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28 Cards in this Set
- Front
- Back
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3 goals of nutritional therapy in critical illness
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- Prevent (further tissue degeneration)
- Promote (healing) - Provide (support for anabolism) |
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4 phases of metabolic response to injury/illness
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- Ebb phase
- Flow phase - Anabolic recovery phase - Multiple organ failure |
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4 characteristics of ebb phase
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- Decreased BP
- Decreased CO - Lower temperature - Decreased O2 consumption |
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4 characteristics of flow phase
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- Hypercatabolism
- Negative N balance - Increased urinary loss of S, P, Mg - Increased O2 consumption |
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Which phase is called the hypermetabolic phase?
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Flow
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Which phase is called the hypometabolic phase?
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Ebb
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What is the general goal of the flow phase?
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Mobilize body resources to counteract ebb phase
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What happens during ebb phase?
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Initial responses to severe body insult (24 - 48 hours)
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3 characteristics of Anabolic recovery phase
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- Positive fluid balance re-established
- Positive nitrogen balance regained - Strength returns |
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Which phase is the conversion from catabolism to anabolism?
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Anabolic recovery phase
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5 characteristics of Multiple Organ Failure stage
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- Pulmonary failure
- Hepatic failure - Renal failure - Metabolic and respiratory acidosis - Septicemia |
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4 things that can lead to multiple organ failure stage
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- Septicemia
- Malnutrition - Immunocompromise - Hypoperfusion |
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Which starvation type has no catabolism?
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Unstressed (uncomplicated)
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Which starvation type has decreased RER activity?
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Unstressed (uncomplicated)
- Stressed (hypermetabolic) is the opposite |
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Which starvation type has increased gluconeogenesis?
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Stressed (Hypermetabolic)
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Which starvation type has an increase rate of malnutrition
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Stressed (Hypermetabolic)
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3 indices most useful in clinical assessment of nutritional status
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- Physical exam
- Laboratory tests - BCS |
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7 steps in providing nutritional support to a hospitalized patient
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- Assess nutritional status
- Estimate fuel source caloric needs - Select route of administration - Select appropriate diet - Plan and initiate program - Evaluate patient response (modify as needed) - Plan transitions |
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Target amount of CNH in a hospitalized patient
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24 - 48%
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Target amount of COH in a hospitalized patient
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10 - 25%
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Target amount of fat in a hospitalized patient
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30 - 50%
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Two ways of calculating RER
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RER = 70 * (BWkg)^0.75
RER = 30*BWkg + 70 |
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2 types of parenteral nutrition
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- TPN
- PPN |
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Which parenteral nutrition provides all nutritional needs for 24 hours?
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TPN
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Which parenteral nutrition provides half nutrition needs for 24 hours?
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PPN
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Which parenteral type is used in smaller hospitals?
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PPN
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Osmolarities of the two parenteral nutrition types
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TPN: > 1,200 mOsm/L
PPN: < 800 mOsm/L |
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Which parenteral nutrition type is safest to use?
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PPN
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