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Clinical 2 EXAM > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

what is the primary function of the respiratory system?

A

gas exchange

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2
Q

what to the lungs enable the body to do?

A

obtain adequate oxygen to meet cellular metabolic demands
and
remove carbon dioxide produced

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3
Q

healthy _ _ & _ are necessary to supply oxygen and nutrients to all tissues

A

nerves, blood and lymph

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4
Q

what do the lungs do to already inspired air?

A

warm, filter and humidify

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5
Q

what is the respiratory centre?

what it involves, where its located & what it does

A

involves: structures that generate rhythmic respiratory movements and reflexes

Located: medulla and pons

Does: electrical impulses are generated here and are carried by phrenic nerves to the diaphragm and other respiratory muscles

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6
Q

airways have 12 types of _

A

epithelial cells

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7
Q

most epithelial cells that line the trachea, bronchi and bronchioles have _

A

cilia

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8
Q

the epithelial surface of alveoli contain _

A

macrophages

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9
Q

what do macrophages do?

A

through phagocytosis, the macrophages engluf inert materials and microorganisms and digest them

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10
Q

what is surfactant?

A
  • secreted from alveolar cells
    it maintains the stability of pulmonary tissue by decreasing surface tension of fluids that coat the lung
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11
Q

what are the metabolic functions of the lungs?

A

1. help regulate acid base balance
- body pH is partially maintained by proper balance of CO2 and O2
2. synthesize arachidonic acid (AA)
- that may be converted to prostaglandins or leukotrienes
- these play a role in bronchoconstriction seen in asthma
3. converts angtiotensin 1 to angiotensin 2
- done by angiotensin-converting enzyme (ACE), found mainly in the capillary beds of the lungs
4. can function as a chemical filter
5. protect systemic circulation
- from exposure to high levels of circulating vasoactive substances

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12
Q

malnutrition and the pulmonary system

malnutrition adversely affects

A
  1. lung structure, elasticity and function
  2. respiratory muscle mass, strength and endurance
  3. the lungs immune defense mechanisms
  4. control of breathing
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13
Q

what is the effects of a pulmonary diagnosis on nutrition status?

A
  1. substantially increase energy requirements
  2. malnutrition-related impaired immunity increases risk for developing respiratory infections
  3. hospitalized pts
    - lengthy stays
    - susceptible to increased morbidity and mortality
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14
Q

Complications of pulmonary dx and their tx can negatively impact:
_
_

A
  • Food intake
  • digestion

Absorption & metabolism of most nutrients are affected

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15
Q

what symptoms are often present in pts with pulmonary diagnosis?

A
  1. Abnormal production of mucus
  2. Vomiting
  3. Tachypnea (rapid and shallow breathing)
  4. Hemoptysis (spitting up blood)
  5. Thoracic pain
  6. Nasal polyps
  7. Anemia
  8. Depression
  9. Altered taste (medication-related)
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16
Q

pulmonary diagnosis often persists in increased energy expenditure related to:

A
  1. increased work of breating
  2. chronic infection
  3. medical treatments
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17
Q

pulmonary diagnosis often causes reduced intake related to:

A
  1. fluid restriction
  2. shortness of breath
  3. decreased oxygen saturation while eatings
  4. anorexia of chronic disease
  5. GI distress and vomiting
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18
Q

in regard to pulmonary diagnosis there can also be additional limitations related to:

A
  1. fatigue-related difficulty with meal prep
  2. lack of financial resources
  3. impaired feeding skills (for infants and kids)
  4. altered metabolism
  5. food drug interaction
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19
Q

Primary vs secondary pulmonary disorders

A

primary:
- TB, asthma, lung cancer

Secondary
- associated with CVD, obesity, HIV, sickle cell or scoliosis

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20
Q

acute vs chronic pulmonary disorder

A

acute:
- airway obstruction, anaphylactic allergy, aspiration pneumonia

chronic:
- CF, COPD

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21
Q

describe how you would assess a pt for pulmonary dx

A
  1. obtain history with a focus on:
    - smoking, inhalation of toxins, and any other relevant exposure
  2. percussion and auscultation
  3. imaging procedures, arterial blood gases, sputum cultures and biopsies
  4. signs and symptoms to look for:
    - cough
    - dyspnea
    - fatigue
    - early satiety
    - sputum production
    - chest discomfort
    - weight loss
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22
Q

what are pulmonary function tests and what different types are there?

