SEPSIS and Burns Background
What is the risk when bacteria from the gut cross into the bloodstream, which can be reduced by early nutrition support?
Bacterial translocation
During the ebb phase, metabolic rate _____ while in the flow phase metabolic rate ______
decreases, increases
inflammatory cytokines and stress hormones leads to an increase of this metabolic process in the liver, which contributes to insulin resistance
Gluconeogenesis
A hemodynamically stable patient complains of diarrhea. What supplement could help manage their symptoms?
Fermentable soluble fiber or probiotics
elevated BUN, creatinine and low GFR labs may indicate ______ dysfunction
renal/kidney
During starvation, BMR decreases and ______ become the primary fuel source
lipids
The metabolic effect of this pro-inflammatory cytokine causes damage to the respiratory monocytes
interferon-𝞬
To avoid worsening hyperglycemia and support lean body mass, patients are fed a ____ calorie, ____ protein diet
low/hypocaloric and high protein diet
Which type of patient is most likely to experience the greatest nitrogen loss due to extensive tissue injury and a prolonged hypermetabolic response?
A major burn patient
Cardiac output, body temperature, and cytokine production increases during the flow phase which contributes to ______
hypermetabolism, increased muscle and fat loss
Which plasma protein, the most abundant in circulation, decreases during metabolic stress as a negative acute-phase reactant, contributing to fluid shifts and edema
Albumin
An ICU patient has gained 8 kg due to IV fluids and edema. Which weight should be used for calculating energy and protein requirements
dry weight or usual body weight
An ICU patient presents tachycardia, fever, decreased urine output, and mild hypotension that persists despite initial fluid resuscitation. Lab reports confirm infection. What sepsis classification does this represent?
Septic Shock
Which hormone decreases in the ebb phase due to prioritization of energy stores for vital organs but rises in the flow phase due to hypermetabolism?
insulin
This acute-phase protein is produced by the liver and works to enhance phagocytosis by targeting bacterial cells for destruction
C-reactive protein
A malnourished critical care patient that presents elevated phosphorus, potassium, and sodium after eating may be at risk of: _______
refeeding syndrome