14847765
Description
Flashcards by Elizabeth Then, updated more than 1 year ago
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Created by Elizabeth Then
about 6 years ago
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| Question | Answer |
| Metabolism | refers to process of anabolism and catabolism |
| During critical illness metabolic function is compromised: | digestion, absorption, immunity, protection |
| GI physiology and effect of crtical illness | role of digestion absorption of nutrients GIT role is immunity and protection |
| GIT abnormal function | digestion and absorption of nutrients are altered gastric acid changes impaired ability of small intestine to absorb nutrients hypoperfusion and decreased oxygenation leading to GIT ischaemia |
| GIT hypoperfusion and consequences | decreased blood flow to GIT disruption of physical barrier to pathogens disruption of chemical control of bacterial overgrowth reduced immunological activities of gut associated lymphoid tissue |
| Factors affecting malnutrition | poor oral intake stress surgery sepsis prolonged bed rest immobility |
| Malnutrition will lead to | impaired immune functino cardiac function ventilatory drive and weak resp muscles prolonged vent dependence increased infectiour morbidity and mortality |
| Defining malnutrition in adults | condition that develops when the body does not get right amount of vitamins, minerals, nutrients, to maintain health tissues and organ function resulting in muscle wasting |
| Estimating nutritional requirements | influnced by: age, gender, body size, activity levels, injury severity, temp, renal function, dialysis, wounds, drains |
| Nutrition requirements | energy - reduce catabolism, preserve lean body mass and provide essential vitamins and minerals protein - promote positive nitrogen balance for wound healing and recovery fluid - adequate hydration vitamins - coenzymes and cofactors in multiple metabolic processes micronutrients - prevent defiency syndrome |
| Comlication of overfeeding | increased metabolic rate increased O2 consumptions and CO2 production ventilator dependence hyperglycaemia - sepsis/infections fatty liver immunosuppression fluid overload electrolyte imbalance |
| Forms of nutritional support | enteral, - tube, parental - iv, vitamin and mineral supplement, orak |
| Enteral feeding | not sued when there is proximal fistula, GIT bleed, hypotension |
| Monitoring enteral feeding | gastric aspirates, abdominal distension, bowel activity , feed delivered, correct rate, prescribed volume regular flushes, correct tape, patient positioning diarrhoead need more than 3 times a day for duration of 3-6 days = cease causes of diarrhoea, infection, sepsis, antibiotics, reduced GIT function |
| TPN management and indications | delivery of pts complete volume administered via CVC or PICC indications - intestinal fistula, prolonged ileus, short bowel syndrome macronuteitns - aminoacids, glucose trace elements, vitamin K weekly monitor for pneumothorax, airembolism, throbosis, site infection, sepsis hyper/hypo glycaemia hynatreamia, hypercalcaemia |
| Contraindications for TPN | functional and usually GIT when aggressive nutrition is not desired |
| Enteral vs parental feeding | enteral feeding cheap, less invasive, better substrate utilisation maintains integrity of gut mucosa less likely to overfeed |
| Hyperglycaemia and increased insulin resistance | characteristics of stress response also associated with poor wound healing higher infection rates higher death rates |
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