Does the use of a nutrition risk indicator identify patients who will most likely benefit from nutrition therapy? correct answers yes, NUTRIC score and
... [Show More] risk screening should be used. High nutrition risk identifies those patients most likely to benefit from early EN therapy.
What additional tools, components, or surrogate markers provide useful information when performing nutrition assessments in critically ill adult patients? correct answers Nutrition assessment should include an evaluation of comorbid conditions, function of GI tract, and risk of aspiration.
traditional serum markers, (pre albumin, albumin, transferrin, retinol binding protein) are a reflection of the acute phase response, do not accurately represent nutrition status in the ICU.
What is the best method for determining energy needs in the critically ill adult patient? correct answers Indirect calorimetry
In the absence of indirect calorimetry, predictive equation or a simplistic weight based equation be used to determine energy requirements
Should protein provision be monitored independently from energy provision in critically ill adult patients? correct answers an ongoing eval of adequacy of protein provision be performed.
Protein appears to be the most important macronutrient for healing wounds, supporting immune function, and maintaining lean body mass.
What is the benefit of early EN in critically ill adult patients compared with withholding or delaying this therapy? correct answers EN should be initiated within 24-48 hours in patients unable to maintain volitional intake
Is there a difference between EN over PN in critically ill patients who require nutrition support therapy? correct answers EN should be initiated over PN when able.
Is the clinical evidence of contractility (bowel sounds, flatus) required prior to initiating EN in critically ill adult patients? correct answers In the majority of SICU and MICU patients, while GI contractility factors should be evaluated when initiating EN, overt signs of contractility should not be required prior to initiation of EN.
What is the preferred level of infusion of EN within the GI tract for critically ill patients? How does the level of infusion of EN affect patient outcomes? correct answers We recommend the level of infusion be diverted lower in the GI tract in those critically ill patients at high risk for aspiration or those who have shown intolerance to gastric EN.
In most critically ill patients, it is acceptable to initiate EN into the stomach
Is EN safe during periods of hemodynamic instability? correct answers Suggest that in the setting of hemodynamic compromise or instability, EN should be withheld until the patient is fully resuscitated and/or stable. Initiation/reinitiation of EN may be considered with caution in patients in patients undergoing withdrawal of vasopressor support [Show Less]