Term
|
Definition
| method used for food and meal planning of diabetes--> glucose and insulin affect postprandial blood glucose levels about the same when eaten in smilar gram amounts. One carbohydrate serving=15g |
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|
Term
|
Definition
| a form of therapy for diabetes using combinations of oral glucose-lowering mediations or a combination of oral glucose-lowering and insulins or other injectable medicaitons |
|
|
Term
| counterregulatory (stress) hormones |
|
Definition
| hormones, including glucagon, epnephrine, norepinephrin, cortisol, and growth hormone, released during stressful situations, that have the opposite effect of insulin and cause the liver to release glucose from stored glycogen and the adipose cells to release FAs: these hormones alose counterbalance declining glucose levels |
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Term
|
Definition
| severe, uncontrolled diabetes resulting from insufficient insulin, in which ketone bodies build up in the blood |
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Term
|
Definition
| food groups into six groups: starches, fruit, milk, vegetable, fat, meat and meat subs; each list is a group of measured foods of about aprox same nutritional value so each food can be exchanged with one another within one group |
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Term
|
Definition
| low blood glucose concentrations in response to no food intake for 8 hours or longer |
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Term
|
Definition
| impaired astric motility; results n delayed or irregular contractions of the stomach leading to slow emptying of the stomach; fullness, bloating, nausea, vomiting, diarrhea, constipation |
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Term
|
Definition
| glucose intolerance, the onset or first recognition of which occurs during pregnancy |
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Term
|
Definition
| a measurement of the relative area under the postprandial glucose curve of 50g of digestable carbs compared to 50g of a standard food, either glucose or white bread |
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Term
|
Definition
| the estimated GI of foods, meals and dietary patterns in calculated by mltpying the glycemic index by the amount of carbs in each food and then totaling the values for all foods n a meal or dietary pattern |
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Term
|
Definition
| a hormone produced by alpha cells of the pancreasthat causes an increase in blood glucose levels by stimulating the relase of glucose from liver glycogen stores |
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Term
| glucose-lowering medications |
|
Definition
| drugs adminstered orally that are sued to control or lower blood glucose levels |
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Term
|
Definition
| beta cells chronically exposed to hyperglycemia become progessively less efficient in responding to a glucose challenge |
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Term
|
Definition
| a blood test that relfects the blood glucose concentrations over the life span of red blood cells, expresssed as a percentage of total hemogloblin with glucose attached |
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Term
|
Definition
| th period after the initial diagnosis of type 1 diabetes when there may be some recovery of beta cell functon and a temporary decrease in exogenous insulin requirements |
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Term
|
Definition
| excessive glucose in the blood cause by too little insulin, insulin resistanceor increased food intake |
|
|
Term
| hyperglycemic hyperosmolar state |
|
Definition
| extremely high glood glucose levels with an absence of or only slight ketosis and profound dehydration |
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Term
| hypoglycemia (or insuln reaction) |
|
Definition
| low blood glucose level caused by the administartion of excessive insulin, too little food, delayed or missed meals or snacks, increased exercise or other physical activity, alcohol intake without food |
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|
Term
| hypoglycemia of nondiabetic origin |
|
Definition
| low levels of blood glucose that lead to ner |
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Term
