refeeding syndrome

Question 1

What is the most dangerous complication of anorexia

Answer 1

Refeeding syndrome

Question 2

What is refeeding syndrome

Answer 2

sudden high caloric intake leading to hypophosphatemia, eventual cardiac decompensation which can possibly lead to heart failure

Question 3

How is refeeding syndrome prevented

Answer 3

• refeed slowly
• start with 500 calories above what pt is taking
• add 200-300 calories every 3-4 days

Question 4

Indications that pt needs hospitalization for anorexia

Answer 4

• blood pressure below 85/50
• severe malnutrition
• dehydration
• electrolyte imbalances
• EKG abnormalities
• sinus bradycardia
• suicidality

Question 5

Patient management for eating disorders

Answer 5

• optimal is interdisciplinary team approach
• usually treated on outpatient basis
• may require initial or periodic hospitalizations

Question 6

Steps to take in managing eating disorders

Answer 6

1. think about acute and chronic care
2. form relationships with inpatient units
3. work with nutritional supports
4. use psychological components
5. involve family
6. avoid splitting, work as a team
7. consider medications (low priority)

Question 7

Goals for management of eating disorders

Answer 7

1. stabilize medical and nutritional status
2. identify and work toward resolving psychosocial problems
3. re-establish healthy eating patterns

Question 8

Nutrition management for eating disorders

Answer 8

1. help regain and maintain adequate weight = BMI of at least 16
2. 2-3 servings of protein/day
3. 30-50 g of fat/day
4. Calcium intake:12-1500 mg daily (3-4 glasses)
5. vitamin supplements
6. MVI 400 IU/day

Question 9

Outpatient nutritional management for eating disorder

Answer 9

reasonable goal is one half to 4 # weight gain per week until minimum goal is met

Question 10

Inpatient nutritional management for eating disorder

Answer 10

aim is a slower weight gain at about 1/2 #/day