Nutritional Elements and Requirements Flashcards
What are the macronutrients
water, amino acids, fats, carbohydrates
Which of the macronutrients fulfill protein requirements
amino acids
Which of the macronutrients fullfill energy requirements
amino acids, fats, carbohydrates
What are the micronutrients
vitamins, electrolytes, trace elements
What are individuals factors that must be considered
gender, age, height/weight, activity and injury factors, under or overnutrition, critically ill
What are the volume status for water requirements
dehydration-45ml/kg/day, post operative-40ml/kg/day, euvolemic-35ml/kg/day, elderly or CHF-30ml/kg/day
How much energy does amino acids contribute
4 kcal/gram
How much energy does a 10%, 20% fat emulsifer contribute
1.1 kcal/ml, 2 kcal/ml
How much energy does carbohydrates contribute
3.4 kcal/gram
Put the macronutrients in order from highest energy contributer to lowest
amino acids, carbohdrates (grams)/ 20%, 10% (ml)
What is the gold standard for estimating energy needs available
Indirect calorimetry
What are the calorie needs of healthy, normal people (not in the hospital)
20-25 kcal/kg/day
What are the calorie needs of patients who are ill, metabolic stress, not obese (BMI < 30)
25-30 kcal/kg/day
What are the calorie needs of patients who are ill, metabolic stress, obese (BMI >/= 30)
11 to 14 kcal/kg/day
What are the calorie needs of patients with major burn injury
greater than 30 kcal/kg/day
What is the order for patients who have calorie needs from lowest to highest
obese/ill patients, healthy/non-ill patients, low to overweight BMI/ill, major burn victims
T/F: When calculating energy requirements ideal body weight should be used in non obese patients
False: Weight used for calculation should be actual body in non obese patients
During periods of inadequate protein or energy what is broken down first for amino acids, how much
skeletal muscle, up to 75 grams
When a patient has normal renal and hepatic function what is the protein requirement for a mild protein depletion ( serum albumin greater than 3.0 g/dl)
1.1-1.3 g/kg/day
When a patient has normal renal and hepatic function what is the protein requirement for a moderate protein depletion ( serum albumin 2.5-2.9 g/dl)
1.3-1.5 g/kg/day
When a patient has normal renal and hepatic function what is the protein requirement for a severe protein depletion (serum albumin less than 2.5 g/dl)
1.5-2 g/kg/day
T/F: When finding the protein requirement for a patient with normal renal and hepatic function the actual body should be used unless obese. If obese the ideal body weight should be used
True
For amino acid solutions what is the max that can be in a central line, peripheral line
10%, 2.5%-3%
What are the two essential fatty acids
linoleic and linolenic
What is the minimum amount of fat that should be given, maximum, starting point
5%, 60% 30%
For the intralipid fat emulsion how much fat does 10% contribute, 20%, 30%
1.1 kcal/ml, 2kcal/ml, 3kcal/ml
For the SMOflipid 20% fat emulsion how much fat is contributed
2 kcal/ml
How long should fat emulsion run for
12-24 hours
What are the contraindications for the fat infusions
elevated triglycerides (over 300 mg/dl), egg allergy, pancreatitis due to hypertriglyceridemia
What is the parenteral source for carbohydrates
Dextrose
What is the maximum concentration for dextrose infusion central, peripheral
35%, 10% to 12.5%
What is the maxium infusion rate for adults
3-5 mg/kg/min
What factors affects how much micronutrients are given
hepatic function, renal function, fluid status, cardiac status, prior nutritional status
What are the fat soluble vitamins
A,D,E,K
What patients get extra vitamins
Alcoholics, wound healing
What are the trace element products, what is the difference
MTE-4 and MTE-5, MTE-5 has Selenium
Which trace elements are eliminated biliary
coppper, manganese
How is selenium excreted
kidneys
When there is a disease that affects trace element elimination how is the dose adjusted
1 ml is still given but instead every other day
What is the standard product for vitamins
MVI 12
