Major Case Study: Enteral and Parenteral Nutrition Due 2/13/15 60 points. Ht: 5 11 Current wt: 156 # UBW: 167 # Serum albumin: 3.

Size: px
Start display at page:

Download "Major Case Study: Enteral and Parenteral Nutrition Due 2/13/15 60 points. Ht: 5 11 Current wt: 156 # UBW: 167 # Serum albumin: 3."

Transcription

1 Name: Wan yi Wang Major Case Study: Enteral and Parenteral Nutrition Due 2/13/15 60 points Mr. R, a 35 yo drug user, is hospitalized after a motor vehicle accident (MVA). He is currently suffering from a severe concussion and lapses of consciousness, a broken jaw, multiple broken bones, and possible internal injuries. He had not eaten anything for several days PTA because he was overdosing on drugs. Enteral feeding has been recommended in order to improve his nutritional status and given his decreased level of alertness. The patient will be bedridden until his mental status improves. A nasogastric feeding tube has been inserted and the physician has asked for your recommendation regarding the type of formula and amounts of kcal/protein needed for this patient. Ht: 5 11 Current wt: 156 # UBW: 167 # Serum albumin: 3.0 mg/dl 1. Write 1 PES statement for this patient. (2 pts) Inadequate oral food/beverage intake (NI-2.1) r/t difficulty swallowing and obtaining adequate nutrition AEB lapses in consciousness, drug abuse, and a broken jaw from a MVA. (source: NTP Appendix C2 p. A-65) 2. Is the nasogastric feeding route appropriate for this patient? Why or why not? (3 pts) With the information provided, nasogastric feeding route is not appropriate for this patient. This patient is at high risk for aspiration due to his decreased level of alertness and lapses of consciousness from his severe concussion. However, enteral feeding must be used to because he is unable to take nutrients in by mouth due to his broken jaw and drug doses. So, I would recommend naso-intestinal feeding such as nasodeudenal tube feeding. This kind of enteral feeding is a better solution because this patient still has functional GI tract and enabling him to absorb the nutrients pum from the stomach and goes sright to small intestine where nutrient are able to be absorb without causing regurgitation. However, if Mr.R cannot tolerate the nasoduodenal route, then we would move the tube further down and use nasojejunal route. (source:nut 116BL Lecture on enteral nutrition tube feeding) 3. What daily intake of kcals, protein, and fluids would you recommend for this patient and why? Show calculations for estimated needs; give recommendations as kcal/d, g protein/d, ml fluid/d. (6 pts) CBW: 156 lbs. /2.2 lbs. /kg = 70.9kg IBW:5 11 = 106 lbs lbs. = 172 lbs. UBW: 167lbs./2.2lbs./kg=75.9kg Height: 71 x 2.54 cm/in = cm BMI: 70.9 kg/1.81 m 2 = 21.7 kg/m 2 Wt Loss: 156#/167 # = 6.6% weight loss (a) Estimated Energy Requirements (EER)= REE x activity factor x injury factor (MSJ equation)

2 REE: (10 x weight (kg)) + (6.25 x height (cm)) (5 x age) + 5 REE: (10 x 70.9kg) + (6.25 x cm) (5x 35 yo) + 5 = kcal Activity factor: 1.2 (confined to bed), 1.4 ((IF skeletal trauma) (PR p.3,9) EER= x 1.2 x 1.2 = 2,399 kcal/d EER= x 1.2 x 1.4= 2,799 kcal/d EER= 2,399-2,799 kcal/d (PR p.3,9) I would recommend 2,399 to 2,799 kcal per day for this patient, this range of kcal is need due to patient having multiple bone fracture and head injury. So, more calories are needed to help with healing process and to balance out his current state of protein catabolism. Thus, this can help prevent depletion of energy store and development of muscle wasting. Also increase calories to help patient to maintain his weight. (b) protein requirement: g protein/kg BW I chose this range because this patient is in moderate-severe stress due to multiple broken bones and possible internal injuries. (Enteral Nutrition Lecture) 1.5 g/ protein / kg BW x 70.9 kg= g protein/ day 2.0 g protein/ kg BW x 70.9 kg = g protein/day (Source: Reviewed this from protein in discussion & PR p.10) So base on this calculation, Mr.R is recommended to consume g protein to gram of protein per day. As result of motor accident and surgery, Mr.R needs a high protein diet so the muscle and tissue can be repair and also rebuild red blood cells. In addition, patient s body is in the state of muscle protein catabolism, with high protein need it help with restoring his body state to anabolic state and increase production of protein. (c) Fluid Requirement: 1ml/ kcal (source: PR p. 11) 2399 kcal/d x 1 ml fluid/kcal = 2,399 ml fluid/day 2799 kcal/d x 1ml fluid/kcal= 2,799 ml fluid/day Base on my calculation this patient needs 2,399-2,799 ml fluid per day. During the motor vehicle accident he lost a large amount of blood and fluid and maybe during surgery as well. Thus, Mr.R will need a large amount of fluid to compensate for the fluid loss. However, we need to give a right balance of fluid, because excess will cause patient to have edema. 4. Based on the needs of this patient, describe three desirable characteristics for the type of formula you would recommend. Give one example of an appropriate enteral formula meeting these characteristics. Use Appendix C2 in NTP text or the formulary provided on the UCD SmartSite. (4 pts) 1) The formula needs to have fiber enrichment to ensure that his GI function remains normal, as his nasogastric tube is temporary. 2) The formula would provide slightly beyond the necessary protein levels to ensure healing in his state of critical illness/ trauma. 3) The kcal content of the formula needs to be high enough to prevent any more weight loss, and help his wounds to heal. Based on these three desirable characteristic and the need of immune support in his formula to fight possible infection. I will suggest the use of Jevity 1.2; this formula will meets these requirements. Because he is suffering from trauma from a motor vehicle accident and is in critical condition, he could also take advantage of an immune support specialized formula enhanced with arginine, nucleic acids, omega-3 fatty acids, etc.