| immune mediatd diabetes mellitus |
|
Definition
| a form of type 1 diabetes resulting for autoimmune destruction of beta cells of the pancreas |
|
|
Term
| injectable glucose-lowering medications |
|
Definition
| drugs administered by injection that are used to control or lower blood glucose levels |
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Term
|
Definition
| a hormone released from the beta cells of the pancreas that enable cells to metabolize and store glucose and other fuels |
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Term
|
Definition
| an impared biological response/ sensitivity to either exogenous or endogenous insulin; involved in the etiology of type 2 diabetes |
|
|
Term
|
Definition
| oral medications that enhance insulin action |
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Term
|
Definition
| dseases of the large blood vessels including coronary arter disease, cardiovascular disease, and peripheral vascular disease |
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Term
|
Definition
| central obesity and insulin resistance with increased risk for cardiovascular disease and type 2 diabetes; associated risk factors include dyslipidemia HTN, presence of prothrombotic factors and impaired glucose tolerance |
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Term
|
Definition
| disease f the mall blood vessels, including retinopathy and nephropathy |
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|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| postprandial blood glucose |
|
Definition
| blood glucose level 1 to 2 hrs after a meal |
|
|
Term
| post prandial hypoglycemia |
|
Definition
| low blood glucose level within 2 to 5 hrs after eating |
|
|
Term
|
Definition
| blood glucose conc that are higher than normal but are not yet high enough to be diagnosed as diabetes; referred to as impaired glucose tolerance or impaired fastng glucose |
|
|
Term
| preprandial blood glucose |
|
Definition
| bood glucose level before ating |
|
|
Term
| self monitoring blood glucose |
|
Definition
| indv testing their own blood glucose levels |
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|
Term
|
Definition
| hypoglycemia gollowed by "rebound" hyperglycemia |
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|
Term
|
Definition
| diabetes that occurs in th persons younger than 30 yrs of age but can occur at any age (previously known and insulin dependent or jouvenile onset) |
|
|
Term
|
Definition
| diabetes that occurs in th persons younger than 30 yrs of age but can occur at any age (previously known and insulin dependent or jouvenile onset) |
|
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Term
|
Definition
| diabetes usually occuring in persons older than 30 yrs of age (non insulin dependent diabetes) |
|
|
Term
|
Definition
| a triad of clinical features that includes low blood glucose levels accompanied by symptoms that are relieved by administartion of glucose |
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Term
|
Definition
| infusion of up to 500 ml of enteral formulas into the stomach over 5 to 20 minutes, usually with a largebore syringe |
|
|
Term
| central parenteral nutrition (CPN) |
|
Definition
| vein, usually the superior vena cava |
|
|
Term
|
Definition
| enteral formula administartion into the gastrointestinal tract via pump, usually over 8 to 24 hrs per day |
|
|
Term
| cyclic entral parenteral nutrition |
|
Definition
| administration of total parenteral nutrition solution fro 12 to 18 consecutive hours, usually at night, followed by 6 to 12 hr perod of no infuson |
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Term
|
Definition
| provision of nutrients into the gastrointestinal tract through a tube when oral intake is inadequate |
|
|
Term
| gastrointestinal decompression |
|
Definition
| prevention of gaseous inflation (distention) of the gastrointestinal tract by the application of intermittent or continuous negative pressure (suction) through a nasogastric tube |
|
|
Term
| intermittent drip feeding |
|
Definition
| enteral formula administered at specified times throughout the day; generally in smaller volumes and at a lower rate than a bolus feeding but n larger volumes and at a faster rate than continuous feeding |
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Term
|
Definition
