Term
| What are the primary nutrients absorbed from each section of the intestines? |
|
Definition
Duodenum: iron
Jejunum: most nutrients (water, carbohydrates, protein, water-soluble vitamins)
Terminal ileum: B12 and bile salts
Water and lipids are absorbed through passive diffusion throughout the small intestine
Large intestines: fluid and electrolytes |
|
|
Term
| Where should measurement of small-bowel length begin in patients with SBS? |
|
Definition
|
|
Term
| What are the recommendations for salt use in SBS patients? |
|
Definition
| Liberal use of salt should be encouraged |
|
|
Term
| What is generally an appropriate interval for reducing PN infusion in patients being weaned off of PN? |
|
Definition
|
|
Term
| What are two strategies for weaning TPN? |
|
Definition
- Reducing the days per week that the patient receives TPN
- Reducing the amount of TPN provided each day
|
|
|
Term
| What types of medications should be avoided in SBS patients? |
|
Definition
|
|
Term
| Is octreotide recommended for SBS patients on TPN? |
|
Definition
| It should be avoided in the early adaptation stage and only used for patients with large stool volume resulting in problematic fluid and electrolyte management |
|
|
Term
| Are pancreatic enzymes recommended for SBS patients? |
|
Definition
|
|
Term
| What are criteria that must be met before SBS patients are weaned from TPN? |
|
Definition
- Daily fluid intake goal is consistently achieved
- Urine output exceeds 1 L/day and is at least 0.5 mL/kg/hr on nights without PN
- Lab measures of hydration stable if urine output cannot be measured
- At least 80% of caloric goal should be able to be met with reductions
- Patients should be able to maintain stable weight between reductions
- Labs sould be stable
- Oral fluid intake minus stool output should be positive (at least 500 mL/d)
|
|
|
Term
| How does SBS affect risk of hypomagnesemia? How should it be treated? |
|
Definition
| Patients with SBS are at risk of hypomagnesemia and PN magnesium may be required. Sodium deficiency must be corrected when treating hypomagnesemia. |
|
|