A

PFTs are used to diagnose or monitor the status of lung dx
- Designed to measure the respiratory system’s ability to exchange O2 and CO2

Pulse oximetry
- uses light waves to measure O2 saturation of arterial blood

Spirometry
- breathing into a spirometer that gives information on:
- - Lung volume & rate at which air can be inhaled & exhaled

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23
Q

what is CF?

A

Life-threatening autosomal recessive inherited disorder

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24
Q

what is CF caused by?

A

mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) protein

CFTR PROTEIN MUTATIONS

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25
Q

the CFRT defect causes impaired transport of _, _, and _.
this results in the production of thick, viscous secretions in:

this leads to increased salt content in _

A

Cl, Na, and HCO3

  • lungs
  • pancreas
  • liver
  • intestines
  • reproductive tract

sweat

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26
Q

what are the 2 predominant burdens of CF?

A

lung disease and malnutrition

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27
Q

“classical” presentation of the CF diagnosis is when an individual has an elevated _ _

A

sweat chloride (greater than 60 mmol/L)

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28
Q

CF pts present with persistent _, _ and _

A

chronic cough, dyspnea ( SOB) and wheezing

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29
Q

as CF diagnosis progresses, pts develop _

A

bronchiectasis

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30
Q

what might you see on physical exam during the diagnosis of CF?

A

clubbing

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31
Q

in a pt with CF what does lung auscultation reveal?

A

crackles in lungs and decreased breath sounds

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32
Q

what does the pulmonary function test show in CF pts?

A

airway obstruction

the spirogram shows decreased expiratory volume and decreased ratio

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33
Q

what is pancreatic insufficiency?

A
  • pancreas fails to make adequate enzymes to digest food in the small intestine
  • most common GI complication of CF
  • 90% or less pts have fat malabsorption by 1 yeat of age
    • steatorrhea: failure to thrive, poor weight gain
    • some present with deficiency in fat soluble vitamins

— frequentyl present with suboptimal vit D status
— also suffer from vit K deficiencies

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34
Q

what is pancreatitis?

A

Abnormal pancreatic secretions cause progressive damage to the pancreas, resulting in acute or recurrent pancreatitis

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35
Q

what is CF-related diabetes (CFRD)?

what is it associated with and when should screening begin?

A

Associated with poor growth, clinical & nutritional deterioration & early death

Annual CFRD screenings are recommended beginning at age 10 yrs

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36
Q

Bone disease in CF

what is it characterized by and what are the risk factors?

A

Characterized by ↑ fracture rates, low bone density & kyphosis (increased curvature of the upper back)

Risk factors include:
1. Chronic corticosteroid use
2. Multiple courses of antibiotics
3. Failure to thrive
4. Malabsorption of calcium, Vit. D, Vit. K, Mg
5. Inadequate overall intake
6. Reduced weight-bearing activities

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37
Q

what drug is used to treat CF?

A

ivacaftor

restores functioning of a mutant CF protein

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38
Q

medical management of Cf consists of:

A
  1. chest PT
  2. Nebulizer therapy
  3. anti-inflammatory agents
  4. pulmonary hygiene
  5. pneumococcal and influenze vaccines
  6. chronic prophylactic antibiotic use
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39
Q

pancreatic enzyme replacement therapy (PERT) helps…..

A

helps inhance CHO, protein and fat absorption among CF patients

  • it is the first step taken to correct maldigestion and malabsorption
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40
Q

why would we prescribe PPI’s to CF patients?

A

to ensure duodenal pH is high enough for the PERT capsule to degrade

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41
Q

the amount of PERT a CF patient recieves depends on….

A
  1. the degree of pancreatic insufficiency
  2. quantity of food eaten (&portion of macronutrients)
  3. type of enzyme used
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42
Q

The dosage of PERT per meal or snack is adjusted based on…

A

the pts GI symptoms and growth (in kids)
- if GI symptoms cannot be controlled, enzyme dose, pt adherence and enzyme type should be reevaluated

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43
Q

why is growth failure a common problem in CF pts?

A

Malabsorption

↑ energy needs

↓ appetite

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44
Q

women with a BMI less than _ and men with a BMI less than _ should be referred for a full nutrition assessment for CF

A

women: less than 22
men: less than 23

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45
Q

in children with CF what should you monitor yearly for?