3 (source: NTP p. 87 & Lecture UCDTF) 5. a.) Based on the enteral formula you selected in question 3 above, what daily total volume of formula would meet Mr. R s estimated kcal and protein needs? Show calculations. (3 pts) average of kcal range = 2599 kcal/day / 1.20 kcal/ml =2,165.8 ml formula/ day ml x 55.5g protein /1000ml) = g protein 120 gram of protein (Protein range is g g) So, 120 gram of protein falls within the range of protein need. Thus, this formula Jevity 1.2 is appropriate to use on this patient. b) What would be the hourly rate for delivery of this tube feeding as a continuous 24hr infusion? Show calculations. (1 pt) ml/24 hours = 90.2 ml/hour 90ml/hr. c) Is this volume of tube feeding adequate to meet his fluid needs? If not, indicate what else is needed and how it would be added to the current tube feeding. Show calculations. (4 pts) Jevity 1.2 is 81% water ml x 0.81 = ml free water. 2599mL ml= ml water fluid needed mL /6x a day = free water free water flush every 4 hrs. 140 ml for ease of feeding. No, since the fluid needs are 2399 ml ml/day and the patient is being given 2,165.8 ml of formula that is 81% free water, there is a fluid needs deficit of ml per day. So, in order to meet his fluid needs, the patient will need additional free water flushes to make up for the deficit. In order to meet his fluid needs, the patient will need additional free water flushes to make up for the deficit. A recommendation for this could be 140 ml free water flushes every 4 hours on top of continuous feeding. (source: NTP p. 87 & Lecture UCDTF) 6. Give 3 blood values that you would monitor for this patient and the reasons why. (6 pts) 1. Blood glucose this lab value can help to assess the effect of the enteral nutrition and the formula contains a great amount of CHO. This can lead to an increase in glucose in blood along with that, Mr. R is suffering from multiple injuries. Thus, his body may not be able to handle and produce sufficient amount of insulin to compensate. As result diabetes can occur. So, is necessary to closely monitor his blood glucose to prevent diabetes development. 2. Blood urea nitrogen (BUN). This marker indicates the amount of nitrogen in the blood due to the presence of urea which is a metabolic by-product of protein catabolism. Monitoring this value in Mr. R will further indicate the severity of his hyper-metabolic state and degree of muscle protein wasting. With an improvement in his status and progressing through his recovery, his BUN value should gradually decrease thus indicating an adequate amount of calories and reduction in muscle protein catabolism. 3. Pre-albumin Protein is crucial to wound healing and patient must not deplete the protein store. Pre-albumin is a good marker for the patient s current protein status because it has a half-life of

4 2-4 days. So it gives a more accurate representation of the patient s current status because it is more sensitive to change in protein energy status. Thus, monitor pre-albumin can help to monitor inflammation, infections and prevent protein energy malnutrition. (source: NUT 116BL enternal nutrition-tube feeding lecture & NTP p. 92 & Nut 116B method of nutrition support lecture Pocket Resource), 7. Give one urine value that you would monitor and the rationale for monitoring it. (2 pts) I would monitor the patient s urine urea nitrogen value due to fact that he is in the hyper-metabolic state and lack of adequate nutrition for at least one week. He is likely to be in the state of protein catabolism which means muscle wasting and urinary excretion of nitrogen in the form of urea. This value measure his nitrogen balance and the more catabolism that is occurring, the greater the amount of urea will be seen in his urine likely indicating a negative nitrogen balance. As his body gains the nutrients it needs through nutrition support, it will be able to increase protein synthesis, decrease muscle protein catabolism and ultimately shift the nitrogen balance toward a positive balance and excrete a lesser amount of urea in his urine. (source: NTP p. 53, 54, 92) The patient, Mr. R, is now 5 days s/p his MVA. He did not tolerate the enteral feedings well (diarrhea and pain) and now has been diagnosed with acute pancreatitis. The MD has ordered a nutrition consult for evaluation of parenteral nutrition (PN) support. For the purposes of answering questions 7-12, assume that your current estimated kcal and protein needs for Mr. R are: 2600 kcal/day and 110 g protein/day. 8. Write a PES statement. (2 pts) Inadequate enteral nutrition infusion (NI 2.3) r/t intolerance to feedings AEB diarrhea, pain, and newly diagnosed acute pancreatitis. (source: Lecture UCDTF & Liver Disease II slide & Appendix C2 in NTP p. A-65) 9. Which type of PN support do you recommend central or peripheral? Justify your answer. (2 pts) Central Vein feeding is recommended, as it is usually used when patient is unable to tolerate enteral feeding for more than 5-7days, with moderate to severe metabolic stress and elevated metabolic rate (hyper-metabolism from multiple bone fractures and head injury), it is also used when the patient requires higher caloric needs. With peripheral parenteral nutrition you have to have a decreased osmolality (<900 mosm/l) to prevent thrombophlebitis. Central access allows a higher osmolality formula to be administered because it is a high flow area (large central vein, usually superior vein cava) which can quickly dilutes the solutions. Another reason why the central route is a better choice is because Mr. R will need the IV fluids for a longer period of time. (source: Nut 116 B & BL nutrition support lecture & NTP p ) 10. Calculate the amount of a 10% lipid emulsion that is needed to provide around 20% of Mr. R s total kcal needs. Show calculations. (2 pts) 10% fat= 1.1 kcal/ml (11kcal/gram) Kcal need = 2600 kcal x 0.20 fat from kcal = 520 kcal from fat 520 kcal from fat / 1.1kcal/ml lipid emulsion = ml of 10% solution 500 ml of 10% lipid emulsion

5 There are only 100 ml, 250ml, and 500 ml bags so we will use a 500 ml bag. So, a 500 ml bag will be used. 500 ml x 1.1 kcal/ml = 550 kcal fat 11. The MD wants the dextrose and amino acid solution to be a total volume of 2 L/day. (The volume of lipid emulsion is separate from this 2 L.) a) Determine the final amino acid concentration of this solution, which would supply 110 g protein/day. Show calculations. (2 pts) (110g/2000mL) x 100=5.5% amino acid solution 6% AA solution 110g x (4kcal/1g)=440kcal protein b) Determine the remaining kcals to be provided as CHO. Express your answer as kcals from CHO and as grams of dextrose. Show calculations. (3 pts) 500 kcal from fat x 1.1 kcal/ml = 550 kcal 110 g protein x 4 kcal/g protein = 440 kcal protein 550 kcal kcal = 990 kcal from fat and protein Remaining kcals to be provided as CHO: = 1610 kcal to be provided as CHO 1610 kcal CHO/3.4 kcal/g = 474 g dextrose c) Determine the final dextrose concentration of the solution. Show calculations. (2 pts) 474 g dextrose/ 2000mL = 23.7 % Concentration Dextrose d) If the PN solution had to be made from a starting stock solution of D 50 W (500 g dextrose in 1 L of water), what volume of this stock D 50 W would be needed to provide the grams of dextrose that you calculated in question 9b above? Show calculations. (2 pts) 474g dextrose / 500g = x 100 = 94.8% of the solution 1000ml x = 948 ml So, 948ml stock D50W solution needed to meet 474 g dextrose requirement e) Compare the grams of dextrose to be provided in this solution with the maximum glucose infusion rate for Mr. R of 5 mg/kg BW/min. Would you make any changes to the PN solution based on this information? Explain your rationale. If so, how would you change it? (2 pts) 5mg x 70.9 kg BW= mg/min mg/min x 60 min/ hr = 21,270 mg/ hr 21,270mg/hr x 24 hr/day x 1 g/ 1000 mg= gram/ day 474 g/day / 1440min/day = 0.329g/min g/min x 1000mg/g = mg/min mg/min / 70.9kg BW = 4.6mg/kg BW/min Since 4.6 mg/kg/min of dextrose he needs falls under the 5 mg/kg/min the maximum glucose infusion rate. I would not make any change to his PN solution.

