Term
| causes of under nutrition |
|
Definition
starvation
impaired nutritional absorption
altered nutrition metabolism |
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Term
|
Definition
a form of protein-energy malnutrition mainly due to prolonged, severe caloric deficit.
look thin and malnourished
normal albumin/prealbumin |
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Term
|
Definition
a form of protein-energy malnutrition produced by sever protein deficiency.
belly sticks out
retarded growth, changes in skin and hair pigment, edema, immune deficiencies, pathologic changes in liver |
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Term
|
Definition
| loss of appetite, especially as a result of disease |
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Term
|
Definition
| weight loss, wasting o fmuscle, loss of appetite, weakness, loss of strength that can occur with chronic disease. (w/normal intake |
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Term
| nutritional requirement depends on |
|
Definition
age, gender, physical activity
current clinical status,
nutritonal status, organ fn/dysfn,
disease state |
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Term
|
Definition
| prealbumin, albumin, transferrin |
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Term
| basal energy expenditure (BEE) |
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Definition
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Term
| total energy expenditure can be |
|
Definition
| estimated,calculated, or directly measure |
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Term
|
Definition
| basal energy expenditure and energy used for physical activity combined |
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Term
| estimation of energy expenditure in healthy adult, normal nutrition, min illness serverity |
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Definition
| 20-266 kcal/kg/day (using ABW) |
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Term
| estimations of energy expenditure for illness, metabolic stress and BMI<30kg/m2 |
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Definition
| 25-30 kcal/kg/day (uses ABW) |
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Term
| estimation of energy expenditure for illness, metabolic stress and BMI> or equal to 30kg/m2 |
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Definition
11-14 kcal/kg/day (use ABW)
22-25 kcal/kg/day (uses IBW) |
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Term
|
Definition
measured way to get energy expenditure.
-usefull for critically ill or obese pts
-limitation is cost and not enough skilled personnel to use
-measure oxygen consumption and carbon dioxide production |
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Term
| what alters the energy needs to pts |
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Definition
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Term
| loop diuretics drug-nutrient interaction |
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Definition
hypOkalemia
hypOmagnesemia |
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Term
| potassium sparing diuretics drug-nutrient interaction |
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Definition
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|
Term
| corticosteroid, cyclosporine drug-nutrient interaction |
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Definition
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|
Term
| propofol drug-nutrient interaction |
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Definition
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|
Term
| antibiotics drug-nutrient interaction |
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Definition
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Term
| cholestyramine drug-nutriend interaction |
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Definition
| fat soluble vitamin deficiency |
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Term
|
Definition
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Term
|
Definition
nasogastric tube
nasoduodenal tube
nasojejunal tube
gastromy tube-into stomach
jejunostomy tube-into intestines |
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Term
| enteral nutrition support |
|
Definition
if gut works, use it
-length of stay decr
-return of cognitive fcn
-maintain gut integrity |
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Term
| if risk of malnourishment, unsafe to swallow/poor oral intake, and non-functional GI tract then use |
|
Definition
| parenteral nutritional support |
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Term
|
Definition
| complete bypass of GI Tract |
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Term
| general indications for PN |
|
Definition
1- inability to absorb nutrients via enteral route
2- EN ia contraindicated or unlikely to provide adequate nutrition w/in 5-7 days
3- mod-severe malnourished cancer pts
4- pts w/eating disorder |
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Term
| peripheral parenteral nutrition |
|
Definition
peripheral vein
- mild-mod stressed pts w/o central access
-lower concen of macro/micro nutrients to prevent necrosis and phlebitis of vein
-lower risk of infection than tpn |
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Term
|
Definition
-large central vein
- pts req greater than 7-14 days in hosp or indefintely @home
- higly concen hypertonic solns
-higher risk of complications/infections than PPN or EN |
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Term
|
Definition
Tunnele central venous catheter
PICC: peripherally inserted central line
non-tunneled CVC |
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Term
|
Definition
femoral vein
midline peripheral catheter
peripheral catheter |
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Term
| PN administration methods |
|
Definition
|
|
Term
|
Definition
AA, CHO, IVFE, sterile water
elctrolytes, minerals, vits, trace elements, other (meds) |
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Term
|
Definition
1- 2-in-1= CHO+AA w/ IVFE piggyback
2- 3-in-1=CHO+AA and IVFE in one bag |
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|
Term
|
Definition
1.1 kcal 10% emulsion
2kcal 20% emulsion
3 kcal 30%emulsion |
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Term
| 30% IVFE not intended for |
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Definition
|
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Term
|
Definition
| fat emulsions made with egg phospholipids |
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Term
| propofol (iv anesthetic) formulated in 10% intralipid so |
|
Definition
| need to adjust pt nutritional requirment due to high source of calories |
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|
Term
| multivitamins should be in |
|
Definition
all adult PN fomrulations
13 essential vitamins |
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|
Term
| trace elements essential in PN |
|
Definition
zinc
copper
chromium
manganese |
|
|
Term
| high doses of supplemental zinc and chromium needed for |
|
Definition
| pts w/ high output ostomies and diarrhea |
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Term
| molybdenum and selenium not in PN for |
|
Definition
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|
Term
| manganese and copper not in PN for |
|
Definition
| pts with cholestatic liver disease |
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Term
|
Definition
sodium, potassium
magnesium, calcium
phosphorus, acetate |
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|
Term
| examples of meds compatible with PN soln |
|
Definition
insulin
famotidine
ranitadine |
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Term
|
Definition
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Term
|
Definition
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|
Term
| mechanical tpn complications |
|
Definition
infusion pump/tubing fail
catheter related complications |
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Term
| infectious complications of tpns |
|
Definition
bacterial infections
fungal infections |
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Term
| metabolic tpn complications |
|
Definition
hyperglycemia
liver disease
refeeding syndrome |
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Term
|
Definition
can be fatal
phosphate levels decrease
-to avoid start at low tpn rate |
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Term
|
Definition
0.8-3 g/kg of protein EN
burns at high end 3g/kg/day
infection, trauma 2 g/kg/day
older 60 yrs 1g/kg/day |
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|
Term
| metabolic complication for EN |
|
Definition
hyperglycemia
refeeding syndrome
fluid electroyte imbalance |
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|
Term
| mechanical complications EN |
|
Definition
tube clog
tube displacement/inadvertent removal by pt
risk of entering tracheobronchial tree |
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|
Term
| gastrointestinal en cmplications |
|
Definition
n/v
ab distention, cramping
aspiration-pneumonia
diarrhea
constipation |
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Term
| hypermetabolic pts protein needed for EN daily |
|
Definition
3g/kg/day
25 kcal/kg/day-total calories |
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Term
| renal disease or hepatic encephalopathy protein needs for en |
|
Definition
lower protein start at 0.8 g/kg/day
no more than 1.5g/kg/day
except when start dialysis |
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