PHRD5985 Pharmacotherapy Lecture 15 - Pharmaconutrition

Card Set Information

Author:
daynuhmay
ID:
273411
Filename:
PHRD5985 Pharmacotherapy Lecture 15 - Pharmaconutrition
Updated:
2014-05-06 07:15:55
Tags:
Pharmaconutrition
Folders:

Description:
Pharmaconutrition
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user daynuhmay on FreezingBlue Flashcards. What would you like to do?


  1. 3 effects of pharmaconutrition
    • immunomodulatory
    • anti-inflammatory
    • antioxidant
  2. 3 drugs often added to nutrition formulations
    • insulin
    • famotidine
    • iron
  3. process to ID an individual who is malnourished or who is at risk for malnutrition to determine if a detailed nutrition assessment is indicated
    screening
  4. screening is mandated by the JC within _____ of admission to an acute care hospital
    24hrs
  5. 4 screening goals
    • ID specific nutrition risks
    • ID malnutrition
    • provide rec's/interventions to improve status
    • provide basis for nutrition intervention
  6. 3 types of malnutrition
    • 1) water/electrolyte imbalances
    • 2) tissue oxygenation
    • 3) immunosuppression
  7. Etiology Classification of Malnutrition (ASPEN)
    • starvation-related (no inflammation)
    • chronic disease-related (mild-mod chronic inflammation)
    • acute disease-related (acute, severe inflammation)
  8. classical starvation related malnutrition, often sever & debilitating
    marasmus
  9. protein specific malnutrition
    - "the sickness that the baby gets when the new baby arrives"
    Kwashiorkor
  10. the "fourth malnutrition"
    sarcopenic obesity
  11. use of non-invasive measurements to measure stores of fat & lean body mass in adults
    anthropometry
  12. high risk waist circumference (m & f)
    • males: >102 cm
    • females: >88 cm
  13. postive acute phase reactants = ____ in inflammation
    increase
  14. what must be normalized before negative acute phase reactants can be interpreted?
    CRP (marker of inflammation)
  15. negative acute phase reactant markers (3)
    • albumin
    • transferrin
    • prealbumin
  16. MUST score needed in order to implement nutritional action
    2+ points
  17. NRS score needed to implement nutritional care plan
    3+
  18. when NOT to use the gut for nutrition (5)
    • severe hemodynamic compromise (shock)
    • severe ileus
    • bowel perforation/obstruction
    • uncontrolled GI bleed
    • high output fistulae
  19. cyclic EN
    pt only receives feeding overnight
  20. bolus EN
    intermittent delivery of feeding over 5-15min intervals throughout day
  21. type of EN administration you should NOT use to feed post-pyloric access pts
    bolus
  22. formula used when impaired digestive capacity is suspected (eg: pancreatitis)
    monomeric
  23. hepatic formula
    higher branched chain AA's, lower simple AA's to prevent hepatic encephalopathy
  24. pulmonary formula
    • immunomodulatory omega-3's
    • higher fat content
  25. immune enhancing formula
    higher arginine, glutamine, omega-3's, antioxidants
  26. caloric dense formula
    2 kcal/mL for fluid restricted pts 

    (watch for osmotic diarrhea!)
  27. when high nitrogen formula is used
    metabolically stressed pts
  28. prokinetic agents used for tube feeding intolerance
    • erythromycin
    • metoclopramide
  29. when peripheral IV access for TPN is indicated
    temporary (ST) parenteral nutrition
  30. order of TPN compounding
    • phosphorus first
    • calcium late
    • lipids last
  31. type of calcium to use when compounding
    calcium gluconate
  32. coalescence
    fusion of small triglycerides into larger ones (INCOMPATIBLE TPN bag)
  33. cracking
    complete separation of oil & water in TPN bag (INCOMPATIBLE)
  34. refeeding syndrome
    • after starvation, increased glucose loads results in intracellular shirts of ions, insulin release, & depleted phosphorus 
    • quick loss of thiamine causes lactic acidosis
  35. max dextrose infusion rate
    4mg/kg/min
  36. which part of TPN requirement should be calculated first
    protein
  37. 20% fat emulsion = _____ kcal/mL
    2 kcal/mL
  38. dose range of fat that is carb sparing
    0.5-1 g/kg/day
  39. fat in TPN
    soybean or saffron oil
  40. Chest Physicians Equation caloric requirement
    25-35 kcal/kg/day
  41. adjusted body weight for TPN
    ADW = IBW + [(ABW-IBW) x 0.25]
  42. fluid requirement equation
    1500 mL + (20 mL/kg for every kg about 20kg)
  43. if underweight & at risk for refeeding, start TPN at ____ goal rate of calories
    1/3
  44. daily monitoring of TPN
    • weight
    • fluid status
    • intake/output
    • additional nutritional intake
    • electrolytes
    • glucose
  45. thrice weekly monitoring of TPN
    • CBC
    • LFTs
    • PT
    • PTT
  46. weekly monitoring of TPN
    • CRP
    • albumin
    • prealbumin
    • triglycerides
  47. starting EN rate
    20mL/hr
  48. contraindications for TPN
    • inability to establish & maintain IV access
    • EN not likely to be required for >7 days
    • adequate gut fcn
  49. permissive underfeeding = _____% of energy
    • 50-75%
    • for obesity & morbid obesity
  50. oxandrolone
    androgenic steroid that helps reverse catabolic cascade in burn pts
  51. propranolol for burn pts
    controls sympathetic tone (bc there is an increase in sympathetic NS activity in these pts)
  52. protein req for pts w/ kidney disease NOT on dialysis
    0.8 g/kg
  53. protein req for pt w/ ESRD on RRT
    1 g/kg
  54. why branched chain AA's are used in liver disease
    less likely to cross BBB & be metabolized into ammonia in hypercatabolic pts

What would you like to do?

Home > Flashcards > Print Preview