Table of Contents. Section 1- Nutrition Assessment. Dietary Reference Intakes (DRIs)... 1

Transcription

1 Section 1- Nutrition Assessment Dietary Reference Intakes (DRIs)... 1 Estimated Average Requirement (EAR)... 1 Recommended Dietary Allowance (RDA)... 1 Adequate Intake (AI)... 1 Tolerable Upper Intake Level (UL)... 1 Table 1.1 DRIs, Recommended Intakes for Individuals, Elements... 2 Table 1.2 DRIs, Recommended Intakes for Individuals, Vitamins... 3 Table 1.3 Tolerable Upper Intake Levels (UL), Elements... 4 Table 1.4 Tolerable Upper Intake Levels (UL), Vitamins... 5 Anthropometrics... 6 Body Mass Index (BMI)... 6 Table 1.5 BMI Classification... 6 Waist Circumference (WC)... 6 Table 1.6 Waist Circumference Measures... 6 Health Risk Classification using both BMI and WC... 7 Table 1.7 BMI and WC... 7 IBW Range (for adults < 65 years of age)... 7 Table 1.8 Average Height-Weight Tables for Persons Age 65 to 95 Years... 8 Significance of Changes in Body Weight... 9 Table 1.9 Calculation and Interpretation of Weight Loss... 9 Table 1.10 Interpretation of Weight Loss... 9 Knee-Height Index... 9 Table 1.11 Estimate of Stature in Centimeters... 9 i

2 Amputee % Standard Weight Table 1.12 Body Segment and Body Weight Figure 1.1 Percent Body Weight by Body Parts Energy and Protein Requirements Harris Benedict Equation Ireton-Jones Equation Table 1.13 Energy Factors and Protein Requirements for Various Clinical States Protein Requirements Energy Requirements for Obese Clients Energy Requirements for Critically Ill Obese Clients (BMI >30 or >120% IBW) Calorie-Protein (Nitrogen) Ratio Table 1.14 Calorie-Nitrogen Ratio Nitrogen Balance Table 1.15 Calculation of Nitrogen Balance Burn Patients Table 1.16 Estimate of Wound Nitrogen Loss Interpretation of Nitrogen Balance Results Table 1.17 Nitrogen Balance and Metabolic Change Water Requirements Table 1.18 Various Methods of Estimating Fluid Needs Additional Fluid Requirements Biochemical Assessment Serum Albumin Corrected Calcium Table 1.19 Classification/Lab Values of Most Common Types of Anemias Table 1.20 Treatment for Anemia in Adults Common Lab Values Table 1.21 RQHR Common Serum Lab Values for Adults Clinical Nutrition Physical Examination Table 1.22 Clinical Nutrition Physical Examination Criteria Grid to Determine Malnutrition Diagnosis Table 1.23 Protein - Energy Malnutrition Table 1.24 Pathophysiological Mechanisms of Malnutrition SI Metric Units - Conversions Atwater Energy Factors ii

3 Table 1.25 Atwater Energy Factors Converting Mass to Mole Other Conversions Table 1.26 Conversion Factors for Common Lab Values Table 1.27 Commonly Used Conversions References Section Section 2 - Enteral Nutrition Indications for Tube Feeding Routes of Feeding Maintaining Tube Patency Water Requirements Advancing Tube Feeds Intermittent and Bolus Feeds Transitional Feeding Tube Feeding and Diarrhea Gastric Residual Volumes Medications and EN Table 2.1 Medications and GI Motility Blue Dye and Enteral Feeds Tube Feeding and Drug Interactions Adult Tube Feeding and Drug Interaction Protocol Table 2.2 Drug Interactions and Incompatibility Guidelines for Nutrition Support Based on ACCEPT Trial Adult Formulas Volumes of Formula Table 2.3 Volumes of Formula Formula Company Websites Table 2.4 Polymeric Formula Supplements Breakfast Anytime Powder with Whole Milk Boost *Ensure *Ensure with Fibre *Ensure High Protein *Ensure Plus *Glucerna Tubefeed iii

