[LABORATORY TEST] Nutritional Support

Proverbs 16:3

Malnutrition

A deficiency, excess, or imbalance of energy, protein, and other nutrients that causes measurable adverse effects on body tissue, size, shape, composition, function and clinical outcome

TRUE

TRUE OR FALSE

• Nutrients can be introduced in the body in different routes

Kwashiorkor

Identify:

a. Marasmus

b. Kwashiorkor

Marasmus

Identify:

a. Marasmus

b. Kwashiorkor

Kwashiorkor

[Kwashiorkor or Marasmus]

It develops in children whose diets are deficient of protein

Marasmus

[Kwashiorkor or Marasmus]

It is due to deficiency of proteins and calories.

Kwashiorkor

[Kwashiorkor or Marasmus]

It occurs in children between 6 months and 3 years of age.

Marasmus

[Kwashiorkor or Marasmus]

It is common in infants under 1 year of age.

Kwashiorkor

[Kwashiorkor or Marasmus]

Subcutaneous fat is preserved.

Marasmus

[Kwashiorkor or Marasmus]

Subcutaneous fat is not preserved.

Kwashiorkor

[Kwashiorkor or Marasmus]

Oedema is present

Marasmus

[Kwashiorkor or Marasmus]

Oedema is absent

Kwashiorkor

[Kwashiorkor or Marasmus]

Enlarged fatty liver.

Marasmus

[Kwashiorkor or Marasmus]

No fatty liver.

Kwashiorkor

[Kwashiorkor or Marasmus]

Ribs are not very prominent.

Marasmus

[Kwashiorkor or Marasmus]

Ribs become very prominent.

Kwashiorkor

[Kwashiorkor or Marasmus]

Lethargic

Marasmus

[Kwashiorkor or Marasmus]

Alert and irritable.

Kwashiorkor

[Kwashiorkor or Marasmus]

Muscle wasting mild or absent.

Marasmus

[Kwashiorkor or Marasmus]

Severe muscle wasting

Kwashiorkor

[Kwashiorkor or Marasmus]

Poor appetite.

Marasmus

[Kwashiorkor or Marasmus]
Voracious feeder.

Kwashiorkor

[Kwashiorkor or Marasmus]

The person suffering from this needs adequate amounts of proteins.

Marasmus

[Kwashiorkor or Marasmus]

The person suffering from this needs adequate amount of protein, fats and carbohydrates.

Kwashiorkor

[Kwashiorkor or Marasmus]

Protuberant belly

Marasmus

[Kwashiorkor or Marasmus]

Prominent bones

Kwashiorkor

[Kwashiorkor or Marasmus]

Xerosis

Marasmus

[Kwashiorkor or Marasmus]

Loose skin

Kwashiorkor

[Kwashiorkor or Marasmus]

Poor wound healing

[MALNUTIRTION]

Steps in clinical approach to nutritional screening and support:

Enteral Nutrition

A method of providing nutritional support via tubes inserted into the stomach or small intestine

Parenteral Nutrition

A nutritionally balanced aseptically prepared or sterile physiochemically stable solution or emulsion for IV administration

Parenteral Nutrition

Indicated whenever the GI tract is inaccessible or nonfunctional or when enteral nutrition is inadequate or unsafe

• Should be compounded using a Laminar Flow

• Infused / Discarded within 24 Hours after Hanging

• Vitamins are only stable at Room Temperature for 24 Hours (added to PN solution at the time of infusion)

[NUTRITION]

Key practice points for parenteral nutrition [3]

laminar flow hood

[Key Practice Points for Parenteral Nutrition]

Parenteral Nutrition should be compounded using a ______

Vitamins

[Key Practice Points for Parenteral Nutrition]

______ in parenteral nutrition are only stable at room temperature for 24 hours. Therefore, they are added to the PN solution at the time of infusion

room temperature

[Key Practice Points for Parenteral Nutrition]

Vitamins in parenteral nutrition are only stable at ____ temperature for 24 hours. Therefore, they are added to the PN solution at the time of infusion

Peripheral / Partial Parenteral Nutrition (PPN)

[PPN or TPN]

_______-

• A nutritional support that supplies only part of daily nutritional requirement

• Oral intake in a peripheral vein for short term nutritional support (<14 days)

Total Parenteral Nutrition (TPN)

[PPN or TPN]

_______-

• Supplies all daily nutritional requirements

• Indicated for long term use (>30 days)

• May be administered continuously over a 24-hour period

Peripheral / Partial Parenteral Nutrition (PPN)

[PPN or TPN]

Contains <10% final concentration of dextrose

Total Parenteral Nutrition (TPN)

[PPN or TPN]

Used for patients who cannot get their nutrition through eating

Total Parenteral Nutrition (TPN)

[PPN or TPN]

10% of dextrose and 5% protein

Peripheral / Partial Parenteral Nutrition (PPN)

[PPN or TPN]

Solution tonicity: <500 mOsm/L

Total Parenteral Nutrition (TPN)

[PPN or TPN]

Solution tonicity: 500 mOsm/L

Peripheral / Partial Parenteral Nutrition (PPN)

[PPN or TPN]

May be administered through a larger peripheral vein

Total Parenteral Nutrition (TPN)

[PPN or TPN]

Central line

Total Parenteral Nutrition (TPN)

[PPN or TPN]

Designed to totally replace enteral intake

1. When specialized nutritional support is required, enteral nutrition should be used in preference to parenteral nutrition.

2. Parenteral nutrition should be used when GI tract is not functional or cannot be adequately nourished by oral diet or enteral nutrition.

3. Specialized nutrition support should be initiated in patients with inadequate oral intake for 7 to 10 days or in those patients in whom inadequate oral intake is expected over a 7- to 14-day period.

ASPEN Guidelines [3]

TRUE

[NUTRITIONAL SUPPORT]

TRUE OR FALSE:

When specialized nutritional support is required, enteral nutrition should be used in preference to parenteral nutrition.

TRUE

[NUTRITIONAL SUPPORT]

TRUE OR FALSE:

Parenteral nutrition should be used when GI tract is not functional or cannot be adequately nourished by oral diet or enteral nutrition.

7 to 10 days

[NUTRITIONAL SUPPORT]

Specialized nutrition support should be initiated in patients with inadequate oral intake for _____ days or in those patients in whom inadequate oral intake is expected over a 7- to 14-day period.

7- to 14-day

[NUTRITIONAL SUPPORT]

Specialized nutrition support should be initiated in patients with inadequate oral intake for 7 to 10 days or in those patients in whom inadequate oral intake is expected over a ______ period.

Components of Parenteral Nutrition

Oral diet vs. Parenteral nutrition

1. Glucose to amino acids: Press the upper left chamber (glucose) to mix with the lower chamber (amino acids).

2. Add electrolytes and trace elements in port.

3. Lipid emulsions: Press the upper right chamber (liquid) to mix with lower chamber.

4. Add vitamins.

5. Mix thoroughly then hang it on the drip stand for 24 hrs

Steps in mixing TPN components [5]