Nutritional Issues in the Hospital Flashcards
When does nutritional depletion occur
Normal, not sick 10-14 days
pretty sick or nutritionally depleted and not sick 5-7 days.
Nutritionally depleted and sick 3-5 days
Sick-o-meter: 25-35 kcal/kg/day, the sicker the person, the greater the energy requirement. The bigger the person the greater the energy requirement.
more food for sick people
25- kinda normal
35- really sick
more food for big people
What labs can we do to see malnutririon
low albumin–> body is making less protein
*but Hx and PE are better than labs
How much should we feed people
energy intake= energy out
Harris Benedict equation can give you a calorie amount
Indirect Calorimetry will tell out output
Entral feeding
Body prefers this
food into the GI tract. If it is working, feed people this way
Not without risk: aspiration pneumonia, problems placing tube.
liquid food (protein, carbs, vits, water)
Parenteral Feeding
IV feeding through a central line
Infection worries
Enteral nutrition may improve __________.
Even a small amount of nutrient to the gut may be helpful.
gut barrier function
Very little ______ in standard “house formulas”.
Omega 3 fatty acids
Respiratory Failure diet
Higher fat and less calories may be beneficial
Liver Disease diet
Diets lower in aromatic AA and higher in branched chain AA may be helpful
Renal Failure diet
Volume (Na and water) overload is a problem
Burns and Trauma diet
Increased energy requirement may be as high as 30-35 kcal/kg/day
May have an increased protein requirement 1-1.5 g/kg/day
Cardiac Diets
Hospital may be a time for the patient to learn about nutrition and their health.
Consider a nutrition consult
Fat soluble vitmaines
ADEK
C deficiency
is scurvy: petechii, hemorrhage