4 *Glucerna Oral Isosource HN *Isosource VHN with Prebiotic *Isosource 1.5 with Prebiotic *Jevity 1 Cal (formerly Jevity) Jevity 1 Cal (formerly Jevity) Ready to Hang *Jevity 1.2 Cal (formerly Jevity Plus) Cans Jevity 1.2 Cal (formerly Jevity Plus) Ready to Hang (RTH) Nutren VHP Nutren VHP with Fibre *Nutren 1.5 (Fibre with Prebio) *Nutren *Nutrisure Puddings *Osmolite 1 cal (formerly Osmolite HN) Cans/Ready to Hang (RTH) Osmolite 1.2 Cal (formerly Osmolite HN Plus) Cans Osmolite 1.2 Cal (formerly Osmolite HN) Ready to Hang *Promote *Resource Boost (*Resource) Fruit Flavoured Beverage Two Cal HN Table 2.5 Elemental Formula Supplements Optimental *Peptamen Peptamen Prebio *Peptamen Peptamen AF *Peptamen Flavour Packets *Peptinex Peptinex Peptinex DT Perative Cans (Ready to Hang) *Vital HN *Vivonex Plus Table 2.6 Renal Formulas *Nepro Novasource Renal Suplena Table 2.7 Specialty Formulas Oxepa Pulmocare Table 2.8 Modules Duocal *Polycose Resource Beneprotein MCT References - Section iv

5 Section 3 - Parenteral Nutrition Guidelines for the Administration of Parenteral Nutrition Indications for Use Routes of Administration Components of TPN Table 3.1 Recommended Glucose Infusion Rate Table 3.2 Components of Liposyn II (Hospira) 10% and 20% Table 3.3 Proportion of Fatty Acids in Liposyn II Solutions Parenteral Osmolarity To Calculate the Osmolarity of a Solution Calculating TPN Electrolytes, Trace Elements and Medications Electrolytes Table 3.4 Normal Daily Electrolyte Requirements for Adults Receiving TPN Trace Elements Table 3.5 Normal Daily Trace Elements Requirements for Adults Receiving TPN Chloride and Acetate Salts Calcium and Phosphorus Solubility Vitamin K as an Additive in TPN Propofol Drug Incompatibilities with Aminosyn Table 3.6 Medications Incompatible with RQHR Solutions Multivitamins and Trace Element Supplement in the RQHR Table 3.7 Multivitamin Supplement for Pediatric Clients Table 3.8 Multivitamin Supplement for Adults Table 3.9 Trace Elements for Adults and Pediatrics Solute Content of IV Fluids Table 3.10 Solute Content of IV Fluids Monitoring of TPN Table 3.11 Correction of Abnormalities TPN Solutions...76 TPN Administration on Weekends and Holidays Table 3.12 RQHR Weekend Standard Solution Electrolytes, Vitamins and Minerals.. 76 Acid-Base Balance Table 3.13 Acute Acid-Base Disorders and Compensatory Responses v

6 Table 3.14 Causes of Acid-Base Disorders Table 3.15 Nutrition Prescription for Acid-Base Disorders References - Section Section 4 - Refeeding Syndrome Potential Candidates for Refeeding Syndrome Negative Consequences of Aggressive Feeding Refeeding Recommendations Physiologic and Metabolic Sequelae of Refeeding Syndrome Table 4.1 Sequelae of Hypophosphatemia, Hypokalemia, Hypomagnesemia and Glucose Intolerance References - Section Section 5 - Pregnancy Abbreviations Energy and Protein Requirements Energy Table 5.1 Energy Requirements During Pregnancy and Lactation Protein Prenatal Supplementation Folic Acid Iron Calcium and Vitamin D Gestational Weight Gain Pattern of Weight Gain Table 5.2 Pattern of Weight Gain for Singleton and Twin Pregnancies Gestational Weight Gain Ranges Table 5.3 Guidelines for Gestational Weight Gain Ranges vi

