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45 Cards in this Set
- Front
- Back
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does the physical stress of starvation alter nutrients?
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YES
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uncomplicated starvation is?
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starvation w/o an underlying cause
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glycogenolysis
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breakdown of glycogen(liver's carb stores)-release glucose into bloodstream
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glucogenesis
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production of glucose from carb stores (from fat stores and muscle)
-results in decrease in LBM |
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lipolysis
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breakdown of adipose tissue for energy-releases fatty acids into blood stream
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ketosis
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accumulation in body of ketone bodies
-during prolonges starvation |
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heart, kidney, and skeletal muscle prefer
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fatty acids and ketone bodies for energy
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hypermetabolism
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major changes in hoe energy it utilized after sever injury, illness, infection
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kilocal needs increase/decrease when?
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increase-due to injury
-decrease-uncomplicated starvation |
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ebb phase
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(1) begins w/ initial stress stimulus
-BP, cardiac OP, body temp increase -stress response stimulated by hormones (cortisol, catcholim, growth hormone) |
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flow phase
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-increases CO, body Tmp,o2 consumption
-favor energy from muscle -protein rqmnts hi |
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anabolic phase
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-greatest protein need
-GH and insulin increase in BS -affected by a. age b. nutritional status c. duration of stressor |
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hypermetabolism
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increased metabolic rate
-negative nitrogen balance -hyperglycemia -increased O2 consumption |
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stress factor
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# assignes to a given patholigical state-predicts kcal increase
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an increase in k cal also = increased in what vitamins?
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-B->helps bring out chemical energy in foods
-vit C-repair -magnesium,phosph,zinc |
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protein needs for non critical care patient
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0.8-1.2 g/kg of ideal body weight
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protein needs for critical care patient
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1.2-1.5g/IBW
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kilocalorie:nitrogen ratio
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1 g N per 300 kcal
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for burns k cal rqmnts may be as high as
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8000 kcal/day
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the deeper the burn=
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higher clients kcal needs
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burn clients are suseptible to
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sepsis-disease producing organisms present in blood
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EQUATION
energy need = |
REE X Activity factor x stress factor
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what kind of diet is ordered for burn clients?
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high protein-high kcal
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respiration
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exchange of gases 02 and Co2
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ventilation
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=breathing
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pulmonary
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concerns lungs
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chronic obstructive pulm disease COPD
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obstruction of airflow-lung disease
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respiratory failure
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acute/chronic disease-caused by imbalance between amount of gas enetering lungs and demand on body cells for gases-->tissue hypoxia
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kcal needed for normal and COPD to breathe?
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normal- 36-72kcal
COPD- 430-720 kcal |
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gastrointestinal distress is common in clients with pulmonary disease ..why?
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-malnutrition
-paralytic ileus-temp cessation of peristalis -causes decrease in food -transloaction of bacteria from GI-->blood -leads to sepsis |
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carbon dioxide retainers are?
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in clients with COPD
-suffer from Co2 retention -oxygen depeletion -goal=decrease level of Co2 |
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what kind of diet is used for Co2 retainers?
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high in fat (fat kcal produce less Co2 than carb K cal
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clients with COPd (diet)
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-fluid restriction
-prevent pulmonary edema |
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why is there a need to incread fluid intake in burn patients?
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capillary permeability is increased-plasma proteins,fluids,electrolytes,escape into interstitial fluid
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diet for burn patients?
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hi kcal protein from fat and N
-hi kcal diet, 6 meals,nutritional oral supplements,8 glasses of milk |
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effects of impaired nutritional status on respiratory function
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-inad food intake
-shortness of breath -cells fatigue-inadeq 02 -GI distress-cause malnutrition -parylytic ileus-temp cessation of peristalis -weight loss -catablism of resp muscles -decrease in LBM lungs -lung death |
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CO2 retainer diet may contain as much as
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50% of kcal from fat
-may be immunosuppresive |
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vit A and C prevent
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lung infection
-dark greens,cheese, eggs |
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refeedign syndrome can result in
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-CHF
-respiratory failure |
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clients at risk for refeeding
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-alcoholics
-anorexics -diabetics -elderly |
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refeeding leads to
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-LBM loss in <3, res muscles
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reintroduction of carbs in starved (refedding) causes
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increase in insulin
-cause sodium/water retention =increased workload of cardiopulm system |
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refeeding syndrome may increase worload of cardiupulm beyond
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its capacity due to loss of LBM and cause CHF and resp failure
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refeeding syndrome causes increase in
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extracellualr fluid and increase loss in intracellular phosphorus, potassium ,and magnesium
-after refeeding minerals go back into intracell |
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safe refeeding
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1.test for correct electrolyte
2.restore circualtory volume 3.slow kcal delivery |
