Nutritional Considerations Flashcards
Serum albumin lab levels
3.5 to 5.4 G/dL
Prealbumin lab levels
15to 35 g/ dL
The most sensitive indicator of protein malnutrition.
Prealbumin
Transferrin lab level
Greater than 200mg/ dL is normal
Serum protein that binds and transfers iron
Transferrin
Predictor of protein depletion when less than 200mg/dL
Transferrin
Nutrition lab levels Total lymphocytes count
1 to 3 x10(9)/L
Lab hydration marker bun/creatinine normal levels
Less than 20
Normal serum osmolality lab levels
275-295 mmol/ kg
Obese 400lb man lost 40 lbs in the last 6months due to starvation, before beginning refeeding what would be considered
Watch for refeeding syndrome the body can start using glycogen from the over during times of starvation. If food is reintroduced to fast the body will have insulin spike causing k/mg/p to be taken up into cells, depleting the system leading to adverse effects. Possibly death.
If patient is unable to take food by mouth when would you use enterstomal tube
needs supplement greater than 6 weeks
If patient is unable to take food by mouth what would you use if there is a risk for aspiration
Duodenal tube
In elderly when could you use mirtazipine for nutrition
patient is malnurished and depressed
When is it practical to use TPN
When GI tract is not usable parenteral nutrition is needed
why is megestrol not suggested for nutrition in elderaly
Beers list and risk of thrombotic event maybe death
Gastromy feedings PEGS CAN BE USE FOR how many weeks
great than 4 weeks
hallmark refeeding syndrome can cause what kind of shift in labs
hypophosphatemia, hypomagnesemia,
hypokalemia, and thiamine deficiency
Patient was on enteral feedings for several weeks what is the syndrome to watch for when started to refeeding
re-feeding syndrome
When some one has hadno or limited nutritional intake fr more than 5 days how should someone be feed to prevent refeeding dsyndrome
10kcal/kg perday slowly increase over days
Before correcting feeding for someone malnurished you should correct what
Fluid and electrolyte
Diagnosis of cachexia & malnutrition
BMI < 18.5 with unintentional weight loss >10% within
3-6 months
Limited or no nutritional intake for more than 5 days
Complications
of Parenteral
Nutrition
Occurs in approximately 50% of patients Pneumothorax Arterial laceration Air emboli Catheter thrombosis Catheter sepsis Hyperglycemia HHNK
Palliative
Care and
Enteral
Feeding considerations
Consider family and patient’s wishes
Obtain swallow test
Feed for pleasure
Essential diagnosis of Anorexia nervosa
female with 3 consecutive missed menses
body image disturbance
weight loss leaving body wt 15% less than expected