7 Diabetes Guidelines for Pregnancy Type 1 and Type 2 Diabetes Mellitus (DM) Gestational Diabetes Mellitus (GDM) Artificial Sweeteners Screening and Target Serum Glucose for GDM Table 5.4 Recommended Glycemic Targets for Women with GDM Pre-existing Diabetes and Pregnancy Table 5.5 Recommended Glycemic Targets Preconception and During Pregnancy Hyperemesis Guidelines Table 5.6 Dietary and Daily Living Suggestions Nutrition Support Enteral Nutrition Parenteral Nutrition Nutrition Support...96 Table 5.7 Daily Vitamin Requirements in Normal Pregnancy Compared with Standards Parenteral Vitamin Addition Table 5.8 Daily Mineral and Trace Element Requirements in Normal Pregnancy References - Section Section 6 - Pediatrics Nutrition Assessment Assessing Growth Figure 6.1 To Correct for Age Determining Ideal Body Weight (IBW) Figure 6.2 Determining % IBW Table 6.1 Classification of Nutrition Status for Infants and Children 0 to 2 Years BMI Table 6.2 Classification of Nutrition Status Using BMI for Children 2 to 20 Years Nutrition Requirements Energy Protein Maintenance Fluid Requirements Table 6.3 Maintenance Fluid Requirements According to Holliday-Segar Method vii

8 Table 6.4 Recommendations for Energy and Protein for Infants, Children and Adolescents 0 to 18 Years Failure to Thrive Definition Energy and Protein Requirements for Catch-up Growth Figure 6.3 Calculating Catch-Up Growth Requirement and Protein Requirements Protein Requirements Concentrating Infant Formula Information Required for Formula Calculations Concentrating Using Formula Powder Figure 6.4 Concentrating Using Formula Powder Calculation Table 6.5 Values Used for Formula Calculations - Powdered Infant Formula Fortification of Expressed Breastmilk Table 6.6 To Fortify Expressed Breastmilk for Term Infants Table 6.7 To Fortify Expressed Breastmilk for Preterm Infants Concentrating Using Liquid Concentrate Figure 6.5 Concentrating Using Liquid Concentrate Calculation Table 6.8 Sample Recipes Using 1 Can (385 ml) Liquid Concentrate Infant Formulas Available to Consumers Table 6.9 Powdered Infant Formulas Table 6.10 Ready to Use Infant Formulas Table 6.11 Liquid Concentrate Formulas Modules Table 6.12 Carbohydrate Modules Table 6.13 Protein Module Table 6.14 Fat Modules Altering Caloric Density of Formula Using a Module - Fat Figure 6.6 Calculation - Altering Caloric Density of Formula Using a Module - Fat Cystic Fibrosis Calculating Energy Requirements Table 6.15 Categories for Nutritional Management of Patients with Cystic Fibrosis Infant and Pediatric Formulas Formula Company Websites Table 6.16 Milk Human Mature Human Mature Preterm Milk viii

9 Cow's Whole Goats Canned Diluted Table 6.17 Cow's Milk Based Formulas Enfamil* (with Iron) *Enfamil Lactose Free (LF) *Enfamil A *Good Start with Omega Kirkland Infant Formula Life Brand Infant Formula with Iron Parent's Choice Infant Formula Regular (& with Iron) President's Choice Infant Formula with Iron (Omega 3 + 6) *Similac Advance with Omega *Similac Advance Lactose Free (LF) *Similac 24 with Iron *Similac 27 with Iron Table 6.18 Human Milk Fortifiers Enfamil Human Milk Fortifier Similac Human Milk Fortifier Enfamil Human Milk Fortifier + Preterm Milk *Similac Human Milk Fortifier + Preterm Milk Table 6.19 Preterm Infant Formulas Enfamil A+ Premature 24, and with Iron Enfamil EnfaCare A *Neosure with DHA, ARA and Nucleotides Similac Advance Special Care (with Iron) 20 and Table 6.20 Therapeutic Formulas *Alimentum *Neocate *Nutramigen *Portagen *Pregestimil Similac PM 60/ Table 6.21 Soy Formulas *Alsoy with Omega *Isomil *Enfamil Soy Table 6.22 Stage 2 Formulas Alsoy 2 with Omega Enfapro Follow-up Transition *Good Start 2 with Omega Isomil Similac Advance Table 6.23 Oral Electrolyte Solutions (OES) and Specialty Formulas Enfalyte (OES) *Pedialyte (OES) Enfamil A+ Thickened Enfamil A+ Hypercaloric, with Iron Table 6.24 Module and Pediatric Formulas Duocal ix

