Term
| What are the nutrition recommendations for patients on corticosteroids? |
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Definition
- Monitor blood sugar and need for carb-controlled diet
- Avoid high-sodium foods (corticosteroids cause sodium retention resulting in edema)
- Ensure adequate intake of calcium and vitamin D
- Ensure adequate protein intake (corticosteroids impair wound healing)
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Term
| What are some complications of cyclosporine and their nutritional management? |
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Definition
- Hyperkalemia -> restrict potassium
- HYPOmagnesemia: supplement magnesium
- Hypertension: restrict sodium
- Hyperglycemia: carb-controlled diet
- HLD: limit fat and simple carb intake, maintain healthy weight
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Term
| What are the complications associated with sirolimus and their nutritional management? |
|
Definition
- Hyperlipidemia -> limit fat and simple carb intake
- GI issues -> monitor and treat as appropriate
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Term
| What are nutritional complications of tacrolimus and the appropriate management strategies? |
|
Definition
- Nausea/vomiting: anti-emetic meds
- Hyperkalemia: restrict potassium
- Hyperglycemia: carb-controlled diet
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Term
| What are the complications and nutritional management of mycophenolate mofetil and mycophenolic acid? |
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Definition
| Diarrhea, nausea, vomiting -> replace fluids |
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Term
| How does obesity affect transplant success? |
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Definition
| Obese patients tend to be less successful |
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Term
| How does organ transplant affect energy needs? What are the recommended needs? |
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Definition
Organ transplant patients do not tend to be hypermetabolic unless secondary conditions such as sepsis are present.
30-35 kcal/kg |
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Term
| How does transplant affect protein needs? Why? What are estimated needs? |
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Definition
Protein needs are higher in acute phase d/t high level corticosteroid administration: 1.5-2 g/kg
Chronic transplant phase: 1 g/kg |
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Term
| Do patients typically require PN after small bowel transplantation? |
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Definition
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Term
| When should nutrition support be initiated after transplant? |
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Definition
| If patient is not able to eat within 2-3 days after transplant |
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Term
| What is the recommended diet progression after transplant? |
|
Definition
Liquid diet when patient passing flatus
General diet when patient begins to have BMs |
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Term
| What are the recommended diets for: hyperglycemia, fluid retention, hyponatremia |
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Definition
Hyperglycemia: carb-controlled
Fluid retention: sodium-restricted
Hyponatremia: fluid-restricted |
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Term
| What type of formula generally recommended with transplant patients? |
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Definition
- Usually a polymeric, high-nitrogen formula
- High fiber if diarrhea/constipation
- Semi-elemental or polypeptide if impaired digestion
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Term
| When should patients be transitioned from 24-hour TF infusion to nocturnal feeds? |
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Definition
| When they can meet 50% of needs |
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