NR 228 - Chapter 16 Nutrition in Metabolic Stress: Burns, Trauma, and Surgery
Inflammation Reactions - CORRECT ANSWER involve central nervous system
... [Show More] and hormones
Immune System - CORRECT ANSWER one of the first body functions affected by impaired nutritional status
components affected:
mucous membranes
skin
GI tract
T-lymphocytes
macrophages
granulocytes
antibodies
Malnutrition - CORRECT ANSWER affects each part of the immune system:
integrity of the skin and mucous membranes
wound healing
reduction in nutrient absorption
damage to the GI tract, which increases the risk that infection causing bacteria will spread outside the intestinal system
antibodies: fewer in number and less effective
If on parenteral tube feedings BS should be - CORRECT ANSWER less than 200 mg/dL after eating
Fasting BS - CORRECT ANSWER 70-110
Eating BS - CORRECT ANSWER less than 200
Primary Protein-Energy Malnutrition (PEM) - CORRECT ANSWER inadequate intake of nutrients
Secondary Protein-Energy Malnutrition (PEM) - CORRECT ANSWER inadequate nutrient consumption because of a disease state that impairs consumption, interferes with absorption, or increases requirements
Cortisol - CORRECT ANSWER (steroid) stress hormone
Increased cortisol for long periods of time - CORRECT ANSWER increased risk of infection
increased need of proteins
Steroids - CORRECT ANSWER decrease inflammation
decrease immunity
increase chances of infection
Starvation - CORRECT ANSWER use of stored carbs, fat, and protein to meet energy demands
decline in metabolic rate (BMR) due to energy conservation
Severe Stress - CORRECT ANSWER vitamin and mineral requirements increase
eat foods high in calcium and vitamin D (milk/green leafy vegetables)
Insulin - CORRECT ANSWER decreased glucose
Glucagon - CORRECT ANSWER increased glucose
Effects of Stress - CORRECT ANSWER carbohydrate metabolism: hepatic glucose production increased. insulin levels and glucose use increased
hydration/fluid status: increased fluid losses possible from fever, increased urine output, diarrhea, draining wounds, or diuretic therapy
Increased Stress - CORRECT ANSWER high risk of infection
increased glucose
increased fluid loss
As Calcium Decreases - CORRECT ANSWER risk of osteoporosis increases
Undernutrition can lead to - CORRECT ANSWER decreased protein synthesis
weakness
multiple organ dysfunction syndrome
death
Before Surgery - CORRECT ANSWER NPO (nothing by mouth)
Bariatric Surgery - CORRECT ANSWER for patients with a BMI exceeding 40 or for individuals with a BMI exceeding 35 who have comorbid (presence of two chronic conditions or diseases) conditions
Patients at high risk for malnutrition - CORRECT ANSWER have significantly longer lengths of hospital stays and higher mortality rates
SIRS - CORRECT ANSWER (sepsis warning signs) inflammatory response that occurs in infection, pancreatitis, ischemia, burns, multiple trauma, shock, and organ injury
Multiple Organ Dysfunction Syndrome - CORRECT ANSWER progressive decline of two or more organ systems at the same time
may follow trauma, severe burns, infection, or shock
usually results from uncontrolled inflammatory response (can progress to organ failure and death)
Third Degree Burns - CORRECT ANSWER (full thickness injury) destruction of entire epidermis, dermis, and underlying subcutaneous tissue. does not heal and skin grafts are required
Significant considerations of patient care (burns) - CORRECT ANSWER pain management
wound care
infection control
nutrition support
Nutrition care for burns - CORRECT ANSWER first 24-48 hours is dedicated to fluid and electrolyte replacement [Show Less]