Basic Nutritional Requirements Flashcards
For who is it necessary to provide nutritional support?
Severely malnourished patients on admission to hospital
Moderately malnourished patients who because of their physical illness, are expected not to eat for 3-5 days
Normal nourished patients who are expected to not eat for 5 days OR are expected to eat less than half their normal intake for 8-10 days
When is enteral nutrition preferred over parenteral nutrition?
When the GIT is functioning normally
What is re-feeding syndrome?
A complication that arises from providing nutritional support to severely malnourished patients
Their metabolism shifts from a catabolic state to an anabolic state.
This means there is insulin release on carbohydrate intake which triggers cellular uptake of potassium, magnesium and phosphate
What are the complications associated with re-feeding syndrome?
Hypokalaemia
Hypomagaesaemia
Fluid overload (due to sodium retention)
What are the NICE guidelines in order to prevent re-feeding syndrome?
A patient who has eaten very little or not eaten for more than 5 days should initially receive no more than 50% of their energy requirements
In an adult, how much water is required per day?
Under what conditions would this requirement increase and decrease respectively?
2-3L of water per day
Increase requirement:
- large output fistula
- nasogastric aspirate
- diarrhoea
Decrease requirement:
- oedema
- hepatic failure
- renal failure
- brain oedema
In an adult, how much energy is required per day?
Under what condition would the energy requirement increase and decrease respectively?
7.5 - 10 MJ/day pr
1800 - 2400 kcal/day
Increase requirement:
- for relation
Decreased requirement
- obesity
In an adult how much protein is required per day?
10-15g N/day /
62-95 grams per day
Increase requirement:
- under catabolic conditions such as extensive burns
In an adult, how much sodium and potassium is required per day?
60-100mol/day
Increased requirement:
- patients with GI effluents (discharge)
Decreased required:
- fluid retention
- hypernaturaemia
- hyperkalaemia
How does the levels of calcium and magnesium differ if using the enteral route compared to the parenteral route and why?
Higher levels required in the enteral route
This is due to the poor absorption of these molecules in the gut
How do the levels of trace elements, iodide, fluoride, selenium compared using the enteral route and parenteral route and why?
Same levels in each route
These trace elements are well absorbed
How do the levels of zinc, chromium, ion and manganese differ between enteral route and parenteral routes and why?
Higher levels required in the enteral route
This is due to the poor absorption of these molecules in the gut
How do the levels of vitamins differ when using the enteral route and the parenteral route and why?
Tends to be higher in parenteral route
Due to disease state being more severe in parenteral routes, patients needing parenteral routes having some of the vitamins broken down already and because of the storage of vitamins being degraded
What vitamin is usually omitted from parenteral regimes and then must be administered separately?
Vitamin K
For which groups are nutritional supplements of more benefit to?
Patients with a BMI of < 20kg/m^2
Children with growth failure
Weight losing patients
Children with continuing growth deteriorating performance
