Nutritional issues in hospital

Question 1

How much to feed person when sick vs healthy

Answer 1

25-35 KCal/kg/day

The sicker the person, the greater the E requirement

The bigger the person, the greater the E requirement.

Question 2

What is the best route to feed nlly?

Answer 2

If working - Enteral:

• feed the GI tract and the body (nutrients)
• may improve gut barrier

Question 3

Overfeeding can cause _____ which occurs ____ days after increase in nutrient administration. It may take ___ days to resolve.

Answer 3

hyperglycemia
1-2 days
1-2 days to resolve too

• Nitrogen balance

Question 4

What is the usual protein requirement?
What may it be increased to?
What may cause it to increase?
How can you measure it?

Answer 4

Usual: 0.5-0.8g/d

Increased to: 0.8-1.8 g/d

Burns and post op

As long as BUN is stable, most of UUN (urinary urea N) represents the oxidation of protein

Question 5

Special nutrient: Arginine fxn

Answer 5

1. Not very stable in enteral formulations
   - conditionally essential
2. Precursor for NO
3. Direct immunomodulatory effect measured by response to mitogens
4. Supplementation Improves N balance
5. Stim GH and insulin sec.

Question 6

Special Nutrient: Glutamine

Answer 6

1. Preferred nutrient for gut epithelium
2. conditionally essential
3. Supplementation increases immune fxn, gut histo and barrier fxn
4. Important glugoneogenic precursor

Question 7

What diet may be most beneficial in respiratory failure

Answer 7

Higher Fat and

less calories

Question 8

Which diet may be beneficial in pts with liver disease?

Answer 8

Diet low in aromatic AA

Lower in branched chain AA

Question 9

Which diet may be beneficial in pts with renal failure.

Answer 9

Get rish of Na+ H2O

Question 10

Burns and trauma E requirement

Answer 10

Increased E requirement as may be 30-35 kcal/kg/day

My have quick discssion about eh

Question 11

Complications of refeeding

Answer 11

1. hypophosphatemia
2. hypohkalemia
3. diarrhea
4. Wenickes

tx: slow, monitor electrolytes