Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
12 Cards in this Set
- Front
- Back
|
Which of the following factors accounts for most of the decrease in energy needs from infancy to adolescence?
a. growth b. stress c. activity d. resting metabolism |
Energy needs in the first 2 mo are calculated to be 120-130 kcal/kg/d, decreasing to 100 kcal/kg/d by one yr. Beyond infancy the requirement for energy decreases from ~100 kcal/kg/d in the one-yr-old to ~ 40 kcal/kg/d in late adolescence. Growth is the single factor that accounts for the most decrease in energy needs.
|
|
|
Which of the following is characteristic of parenteral nutrition administration?
a. The gain in body fat is greater when fat is used along with carbohydrate b. Nitrogen retention is higher when the caloric source used is carbohydrate alone c. The respiratory quotient is higher when glucose and fat both are used as compared to glucose alone d. The combined energy source with CHO and fat may require less calories because of more efficient utilization |
If only a carbohydrate source is used to provide energy, then energy expenditure increases and respiratory quotient frequently goes above one. When fat is used along with carbohydrate, respiratory quotient decreases to less than one, total energy expenditure is decreased, and nitrogen equilibrium is attained faster with fewer calories. The use of carbohydrate source alone may cause greater gain in body fat because of increased fat synthesis.
|
|
|
Which of the fo.llo.wingis MOST characteristic o.f the metabo.lic resPo.nse to.brain injury?
Uremia and uric acidemia Hypothermia and hypoglycemia Hyperalbuminemia and hyperzincemia I Hypermetabo.lism and hypercatabo.lism |
The body's response to brain injury results in
increased metabolic rate and increased catabolism. In addition, there is decreased plasma zinc and increased ur inary excretion of zinc, increased C-reactive protein, and increased serum and urine cortisol and catecholamines. Manyaspects of the acute phase response are thought to be mediated by cerebrovascular release of interleukin-l. |
|
|
Which of the following routinely requires home parenteral nutrition?
a. Duodenal ulcer b. Esophageal cancer c. Short-bowel syndrome d. Cerebrovascular accident |
According to the ASPEN, short-bowel syndrome is the one category of situations where home parenteral nutrition should be a part of routine care.
|
|
|
Which of the fo.llo.wingis most; characteristic
o.fa vender's expenses in supplying ho.me parenteral nutritio.n? Amino. acid so.lutio.nsare the mo.st expensive co.mpooent Disposable supplies are the mo.st expensive corponent Equipment such as pumps and refrigerato.rs are the mo.st expensive co.mpo.nent The service co.mpo.nentis generally mo.re costly than supplies |
In a study of homeparenteral nutrition charges',
the extent of a vendor's services to a patient was one of the major variables affecting final charges. REF: 783 |
|
|
Which of the fo.llo.wingoccurs in a patient
w].th cancer cachexia? Resting energy expenditure is increased Ano.rexia is an important etio.logic facto.r Adaptatio.n to.energy sparing during end stage is intact An increase in energy expend iture is accounted for by an increase in tumor metabo.lism |
Patients with cancer have increased eni:!tgi '
expenditure corrpared to normal individuals. As they becomemalnourIshed , energy expenditure decreases. Whole body energy-spar ingadaptation becomes similar to adapt.at Ion seen in noncancer edvanced state malnoorished patients ~ The tumor mass is generally larger in advanced stage corrpared to early disease but energy expenditure falls indicating the earlier increase maybe due. to tumor metabolism. |
|
|
A child with thin coocave nails, pal Ior ,
apathy, and glo.ssitis may be deficient in Q Iron . 2. zinc. 3. vitamin C. 4 • r ibo.flavin • |
Vitamin C deficiency manifests as bleeding gums,
rachitic rosary, epiphyseal swelling, and pain with movement. Zinc deficiency causes hair loss, acrofacial and perianal dermatitis, poor wOUI'rl healing, dwarfism, and hypoqonedIsm, Dermatitis, cheilosis, angular stomatitis, and glossitis are synptoms of riboflavin deficiency. |
|
|
To.maintain opt imal,hepatic drug oxidat Ion ,
what percent of the energy intake should be administered as lipid? 1- ~ 4. 0% 5% 25% 50% |
Hepatic dysfunction is a corrplication of
parenteral nutrition as suggested by derangement of standard liver function tests. Antipyrine clearance, a sensitive indicator of hepatic microsomal enzymeactivity, provides a more specific indication of hepatic function. Patients who receive fat-free parenteral nutrition show marked reductions of antipyr ine clearance, whereas diets providing 25%of the energy as lipid allow maintenance of microsomal oxidative function. |
|
|
Which o.f the fo.llo.wingis.mr characteristic
o.f the refeeding syndro.me? Hypokalemia Hypocalcemia Hypomagnesemia 4 • Hypophosphatemia |
Refeeding malnourished patients requires caution
whenusing hypertonic dextrose solutions. Aggressive nutritional support will result in the intracellular trapping of phosphate lecrling to a drop in serum phosphate levels. Hypokalemia and hypomagnesemiamayoccur due to their intracellular shift when refeooing occurs too rapidly. This "syndrome" can be prevented if patients are fed their basal energy requirements initially and gradually advancoo over a 5-7 day per Icd , Serumpot ass Ium, phosphate, and magnesIum should be monitored daily during the first week of therapy. REF: 631 |
|
|
Which of the fo.llo.wingconpoonds is found in
both standard infant fo.rmulas and breas t milk but not in parenteral so.lutio.ns? Pro.line Taurine Carnitine Pho.spho.lipase |
Premature infants are born with a relative
inability to synthesize carnitine which facilitates 'the transfer of fatty acids across the mittt:hondrial merrbraneand is necessary for mitochondrial fat o~),.datiori. In its absence, beta~}{idat,~on of,,).ong-cQain fatty acids, and thus cellular energy ~tabc;>JJ~mr,is irrpaired. There is not- ,yet "gooo'doC~ntatioz:t of i..npairoo fat , utHization' in neonates-In the absence of exogenous carnf.t irie.~ |
|
|
Parenteral nutritio.n is most stro.ngly indicated
fer which o.f the follo.wing co.nditio.ns? Po.sttraumatic pancreatic fistula Disruptio.n o.f an ileocolic anasto.mosis resulting in a double-barrelled sto.ma Po.stoperative fistula fro.m a lo.Wco.lo.rectal anasto.mosis in elderly patient Cro.hn's disease with spontaneous entero.- cutaneous fistula two years fo.llo.wing ileocecal resectio.n |
bbb
|
|
|
If ho.meparenteral nutritio.n is the o.nly
o.ptio.n,which o.f the fo.llo.wingis mo.st critical to.its success? Patient is at bedrest Patient is up and about A resPo.nsible party is available in the ho.me Ho.me health care nurse is o.ncall 24 hours per day |
dd
|