10 *Nutren Junior (with fibre) *Pediasure with Fibre *Pediasure Plus with Fibre *Resource Just for Kids (Fibre) with Prebiotic *Resource Just for Kids 1.5 cal with Fibre and Prebiotic Table 6.25 Elemental Formulas *Neocate Junior (Unflavoured/Tropical Fruit) Pediatric Peptinex DT *Peptamen Junior References - Section Section 7 - Disease States Burns Adult Burns - Daily Nutritional Requirements Table 7.1 Vitamin Orders Table 7.2 Predictive Equations for Energy Requirements of Burn Patients To Calculate a Modular Feed for a Burn Patient Cardiovascular Disease Nutrient-Drug Interactions Grapefruit Juice - Drug Interactions Table 7.3 Significant Nutrient - Cardiac Drug Interactions Table 7.4 Lipid Lowering Drugs Dietary Recommendations to Help Lower Cholesterol Gastrointestinal Figure 7.1 Sites of Secretion and Absorption in the Gastrointestinal Tract Table 7.5 Length of Small Bowel and Colon Nutritional Considerations in Inflammatory Bowel Disease Hepatic Disease Goals Table 7.6 Daily Nutrient Requirements for Adults with Liver Disease Encephalopathy Liver Cholestasis Nutrient Requirements Post Liver Transplant Pancreatitis Table 7.7 Acute and Chronic Pancreatitis x

11 Renal Disease Calculation of Creatinine Clearance (CrCl) Table 7.8 Daily Nutrient Requirements for Adults with Renal Failure Estimates of Calories Absorbed from Peritoneal Dialysate Table 7.9 Estimates of Calories Absorbed from Peritoneal Dialysate Human Immunodeficiency Virus (HIV) & Acquired Immunodeficiency Syndrome (AIDS). 152 Nutrition Assessment Common Symptoms Related to HIV Infections HIV Lipodystrophy Syndrome Table 7.10 Metabolic and Morphologic Changes in Lipodystrophy Syndrome Drug Therapy - Nutrient Interactions Nutrition Intervention Diabetes Mellitus (DM) Type 1 and Type 2 DM Dietary Recommendations Medications Table 7.11 Recommended Targets for Glycemic Control Insulins Available in Canada (March 2005) Medications for the Management of Type 2 Diabetes Table 7.12 Antihyperglycemic Agents for Use in Type 2 Diabetes Spinal Cord Injury Figure 7.2 Relationship of Vertebrae, Spinal Cord and Spinal Nerves Spinal Cord Injury (SCI) - Rehabilitation/Chronic Stage Table 7.13 Calculating IBW for SCI Assessment of Energy Requirements Assessment of Protein Requirements Location and Extent of Brain Injury Brain Stem Injuries and Damage to the Cranial Nerves Cranial Nerve Damage Hypothalamic Injury Cerebral Damage Frontal Lobe Damage Table 7.14 Glasgow Coma Scale Table 7.15 Swallowing Disorders after CVA Figure 7.3 Tracheostomy Patients Cancer xi

12 Table 7.16 Metabolic Rate and Tumour Type Energy Requirements Protein Requirements Other Nutrients References - Section Section 8 - Appendices Appendix 1 - RQHR Approved Abbreviations Appendix 2 - Growth Charts Appendix 3 - Global CV Risk Management xii