A

PTH levels
25 hydroxy-vitamin D levels
Serum calcium
Serum phosphate
Bone Density (DXA) (for older children)

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46
Q

What are the 4 goals of MNT for CF pts?

A

Increasing muscle strength

Promoting optimal growth

Weight maintenance

Enhancing quality of life

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47
Q

what are the energy recommendations in newborns-2 , ages 2-20 and adult male/female

percentiles and BMI

A

Newborn-24 months: weight/length greater than or equal to 50th percentile (CDC charts)

Maintaining BMI 50th– 85th percentile for age between 2-20 years

Maintain BMI of 22-27 for adult females and BMI 23-27 for adult males

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48
Q

all CF pts should take 1500 - 2000 IU _ per day and up to 10000 IU/day for CF pts 18 or older

A

Vitamin D

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49
Q

how much vitamin K should be taken?

A

1000 mcg or more/day

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50
Q

what is asthma and what are the symptoms?

A

Chronic disorder that affects airways
- Characterized by bronchial hyper-reactivity, reversible airflow obstruction, airway remodling

Symptoms include:
- Periodic episodes of chest tightness
- Breathlessness
- Wheezing
* symptoms usually worsen at night

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51
Q

what is Extrinsic asthma?

A

chronic allergic inflammation of airways

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52
Q

what is intrinsic asthma?

A

triggered by nonallergic factors such as exercise, certain chemicals and extreme emotions

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53
Q

why might we not provide pts with chronic corticosteroid therapy?

A

can ↑ risk of osteopenia, bone fracture or steroid-induced hyperglycemia

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54
Q

what are the essential compoents of medical management for asthma?

A
  • routine monitoring of symptoms and lung function
  • Patient education
  • Control of environmental triggers
  • Pharmacotherapy
  • —Tailored to the individual
  • —Step-wise – dependent on attack classification
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55
Q

what is the RD’s purpose in treating asthma?

A

Addresses dietary triggers

Corrects energy & nutrient deficiencies/excess in the diet

Educates the pt on personalized diet

Monitors growth (in children)

Watches for food-drug interactions

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56
Q

_ and food allergies are 2 common dietary triggers of asthma

A

GERD

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57
Q

What should you be aware of if the pt is on maintenance oral steroids?

A

potential drug-nutrient interactions

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58
Q

what are the risk factors for COPD?

A

Smoking

Biomass fuel used for cooking and heating

occupational smoke or dust

Air pollution

Genetic factors

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59
Q

a decrease in food intake and malnutrition are associated with COPD, Why?

A

Respiratory muscle weakness

↑ disability

↑ susceptibility to infection

Hormonal alterations

60
Q

what is chronic bronchitis & what is emphysema

A

Chronic bronchitis – if primary, more likely to see hypoxia, hypercapnia, pulmonary HTN, & right heart failure

emphysema – if primary, suffer from greater dyspnea & cachexia (lungs less flexible and less able to act as filters)

The two may co-exist in varying degrees

61
Q

what are some of the causes of COPD exacerbations?

A

Allergies

smoking

Congestive heart failure (CHF)

Pulmonary embolism 9blood clot caught in artery in lungs)

pnemonia

Systemic infections (bacterial or viral)

62
Q

Osteoporosis in COPD pts predisposes them to:

A

Vertebral fractures

& alters the configuration of the chest wall

63
Q

Frequent COPD exacerbations ↑ the severity of …

& leads to…

A

chronic system inflammation

Leads to bone loss by inhibiting bone metabolism

64
Q

what does the prognosis of COPD depend on?

A

severity of disease,
genetic predisposition,
nutritional status,
environmental exposures,
acute exacerbations

65
Q

what is the main treatment for COPD?

A

inhaled bronchodilators

  • usually given by metered dose inhalers
  • in cases of devere dyspnea, may be administered in nebulized form
66
Q

what do hypoxemic pts require?

A

supplemental oxygen

67
Q

pts who progress to respiratory failure may require …

A

mechanical ventilation

68
Q

what are some of the common reasons for early readmission to hospital after acute exacerbation of COPD?

A

Depression
Smoking
Anxiety
GERD
Reduced functional status
Unwillingness to use oxygen
malnutrition

69
Q

because malnutrition risk is increased in COPD pts what is required?

