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Nutrition
| Question | Answer |
|---|---|
| Arthropometric measurements | skinfold for assessment of fat; arm muscle circumference for amount of skeletal muscle |
| Marasmus | 1) depleted fat and muscle stores; 2) normal biochem measurements; 3) intact immune status |
| Kwashiokor | 1) normal or elevated fat and body weight; 2) abnormally low biochem measurements; 3) depressed immune status |
| Kwashiokor-Marasmus mix | all depressed markers |
| biochem measurements | albumin, prealbumin, transferrin |
| obesity | 120% > IBW; Class I - 30-35; Class II 35-40; Class III - >40 |
| Nutritional requirements in terms of kcal | 25 kcal for patients with little stress; 30 kcal for infections, skeletal trauma; 35 kcal for major trauma; 40 kcal for burns |
| Caloric contribution of glucose | 3.4 kcal/g |
| caloric contribute of fat | 9 kcal/g |
| caloric contribution of protein | 4 kcal/g; recommended is 0.8 g/kg/day; 1.0 g/kg/day for minor stress; 1.5 for major trauma/infection; 2.0 for severe head injury, sepsis, severe burn |
| nitrogen balance eqn | nitrogen in - nitrogen out |
| nitrogen in | amount of proteins in a day/6.25 |
| nitrogen out | measure of grams of urea excreted during 24 urine collection and adding a factor of 2 or 4g for insensible loses |
| sodium requirement | 60-100 |
| Cl- requirement | 60-100 |
| potassium requirement | 60-100 |
| calcium requirement | 5-15 |
| phosphorous | 20-45 |
| magnesium requirement | 10-20 |
| trace elements | zinc, copper, chromium |
| Fat given as... | 10% = 1.1 kcal/mL; 20% = 2 kcal/ml; 30% = 3 kcal/ml |
| dont exceed this dextrose rate | 5 mg/kg/min |
| advantages of TNA | decreased admin time; decreased touch contamination; decreased pharmacy prep time; decreased cost |
| disadvantages of TNA | better media for bacterial growth; impossible to visualize particulate matter; can't filter with 0.22 micron filter; Ca++ and phosphate less compatible |
| advantages of central vein | 1) maximize caloric intake; 2) can volume restrict patients; 3) long term cath maintained |
| disadvantages of central vein | 1) mech complications; hyperosmolar complications (because hypertonic dextrose used); 3) septic catheter complications |
| Advantages of peripheral | 1) easier to place; 2) acoid hyperosmolar complications because dilute concentration used |
| disadvantages of peripheral | 1) high incidence of thrombophlebitis; 2) require vein rotation; 3) energy intake limited; 4) volume restriction not possible; 5) higher cost |
Created by:
cytoskeletor
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