohn’s disease?
1-1.5
Pts with frequent use of these types of meds are recommended to take 1500mg/day supplemental calcium and 800-1000IU of vit D/day.
Corticosteroids
What type of EN formula is best for cystic fibrosis?
A concentrated formula, either 1.5kcal/ml or 2kcal/ml
In chronic cholestatic diseases, supplementation of which vitamins may be necessary?
Fat soluble -ADEK
What are the protein requirements for cirrhosis?
1-1.5 g/kg
What are the kcal requirements for cirrhosis?
1.2-1.4 x REE
What supplements should be given in alcoholic liver disease?
B1, B6, B12, folate, and zinc
What anatomical variant of short bowel syndrome is the most difficult to manage in the most likely to require permanent TPN?
The end jejunostomy variant
What part of the small bowel Is the primary site of carbohydrate protein and water soluble vitamin absorption?
The proximal 100cm of the jejunum
What part of the small bowel is the primary site of carrier mediated absorption of vitamin B12 and enterohepatic recirculation of bile?
The terminal ileum
To qualify for a diagnosis of short vowel syndrome, the patient must have how many feet or less of residual small bowel?
5 ft or less
What is the normal PCO2 range?
35-45 mmHg
What is the normal serum bicarbonate range?
22-26 mEq/L
What is a acetate converted to in the liver?
Bicarbonate
What are the protein needs in the acute organ post-transplant phase?
1.5-2g/kg