A

Extra energy required for the work of breathing & to combat frequent/recurrent respiratory infections

70
Q

what is an independent predictor of mortality in COPD pts?

A

low body weight

71
Q

what are the PRIMARY targets for intervention of COPD

A

inadequate food intake and poor appetite

72
Q

what nutrients are commonly depleted in COPD pts?

A
  • Protein
  • Calcium
  • Magnesium
  • Potassium
  • Phosphorous
  • Contribute to respiratory muscle function impairment
73
Q

what are the 2 main goals in managing COPD related hypermetabolism and how are these accomplished?

A
  • Prevention of weight loss
  • Prevention of loss of lean body mass

Accomplished via:
1. Nutritionally dense small, frequent meals
2. Encouraging the pt to eat the main meal when energy levels are highest
3. Providing adequate calories, protein, minerals & vitamins to maintain a BMI of 20-24
4. Enhancing availability of foods requiring less preparation
5. Limitation of alcohol to <2 drinks/day
6. Rest period before meal times

74
Q

iron deficiency anemia is seen in 10-30% of COPD pts
Correcting the deficiency improves _

A

dyspnea

75
Q

what are the primary goals of MNT in COPD pts?

A

Facilitate nutritional well-being

Maintain appropriate ratio of lean body mass to adipose tissue

Correct fluid imbalance

Manage drug-nutrient interactions

Prevent osteoporosis

76
Q

in pts with COPD nutritional depletion may be evidenced by:

A

Low body weight for height

Decreased grip strength

77
Q

it is crucial to remember that energy balance and _ are intertwined

A

nitrogen balance

78
Q

what is the protein recommendation for COPD pts?

A

1.2-1.5 g/kg of dry body weight per day

79
Q
A
79
Q

those continuing to smoke with COPD will require additional …

A

vitamin C

80
Q

those with COPD who are retaining fluid may be required _ and _ restriction

A

sodium and fluid restriction

81
Q

how much fluid is recommended for COPD pts?
ages 18-60
& 60+

A

18-60 yrs = 35 ml/kg body weight daily
60 + yrs = 30 ml/kg body weight daily

82
Q

what are the possible reasons for reported difficulty eating in COPD pts?

A

Low appetite

Increased breathlessness when eating

Difficulty shopping & preparing meals

dry mouth

Early satiety & bloating

Anxiety and depression

Fatigue

83
Q

how is pulmonary cachexia defined and what are the main treatment?

A

defined as BMI less than 17 in men and less than 14 in women

Pharmacotherapy, respiratory rehab & nutrition counseling are the mainstays of pulmonary cachexia tx

84
Q

any sudden drop in _ is a mark of developing osteoporosis

A

height

84
Q
A
85
Q

most pts with active pulmonary TB infections present with:

A

Chronic cough

Prolonged fever

Night sweats

Anorexia

Weight loss

86
Q

TB pts are to be contained in respiratory isolation until the _ _ comes back negative

A

sputum smear

87
Q

for pts with TB nutritional supplementation is necessary until a BMI of _ is achieved

A

18.5

88
Q

what are the nutrition related symptoms of active TB?

A
  1. weight loss
  2. cachexia
  3. low serum concentration of leptin
89
Q

what is the recommended energy intake of pts with TB?

A

35 to 40 kcal/kg of ideal body weight
- if a more serious infection is present suchbas HIV, increase energy by 20-30% to maintain body weight

90
Q

what is the protein recommendation for pts with TB?

A

1.2-1.5 g/kg ideal body weight

91
Q

tumors affecting the lower respiratory tract are _

A

heterogenous

91
Q

bronchogenic carcinomas are comprised of:

A

Squamous cell carcinoma

Adenocarcinoma

Small cell undifferentiated carcinoma

Large cell undifferentiated carcinoma

91
Q

how is lung cancer typicalled detected in an asymptomatic smoker?

A

routine chest radiograph

92
Q

what symptoms might lung cancer present with?

