Other Flashcards by Sydney Lobdell

What 3 elements are well absorbed in the duodenum?

Ca++, Mg++, and Fe++

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The stomach is important in digestion for producing what?

Intrinsic Factor

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What is less likely to cause maldigest ion issues when fully resected?? Ileum or jejeunum

jejunum

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What nutrients are absorbed well in the ileum?

B12 and bile acids

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What is less likely to cause maldigestion issues when fully resected?? Ileum or jejunum

jejunum

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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

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What criteria are used in the STAMP screening tool for pediatric?

Clinical information, nutritional intake, weight and height

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What criteria are used in the STRONGkids screening tool for pediatrics

clinical information, nutritional intake, weight, height, change in weight

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What criteria are used in the PYMS screening Tool for pediatrics?

Clinical information, BMI, change in weight, nutritional intake

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Low birth weight infants weigh
a. <3000 g
b. <2500 g
c. <1500 g
d. <1000 g

b. <2500 g

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Extremely low birth weight infants weigh:
a. <2500 g
b. <1500 g
c. <1000 g
d. <750 g

c. <1000 g

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BMI <5th percentile in pediatrics is considered
a. normal wt
b. underweight
c. obese
d. overweight

b. underweight

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What is the max dose of enzyme therapy in CF pediatric patients?

2500 units lipase/kg/meal or 10,000 u lipase/kg/day

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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

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How much protein g/kg/day is generally recommended for children 0-12 mo.

1.5 g/kg/day

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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

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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

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Pediatric PN <1 yr of age has increased levels of what 2 AA?

Tyrosine and Histadine

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Pediatric PN <1 yr of age has decreased levles of what 3 AA?

phenylalanine, methionine, glycine

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What is the average nitrogen content of protein?

16%.
Total grams of protein x 0.16

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Normal PCO2

35-45

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normal HCO3

22-26

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anion gap calculation

na-(CL+HCO3). Normal 8-12

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Normal Chloride

98-108 mEq/L

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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

4. 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.

2. 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