6 12. List three lab values that you would monitor for this patient and the reasons why. (6 pts) 1. Liver Enzymes- there is an association of PN and liver disease, and lack of feeding to the GI tract. Through monitor Mr. R s liver enzymes can help to prevent and early detection of any liver function alteration or malfunction. 2. Electrolytes (Sodium, Magnesium, Calcium, Phosphorous etc.), Electrolyte aid in regulation of body s nerve and muscle function, blood ph, blood pressure and hydration; While sodium and potassium keep the body in homeostasis. However, with PN, abnormal in electrolytes level or severe electrolytes changes are commonly seen, which maybe a result from diarrhea, renal insufficiency, large wounds etc. Thus, corrections to solution content must be made as soon as possible if noticed abnormalities in electrolytes level. As adequate level of electrolyte can help patient maintain hydrated and heals wound properly. 3. Serum lipids, namely triglycerides. The amount of triglycerides present in his blood is reflective of his tolerance of the lipid emulsion and physiological compensation in response to this tolerance. If he is not tolerating the lipid emulsion well, the expectation would be to see high levels of serum triglycerides both from the lipid emulsion as well as his state of catabolism, indicating the release of free fatty acids by extrahepatic tissue for energy usage by cells. (source: Nut 116BL parenteral nutrition lecture & NTP p 101 & table 5.3) 13. Mr. R develops hyperglycemia while on PN support. Describe two actions you would recommend to help lower blood glucose and achieve metabolic control of the patient. (2 pts) 1) I recommend lower the amount of dextrose given per minute or spreading out the dispersal of the required levels of CHO and help his insulin catch up with the tube feeding formula. This is to prevent his blood glucose from going to high. 2) I recommend giving patient an intensive insulin therapy; as there will be development of hyperglycemia when too much sugar is present in the blood. So, is ideal to include his body regulating its own blood glucose levels along with the treatment. The goal of this treatment is to decrease his blood glucose and maintain at normal levels to prevent any abnormal effects on his physiology. (source: NTP textbook P. 101) 14. What is refeeding syndrome? Why is it important to monitor for refeeding syndrome in a severely malnourished patient who is started on PN? (4 pts) Refeeding syndrome describe the condition in which several metabolic changes have as a result of starvation of the body. Refeeding syndrome occurs as a patient who has been severely malnourished is first been feed with a highly nutritious diet. With high level of carbohydrate, it will cause electrolytes to move into the cells for metabolism. Refeeding syndrome can result in hypophopatamia, hypomagneisum, hypokalemia and abnormal sodium level, alteration in protein and fat metabolism. Rapid infusion of carbohydrate will stimulate insulin and decrease sodium and water excretion, which can cause retention of fluid in extracellular space (edema). The patient s body is not used to this high amount of calories and nutrient which is the reason there will be dangerous fluctuation of fluids and electrolytes. Refreeding syndrome can also lead to various complications such as hemolysis, weakened respiratory function and cardiac function.

7 Thus, is crucial to monitor refeeding for severely malnourished patients who have begun PN because the sudden shift from no nutrients to relatively excessive nutrients can cause this potentially fatal shift in fluids and electrolytes. So, to effectively prevent refeeding syndrome in general as well as in PN patients, caution must be taken and start with small amount of nutrient and calories and then gradually increase as the patient start to tolerate. (source: NTP textbook p & Lecture Fluid and Electrolyte Balance & NUT 116B lecture methods of Nutrition Support)

Major Case Study: Enteral and Parenteral Nutrition

Major Case Study: Enteral and Parenteral Nutrition Major Case Study: Enteral and Parenteral Nutrition Mr. R, a 35 yo drug user, is hospitalized after a motor vehicle accident (MVA). He is currently suffering from a severe concussion and lapses of consciousness,

More information

Major Case Study: Enteral and Parenteral Nutrition Due 2/13/15 60 points. Ht: 5 11 Current wt: 156 # UBW: 167 # Serum albumin: 3.

Major Case Study: Enteral and Parenteral Nutrition Due 2/13/15 60 points. Ht: 5 11 Current wt: 156 # UBW: 167 # Serum albumin: 3. NUT 116BL Winter 2015 Name: yimeng Ma Section: Major Case Study: Enteral and Parenteral Nutrition Due 2/13/15 60 points Mr. R, a 35 yo drug user, is hospitalized after a motor vehicle accident (MVA). He

More information

Amanda Hernandez FND Parenteral Nutrition Worksheet October 26, 2011

Amanda Hernandez FND Parenteral Nutrition Worksheet October 26, 2011 Amanda Hernandez FND 430-001 Parenteral Nutrition Worksheet October 26, 2011 1. HP needs TPN because he has short bowel syndrome and his GI tract is not functional. His entire jejunum was and proximal

More information

Parenteral and Enteral Nutrition

Parenteral and Enteral Nutrition Parenteral and Enteral Nutrition Audis Bethea, Pharm.D. Assistant Professor Therapeutics I December 5 & 9, 2003 Parenteral Nutrition Definition process of supplying nutrients via the intravenous route

More information

Amanda Hernandez FND October 17, 2011 Enteral Feeding Case Study

Amanda Hernandez FND October 17, 2011 Enteral Feeding Case Study Amanda Hernandez FND 430-001 October 17, 2011 Enteral Feeding Case Study 1. Nutritional Assessment to determine energy and protein needs Percent Usual Body Weight [(current body weight/usual body weight)

More information

Esophageal Cancer Treated with Surgery and Radiation Case Study (Evaluation and ADIME Note)

Esophageal Cancer Treated with Surgery and Radiation Case Study (Evaluation and ADIME Note) Esophageal Cancer Treated with Surgery and Radiation Case Study (Evaluation and ADIME Note) Nutritional care plan: N.S. is a 58 yr old male. His serum albumin is below normal with a value of 3.1L (9/5)

More information

PARENTERAL NUTRITION

PARENTERAL NUTRITION PARENTERAL NUTRITION DEFINITION Parenteral nutrition [(PN) or total parenteral nutrition (TPN)] is the intravenous infusion of some or all nutrients for tissue maintenance, metabolic requirements and growth

More information

Nutrition and Medicine, 2006 Tufts University School of Medicine Nutrition and Acute Illness: Learning Objectives

Nutrition and Medicine, 2006 Tufts University School of Medicine Nutrition and Acute Illness: Learning Objectives Nutrition and Medicine, 2006 Tufts University School of Medicine Nutrition and Acute Illness: Learning Objectives Margo N. Woods, D.Sc. 1. Define protein-calorie, or protein-energy malnutrition (PEM) and

More information

Nutrition Services at a glance

Nutrition Services at a glance Nutrition Services at a glance Ragini Raghuveer, MS, RD, LD/N Systems Clinical Nutrition Manager Linette De Armas, RD, LD/N Clinical Dietitian Melissa Lorenzo, RD, LD/N Clinical Dietitian 1 Learning Objectives

More information

Fluid & Electrolyte Balances in Term & Preterm Infants. Carolyn Abitbol, M.D. University of Miami/ Holtz Children s Hospital

Fluid & Electrolyte Balances in Term & Preterm Infants. Carolyn Abitbol, M.D. University of Miami/ Holtz Children s Hospital Fluid & Electrolyte Balances in Term & Preterm Infants Carolyn Abitbol, M.D. University of Miami/ Holtz Children s Hospital Objectives Review maintenance fluid & electrolyte requirements in neonates Discuss

More information

Chapter 16 Nutrition, Fluids and Electrolytes, and Acid-Base Balance Nutrition Nutrients Water o Functions Promotes metabolic processes Transporter

Chapter 16 Nutrition, Fluids and Electrolytes, and Acid-Base Balance Nutrition Nutrients Water o Functions Promotes metabolic processes Transporter Chapter 16 Nutrition, Fluids and Electrolytes, and Acid-Base Balance Nutrition Nutrients Water o Functions Promotes metabolic processes Transporter for nutrients and wastes Lubricant Insulator and shock

More information

Clinical Manifestations. Principles of Nutrition Assessment. Significance of nutritional assessment. Nutrition Deficiency States.

