Nutrition Support in Specific States

Question 1

Which 5 main vitamins/minerals are important for fetal growth?

Answer 1

Iron, folate, calcium, vit B12, zinc

Question 2

What is the RDA (recommend dietary allowance) for CHO during pregnancy?

Answer 2

175g/day

Question 3

The Institute of Medicine recommends what g/kg of protein during pregnancy?

Answer 3

1.1g/kg

Question 4

What is the target BG of a pregnant woman on PN?

Answer 4

140mg/dL

Question 5

Which vitamin protects neutrophils, fibroblasts, and collagen, allowing wound healing to transition from the inflammation to the proliferative phase?

Answer 5

Vit C

Question 6

Deficiency of this mineral can adversely affect B and T lymphocyte production, leading to delayed wound healing

Answer 6

Zinc

Question 7

Deficiency of this mineral can adversely affect B and T lymphocyte production, leading to delayed wound healing

Answer 7

Zinc

Question 8

Which two amino acids are conditionally essential during wound healing?

Answer 8

Arginine and glutamine

Question 9

Which amino acid improves pressure wound healing?

Answer 9

Arginine

Question 10

How soon (hrs) after ICE addmission should EN be initiated in burn patients?

Answer 10

4 - 6 hrs

Question 11

How many days should you wait to start supplemental PN if a patient is unable to meet 60% of their kcal and protein needs?

Answer 11

7 - 10 days

Question 12

What are the kcal and protein requirements of a malnourished pt with stage 2 and 3 pressure wounds?

Answer 12

30-35kcal/kg, 1.2-1.5g/kg

Question 13

In TBI, estimated energy requirements is 140% of which equation?

Answer 13

Harris Benedict

Question 14

Supplementing with insulin-like growth factor 1 (IGF-1) and which trace mineral has been shown to improve outcomes in TBI?

Answer 14

Zinc

Question 15

What is the primary treatment of syndrome of inappropriate antidiuresis (SIAD)?

Answer 15

Fluid restriction

Question 16

TBI is a common cause of SIAD, which results in which type of hyponatremia?

Answer 16

Eurvolemic

Question 17

What is the protein requirement range for TBI pts?

Answer 17

1.3-2.5g/kg

Question 18

In TBI, estimated energy needs is 140% of which energy equation?

Answer 18

Harris Benedict

Question 19

What is the protein requirement range immediately following a stroke?

Answer 19

1-1.5g/kg

Question 20

When is PEG tube placement recommended in pts with ALS?

Answer 20

When the pt has dysphagia; BMI <20; weight loss of 5-10% of UBW.

Question 21

What are the kcal and protein requirements for pts with ALS?

Answer 21

35kcal/kg, 0.8-1.2g/kg

Question 22

What are the four metabolites used for gluconeogenesis?

Answer 22

Lactate, pyruvate, alanine, and glycerol

Question 23

In sepsis, energy needs increases by what percentage range?

Answer 23

20-80%

Question 24

What is the general guideline for EN and PN lipid delivery amount?

Answer 24

1g/kg/day

Question 25

What length of fatty acids do not require carnitine for transport into the mitochondria?

Answer 25

Medium chain fatty acids

Question 26

What is the protein requirement range during sepsis?

Answer 26

1.5-2g/kg (possibly up to 2.5 in some cases)

Question 27

ASPEN guidelines recommend use of an arginine/fish oil formula in surgical ICU pts, but not in pts with ___________.

Answer 27

Sepsis

Question 28

Which two nutrition assessment scoring systems does ASPEN recommend in critical illness?

Answer 28

The Nutrition Risk Screening (NRS-2002) and the Nutrition Risk in Critically ill (NUTRIC)

Question 29

What type of EN formula is recommended by ASPEN in post-op and trauma ICU pts?

Answer 29

Immunonutrition formulas with supplemental Omega-3s and arginine

Question 30

The clinical manifestations of copper deficiency can be similar to what other micronutrient deficiency?

Answer 30

Vit B12

Question 31

Which low electrolyte in the blood is the hallmark for refeeding syndrome.

Answer 31

Hypophosphatemia

Question 32

What is the protein requirement range for crohn's disease?

Answer 32

1-1.5

Question 33

Pts with frequent use of these types of meds are recommended to take 1500mg/day supplemental calcium and 800-1000IU of vit D/day.

Answer 33

Corticosteroids

Question 34

What type of EN formula is best for cystic fibrosis?

Answer 34

A concentrated formula, either 1.5kcal/ml or 2kcal/ml

Question 35

In chronic cholestatic diseases, supplementation of which vitamins may be necessary?

Answer 35

Fat soluble -ADEK

Question 36

What are the protein requirements for cirrhosis?

Answer 36

1-1.5 g/kg

Question 37

What are the kcal requirements for cirrhosis?

Answer 37

1.2-1.4 x REE

Question 38

What supplements should be given in alcoholic liver disease?

Answer 38

B1, B6, B12, folate, and zinc

Question 39

What anatomical variant of short bowel syndrome is the most difficult to manage in the most likely to require permanent TPN?

Answer 39

The end jejunostomy variant

Question 40

What part of the small bowel Is the primary site of carbohydrate protein and water soluble vitamin absorption?

Answer 40

The proximal 100cm of the jejunum

Question 41

What part of the small bowel is the primary site of carrier mediated absorption of vitamin B12 and enterohepatic recirculation of bile?

Answer 41

The terminal ileum

Question 42

To qualify for a diagnosis of short vowel syndrome, the patient must have how many feet or less of residual small bowel?

Answer 42

5 ft or less

Question 43

What is the normal PCO2 range?

Answer 43

35-45 mmHg

Question 44

What is the normal serum bicarbonate range?

Answer 44

22-26 mEq/L

Question 45

What is a acetate converted to in the liver?

Answer 45

Bicarbonate

Question 46

What are the protein needs in the acute organ post-transplant phase?

Answer 46

1.5-2g/kg