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Flashcards in Surgery Nutrition Deck (9)
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1

Malnutrition Consequences


What on physical exam may suggest malnutrition?

Consequences:
-increased susceptibility to infection
-poor wound healing
-increased frequency of decubitis ulcers
-overgrowth of bacteria in GI

Malnutrition PE:
-BMI
-temporal wasting
-pallor
-xerostosis
-bleeding gums
-dentition
-angular cheilosis (dry cracked lips)
-dentition
-thyromegaly
-extremities: edema, muscle wastin g
-neuro: peripheral neuropathy
-ecchymosis, petechiae, pressure ulcers
-evidence of heart failure.

2

Lab evaluation of Nutrition

Labs:
-protein assessment:
--serum albumin (less than 2.2g/dL = poor outcomes)
--serum transferrin (reflects Fe status)
--serum prealbumin

-CBC
-CMP
-Vitamin levels

3

T/F pts undergoing surgery have better outcomes if they are healthy, eat high protein and caloric diets.

True. if they are not and require surgery then they need parenteral nutrition. may benefit to have delayed surgery to get nutrition if severe malnutrition.

4

What is the difference between enteral and parenteral feedings?

Enteral = nutrition via intestinal route

Parenteral = nurtrition per IV solution

5

Benefits of enteral feeding?

Lead to more rapid of PO feedings

Fewer infections

lower cost

shorter hospital stays

6

Enteral nutrition consists of what?

How is enteral nutrition administered?

Calories, protein, electrolytes, vitamins, minerals, & fluid.

AdministratioN:
-NG or nasoenteric tube (less than 30d)
-nasojejunal tubes (used for those with impaired stomach motility, increased risk of aspiration) (also short term)
-PEG (used for extended period of time)
-percutaneous jejunostomy tubes

7

Complications of Tube feedings

Aspiration

Diarrhea (from meds, composition of feeding, infusion rate)

Metabolic disturbances

8

Dumping Syndrome:
-what is this?
-sx
-tx

What: can follow rapid infusion of feeds via jejunal tubes or rapid gastric bolus feeds.

Sx: faintness, palpitations, diaphoresis, pallor, tachycardia, and hypoglycemia

Tx: slow rate of feeding or change formula to one with more complex carbs

9

Parenteral nutrition:
-infuse through which type of line?
-what type of solution is used?

Infused through a large central vein such as SVC, RA, IVC

Solution: hypertonic