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FSHN 450-2critical
| Question | Answer |
|---|---|
| 3 outcomes of acute care | recover, die, chronic acute illness |
| what happens w/ continued low organ perfusion? | anaerobic metabolism, acid build up |
| effect of stress on heart | TNFa and Il1 impact cardiac function, and pulmonary resistance can result in right ventricular overload |
| effect of stress on liver | bacteremia |
| PE are derived from | arachadonic acid |
| Effects of underfeeding | longer stay, nosocomial infections, increased duration of mechanical ventilation that can lead to loss of respiratory muscle strength |
| Effects of overfeeding | stress organs, RQ>1, hypertriglyceridemia, hyperglycemia, n6 exacerbate inflammation |
| GIR | glucose infusion rate, 5-7 mg/kg/min |
| Who is at highest risk for refeeding? | malnourished, low BMI, weight loss |
| Energy critically ill | 25-30 kcal/kg/day |
| PN should provide no more than___ kcal/kg | 25 |
| Kcal/day high risk for re-feeding | 10 |
| Kcal/day moderate risk for re-feeding | 20 |
| Energy to use in critically ill | Penn State 2003b or 2010 if obese (need Tmax and Ve) |
| Permissive underfeeding | 11-14 kcal/kg actual weight |
| Which equation- adult wt management | Mifflin |
| Which equation- chronic kidney disease | 23-35 |
| Which equation- AKI w/ CRRT | 25-30 |
| Which equation- critically ill non obese/old obese | penn state 2003b |
| Which equation- critically ill obese | |
| Which equation- critically ill ventilated | penn state or ireton jones |
| Which equation- heart failure | Mifflin or harris benedict |
| Which equation- cancer | harris benedict |
| Which equation- unintended weight loss | 25-35 kcal/kg |
| Surgery protein | 1.5-2 |
| Traumatic brain injury protein | 1.5-2.2 |
| Acute spinal cord injury protein | 2 |
| Protein class I/II obese | 2.0 ideal |
| Protein class III obese | 2.5 ideal |
| AKI protein | 1.5-2 dry weight (fluid retention makes bmi useless) |
| Hyperglycemia | 140-180 mg/dL w/ insulin drip |
| 4 factors affecting severity of burns | thickness, extent, location, complicating factors (DM, age, lung/heart disease) |
| major burns | >30 BSAB, high risk, electrical burns |
| minor burns | <10 BSAB |
| energy kids burns | 1.3-1.4 EE |
| energy adults burns | 1.2-1.3 EE (35-45 kcal/kg) |
| Curreri formula | multiplies 40kcal by BSAB (up to 50%) |
| Galveston formula | for children burn patients |
| Curreri junior | changes w/ age |
| Protein <10% BSAB | 1.2g/kg/day |
| Protein >10% BSAB | 1.5-2.0g/kg/day |
| Protein burn kids 0-6 | 3-4.5g/kg/day |
| Protein burns kids >6 | 2.5-3g/kg/day |
| Carbohydrate burns | 40-60% kcal, but can’t exceed 5-7mg/kg/min |
| Fat burns | <30%, <5% n-6 |
| Zinc burn patients | often deficient, supplements (but can interfere w/ Cu) |
| What minerals to monitor w/ burns | electrolytes (Na, Mg, K, P) |
| Mg burns | losses through skin are significant |
| Na burns | increased losses w/ silver nitrate treatment |
| Major burns vitamins | multivitamin + vitamin C and vitamin A |
Created by:
melaniebeale
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