Nutrition

High prevalence of __ deficits in hospitalized patients

__ % of hospitalized patients suffer from some degree of malnutrition (depending on disease and population)

Loss of weight, appetite, muscle atrophy, and weakness in someone not trying to lose weight, usu. signifies an underlying disease

acute visceral protein depletion (chronic protein intake insufficiency), usually affects young children, edema, pigmentation, pot belly

Simple starvation (chronic caloric intake insufficiency)loss of lean body mass, fat, and visceral proteins

40% in liver (rapidly depleted)

60% in muscle

Obligatory gluconeogenesis, Protein catabolism, Increased nitrogen loss, Unresponsive to glucose administration, Magnitude of loss proportional to injury

__ common finding with deficiencies in niacin, thiamine, vitamin B6, vitamin B12

Represents the critical cellular mass necessary for cellular structure as well as function

Represents 40% of total body weight

Depletion is severe insult and defines patient morbidity and mortality

60% skeletal muscle

20% red blood cells and connective tissue

20% cell mass

Utilized for clinical determination of total body fat and skeletal muscle store. Simple, inexpensive, non-invasive technique

__% of the total body protein is contained in skeletal muscle

this is major site of protein catabolism during starvation and/or illness

Most widely used biochemical marker of muscle mass

Creatinine is degradation product of creatine,__

Maintains plasma oncotic pressure and is a carrier for enzymes, drugs, hormones, etc.

Serum albumin

Carrier for iron. Limited use because level fluctuates with iron stores

Carrier for thyroxine and retinol-binding protein. Sensitive to acute changes in nutrient intake

Resting energy expenditure calculated by using the __ equation

Nitrogen Balance

Nitrogen Balance (N intake - N loss):If positive (goal +2 to +4), net state of __

Nitrogen Balance (N intake - N loss): If negative, net state of __

Nitrogen Intake (enteral and parenteral)(1 gm N/__ g Protein

Estimates severity of lean body mass catabolism and quantifies severity of metabolic stress

In general, adults will require nutritional support if NPO for greater than __ days

if the gut works

contraindications to enteral nutrition

Used for conscious patients; preferred for short-term feeding (< 30 days)

Nasogastric: adequate gastric emptying require; maintain gastric residuals < __% of total infusion over prior 4 hours

Nasoenteric Tube Feeding: used in patients with high aspiration risk (neurological impairment; poor gastric motility)

tube feeds cause

in a patient with tube feeding and diarrhea check for __ before changing anything else

Involves continuous infusion of hyperosmolar solution containing carbohydrates, proteins, fats, and other necessary nutrients through an indwelling catheter inserted into the superior vena cava

Any patient who will not have functioning GI tract for __ days should be considered for TPN

Principal indication for __ are found in seriously ill patients suffering from malnutrition, sepsis, or surgical or accidental trauma when use of the GI tract for feedings is not possible

1. Intravenous vitamin preparations should be added 2. Vitamin K and folate should be administered once a week 3. Vitamin B12 is given once a month intramuscularly

May present as dry, scaly dermatitis and loss of hair - Syndrome may be prevented by periodic infusion of a fat emulsion equal to 4 - 5% of total calories

- Most frequent trace mineral deficiency is __, which presents as an eczematoid rash developing both diffusely and at intertriginous areas