A

symptoms:
Related to the tumor itself (e.g., obstruction)

Related to local extensions of the tumor or widespread metastases

Experienced systemically, such as anorexia, weight loss, weakness and paraneoplastic syndromes

93
Q

in pts with lung cancer, pain and fatigue are very common.
Pain may be _, _ or _

A

in the lungs, musculoskeletal or in the bones

94
Q

lung cancer management choices depend on:

A

Tumor cell type
Tumor stage
Resectability of the tumor
Suitability of the pt for surgery

95
Q

some lung cancer pts will recieve palliative treatment which can include:

A

Psychologic support,
Control of distressing symptoms
Palliative chemotherapy &/or
Palliative radiotherapy

96
Q

MNT for lung cancer

National Comprehensive Cancer Network (NCCN) guidelines encourage

A
  1. Treatment of reversible causes of anorexia such as early satiety
  2. Evaluation of the rate & severity of weight loss
  3. Treatment of symptoms interfering with food intake
    - Nausea and vomiting; dyspnea; mucositis, constipation; pain
  4. Assessing use of appetite stimulants
  5. Provision of nutritional support (EN or PN)
97
Q

what is cancer cachexia syndrome?

A

Presence of a metabolic state that leads to energy and muscle store depletion
- Pts lose adipose & skeletal muscle mass

Wt loss is irreversible & worsens regardless of nutritional intake

98
Q

nutrition repletion is difficult in advanced lung cancer because:

A

Dyspnea & fatigue interfere with food prep & consumption

Altered sputum changes the taste of food

Early satiety results from flattening of the diaphragm

Nausea and indigestion are side effects of medications

Lack of motivation to eat is common secondary to depression

99
Q

MNT for lung cancer

what are the accepted components of oral nutrition therapy in lung cancer pts?

A

Small, frequent meals high in calories and protein dense

Provision of adequate calories > REE

Rest before meals

Meals requiring minimal preparation

Oral nutrition supplements (homemade or prepared)

100
Q

in pts with lung cancer, prokinetics can be used to treat …

A

delayed gastric emptying

101
Q

ghrelin lowers _ use and stimulates _

A

fat use
stimulates feeding

102
Q

what is obesity hypoventilation syndrome?

A

Defined as
- BMI >30
- Arterial CO2 >45 mm Hg when awake

103
Q

obstructive sleep apnea is a common chronic disorder characterized by:

A

Loud snoring,
Excessive daytime sleepiness
Witnessed breathing interruptions &/or
Awakenings related to gasping or choking

104
Q

what is used to classify whether obstructive sleep apnea (OSA) is mild, moderate or severe?

A

number of episodes per hour or hyponea per hour

105
Q

what is the treatment for obesity hypoventilation syndrome?

A

continuous positive airway pressure (CPAP)

106
Q

what is pleural effusion and what can it present with?

A

Accumulation of fluid in the pleural space
- Can be asymptomatic
- Can present with:
— Shortness of breath
— Chest pain
— Symptoms related to the underlying cause (e.g., pneumonia, CHF)

Effusions can be unilateral or bilateral

107
Q

management of pleural effusion typically involves drainage of fluid either to:
.
.

A

Make a diagnosis, or
Relieve symptoms
In those with large effusions

108
Q

MNT for pleural effusion should be directed toward…

A

the underlying disorder causing the pleural effusion

109
Q

what is chylothorax and what is it caused by?

A

Rare cause of pleural effusion

Caused by disruption or obstruction of the thorracic duct, resulting in leakage of chyle into the pleural space

110
Q

Pleural fluid triglyceride concentration of >_ mmol/L strongly supports chylothorax diagnosis

A

1.24

111
Q

chylothorax may result from nontraumatic causes such as:
.
.
or result from surgical trauma
.
.

A

non traumatic causes:
- Sarcoidosis
- Benign idiopathic chylothorax

surgical trauma:
- Post-op chylothorax
- Postpneumonectomy chylothorax

112
Q

what are the goals of chylothorax treatment?

medical

A

Treat the underlying condition

Drain the pleura to relieve dyspnea

113
Q

chylothorax

If pleural drainage & treatment of underlying condition are not effective, may require …

A

thoracic duct ligation or pleurodesis

114
Q

what is the MNT goal for treated chylothorax

A

reduce the flow of chyle
- Particularly in those with high volume chylous draining (<1L/day)

implement high protein, low fat (less than 10 g/day) diet

decreasing fat intake will result in less fat to be absorbed in the GI, thus reducing chyle production

115
Q

what are the possible side effects of consumption of MCTs

A

GI upset
Steatorrhea
Hyperlipidemia

116
Q

as chylous drainage declines, _ intake can be increased gradually

A

fat

may take 7-10 days for chylous drainage to clear

117
Q

acute respiratory distress syndrome (ARDS)
is a clinical state in which pts develop….