Clinical Manifestations. Principles of Nutrition Assessment. Significance of nutritional assessment. Nutrition Deficiency States. Clinical Manifestations Principles of Nutrition Assessment Audis Bethea, Pharm.D. Assistant Professor Therapeutics I December 5 & 9, 2003 Impaired cellular immunity Impaired wound healing End organ dysfunction

More information

CHS 431. Enteral and Parental Nutrition (Practical Part)

CHS 431. Enteral and Parental Nutrition (Practical Part) King Saud University College of Applied Medical Sciences Community Health Sciences CHS 431 Enteral and Parental Nutrition (Practical Part) 1 st semester 1432-1433 Student Name: Student Number:.. Total

More information

Methods of Nutrition Support KNH 406

Methods of Nutrition Support KNH 406 Methods of Nutrition Support KNH 406 Malnutrition 30 50% of hospitalized patients 95% of nursing home patients Resulting in reduced quality of life & increased health care costs May be remedied by providing

More information

Nutrition Support Calculations Brianne Squires

Nutrition Support Calculations Brianne Squires Nutrition Support Calculations Brianne Squires 1. Determine the following for Ensure at 68 ml/hour (Note: when working with volumes of formula for enteral formula, it is expressed in total volume/ml not

More information

Introduction to Clinical Nutrition

Introduction to Clinical Nutrition M-III Introduction to Clinical Nutrition Donald F. Kirby, MD Chief, Section of Nutrition Division of Gastroenterology 1 Things We Take for Granted Air to Breathe Death Taxes Another Admission Our Next

More information

Intensive Care Nutrition. Dr Alan Race BSc(Hons) PhD FRCA

Intensive Care Nutrition. Dr Alan Race BSc(Hons) PhD FRCA Intensive Care Nutrition Dr Alan Race BSc(Hons) PhD FRCA Objectives 1. What examiners say 2. Definition 3. Assessment 4. Requirements 5. Types of delivery 6. CALORIES Trial 7. Timing 8. Immunomodulation

More information

Pediatric Nutrition Care as a strategy to prevent hospital malnutrition. Div Pediatric Nutrition and Metabolic Diseases Dept of Child Health

Pediatric Nutrition Care as a strategy to prevent hospital malnutrition. Div Pediatric Nutrition and Metabolic Diseases Dept of Child Health Pediatric Nutrition Care as a strategy to prevent hospital malnutrition Div Pediatric Nutrition and Metabolic Diseases Dept of Child Health Child is not a miniature adult Specific for child growth and

More information

Intradialytic Parenteral Nutrition in Hemodialysis Patients. Hamdy Amin, Pharm.D., MBA, BCNSP Riyadh, Saudi Arabia

Intradialytic Parenteral Nutrition in Hemodialysis Patients. Hamdy Amin, Pharm.D., MBA, BCNSP Riyadh, Saudi Arabia Intradialytic Parenteral Nutrition in Hemodialysis Patients Hamdy Amin, Pharm.D., MBA, BCNSP Riyadh, Saudi Arabia Disclosure Information Intradialytic Parenteral Nutrition in Hemodialysis Patients Hamdy

More information

EU RISK MANAGEMENT PLAN (EU RMP) Nutriflex Omega peri emulsion for infusion , version 1.1

EU RISK MANAGEMENT PLAN (EU RMP) Nutriflex Omega peri emulsion for infusion , version 1.1 EU RISK MANAGEMENT PLAN (EU RMP) Nutriflex Omega peri emulsion for infusion 13.7.2015, version 1.1 III.1. Elements for a Public Summary III.1.1. Overview of disease epidemiology Patients may need parenteral

More information

Final Case Study: Renal Disease Due 3/19/14 60 points

Final Case Study: Renal Disease Due 3/19/14 60 points NUT 116BL Name: CHRISTINE WOO Winter 2014 Section: 1 Final Case Study: Renal Disease Due 3/19/14 60 points Part I: Initial Presentation Present Illness: Jenny is a 19 yo F student referred to the renal

More information

ICU NUTRITION UPDATE : ESPEN GUIDELINES Mirey Karavetian Assistant Professor Zayed University

ICU NUTRITION UPDATE : ESPEN GUIDELINES Mirey Karavetian Assistant Professor Zayed University ICU NUTRITION UPDATE : ESPEN GUIDELINES 2018 Mirey Karavetian Assistant Professor Zayed University http://www.espen.org/files/espen- Guidelines/ESPEN_Guideline_on_clinical_nutrition_in_-ICU.pdf Medical

More information

Nutritional intervention in hospitalised paediatric patients. Dr Y.K.Amdekar

Nutritional intervention in hospitalised paediatric patients. Dr Y.K.Amdekar Nutritional intervention in hospitalised paediatric patients Dr Y.K.Amdekar Back to basics Suboptimal nutrient intake is always dangerous in health and more so in disease to feed or not to feed is it a

More information

CASE STUDY REPORT: NUTRITIONAL MANAGEMENT OF CROHN S DISEASE

CASE STUDY REPORT: NUTRITIONAL MANAGEMENT OF CROHN S DISEASE CASE STUDY REPORT: NUTRITIONAL MANAGEMENT OF CROHN S DISEASE Lindsey Warren, MS ARAMARK Dietetic Intern Providence Medical Center February 13 th, 2012 Crohn s Disease and Malnutrition Medication Malabsorption

More information

Shyana Sadiq DFM 484: MNT Case Study 33: Esophageal Cancer Treated with Surgery and Radiation 10/14/2013

Shyana Sadiq DFM 484: MNT Case Study 33: Esophageal Cancer Treated with Surgery and Radiation 10/14/2013 Shyana Sadiq DFM 484: MNT Case Study 33: Esophageal Cancer Treated with Surgery and Radiation 10/14/2013 I. Understanding the Disease and Pathophysiology 1. Mr. Seyer has been diagnosed with adenocarcinoma

More information

Nutritional Demands of Disease and Trauma

Nutritional Demands of Disease and Trauma al Demands of Disease and Trauma Lecture 89 Medical School al Requirements Based on needs to support optimal physiological function Are changed by disease or injury metabolism is altered to prevent further

More information

CLINICAL WORKSHEET #2 Nutrition Support In: Extended Care Facilities, HIV Disease, and Thermal Injury

CLINICAL WORKSHEET #2 Nutrition Support In: Extended Care Facilities, HIV Disease, and Thermal Injury Name: Danielle Reschke BRIGHAM YOUNG UNIVERSITY NDFS 466 Clinical Worksheet #2 CLINICAL WORKSHEET #2 Nutrition Support In: Extended Care Facilities, HIV Disease, and Thermal Injury Purpose(s) 1. To complete

More information

L.Mageswary Dietitian Hospital Selayang

L.Mageswary Dietitian Hospital Selayang L.Mageswary Dietitian Hospital Selayang 14 15 AUG ASMIC 2015 Learning Objectives 1. To understand the importance of nutrition support in ICU 2. To know the right time to feed 3. To understand the indications

More information

NUT 116BL Name: Jeana Lim Section: A01 Winter 2013

NUT 116BL Name: Jeana Lim Section: A01 Winter 2013 NUT 116BL Name: Jeana Lim Section: A01 Winter 2013 Case Study #3: Renal Disease 50 points 1. Please be concise and use only the space provided. 2. Please cite sources as necessary. 3. You may use your

More information

Who Needs Parenteral Nutrition? Is Parenteral Nutrition An Appropriate Intervention?

