Other Flashcards
What 3 elements are well absorbed in the duodenum?
Ca++, Mg++, and Fe++
The stomach is important in digestion for producing what?
Intrinsic Factor
What is less likely to cause maldigest ion issues when fully resected?? Ileum or jejeunum
jejunum
What nutrients are absorbed well in the ileum?
B12 and bile acids
What is less likely to cause maldigestion issues when fully resected?? Ileum or jejunum
jejunum
What are good prognostic factors for the severity of SBS?
<80% small bowel affected
site of resection: jejunum
No other GI involvement
time onset >1 year
colon present and nondiseased
ileocecal valve present
What criteria are used in the STAMP screening tool for pediatric?
Clinical information, nutritional intake, weight and height
What criteria are used in the STRONGkids screening tool for pediatrics
clinical information, nutritional intake, weight, height, change in weight
What criteria are used in the PYMS screening Tool for pediatrics?
Clinical information, BMI, change in weight, nutritional intake
Low birth weight infants weigh
a. <3000 g
b. <2500 g
c. <1500 g
d. <1000 g
b. <2500 g
Extremely low birth weight infants weigh:
a. <2500 g
b. <1500 g
c. <1000 g
d. <750 g
c. <1000 g
BMI <5th percentile in pediatrics is considered
a. normal wt
b. underweight
c. obese
d. overweight
b. underweight
What is the max dose of enzyme therapy in CF pediatric patients?
2500 units lipase/kg/meal or 10,000 u lipase/kg/day
How much salt should be supplemented in infants with CF?
1/8 tsp/day for 0-6 mo, 1/4 tsp/day for > 6 mo
How much protein g/kg/day is generally recommended for children 0-12 mo.
1.5 g/kg/day
Premature infant formulas contain how many kcal/oz generally?
a. 30 kcal/oz
b. 26 kcal/oz
c.24 kcal/oz
d. 22 kcal/oz
c. 24 kcal/oz
standard infant formulas contain how many kcal/oz?
a. 22 kcal/oz
b. 20 kcal/oz
c. 18 kcal/oz
d. 24 kcal/oz
b. 20 kcal/oz
Pediatric PN <1 yr of age has increased levels of what 2 AA?
Tyrosine and Histadine
Pediatric PN <1 yr of age has decreased levles of what 3 AA?
phenylalanine, methionine, glycine
What is the average nitrogen content of protein?
16%.
Total grams of protein x 0.16
Normal PCO2
35-45
normal HCO3
22-26
anion gap calculation
na-(CL+HCO3). Normal 8-12
Normal Chloride
98-108 mEq/L
normal CO2
23-30 mEq/L
Normal Phos levels in adults
2.5-4.5 mg/dl
Normal magnesium levels in adults
1.7-2.4 mg/dl
Adult Na requirements
1-2 mEq/kg/day
adult phosphorus requirements
20-40 mmol/day
adult magnesium requirements
8-20 mEq/day
water deficit calculation
TBW [(serum Na-140)/140]
1 mmol Potassium phosphate has how much potassium?
1.5 mEq K
1 mmol Sodium phosphate has how much Na?
1.33 mEq Na
phos replacement dose <1.5 mg/dl
0.32-0.64 mmol/kg
Amino acids in PN osmolality
1 g= 10 mOsm
Dextrose in PN osmolality
1 g = 5 mOsm
IV lipids PN osmolality
1 g= 0.71 mOsm
Corrected Ca equation
0.8 (4-measured albumin)+ Ca
How many mEq Sodium are in 15 mmol Na Phos?
19.95 mEq Na 1mmol Na Phos= 1.33 mEq Na
How many grams of nitrogen are in 80 grams of protein?
12.8 g nitrogen. (80x0.16)
How many mEq K are in 10 mmol KPhos?
15 mEq 1 mmol KPhos=1.5 mEq K
The right of individuals to make their own decisions
Autonomy
Doing the right thing for the patient.
Beneficence
Doing no harm; balancing helping the patient through care as opposed to hurting them
nonmaleficence
Acting fairly; providing similar treatment to patients in similar situations
Justice
Acting fairly; providing similar treatment to patients in similar situations
Justice
Indirect calorimetry provides a measured of
Energy expenditure
During parenteral nutrition, the infusion of large amounts of dextrose increases electrolyte
requirements for
1. sodium and potassium.
2. sodium and phosphorus.
3. potassium and chloride.
4. potassium and phosphorus
potassium and phosphorus
Which of the following is a metabolic adaptation to simple starvation?
1. Decrease in urinary nitrogen losses
2. Increase in hepatic glucose production
3. Decrease in utilization of body fat stores
4. Increase in cerebral glucose utilization
Decrease in urinary nitrogen losses
The small bowel usually has an absorption capacity of approximately
1. 400 mL/day.
2. 1 L/day.
3. 2 L/day.
4. 9 12 L/day
- 9 12 L per day
Increased acetate supplementation in parenteral nutrition is most likely to be required in
1. respiratory failure.
2. intractable diarrhea.
3. prolonged vomiting.
4. furosemide treatment.
- intractable diarrhea
Saline responsive metabolic alkalosis
uCl <10 mEq/L, DAMPEN
Saline resistant metabolic alkalosis
uCl >10 mEq/L, ABELCH
How can PN be adjusted to treat metabolic alkalosis?
increase chloride to acetate salt ratio
Acetate is converted to what in the liver?
HCO3
Purple hue within 2 cm of PN catheter site would indicate?
Exit site infection
Erythema, tenderness, purulence > 2 cm of site would indicate what type of catheter related infection?
Tunnel infection
Erythema over site of port, purulent drainage, cellulitis, necrosis would indicate what type of catheter related infection?
Pocket infection
Do not allow alcohol to dwell in what catheter material?
Polyurethane
ETOH would be effective for what type of catheter precipitate?
Lipid precipitate
Why should a dietitian be cautious with using elemental formulas in patients with post pyloric tubes?
Very high osmolality
Error caused by rejecting a null hypothesis when it is true.
Type 1 error
Error that occurs when the null hypothesis is accepted when it is not true (false negative)
Type II error
Infuse what agent for calcium phosphate precipitate in PN catheter?
0.1 N HCl
Mag dosage for serum Mg 1-1.5 mg/dL
8-32 mEq up to 1 mEq/kg
Mg dosage for serum Mg <1 mg/dL
32-64 mEq up to 1.5 mEq/kg
Infusion rate for Mg
<= 8 mEq per hour
Phos replacement for serum P 2.3-2.7 mg/dL
0.08-0.16 mmol/kg
Phosphorus infusion rate
<= 7 mmol phos per hour
Mild malnutrition in pediatrics
Z score -1 to -1.99
Severe malnutrition in pediatrics
Z score -3 or more
Moderate malnutrition in pediatrics
Z score -2 to -2.99
Neonate MVI dose for <1 kg
1.5 ml/day
Neonate MV dose for 1-3 kg
3.25 ml/day pediatric
MVI dosage for 3 kg to 11 years
5 ml/day
MV dose for >11 years old
10 ml/day adult MV
Preterm infant protein goal
3-4 g/kg/day
Kcal goal for preterm infant on PN
85-111 kcal/kg
Fluid re absorbed in the colon
About 1.4 L Max of 5 L
Salivary juice production
About 1.5 L
Ideal EN osmolality
300 mOsm