Hospital-based Nutrition

Question 1

To minimize CO2 production while still giving adequate energy you might consider feeding people on a ventilator a ___ diet

Answer 1

high fat and less calories

Question 2

it may be prudent to limit ________ in a person who has hepatic encephalopathy

Answer 2

protein, salt and water intake

Question 3

Some clinicians would limit the amount of dietary ______ a person with renal failure gets each day

Answer 3

protein

Question 4

For patients with CHF, the main dietary constituent to restrict is Na+. A standard approach is to place these patients on a _____ diet

Answer 4

2 g Na+

Question 5

A “cardiac diet” is often an option for hospitalized patients. This diet typically consists of _______

Answer 5

low fat, low sodium, low saturated fat

Question 6

what does the diabetic diet” consist of:

Answer 6

restricted in calories, fat and simple sugars

Question 7

When does nutritional depletion occur in a Normal person who is not sick.

Answer 7

10-14 days

Question 8

When does nutritional depletion occur in a Normal and pretty sick..or nutritionally depleted and not sick person.

Answer 8

5-7 days.

Question 9

When does nutritional depletion occur in a Nutritionally depleted and sick person.

Answer 9

3-5 days

Question 10

what effect does arginine supplementation have?

Answer 10

Not very stable in enteral formulations. “Conditionally essential”.
Precursor for Nitric Oxide.
Direct immunomodulatory effects as measured by response to mitogens.
Supplementation improves nitrogen balance.
Stimulates GH and insulin secretion.

Question 11

what effects does glutamine supplementation have?

Answer 11

Supplementation increases immune function, gut histology and barrier function.
Important gluconeogenic precursor so supplementation improves nitrogen balance.

Question 12

there is Very little _____ in standard “house formulas” (hospital formulas?)

Answer 12

Omega 3 fatty acids

Question 13

what diet is better for patients with liver disease

Answer 13

Diets lower in aromatic AA and higher in branched chain AA may be helpful

Question 14

Volume (Na and water) overload is a problem in patients with _______

Answer 14

renal failure

Question 15

what dietary considerations should be made in patients with burns and trauma

Answer 15

Increased energy requirement may be as high as 30-35 kcal/kg/day
May have an increased protein requirement 1-1.5 g/kg/day

Question 16

what are complications that could occur with feeding Malnourished patients who have lost substantial weight, or who have a prolonged period of poor nutrition recently

Answer 16

Complications: hypophosphatemia, hypokalemia, diarrhea, Wernicke’s encephalopathy (acute thiamine deficiency

Question 17

how do you manage the diet of a person who is Malnourished and who has lost substantial weight, or who has a prolonged period of poor nutrition recently

Answer 17

Begin with thiamin, folate and multivitamin solution intravenously.
Begin feeding slowly, monitor electrolytes.