Who Needs Parenteral Nutrition? Is Parenteral Nutrition An Appropriate Intervention? Who Needs Parenteral Nutrition? 1 Is Parenteral Nutrition An Appropriate Intervention? Key questions to ask with initial consultation Can the gastrointestinal (GI) tract be utilized? Can the GI tract be

More information

Nutrition Support in Children. Lyon 21 sept 2013

Nutrition Support in Children. Lyon 21 sept 2013 Nutrition Support in Children Lyon 21 sept 2013 Malnutrition : why detecting it in children? Alters cognitive development (observational or interventional studies) Responsible for prolongation of hospitalisation

More information

NUTRITION. Elizabeth Viner Smith & Catherine Jones Foundations of Critical Care Nursing September 2017

NUTRITION. Elizabeth Viner Smith & Catherine Jones Foundations of Critical Care Nursing September 2017 NUTRITION Elizabeth Viner Smith & Catherine Jones Foundations of Critical Care Nursing September 2017 Step One Competency 1.19 Factors contributing to nutritional impairment in critical illness. Nutritional

More information

Nutritional Demands of Disease and Trauma

Nutritional Demands of Disease and Trauma Nutritional Demands of Disease and Trauma Lecture 89 2000 Northwestern University Medical School Nutritional Requirements Based on needs to support optimal physiological function Are changed by disease

More information

TOTAL PARENTERAL NUTRITION

TOTAL PARENTERAL NUTRITION TOTAL PARENTERAL NUTRITION Indication See algorithm. Timing Start TPN as indicated on algorithm 1. There is no need to build up TPN volume. The volume of TPN (including lipids) should equate to the total

More information

Small Bowel Obstruction after operation in a severely malnourished man. By: Ms Bounmark Phoumesy

Small Bowel Obstruction after operation in a severely malnourished man. By: Ms Bounmark Phoumesy Small Bowel Obstruction after operation in a severely malnourished man By: Ms Bounmark Phoumesy Normal length of GI tract Normal length(achieved by age 9) Small bowel 600cm (Men: 630 cm; Women: 592 cm)

More information

Inflammatory Bowel Disease

Inflammatory Bowel Disease + Inflammatory Bowel Disease Christina Kalafsky, Dietetic Intern University of Maryland College Park Children s National Medical Center Case Study January 31, 2014 + Outline n Inflammatory Bowel Disease

More information

The Role of Parenteral Nutrition. in PEDIATRIC INTENSIVE CARE UNIT. Dzulfikar DLH. Pediatric Emergency and Intensive Care Unit

The Role of Parenteral Nutrition. in PEDIATRIC INTENSIVE CARE UNIT. Dzulfikar DLH. Pediatric Emergency and Intensive Care Unit The Role of Parenteral Nutrition in PEDIATRIC INTENSIVE CARE UNIT Dzulfikar DLH Pediatric Emergency and Intensive Care Unit Department of Child Health, Faculty of Medicine Universitas Padjajaran, Hasan

More information

By; Ashraf El Houfi MD MS (pulmonology) MRCP (UK) FRCP (London) EDIC Consultant ICU Dubai Hospital

By; Ashraf El Houfi MD MS (pulmonology) MRCP (UK) FRCP (London) EDIC Consultant ICU Dubai Hospital By; Ashraf El Houfi MD MS (pulmonology) MRCP (UK) FRCP (London) EDIC Consultant ICU Dubai Hospital Introduction The significance of nutrition in hospital setting (especially the ICU) cannot be overstated.

More information

Nutrition and Dietetics in the Normal Patient

Nutrition and Dietetics in the Normal Patient Nutrition and Dietetics in the Normal Patient Study Aims Definition Malnutrition Actual body weight Ideal body weight Predicted body weight Nutritional assessement Calculation of nutritional needs Complications

More information

Refeeding syndrome a practical approach

Refeeding syndrome a practical approach Refeeding syndrome a practical approach PENG pre-bapen Conference Teaching Day Birmingham Monday 20 th November 2017 Rhys White Acting Clinical and Operational Lead Dietitian Guys and St Thomas NHS Foundation

More information

Clinician Blood Panel Results

Clinician Blood Panel Results Page 1 of 7 Blood Panel - Markers Out of Range and Patterns (Pattern: proprietary formula using one or more Blood Markers) Blood Panel: Check for Markers that are out of Lab Range ***NOTE*** Only one supplement

More information

Vanderbilt University Medical Center Trauma ICU Nutrition Management Guidelines

Vanderbilt University Medical Center Trauma ICU Nutrition Management Guidelines Vanderbilt University Medical Center Trauma ICU Nutrition Management Guidelines Trauma Critical Care Nutrition Guidelines Clinical judgment may supersede guidelines as patient circumstances warrant ASSESSMENT

More information

Class 3: Refeeding Syndrome. Liz Hudson MPH, RD

Class 3: Refeeding Syndrome. Liz Hudson MPH, RD Class 3: Refeeding Syndrome Liz Hudson MPH, RD Case Study #1 NUTRITION ASSESSMENT: Consult PATIENT MEDICAL/HEALTH HISTORY: 49 y/o male with significant history of HTN, DM, and stage V CKD currently on

More information

Division of Acute Care Surgery Clinical Practice Policies, Guidelines, and Algorithms: Enteral Nutrition Algorithm Clinical Practice Guideline

Division of Acute Care Surgery Clinical Practice Policies, Guidelines, and Algorithms: Enteral Nutrition Algorithm Clinical Practice Guideline Division of Acute Care Surgery Clinical Practice Policies, Guidelines, and Algorithms: Enteral Nutrition Algorithm Clinical Practice Guideline Original Date: 08/2011 Purpose: To promote the early use of

More information

Surgical Nutrition for the Cardiothoracic Patient. Stephanie Kunioki RD, CNSC, LD Memorial Hermann TMC

Surgical Nutrition for the Cardiothoracic Patient. Stephanie Kunioki RD, CNSC, LD Memorial Hermann TMC Surgical Nutrition for the Cardiothoracic Patient Stephanie Kunioki RD, CNSC, LD Memorial Hermann TMC Financial Disclosures NONE Declared PROPER NUTRITION Surgical Effects on Nutrition Intake & Status

More information

Nutrition Diagnosis (3 pts) Inadequate energy intake and limited food acceptance R/T poor appetite due to chemotherapy AEB 8.9% weight loss, BMI 18.

