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Advanced Pharmacology Exam 1 > Nutrition > Flashcards

Nutrition Flashcards

(72 cards)

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1
Q

adult maintenance fluid requirements

A

1500 ml + 20ml/kg over 20 kg

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2
Q

weight change concerning for malnutrition

A

> 10% in past 6 months

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3
Q

Mifflin-St. Jeor Equation

A

equation used to calculate fluid needs for obese patients

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4
Q

concentration of protein

A

4 kcal/g

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5
Q

concentration of lipids

A

9 kcal/g

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6
Q

calorie density of lipid solutions

A 
20% = 2 kcal/ml
30% = 3 kcal/ml
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7
Q

concentration of dextrose/CHO

A

3.4 kcal/g

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8
Q

most detrimental consequence of refeeding syndrome

A

hypophosphatemia

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9
Q

fat soluble vitamins

A

A, D, E, K

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10
Q

water soluble vitamins

A

B, C

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11
Q

required dose of folate for pregnancy

A

800 mg

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12
Q

dietary sources of vitamin K

A

green leafy vegetables

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13
Q

vitamin D deficiency

A

serum concentration <30ng/mL

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14
Q

Components of enteral nutrition solution

A

proteins
fiber
micronutrients
water

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15
Q

protein-nitrogen balance

A

6.25 g of protein contains 1 g of nitrogen

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16
Q

nepro, novasource renal, magnacal renal

A

enteral formulas for renal failure

low protein, high amino acids, designed to minimize BUN

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17
Q

hepatic AID

A

enteric formula for hepatic failure

high conc of branched amino acids, low conc of aromatic amino acids, decrease risk for hepatic encephalopathy

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18
Q

pulmocare, novasource pulmonary, nutrivent

A

enteral formulas for pulmonary disease

low conc of carbs, high conc of fats, minimize accumulation of CO2

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19
Q

glucerna, diabetisource

A

enteral formulas for diabetes

low carbohydrates, high fat/fiber, better glc control

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20
Q

maximum concentration of TPN that can be delivered peripherally in adults and peds

A

adults - 10% dextrose

peds - 900 mOsm/L dextrose/10%, 4% amino acids, 40 mEq/L K, no Ca

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21
Q

peds monitoring for TPN protein

A

BUN, LFTs, albumin, pre-albumin

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22
Q

peds monitoring for TPN lipids

A

triglycerides, bilirubin

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23
Q

lipids infusion rate in infants

A

max 0.15 g/kg/h

infused over 18-24 h (over 12 h in older children and adults)

