Nutrition Flashcards
(34 cards)
Complications of enteral feeding?
- diarrhoea
- aspiration
- hyperglycaemia
- refeeding syndrome
Nutritional options in surgical patients
- oral intake
- NG nasogastric feeding
- nasojejunal feeding
- feeding jejunostomy
- PEG percutaneous endoscopic gastrostomy
- TPN total parenteral nutrition
Complications of NG feeding
- aspiration of feed
- misplaced tubing
Contraindications of NG feeding
Following head injury/base of skull fracture
Benefit of nasojejunal feeding
Avoid problems of feed pooling in stomach
Avoids risks of aspiration
Risks of feeding jejunostomy
- tube displacement
- peritubal leakage immediately following insertion > peritonitis risk
Risks of PEG feeding
Aspiration
Leakage at insertion site
Complications of total parental nutrition
- catheter related bloodstream infections
- sepsis from central line contamination
- refeeding syndrome
- electrolyte disturbances
- hyperglycaemia or hypoglycaemia
- fatty liver
- cholestasis
- gallstones
- long term liver fibrosis
- venous thrombosis
- thrombophlebitis
- metabolic bone disease
What is refeeding syndrome?
The metabolic abnormalities which occur on feeding a person following a period of starvation
Metabolic consequences of refeeding syndrome
- hypophosphataemia
- hypokalaemia
- hypomagnesaemia
- abnormal fluid balance
What affect can hypophosphataemia in refeeding syndrome have?
Significant muscle weakness incl:
- myocardial muscle > cardiac failure
- diaphragm > respiratory failure
- rhabdomyolysis
Pathophysiology of hypophosphataemia in refeeding syndrome
- switch from fat to carb metabolism
- intracellular movement of phosphate
- decreased phosphate stores
Who are at risk of refeeding syndrome?
- BMI <16
- unintentional weight loss >15% over 3-6 months
- little nutritional intake >10 days
- hypokalaemia, hypophosphataemia or hypomagnesaemia prior to feeding
What does NICE recommend if a patient hasn’t eaten for >5 days for nutritional requirement?
No more than 50%of requirements for first 2 days
Patients identified as being malnourished include
- BMI <18.5
- unintentional weight loss >10% over 3-6 months
- BMI <20 + unintentional weight loss of >5% over 3-6 months
Patients at risk of malnutrition
- eaten nothing or little >5 days + likely to eat little for next 5 days
- poor absorptive capacity
- high nutrient losses
- high metabolism
What is food fortification?
Using butter, cheese/fats to increase calories in food
Diets for weight loss
- Mediterranean
- low-fat
- low carb
- ornish diet
- vegetarian/vegan
- weight reduction
- paleo
- intermittent fasting
What is the ornish diet?
Vegetarian
Low fat
Refined sugar
What is paleo diet?
Fruits
Vegetables
Lean meats
Fish
Eggs
Nuts
Seeds
What calorie deficit is needed to maintain weight loss?
600 kcal/day
Guide for a serving of protein
1 palm
Guide for a serving of vegetables
1 fist
Guide for a serving of carbs
1 cupped hand