Nutrition Diagnosis (3 pts) Inadequate energy intake and limited food acceptance R/T poor appetite due to chemotherapy AEB 8.9% weight loss, BMI 18. Taylor Zwimpfer Nutrition 302L 2/12/2014 Albumin Assessment Lab (NCP) Nutrition Assessment (3 pts) Diagnosis: Bladder Cancer Nutrition-related PMH, treatments, surgeries: Chemotherapy, appetite affected

More information

HISTORY OF THE KETOGENIC DIET

HISTORY OF THE KETOGENIC DIET Laura Roche RD Horizon Health Authority May 29, 2018 AGENDA History of the Ketogenic Diet Diet Pathophysiology Side Effects Pros and Cons How and Why the Diet works Ketogenic Diet for Type 2 Diabetes Ketogenic

More information

Oklahoma Dietetic Association. Ainsley Malone, MS, RD, LD, CNSD April, 16, 2008 Permissive Underfeeding: What, Where and Why? Mt.

Oklahoma Dietetic Association. Ainsley Malone, MS, RD, LD, CNSD April, 16, 2008 Permissive Underfeeding: What, Where and Why? Mt. The What, Why and When of Permissive Ainsley Malone, MS, RD, CNSD Nutrition Support Team Mt. Carmel West Hospital Mt. Carmel West 500 bed academic center Non-physician based NST Dietitian, pharmacist and

More information

Nutrition. Chapter 45. Reada Almashagba

Nutrition. Chapter 45. Reada Almashagba Nutrition Chapter 45 1 Nutrition: - Nutrient are organic substances found in food and are required for body function - No one food provide all essential nutrient Major function of nutrition: providing

More information

Nutrition. By Dr. Ali Saleh 2/27/2014 1

Nutrition. By Dr. Ali Saleh 2/27/2014 1 Nutrition By Dr. Ali Saleh 2/27/2014 1 Nutrition Functions of nutrients: Providing energy for body processes and movement. Providing structural material for body tissues. Regulating body processes. 2/27/2014

More information

Nutrition Support. John Cha Department of Surgery DHMC/UCHSC

Nutrition Support. John Cha Department of Surgery DHMC/UCHSC Nutrition Support John Cha Department of Surgery DHMC/UCHSC Overview Why? When? How much? What route? Fancy stuff: enhanced nutrition Advantages of Nutrition Decreased catabolism Improved wound healing

More information

Nutrition Care Process: Case Study B Examples of Charting in Various Formats

Nutrition Care Process: Case Study B Examples of Charting in Various Formats Nutrition Care Process: Case Study B Examples of Charting in Various Formats Case: JG is a 68 year old woman with a history of type 2 diabetes, chronic renal failure which is treated with hemodialysis

More information

KNH 413 Case Study #4- Metabolic Brittany Wrasman

KNH 413 Case Study #4- Metabolic Brittany Wrasman KNH 413 Case Study #4- Metabolic Brittany Wrasman 1. What is the Glasgow Coma Scale (GCS)? A. The Glasgow Coma Scale is used to evaluate and rank the severity of a traumatic brain injury. The individual

More information

Parenteral Nutrition in Oncology

Parenteral Nutrition in Oncology Parenteral Nutrition in Oncology Presenter: Pam Wagner, RD, CNSC Learning Objectives List indications for initiating PN in oncology patients Describe considerations when determining an appropriate candidate

More information

Recognize the importance of early nutritional support in the ICU Assessment and monitoring of nutritional status Determine how to estimate specific

Recognize the importance of early nutritional support in the ICU Assessment and monitoring of nutritional status Determine how to estimate specific Recognize the importance of early nutritional support in the ICU Assessment and monitoring of nutritional status Determine how to estimate specific nutritional requirements Enteral vs. Parenteral Specific

More information

ESPEN Congress Florence 2008

ESPEN Congress Florence 2008 ESPEN Congress Florence 2008 PN Guidelines presentation PN Guidelines in pancreas diseases L. Gianotti (Italy) ESPEN Guidelines on Parenteral Nutrition: Pancreas L.Gianotti, R.Meier, D.N.Lobo, C.Bassi,

More information

Principles of nutrition in the preterm infant. Importance of nutrition: Undernutrition is very common in VLBW infants

Principles of nutrition in the preterm infant. Importance of nutrition: Undernutrition is very common in VLBW infants Principles of nutrition in the preterm infant Dr. S. Navarro-Psihas Pädiatrie IV, Klinik für Neonatologie Medizinische Universität Innsbruck Importance of nutrition: Undernutrition is very common in VLBW

More information

CASE STUDY: ULCERATIVE COLITIS. Sammi Montag Dietetic Intern

CASE STUDY: ULCERATIVE COLITIS. Sammi Montag Dietetic Intern CASE STUDY: ULCERATIVE COLITIS Sammi Montag Dietetic Intern 2013-2014 PATIENT (CK) INTRODUCTION 26 year old female Chief complaint: bloody diarrhea and abdominal pain Admitting diagnosis: Ulcerative colitis

More information

NUTRITIONAL OPTIMIZATION IN PRE LIVER TRANSPLANT PATIENTS

NUTRITIONAL OPTIMIZATION IN PRE LIVER TRANSPLANT PATIENTS NUTRITIONAL OPTIMIZATION IN PRE LIVER TRANSPLANT PATIENTS ACHIEVING NUTRITIONAL ADEQUACY Dr N MURUGAN Consultant Hepatologist Apollo Hospitals Chennai NUTRITION IN LIVER FAILURE extent of problem and consequences

More information

Current concepts in Critical Care Nutrition

Current concepts in Critical Care Nutrition Current concepts in Critical Care Nutrition Dr.N.Ramakrishnan AB (Int Med), AB (Crit Care), MMM, FACP, FCCP, FCCM Director, Critical Care Services Apollo Hospitals, Chennai Objectives Why? Enteral or Parenteral

More information

Nutrition in hemodialysis patients with focus on Intradialytic Parenteral Nutrition (IDPN)

Nutrition in hemodialysis patients with focus on Intradialytic Parenteral Nutrition (IDPN) Nutrition in hemodialysis patients with focus on Intradialytic Parenteral Nutrition (IDPN) Enrico Fiaccadori enrico.fiaccadori@unipr.it Acute and Chronic Renal Failure Unit Medicine & Surgery Dept. Parma

More information

Acute management of severe malnutrition. Dr Simon Gabe St Mark s Hospital, London

Acute management of severe malnutrition. Dr Simon Gabe St Mark s Hospital, London Acute management of severe malnutrition Dr Simon Gabe St Mark s Hospital, London Malnutrition definition A state resulting from lack of uptake or intake of nutrition leading to altered body composition

More information

Diabetes Mellitus Case Study

Diabetes Mellitus Case Study COLORADO STATE UNIVERSITY Diabetes Mellitus Case Study Medical Nutrition Therapy By: Emily Lancaster 9/28/2012 [Type the abstract of the document here. The abstract is typically a short summary of the

More information

Enteral and parenteral nutrition in GI failure and short bowel syndrome

Enteral and parenteral nutrition in GI failure and short bowel syndrome Enteral and parenteral nutrition in GI failure and short bowel syndrome Alastair Forbes University College London Intestinal failure Inadequate functional intestine to allow health to be maintained by

More information

Substrates in clinical nutrition Ilze Jagmane

Substrates in clinical nutrition Ilze Jagmane Substrates in clinical nutrition Ilze Jagmane Latvian Society of Parenteral and Enteral Nutrition September, 2013 Introduction Food contains one or more of the following nutrients: Water Carbohydrate Lipids

More information

PROTOCOL FOR PARENTERAL NUTRITION

PROTOCOL FOR PARENTERAL NUTRITION PROTOCOL FOR PARENTERAL NUTRITION Based on; Roberton s textbook of neonatology. 4 th edition. 2005. Sudha Chaudari and Sandeep Kumar.TPN in neonates. Indian Paediatrics. November 2006 Deepak Chawla, Anu

More information

Case Study BMIs in the range of are considered overweight. Therefore, F.V. s usual BMI indicates that she was overweight.