| the number of particles per liter of solution |
|
|
Term
|
Definition
| the number of particles of solute per kilogram of solvent |
|
|
Term
|
Definition
| provision of nutrients intravenously |
|
|
Term
| percutaneous endoscopic gastronomy (PEG) |
|
Definition
| feeding tube, the insertionf of which into the stomach involves usng an endoscope and pulling the tube through a small incision in the abdominal wall |
|
|
Term
| percutaneous endoscopic jejunostomy |
|
Definition
| feeding tube inserted into the jejunum using an endoscopic technique |
|
|
Term
| peripheral parenteral nutrition |
|
Definition
| delivery of nutrients into a smaller perpheral vein |
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|
Term
|
Definition
| low serum levels of potassium, magnesium, and phosphorus with severe, potentially lethal outcome that results from the too-rapid infusion of substrates, particularly CHO, into plasma with the consequent release of insulin and shoft of electrolytes into the intracellular spaces as glucose moves into cells for oxidations and there is reduction in salt and water excretion |
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|
Term
|
Definition
| a process of pregressing from one method of nutrition support to another or to oral feeding |
|
|
Term
|
Definition
fasting glucose>= 126mg/dl
casual glucose>= 200mg/dl
2hr GTT>= 200mg/dl |
|
|
Term
|
Definition
fasting glucose values 100-125mg/dl
2hr GTT: 140-199 mg/dl |
|
|
Term
|
Definition
| 75g glucose to drink, measure blood sugar 2hr later (fasting not necessary) |
|
|
Term
|
Definition
| non fasting glucose readng >= 200 with S/S excessive thirst, urination, hunger, wt loss |
|
|
Term
|
Definition
onset24-28wks w/ 50g glucose challenge (>140mg/dl)
Associated with placental hormones that work against insulin making then less effective ( after delivering placenta, BS decreases)
Predisposed to type 2 DM
Risk of Macrosomia |
|
|
Term
| Gestational Diabetes: 100g GTT |
|
Definition
fasting>= 95
1hr>= 180
2hr>=155
3hr>=140
** if any 2 readngs are high Dx with GDM |
|
|
Term
|
Definition
Polyuria
Polydipsia
Hyperglycemia
Fatigue
Irritable/Moody
Ketouric-usually only type 1
Loss of LBM/ weight loss |
|
|
Term
| Acute Complications of DM |
|
Definition
Insulin Shock: too much insulin relative to carbs, pulls too much glucose into the cells leading to hypoglycemia
Caused my miscalculation of too much insulin, waiting too long to eat after nsulin injection or failure to follow diet on fixed insulin |
|
|
Term
| Acute complications of DM |
|
Definition
Ketoacidosis: severe hyperglucemic state
Too much carbs relative to insulin, omission of insulin injection with meal, oor following of diet prescription, infection (hormones workng against insulin raising blood sugar)
Treatment: insulin injection, replace electrolytes |
|
|
Term
| Chronic Complications of DM |
|
Definition
Macrovascular: Damage to coronary vessels due to dyspilidemia
Type 2: low HDL, high TG, high LDL
Type 1: abnormal lipids
W/ elevated LDL 100mg/dl is target b/c DM is coronary heart disease riak eq.
HTN-hyperinsulinemia stimulates aldosterone raising BP |
|
|
Term
|
Definition
Microvascular:
Nephropathy- kidney damage due to poor management leads to kidney failure, chronic bouts of high blood sugar to be excreted by the kidneys |
|
|
Term
| Chronic Complications; Microvascular: Neuropathy |
|
Definition
damage to nervus system due to evelated BS damages nerves, vagus nerve for GI tract, impacts paristolic activity in GI tract
**Low Fiber! |
|
|
Term
| Chronic Complications: Microvascular- Retinopathy |
|
Definition
| Damage of capillaries to the retina in the eyes leads to blindness |
|
|
Term
| Chronic Complications: Microvascular- Gout |
|
Definition
| Inflammation of the joints, poor type 1 management. Elevated ketons interfere with excretion of uric acid allowing it to build up in the blood and joints |
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|
Term
| Primary Action of Insulin:Normal- CHO |
|
Definition
Glucose uptake in muscle and adipose to clear sugar from blood, favors glycolysis, favors glycogen synthesis (for storage)
-insulin is an anabolic hormone that works to store carbs in the liver and muscle
-stimulate glycolysis in the liver for conversion to ATP |
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|
Term
| Primary action of insulin: Diabetic- CHO |
|
Definition