A

Diffuse pulmonary infiltrates
Severe hypoxia
Respiratory failure

118
Q

In ARDS, alveoli get filled with bloody, proteinaceous fluid that interferes with _ _

A

gas exchange

119
Q

in Acute Respiratory Distress Syndrome (ARDS) pts present with:

A

Acute onset of shortness of breath

Tachypnea

Hypoxemia

120
Q

what does the medical treatment of ARDS involve?

A

Treatment of the underlying cause

Mechanical ventilatory support

ICU including sedation with or without paralytic drug

Maintenance of hemodynamic stability

Prevention of complications (e.g., aspiration pneumonia, hyperglycemia)

Nutrition support

Pharmacotherapy (e.g., corticosteroids, exogenous surfactant)

121
Q

in pts with ARDS, nutrition support is necessary for preventing:

A

Cumulative caloric deficits

Loss of lean body mass

Malnutrition

Deterioration of respiratory muscle strength

122
Q

overfeeding in ARDS pts can lead to:

A

Stress hyperglycemia

Delayed weaning from the ventilator

Delayed wound healing

123
Q

what is pneumonia?

list the various kinds and those who are more susceptible

A

An inflammatory condition of the lungs causing chest pain, fever, cough & dyspnea

Various kinds:
- Ventilator associated
- Hospital-acquired
- Aspiration acquired (viral or bacterial)
- Aspiration pneumonia

Individuals who are immune-compromised are more susceptible

124
Q

what are the 2 pre-conditions of aspiration pnemonia?

A
  1. Breach in normal defense mechanism
  2. Large enough inoculum enters the lungs
125
Q

what conditions predispose someone to aspiration pnemonia?

A

Impaired level of consciousness
Dysphagia

Gastric reflux, disorders of or surgery on the upper GI tract

Mechanical disruption of glottis closure (e.g., tracheostomy, placement of NG)

Protracted vomiting, EN feeding at less than 45-degree angle, persistent recumbent position

126
Q

what is the main treatment of pneumonia?

A

supporting of pulmonary function

127
Q

MNT for pneumonia

A

Direct tube feedings into the small bowel vs. stomach

Continious feeds preferred over bolus feeds

Elevate head of bed to 30-45 degrees

Use prokinetic agents (e.g. Motilium)

Minimize sedative use

Optimize oral hygiene

128
Q

what is bronchopulmonary dysplasia (BPD)?

A

Chronic neonatal lung disease seen in premature infants requiring mechanical ventilation and oxygen therapy for acute respiratory distress

BPD occurs in 40% of preterm neonates <28 weeks gestational age

Condition is characterized by impairment of alveolarization

Many require respiratory support
- Periodic attempts are made to wean infants from ventilator support
- Aim to minimize suctioning to limit tracheal and bronchial injury

Medical management is targeted at
- Minimizing further injuries
- Optimizing growth and recovery

129
Q

Most infants have a modest fluid restriction of - ml/kg/day

A

140-150

130
Q

if diuretics are prescribed for BPD, infants may experience….

A

electrolyte abnormalities

131
Q

in infants with BPD, energy needs are _ - _% higher than for healthy infants

aim for - kcal/kg/day during active disease

A

15-20%

140-150

132
Q

in infants with BPD aim for _ - _ g protein/kg body weight

A

3.5 - 4.0g

133
Q

for infants with BPD, amino acids are administered within the first 24 hours of life because they…..

A

Are well tolerated

Improve glucose tolerance

Create positive nitrogen balance

134
Q
A
134
Q

in infants with BPD, lipids are held or administered in small quantities because they can….

A

Cause hyperbilirubinemia
Increase risk of kernicterus

135
Q

for infants with BPD what is the fat recommendation?

A

4.4-6 g/kg fat/ 100 kcal

136
Q

use of corticosteroid & diuretics in BPD infants can lead to ….

A

urinary loss of calcium & decreased bone mineralization

137
Q

Osteopenia of prematurity is common in infants with BPD resulting from _ & _ deficiencies

A

Ca & P

138
Q

infants with BPD Ca & P levels are monitored every _ - _ weeks

A

1-2 weeks

139
Q

for infants with BPD, PN is continued along with EN until feeding volume reaches _ ml/kg/day

A

100

140
Q
A

Clinical 2 EXAM (2 decks)

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