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24
Q

peds monitoring for TPN carbohydrates

A

serum glc, urine glc

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25
GIR (glucose infusion rate)
((rate)(concentration))/6(weight in kg)
26
optimal calcium/phosphate ratio
preterm infants - 2.6 mEq Ca: 1 mMol PO4
27
who needs vitamin K supplementation?
TPN infusion > 2 weeks
28
similac special care, enfamil premature formula
premature formulas
29
neosure, enfacare
transitional formulas
30
similac, enfamil, enfaml enspire, enfamil AR, similac for spit up
term formulas
31
enfamil gentlease, enfamil sensitive, similac total comfort, enfamil reguline
allegy formulas
32
isomil, prosobee
soy formulas
33
progestimil, alimentum, nutramigen, enflora LGG
casein hydrolysate formulas
34
puramino, neocate, elecare
elemental formulas
35
contraindication to receiving parenteral lipids
egg allergy
36
treatment for high gastric residuals
metoclopramide, erythromycin
37
what peds need iron supplementation?
preterm infants w/o formula or breastmilk fortifier, other infants at high risk/anemic, term infants at 4 mo if exclusively breastfedw
38
what peds need vitamin D supplementation?
preterm if not on formula/fortifier, all term breastfed infants
39
what peds need multivitamins?
preterm if not on formula/fortifier, high risk infants >6mo
40
s/s of vitamin D deficiency
rickets, osteomalacia, osteoporosis, cancer, DM, HTN, HF, infections
41
groups at risk for thiamine deficiency
``` chronic alcoholics post bariatric surgery HIV/AIDS DM malnourished ```
42
s/s of thiamine deficiency
beriberi syndrome - dry (neurotoxicity) - sensory disturbances, peripheral neuropathy, depression - wet (cardiovascular) - dyspnea, tachycardia, cardiac failure wernicke-korsakoff syndrome - wernecke's encephalopathy - reversible neuro disorder w/ confusion, nystagmus, ataxic gate - korsakoff's - irreversible neuro disorder w prolonged memory impairment
43
tx for thiamine deficiency
50-100 mg IV, then or PO high dose - 100-500 mg IV or PO q8 x3-5 d
44
groups at risk for vitamin B12 deficiency
bariatric surgery vegetarians IBD
45
s/s of vitamin B12 deficiency
tingling, weakness, numbness, fatigue, memory loss affects tissues w high turnover rate - hematopoietic/nervous systems
46
assessment of vitamin B12 deficiency
serum normal level 200-900 pg/ml | schilling test
47
tx for B12 deficiency
cyanocobalamin 100 mcg IM/SC weekly x4 weeks, then monthly B12 1000 mcg PO QD
48
s/s of folic acid deficiency
megaloblastic anemia
49
tx for folic acid deficiency
folic acid supplementation can reverse hematopoietic manifestations but not neuro s/s oral/IV 1 mg QD 400 mg OTC
50
normal plasma folate
4-20 ng/ml
51
s/s of vitamin B6 deficiency
peripheral neuropathy, glossitis, confusion
52
groups at risk for B6 deficiency
protein malnutrition, malabsorption, ETOH, hyperthyroidism
53
what is the most accurate biomarker of nutritional status?
pre-albumin
54
advantages of breast milk
immunologic properties reduce risk of immune-mediated diseases psych and cognitive advantages emotional bonding excellent bioavailability of certain component
55
american academy of pediatrics recommendation for breastfeeding
exclusive breastfeeding for the first 6 months of life and continuation for the second 6 months
56
formula for infant w milk allergy
similac alimentum advance
57
meds w enteral feeding interactions
decreased absorption - levothyroxine, fluroquinolones, carbamazepine, phenytoin obstruction - sucralfate, sevelamer clotting - warfarin
58
what amino acid supplementation is used for infants in the first year of life?
trophAmine
59
harris-benedict equation
used to determine total caloric needs
60
contraindications for enteral nutrition
``` GI obstruction ileus severe malabsorption severe GI bleeding IBD ```
61
polymeric tube feeds are used for
patients with normal digestive process
62
partially hydrolyzed/oligomeric tube feeds are used for patients
with malabsorptive processes
63
how long can TPN run through PIV?
2 weeks
64
component of parenteral nutrition
``` fluids dextrose amino acids fats electrolytes micronutrients ```
65
what trace element is not in TPN that needs to be supplemented?
vitamin K supplement if on TPN >1 week
66
schofield equation
used to calculate caloric needs for peds
67
peds indications for TPN
``` premature neonates resp distress congenital GI anomalies abdominal wall defects necrotizing enterocolitis chronic diarrhea IBD metabolic error pancreatitis, chylothorax, obstruction hypermetabolic - trauma, cancer anorexia cystic fibrosis chronic renal failure hepatic failure ```
68
conditionally essential amino acids
**peds don't break down all aminos - give more cysteine, taurine, tyrosine accumulation of other aminos - give less phenylalanine and methionine
69
conditions that decrease calcium/phos solubillity
increased pH increased temperature increased concentration increased exposure time
70
what is the benefit of adding cystine to premature formula?
increasing the potential amount of calcium and phos
70
what is the benefit of adding cystine to premature formula?
increasing the potential amount of calcium and phos
71
multivitamins for peds
<11 - MVI with A, D, E, K | >11 - MVI-12 + vitamin K supplement

Advanced Pharmacology Exam 1 (4 decks)

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