Cant produce insulin/ inadequate, poor glucose uptake into adipose/muscle tissue
-favors glucogeneogenesis (generation of glucose) in the liver--> starvation mode to fuel tissues
-glycogen stores are broken down by the liver to release glucose for fuel
- muscle cant release stored glucose from glycogen
-poor glucose uptake into muscle and adipose causing increase in blood sugar inhbiting glycolysis in the liver releasing extra glucose into the blood |
|
|
Term
| primary action in insulin: Normal- Lipids |
|
Definition
-Promotes fat storage
-Promotes FA synthesis
-Lipoprotein Lipase is stimulated by insuln, once stimulated breaks down TG to FA+G to be taken up into the tissue for fat storage
-Promotes FA synthesis in the liver |
|
|
Term
| Primary Action of Insulin: Diabetic-Lipids |
|
Definition
-Promotes fat breakdown and mobilization
-Promotes FA breakdown and ketogenesis
-LipoLipase isnt active, TG rich particles build up in the blood changing the blood profile
-Hormone sensitive lipas in adipose is sensitive to glucagon stim, the hormone to break down TG's in the tissue and released into the blood= Ketoacidosis |
|
|
Term
| Primary Action of Insulin: Normal- Proten |
|
Definition
-Promotes protein synthesis
-Promotes amino acid uptake into muscle and decrases uptake into liver |
|
|
Term
| Primary Action of Insulin: Diabetic- Protein |
|
Definition
-Promotes protein breakdown (LBM)
-Promotes amino acid uptake by liver
-Amino acids are released from muscle tissue and diverted to the liver for gluconeogenesis for glucose production when are then released into the blood causng hyperglycemia |
|
|
Term
| Goals of MNT in Diabetes #1 |
|
Definition
1. Balance Food intake with insulin and excercise/ PA
* Exercise lowers glucose levels in the blood by pulling glucose into tissue without insulin but can cause hypoglycemias if not balanced with insulin |
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|
Term
| Goals of MNT for Diabetes #2 |
|
Definition
| 2. Achieve optimal lipids (LDL<100, HDL, Chol) |
|
|
Term
| Goals of MNT for Diabetes #3 |
|
Definition
| Provide evergy to achieve optimal weight: weight loss for Type 2 will improve insulin sensitivityand glucose control |
|
|
Term
| Goals for MNT for diabetes #4 |
|
Definition
| Reach/ maintain normal growth and development (expecially in chldren with type 1) |
|
|
Term
| Goals for MNT for Diabetes #5 |
|
Definition
| Prevent or treat acute and chronic complications: remedy any issues to prevent defecits or deficiencies that may cause insulin shock or DKA |
|
|
Term
| Goals of MNT for Diabetes #6 |
|
Definition
| Improve/ maintain optimal nutrition status (balanced) |
|
|
Term
| Determining Fat Quantity and Quality |
|
Definition
TLC- (chol<200, 20-35% fat, sat fat <7%cals)
-Type 1- same lipid profile as non-diabetic
-Type 2: high TG and Low HDL sometimes high LDL--> if weight loss then calorie restriction, if high TG/low HDL (35% fat, 15-20% MUFA, if high LDL--> |
|
|
Term
|
Definition
Between 10-35% calories
Pregnancy- +10g and lactation +15g
Renal disease- restrict protein
* Patient with renal disease and DM with poor renal function will be at 10% |
|
|
Term
|
Definition
| Poor control, increased cortisol levels promote protein breakdown taxing the kidneys, protein should be limited in these cases! |
|
|
Term
| Carbohydrate levels for DM |
|
Definition
-Between 50-60%, 45-50% w/ high TG
-Total amount of CHO more important than type (sucrose, fructose, sorbitol-lower GI response)
Fiber- 25-35g, 25% soluble, higher soluble for abnormal lipids |
|
|
Term
| Net Carbohydrate (digestable carbohydrates) |
|
Definition
Fiber doesnt convert to glucose when eaten
Ripe foods increase GI
Portein/fat decreases GI
High Fiber decrease GI |
|
|
Term
|
Definition
| How much a food raises blood sugar compared to glucose or white break (may reduce glucose variability in the blood) |
|
|
Term
|
Definition
| CHO content of food x GI/100 |
|
|
Term
|
Definition
Low GI: <= 55
Med GI: 56-69
High GI: >= 70
Decrease risk of Type 2 BM and CVD
**Higher GI is harder on clugose control
**consumption of CHO raises blood sugar within 15 mn but normalizes wthin 2 hrs |
|
|
Term
|
Definition
May cause HTN/Obesity
2g diet will control HTN |
|
|
Term
|
Definition
<2oz/day
-Controls lipids and HTN
-excessive amounts slow down the livers ability to produce ATPshutting off gluconeogenesis causing a drop in blood sugar (when alcohol isnt served with a meal) |
