1.Copper deficiency is associated with
1: leukocytosis.
2: macrocytic anemia.
3: microcytic hypochromic anemia.
4: erythrocytosis. correct answers 3:
... [Show More] microcytic hypochromic anemia.
A pregnant patient is admitted with hyperemesis gravidarium (HG). Which of the following is a clinical indication for PN use?
1: Vomiting NOT controlled with supportive care within 48 hours
2: Intolerance to EN trial and supportive care measures
3: Patient refusal of EN tube placement
4: Fluid and electrolyte imbalances correct answers Hyperemesis gravidarum (HG) is a severe form of pregnancy-induced nausea and vomiting. Due to the likelihood that the patient's nutritional intake has been poor for several weeks due to vomiting, EN or PN may be required. Prior to implementation of nutritional therapy for HG, fluid and electrolyte imbalances, ketonuria, and dehydration would be treated via IV fluid. Multivitamins with additional B vitamins are typically added to address suboptimal vitamin intake and prevent complications such as neuropathies (B6 and B12), Wernicke's encephalopathy (thiamine), and neural tube defects (folic acid). Antiemetic treatment would begin and oral intake would temporarily be avoided. Initiation of an EN trial for HG would be appropriate if the patient is still unable to take oral feedings after 24-48 hours of supportive therapy as listed above. If the EN trial fails due to exacerbated nausea, vomiting, diarrhea, significant gastric residuals, or tube displacement and is associated with clinically significant weight loss (greater than 5% of body weight), it is appropriate to begin PN.
Rapid intravenous infusion of potassium phosphate may result in
1: thrombophlebitis.
2: hypercalcemia.
3: metabolic alkalosis.
4: vitamin D deficiency. correct answers Infusion rates of phosphate should not exceed 7 mmol/h because faster infusion rates can often cause thrombophlebitis (ie, potassium phosphate) and metastatic calcium-phosphate deposition with potential resultant organ dysfunction.
3. What is the most common complication associated with PN administration?
1: Hypophosphatemia
2: Hyperkalemia
3: Hyponatremia
4: Hyperglycemia correct answers Hyperglycemia is the most common complication associated with PN administration and can be caused by various factors. Stress-associated hyperglycemia in acutely ill and septic patients often develops as a result of insulin resistance, increased gluconeogenesis and glycogenolysis, and suppressed insulin secretion. [Show Less]