Case Study BMIs in the range of are considered overweight. Therefore, F.V. s usual BMI indicates that she was overweight. Morgan McFarlane February 26 th, 2013 HHP 439 Professor White Case Study 7.10 1. What is your interpretation of F.V. s clinical data? F.V. s clinical data includes chronic abdominal pain, loose stools,

More information

Nutritional Management in Enterocutaneous fistula Dr Deepak Govil

Nutritional Management in Enterocutaneous fistula Dr Deepak Govil Nutritional Management in Enterocutaneous fistula Dr Deepak Govil MS, PhD (GI Surgery) Senior Consultant Surgical Gastroenterology Indraprastha Apollo Hospital New Delhi What is enterocutaneous fistula

More information

Nutrition Therapy. Medical Coverage Policy Enteral/Parenteral EFFECTIVE DATE: POLICY LAST UPDATED: 11/20/2018 OVERVIEW

Nutrition Therapy. Medical Coverage Policy Enteral/Parenteral EFFECTIVE DATE: POLICY LAST UPDATED: 11/20/2018 OVERVIEW Medical Coverage Policy Enteral/Parenteral Nutrition Therapy EFFECTIVE DATE: 01 20 2007 POLICY LAST UPDATED: 11/20/2018 OVERVIEW This policy describes the reimbursement for enteral and parenteral nutrition

More information

Section 38 1 Food and Nutrition (pages )

Section 38 1 Food and Nutrition (pages ) Chapter 38 Digestive and Excretory Systems Section 38 1 Food and Nutrition (pages 971 977) Key Concepts What are the nutrients your body needs? Why is water such an important nutrient? Food and Energy

More information

THE AUTHOR OF THIS WHAT S NEW IN NUTRITION? OBJECTIVES & OUTLINE EVIDENCE-BASED MEDICINE: PARENTERAL NUTRITION (PN)

THE AUTHOR OF THIS WHAT S NEW IN NUTRITION? OBJECTIVES & OUTLINE EVIDENCE-BASED MEDICINE: PARENTERAL NUTRITION (PN) WHAT S NEW IN NUTRITION? Alisha Mutch, Pharm.D., BCPS THE AUTHOR OF THIS PRESENTATION HAS NOTHING TO DISCLOSE. OBJECTIVES & OUTLINE MALNUTRITION OBJECTIVES Indicate when parenteral nutrition (PN) is warranted

More information

Osama Tabbara, RPh R.Ph., BCNSP Senior Director, Pharmacy Department

Osama Tabbara, RPh R.Ph., BCNSP Senior Director, Pharmacy Department Clinical Scenarios in Parenteral Nutrition Osama Tabbara, RPh R.Ph., BCNSP Senior Director, Pharmacy Department Cleveland Clinical Scenarios Clinic Abu in Parenteral Dhabi (CCAD) Nutrition King Faisal

More information

Aspetti nutrizionali nel paziente in emodialisi cronica

Aspetti nutrizionali nel paziente in emodialisi cronica Aspetti nutrizionali nel paziente in emodialisi cronica Enrico Fiaccadori enrico.fiaccadori@unipr.it Università degli Studi di Parma Agenda Diagnosis of protein-energy wasting (PEW) in ESRD on HD Epidemiology

More information

Patient Description and Diagnosis: Sarah Jones is a 50-year-old female, 5 4, 131

Patient Description and Diagnosis: Sarah Jones is a 50-year-old female, 5 4, 131 Julia Kaesberg Counseling Session KNH 413 February 27 th, 2014 Patient Description and Diagnosis: Sarah Jones is a 50-year-old female, 5 4, 131 pounds and her usual body weight is 125 pounds. Her %UBW

More information

PAEDIATRIC PARENTERAL NUTRITION. Ezatul Mazuin Ayla binti Mamdooh Waffa Hospital Sultanah Aminah

PAEDIATRIC PARENTERAL NUTRITION. Ezatul Mazuin Ayla binti Mamdooh Waffa Hospital Sultanah Aminah PAEDIATRIC PARENTERAL NUTRITION Ezatul Mazuin Ayla binti Mamdooh Waffa Hospital Sultanah Aminah Johor Bahru Malnutrition INTRODUCTION pathologic state of varying severity with clinical features caused

More information

Nutrition care plan. Components and development

Nutrition care plan. Components and development Nutrition care plan Components and development Objectives To define the nutrition care plan To present the components of the nutrition care plan To discuss the different approaches in determining the contents

More information

Pediatric Dehydration and Oral Rehydration. May 16/17

Pediatric Dehydration and Oral Rehydration. May 16/17 Pediatric Dehydration and Oral Rehydration May 16/17 Volume Depletion (hypovolemia): refers to any condition in which the effective circulating volume is reduced. It can be produced by salt and water loss

More information

A Guide to Prescribing Adult Oral Nutritional Supplements in West Kent CCG

A Guide to Prescribing Adult Oral Nutritional Supplements in West Kent CCG A Guide to Prescribing Adult Oral Nutritional Supplements in West Kent CCG Aim This guideline has been designed to support primary care prescribers initiating nutrition support for adults in West Kent.

More information

Nutrition care plan for surgical patients. Objectives

Nutrition care plan for surgical patients. Objectives Slide 1 Nutrition care plan for surgical patients Surgical Nutrition Training Module Level 1 Philippine Society of General Surgeons Committee on Surgical Training In this session we will discuss the most

More information

Neoplastic Disease KNH 406

Neoplastic Disease KNH 406 Neoplastic Disease KNH 406 Cancer Carcinogenesis - Etiology Genes may be affected by antioxidants, soy, protein, fat, kcal, alcohol Nutritional genomics study of genetic variations that cause different

More information

Metabolic Abnormalities in the Burn Patient Part 1

Metabolic Abnormalities in the Burn Patient Part 1 Metabolic Abnormalities in the Burn Patient Part 1 Objectives To understand normal body composition and importance of lean body mass To understand the metabolic changes which occur in the burn patient

More information

ENTERAL NUTRITION IN THE CRITICALLY ILL

ENTERAL NUTRITION IN THE CRITICALLY ILL ENTERAL NUTRITION IN THE CRITICALLY ILL 1 Ebb phase Flow phase acute response (catabolic) adoptive response (anabolic) 2 3 Metabolic Response to Stress (catabolic phase) Glucose and Protein Metabolism

More information

Information about Feeding Tubes

Information about Feeding Tubes Information about Feeding Tubes By Theresa Imperato, RN and Lorraine Danowski, RD What is a feeding tube? It is a small, flexible tube, about ¼ in diameter that is an alternative route for nourishment