|
|
Term
| Chromium/Magnesium and DM |
|
Definition
Chromium:Helps insulin bind to its receptors but only effective when there is a deficiency
Magnesium: improves glycemic control but only when deficiency is present |
|
|
Term
|
Definition
-Focuses on the amount of CHO eaten at meals and snacks
-Take total calories, mltply percentage to get total CHO, divide throughout the day (gram goals per meal)
- CHO is the nutrient with the greatest effect on BS
- Match CHO intake with insulin and exercse
-4 main groups
-1oz insulin per 15g CHO |
|
|
Term
| Recommendations for Glycemic Control |
|
Definition
-Average pre-meal glucose= 90-130mg/dl
-peak after-meal glucose (1-2hrs) <180mg/dl
-A1c (%) <7% |
|
|
Term
|
Definition
-7groups (Fruits, Veggies, Starches, Meat, Meat Substitutes, Fats, other CHO, Milk)
-Determine number of exchange goals per meal |
|
|
Term
|
Definition
Type 1 susceptible to: dehydration (due to loss of body fluids), hyperglycemia (sickness), ketonuria
-hormonal changes work against insulin pullin glucose into the cells
-Hormones are eleveated b/c starvation phas during which ketones are produced and spill out into the blood and urine
-15g CHO every 1-2 hrs or 50g every 3-4hr |
|
|
Term
|
Definition
-improves insulin sensitivity
-decreases glucose concn in blood
- weight control |
|
|
Term
|
Definition
-hypoglycemia
-hyperglycemia if blood sugar is high before event |
|
|
Term
|
Definition
-monitor blood sugar pre, during and post
-low intensity: glucose<100mg/dl give pre exercise snack (15g CHO)
->100mg/dl no snack needed
->250-300 dont exercise
ROutine exercise (45-60 mins)
- may need to decrease insulin dose
- see specific guidelines for modereate/strenuous activity |
|
|
Term
| Advantages of CHO Counting |
|
Definition
| Simple, flexible, quick and easy to learn, can improve blood sugar control, useful for patients taking bolus injection of insulin |
|
|
Term
| Disadvantages of CHO counting |
|
Definition
-Weght gain
-Poorly balanced diet (esp. in children recieving low diet quality nutrients) |
|
|
Term
| Insulin (Radpid actng):Lispro |
|
Definition
onset<15 mins
Peak (30mins-1hr)
Duration (2-4 hrs) |
|
|
Term
| Insulin (Short acting): Regular |
|
Definition
Onset 30mins-1hr
Peak 2-3 hrs
Duration 3-6 hrs |
|
|
Term
| Insulin (Intermediate Acting): NPH/Lente |
|
Definition
onset 2-4hrs, 3-4hrs
Peak 6-10hrs, 6-12hrs
Duration 10-16hrs, 12-18hrs |
|
|
Term
| Insulin (long acting): Lantus |
|
Definition
Onset 6-10 hrs
peak 10-16 hrs
duration 18-20 hrs |
|
|
Term
|
Definition
Pen Injectors
Jet Injctors (no needle)
Inhaled Insulins (only covers meals, not basal needs)
Insulin Pump (short acting covers dietary insulin and basal insulin-continuous insulin throughout the day and balances wth CHO at meals) |
|
|
Term
|
Definition
-Basal vs dietary requirements
-most common combinations (basal-lispro, bolus-meal)
-insulin pump |
|
|
Term
|
Definition
- most effective in non-obese type 2
-prescribed after diet failure
-duration of action 6-12hrs
-sulfonylureas
-metfornin
-consistent CHO intake increases effectiveness of medication |
|
|
Term
|
Definition
| Liquid, soft, regular diets eaten through usual manner |
|
|
Term
| enteral Nutrition Support |
|
Definition
| Food taken into the gut, must have a functioning gut (at least 2 ft worth) that enable optimal digestion and absorption of nutrients but cant obtain enough food in the normal manner to meet nutr. needs (oral supps, tube feeding) |
|
|
Term
| Parenteral Nutrition Support |
|
Definition
| less than 2 ft GI tract remaining. Nutrients are broken down to elemental form to be put into vein for processing by the body--> opens body for possible infection, costly so its reserved only for special cases |
|
|
Term
| Enteral: Oral Supplements |
|
Definition
-increase calories or macronutrients
-sole source of nutrition for a limited time (ex:surgery)
Characteristics: 250-300kcal/8oz,
fat-long chain TG or MCT (benefits of MCT)
CHO- sucrose (increase pt acceptance, increase osmolality)
Pro- 8-14g, complete or hydrolyzed
Vitamins/Minerals-variable
Types: liquid, pudding, modular (macronutrient) |
|
|
Term
|
Definition
| Medium Chain Triglyceride: dont require pancreatic lipase for dgestion, doesnt need bile for emulsification and absorption, wont be repacked into chylo's |
|
|
Term
|
Definition
-Calc patients caloric/nutrient requirements(defecit?)
