Study Guide NUR 242 Nutrition

Ch 16 Nutrition in Metabolic and Respiratory Stress

Vocab:
Metabolic stress
Respiratory stress
Hypermetabolism
Wasting

Typical situations/diagnoses that put people into metabolic stress?

Hormonal response to stress—see the “body’s responses to stress and injury”

slide (slide #4).
Don’t need to know which hormone does what specific action—do need to have
“big picture”.

Inflammatory response
Initial concerns of acute stress are:
Initial care: fluids and electrolytes and stabilize pt, take care of underlying
problem. Then feed, using the GI system if possible. Starting sooner leads to fewer
complications, shorter stays.

Nutrition therapy goals for metabolic stress (3 goals):

Quick method for estimating energy needs: ___________kcal/kg

Protein requirements in acute stress: obese critically ill pts are fed more protein
and possibly lower total kcal than healthy wt pts.
Normal RDA for protein __________g protein/kg
Nonobese critically ill pts ____________ g protein/kg
Micronutrients: increase ____, ______, and ________ for ACute streZ.
Hypermetabolic pts need more ____ vitamins for energy metabolism.
Respiratory Stress
Condition Characterized by
respiratory stress
COPD (stands for:
chronic bronchitis
emphysema

Causes of COPD:
Why do these people need more kcals?
Reasons for poor food intake in COPD:
Goals of nutrition therapy for COPD:
Pulmonary formulas usually have _____ fat, _______carb to help _________ CO2.
If the pt has pulmonary edema, probably use 2 kcal/cc formula to help with fluid
overload.
Fluid challenge with COPD patients:
Too little fluid:
Excessive fluid:

Caloric challenge with COPD patients:

Too few kcalories results in …
Excessive energy intakes may result in _________________(especially in
respiratory failure)

If need to use enteral feeding, what placement is preferred? Why? (See the
Respiratory Failure section and slides.)