More information

INTRAVENOUS FLUID THERAPY

INTRAVENOUS FLUID THERAPY INTRAVENOUS FLUID THERAPY PRINCIPLES Postnatal physiological weight loss is approximately 5 10% in first week of life Preterm neonates have more total body water and may lose 10 15% of their weight in

More information

PACKAGE LEAFLET: INFORMATION FOR THE USER. Glucose Intravenous Infusion BP 10% w/v solution for infusion Glucose (as glucose monohydrate)

PACKAGE LEAFLET: INFORMATION FOR THE USER. Glucose Intravenous Infusion BP 10% w/v solution for infusion Glucose (as glucose monohydrate) PACKAGE LEAFLET: INFORMATION FOR THE USER Glucose Intravenous Infusion BP 10% w/v solution for infusion Glucose (as glucose monohydrate) Read all of this leaflet carefully before you start using this medicine

More information

HOME TUBE FEEDING BASICS

HOME TUBE FEEDING BASICS HOME TUBE FEEDING BASICS UBC DIETETICS PROGRAM Module 1 of 2 SCOPE OF THESE MODULES Modules 1 & 2 address the following Nutrition Care Process steps Intervention Monitoring and Evaluation Assessment and

More information

2. What is the etiology of celiac disease? Is anything in Mrs. Gaines s history typical of patients with celiac disease? Explain

2. What is the etiology of celiac disease? Is anything in Mrs. Gaines s history typical of patients with celiac disease? Explain Pauline Huang NFSC 470 Case Study I. Understanding the Disease and Pathophysiology 1. The small bowel biopsy results state, flat mucosa with villus atrophy and hyperplastic crypts inflammatory infiltrate

More information

Nutrition BCH 445 L e c t u r e s : 1-3

Nutrition BCH 445 L e c t u r e s : 1-3 Nutrition BCH 445 L e c t u r e s : 1-3 Biochemistry department Sciences college Course description This course is designed to study nutrition via biochemical concepts with emphasis on biochemical and

More information

Pancreatitis/Hepatitis Resulting in Alcoholic Cirrhosis. Kelli-Ann Wong November 27, 2012

Pancreatitis/Hepatitis Resulting in Alcoholic Cirrhosis. Kelli-Ann Wong November 27, 2012 Pancreatitis/Hepatitis Resulting in Alcoholic Cirrhosis Kelli-Ann Wong November 27, 2012 Summarize History RFA: 46yo M admitted c epigastric pain PMHx: Acute pancreatitis with an enlarged fatty liver Epigastric

More information

Case Study: Renal Disease

Case Study: Renal Disease Name: Melissa Hayes Case Study: Renal Disease Part I: Initial Presentation Chief Complaint: progressive anorexia with N/V, 5 kg weight gain in the past 10 days, edema, fatigue, worsening SOB with 2 pillow

More information

Case Study #3: Renal Disease 1. Please be concise and use only the space provided. 2. Please cite sources as necessary.

Case Study #3: Renal Disease 1. Please be concise and use only the space provided. 2. Please cite sources as necessary. NUT 116BL Winter 2013 Name: Cammane Wun Section: A02 Case Study #3: Renal Disease 50 points 1. Please be concise and use only the space provided. 2. Please cite sources as necessary. 3. You may use your

More information

Nutrition in Pancreatic Cancer. Edmond Sung Consultant Gastroenterologist Lead Clinician for Clinical Nutrition and Endoscopy

Nutrition in Pancreatic Cancer. Edmond Sung Consultant Gastroenterologist Lead Clinician for Clinical Nutrition and Endoscopy Nutrition in Pancreatic Cancer Edmond Sung Consultant Gastroenterologist Lead Clinician for Clinical Nutrition and Endoscopy Overview The pancreas and nutrition Nutrition screening - can we do this well?

More information

PARENTAL NUTRITION SUPPORT. Dr Rezzan Khan Consultant Nutritionist Shifa International Hospital

PARENTAL NUTRITION SUPPORT. Dr Rezzan Khan Consultant Nutritionist Shifa International Hospital PARENTAL NUTRITION SUPPORT Dr Rezzan Khan Consultant Nutritionist Shifa International Hospital Objectives Explain the indications and contraindications of PN Describe the types of PN How to set PN Explain

More information

PAEDIATRIC PARENTERAL NUTRITION - INDIAN CONTEXT. Dr. Sarath Gopalan

PAEDIATRIC PARENTERAL NUTRITION - INDIAN CONTEXT. Dr. Sarath Gopalan PAEDIATRIC PARENTERAL NUTRITION - INDIAN CONTEXT Dr. Sarath Gopalan Senior Consultant in Pediatric Gastroenterology, Hepatology Indraprastha Apollo Hospital, New Delhi PN DELIVERY CENTRAL PERIPHERAL

More information

Nutritional Assessment of Patients with Respiratory Disease C H A P T E R 1 7

Nutritional Assessment of Patients with Respiratory Disease C H A P T E R 1 7 Nutritional Assessment of Patients with Respiratory Disease C H A P T E R 1 7 Nutritional Status Major factor influencing acute and long term outcomes Quantity and quality of food affects the efficiency

More information

Choosing What You Eat and Why. Chapter 1 BIOL1400 Dr. Mohamad H. Termos

Choosing What You Eat and Why. Chapter 1 BIOL1400 Dr. Mohamad H. Termos Choosing What You Eat and Why Chapter 1 BIOL1400 Dr. Mohamad H. Termos Objectives Following this lecture, you should be able to describe: - Nutrition definition - Sources of nutrients - Energy sources

More information

HOMES AND SENIORS SERVICES. APPROVAL DATE: February 2011 REVISION DATE: January 2015; July 2018

HOMES AND SENIORS SERVICES. APPROVAL DATE: February 2011 REVISION DATE: January 2015; July 2018 POLICY: Page 1 of 6 A resident requiring enteral (tube) feeding as a sole source or adjunctive nutrition support have access to a comprehensive enteral feeding program and receive appropriate support from

More information

Adams Memorial Hospital Decatur, Indiana EXPLANATION OF LABORATORY TESTS

Adams Memorial Hospital Decatur, Indiana EXPLANATION OF LABORATORY TESTS Adams Memorial Hospital Decatur, Indiana EXPLANATION OF LABORATORY TESTS Your health is important to us! The test descriptions listed below are for educational purposes only. Laboratory test interpretation

More information

Prevention of Electrolyte Disorders Refeeding Syndrome พญ.น นทพร เต มพรเล ศ

Prevention of Electrolyte Disorders Refeeding Syndrome พญ.น นทพร เต มพรเล ศ Prevention of Electrolyte Disorders Refeeding Syndrome พญ.น นทพร เต มพรเล ศ Outline Refeeding Syndrome What is refeeding syndrome? What Electrolytes and minerals are involved? Who is at risk? How to manage

More information

Unit 11. Objectives. Indications for IV Therapy. Intravenous Access Devices & Common IV Fluids. 3 categories. Maintenance Replacement Restoration

Unit 11. Objectives. Indications for IV Therapy. Intravenous Access Devices & Common IV Fluids. 3 categories. Maintenance Replacement Restoration Unit 11 Fluids, Electrolytes and Acid Base Imbalances Intravenous Access Devices & Common IV Fluids Objectives Review the purpose and types of intravenous (IV) therapy. Recall the nursing care related

More information