-monitor caloric nutrient intake
-Choose supplement to meet needs
-Follow up to ensure adequate intake |
|
|
Term
|
Definition
-patients with at least 2-3ft functional GI
-Oral intake is inadequate to restore/maintain nutritional status
Ex: neurological problems, facial/esophogeal trauma, intestinal inflammation, resection (crohn's), severe muscle wasting, AIDS or cancer
***No Stomach activity is a risk for aspiration |
|
|
Term
|
Definition
-surgical resection caused scar tissue to form, this may block GI to the gut or any ntestinal obstruction
-malabsorptive syndrome- diarrhea
-Premature infants (immature gut)
-aggressive support not warranted |
|
|
Term
|
Definition
Feeding tube in nose
Normal GI
No risk of aspiration
Short term (4weeks)
Administration (continuous, intermittent, bolus)
**Never bolus feed into the Intestine! |
|
|
Term
|
Definition
-Short term, critically ill pt.
-better absoprtion of the nutrients, much more hydrolyzed and broken down (elemental/basic form)
-pts with delayed gastric emptying
-pts at risk of aspiration
-Rsk of aspiration
**Do not Bolus, only continuous or intermittent |
|
|
Term
|
Definition
-Functioning GI
-Long duration
-No risk of aspiration
-full movement of food through stomach and small intestine 4 wks or longer
-1st section of small intestine is naccessible for all tube feeding |
|
|
Term
|
Definition
-Delayed Gastric emptying, pancreas not functioning properly
-long duration
-risk of aspiration
-no bolus feeding
-risk of infection if not properly positioned |
|
|
Term
|
Definition
2kcals/ml--> pts wth volume limitations (high osmolality)
-increased caloric requrements |
|
|
Term
|
Definition
.5kcal/ml
-damaged GI lining, malabsorptive problems, increased fluid requirements |
|
|
Term
|
Definition
-High biological value
-4-32% of kcals
-Forms: polymeric, hydrolyzed/elemental, semi-elemental, amino acid mixture |
|
|
Term
| Additional Protein (formula) considerations |
|
Definition
-Renal Solute Load (1.5-2 x RSL= total urine output)
-Calorie:nitrogen ratio (nonprotein calorie:nitrogen)
-Amino acid additives: glutamine, arginine, branched chain |
|
|
Term
| Primary Energy source: CHO |
|
Definition
-40-90% kcals
-Sources:disaccharides, monosacch.,corn syrup, maltodextrins (hydrolyzed starch)
-Degree of hydrolysis effects osmolality, digestability, absorptability
** consider amylase-->digests CHO in pancreas
** Duo, Jej- inflammation impacts dig
** Feeding into SI required hydrolyzed forms
Fiber usually added to prevent constipation |
|
|
Term
| Primary Energy Source: Fat |
|
Definition
-30-40%kcals
-Functions: energy, FSV, EFA, doesnt effect osmolality
-Sources: corn, soy, and safflower oils (omega 6 PUFA)
-MCT+form of EFA
-Linoleic acid @ 2-4% kcals
**Omega 6 suppresses immune function in tube feeding not to be used with immunocompromised (50:50 omega6 to omega3) |
|
|
Term
| Micronutrients in formula |
|
Definition
-Meeta DRI (RDI,AI)
-Special needs for critical cases: vitamin A, Vitamin C, Vitamin E, Zinc, electrolytes |
|
|
Term
|
Definition
Requirements: 30-35ml/kg body wt (usually same as calorie requirements)
Formulas- 60-85% water
Add water to flush tube |
|
|
Term
| General/Polymeric Formula |
|
Definition
