Math!
JT, a 75yo pt with an ileus is receiving D10W at 100 mL/hr. How many calories of dextrose is he receiving per day?
What is 816?
100 mL/hr x 24 h = 2,400 mL x 0.10 = 240 g x 3.4 kcal/g = 816 kcal
Which of the following foods would NOT be appropriate on a diet for dysphagia?
a. pudding
b. peanut butter
c. baby cereal
d. pureed sweet potatoes
What is peanut butter?
In diverticulitis, a patient is recommended to consume a ____ fiber diet, while diverticulosis patients benefit from a ____ fiber diet.
High/Low or Low/High
What is low/high?
In diverticulitis, a patient is recommended to consume a low fiber diet; once the initial inflammation resolves, the patient is considered to have diverticulosis and may be able to prevent further occurrences of diverticulitis with a high fiber diet.
Following gastric surgery, a lack of __________ secretion in the stomach may lead to b12 deficiency or pernicious anemia.
a. Homocysteine
b. Intrinsic factor
c. Bilirubin
d. Methylmalonic acid
What is intrinsic factor?
What is the compensatory mechanism of the body for respiratory acidosis?
a. increase bicarbonate reabsorption
b. increase bicarbonate excretion
c. lungs slow down respirations
d. lungs increase respirations
a. increase bicarbonate reabsorption
In respiratory acidosis, the lungs have decreased work (less CO2 excretions), so the serum pH decreases/becomes more acidic. The kidneys compensate by reabsorbing more bicarbonate.
A patient with severe acute pancreatitis with nausea and vomiting requires 2500 kcal per day. How many calories does the following PN prescription provide?
1000 cc of D50 W, 1000 cc of 7% amino acids and 500 cc of 10% lipids
What is 2,530 kcal?
Dex: 1000 mL x .50 = 500 g dextrose 500 x 3.4 kcal/g = 1700 kcal
AA: 1000 mL x .07 = 70g x 4 kcal/g = 280 kcal
Lipid: 500 mL x 1.1 kcal/ml = 550 kcal
Total 2530 kcal/day.
Patients may be instructed to remain upright after eating, to lose weight, to wear loose-fitting clothing, and to raise the head of their bed for sleeping when experiencing this condition:
What is GERD – Gastroesophageal Reflux Disease?
BONUS (200pts) A complication of severe chronic GERD involving changes in the cells of the tissue that line the bottom of the esophagus. These esophageal cells become irritated when the contents of the stomach back up, increasing risk of cancer of the esophagus
-----
Barrett's esophagus
The following PES and intervention would be appropriate for which GI condition/disease?
Altered GI function RT decreased functional length of the GI tract AEB postop status <200 cm of small bowel remaining, diarrhea, and dehydration.
Initial TPN to meet EER of 1600 kcal and 85 g pro/day; monitor fluids and electrolytes; start sips of oral rehydration away from meals; small frequent meals low in simple sugar and fiber.
What is Short Bowel Syndrome?
The thiamin, B12, and vitamin D are all absorbed in which section of the GI tract?
a. Duodenum
b. jejunum
c. Ileum
d. Colon
What is the ileum?
Why might a patient with kidney failure have a low serum bicarbonate level?
a. the kidneys excrete extra bicarbonate because there is less acid present
b. the supply of ketoacids exceeds the demands of the cell
c. the kidneys conserve more bicarbonate due to chronic anemia
d. accumulation of hydrogen ions leads to depletion of bicarbonate, as it tries to buffer the excess acid
d. accumulation of hydrogen ions leads to depletion of bicarbonate, as it tries to buffer the excess acid
Because the kidneys are unable to excrete waste products, the blood becomes more acidic ashydrogen ions (acid) build up. This is metabolic acidosis. Bicarbonate becomes depleted because itis used in an attempt by the body to buffer the excess acid.
A 60-kg female intensive care patient requires ventilator support and total parenteral nutrition support.Calculate the glucose utilization (or infusion) rate of the following nutrition support regimen: TPN (25% dextrose, 3.5%aminosyn ) at 75cc/hour.
What is 5.21 mg/kg/min?
Total dextrose/day: 75cc hr x 24 hr = 1800 mL/day x .25 = 450 g/day x 1000mg/g = 450,000 mg dextrose
450,000 ÷ (60kg x 1440 min/day) = 5.208
Esophageal varices may be caused by:
a. portal hypotension
b. portal hypertension
c. a high fiber diet
What is portal hypertension?
The standard first step in reducing symptoms of steatorrhea would be to:
a. increase intake of fat-soluble vitamins
b. restrict carbohydrate intake
c. limit fluids
d. restrict fat intake to 25–30 g/day
What is "restrict fat intake to 25–30 g/day"?
What recommendations should the dietitian make for a client with a newly placed ostomy?
a. Eat the largest meal of the day in the evening to reduce output overnight.
b. Choose foods that can thicken stools, such as peanut butter, margarine, and yogurt.
c. Avoid spicy or fried foods, which can cause diarrhea.
What is "Avoid spicy or fried foods, which can cause diarrhea"?
A patient who has had a gastrojejunostomy is at risk of developing:
a. folic-acid deficiency
b. fatty liver
c. metabolic acidosis
d. iron-deficiency anemia
d. iron-deficiency anemia
In the surgical procedure, gastrojejunostomy, the stomach is anastomosed to the jejunum,bypassing part of the stomach and the duodenum. Since the majority of iron is absorbed through the duodenum, iron-deficiency anemia can develop.