2nd Semester Flashcards
(24 cards)
3.4 kcal/g
Dextrose for TPN
1 can of EN
237 mL/can
4.0 kcal/g
Protein
Lipid for TPN
10%
20%
30%
- 1 kcal/mL
- 0 kcal/mL
- 9 kcal/mL
Nitrogen: Protein
1 gram = 6.25 grams
Bolus feeding
6 feedings/day
ebb phase
catabolic
“cut-down”
hypovolemic shock
flow phase
anabolic
Recovering/rebuilding
metabolic response to stress
1) breakdown of lean and skeletal mass
2) negative nitrogen balance
3) muscle wasting
zero nitrogen balance
protein IN matches what is needed in the body for:
1) maintenance
2) excretion
positive nitrogen balance
Nitrogen IN exceeds Nitrogen OUT
Positive = Good
**utilization for growth and other purposes
Measuring Nitrogen Balance
IN - OUT = nitrogen balance
Preferred feeding route for critically ill patients
1 if the gut works: USE IT!
1) oral
2) EN
3) PN
MNT for critically ill patients
2
25-30 kcal/kg
14-18 kcal/kg (overweight)
Protein: 1.2-2.0 g/kg (300:1)
MNT for burn patients
3
1) Ireton-Jones 1992 (BEEx2.0)
2) protein needs: 20-25%
3) vitamin needs: Vitamin A, C; Ca & Zn
PN access and duration
1) PPN (short-term: 10-14 days)
2) TPN/CPN (long-term)
PN administration
1) continuous infusion (24 hr)
2) cyclic infusion (12 hr)
EN access routes/duration
1) NGT: short-term
2) NDT/NJT: short-term
3) NET: short-term
4) PEG/PEJ: long-term
5) bolus feeding: long-term
EN administration
1) intermittent drip feedings (4-6 feedings/day)
2) continuous drip feedings (over 1 day)
EN complications
1) pulmonary aspiration
2) leakage from PEG/PEJ site
3) diarrhea
PN complications
1) access infections
2) refeeding syndrome
3) hypo-/hyper-glycemia
4) hyperlipidemia
TPN
DO NOT SUDDENLY STOP!
PN MUST GRADUALLY DECREASE OVER 2-3 DAY PERIOD
Refeeding syndrome
Potassium
Phosphorus
Magnesium
High fluid around heart
Bolus feeding
6 feedings/day