| Intact micronutrients, not broken down. Distributed similar to guidelines. Pt with good ability to digest/absorb macronutrients. Good GI function, usually lowest in cost. Osmolality may be hard to tolearte (ex: ensure, osmolite) |
|
|
Term
| Defined/Hydrolyzed Formula |
|
Definition
| Pt with GI compromise, need assistance with predgestion of macronutrients. Maltose, MCT-->hydrolyzed. osmolality is lower, cost is increased. Caloric density increases to about 1.2-1.3kcals/ml |
|
|
Term
|
Definition
| Most elemental form of nutrients (amino acids, glucose, dextrose, little fat) 70% carbs, little protein, little fat, pt with limited GI function. Tube feed into Jejunum |
|
|
Term
|
Definition
| Midification of macronutrients due to disease, accomidate increased or decreased protein needs, alterations in vitamins and minerals |
|
|
Term
|
Definition
early Stages of critical care when pt dehydrated
parenteral: enteral feedings, diseases with igh fluid requirements a lot of fluid and electrolytes per kcal |
|
|
Term
|
Definition
| Contains only one macronutrient |
|
|
Term
|
Definition
-diarrhea
-lactose intolerance
-osmolality
-too qucikly feeding rate
-bolus may not be tolerable
-medication interaction (sorbitol content)
**check gastric emptying by suctioning stomach content 3-4 hrs after eatng and test pH |
|
|
Term
| The three classic symptoms of diabetes |
|
Definition
Polydypsia (increased thirst)
Polyuria (frequent urination)
Unexplained weight loss |
|
|
Term
| Enteral Feeding GI problems: Diarrhea |
|
Definition
signs: >3 liquid stools a day
Reason: Lactose intolerance, Hyperosmolar, Too rapid Infusion, Concomtant drug therapy
Solution: Lactose free formula,reduce osmolarity, change to continuous drip, check medications |
|
|
Term
| Enteral GI problem: Inadequate Gastric Emptying |
|
Definition
Signs: >150mL gastric residuals
reasons: poorly functioning GI, Too rapid infusion, fat malabsorption
Solutions: Reposition feeding tube into duodenum, reduce feeding rate, change formula to lower fat choice |
|
|
Term
| Enteral GI problem: Nausea/Vomiting |
|
Definition
Signs: Expulsion of gastric content
Reasons: poorly functioning GI, Too rapid Infusion, Fat malabsorption
Solution: Reposition feeding tube into duodenum, reduce feeding rate, change formula to lower fat choice |
|
|
Term
| Enteral GI problem: GI Bleeding |
|
Definition
Sign: Blood in residuals
Reasons: Poorly functioning GI
Solution: Change to parenteral nutrition |
|
|
Term
| Enteral feeding, Metabolic problem: Hyperkalemia |
|
Definition
sign: High serum K
Reasons: Formula with increase K, K retention
Solution: use enteral with less K |
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Term
| Enteral Feeding, Metabolic problem: Hyponatremia |
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Definition
Sign: lower serum Na
Reason: Fluid retention
Solution: reduce free water, pick more nutrient dense formula |
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Term
| Enteral Feeding, Metabolic problem: Micro/Macro deficiencies |
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Definition
sign: abnormal lab tests
reasons: poor feeding, inadequate intake
solution: supplement enteral feeding, pick more nutrient dense formula |
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