Define refeeding syndrome. Why does it occur, and how can it be prevented?
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Severely malnourished patients who are aggressively fed may develop refeeding syndrome, characterized by fluid and electrolyte imbalances and hyperglycemia. These effects occur because dextrose infusions raise levels of circulating insulin, which promotes anabolic processes that quickly remove phosphate, potassium, and magnesium from the blood. The altered electrolyte levels can lead to fluid retention and life-threatening changes in various organ systems. Heart failure and respiratory failure are possible consequences. Refeeding syndrome generally develops within 2 weeks of beginning parenteral infusions. The patients at highest risk are those who have experienced chronic malnutrition or substantial weight loss. Symptoms include edema, cardiac arrhythmias, muscle weakness, and fatigue. To prevent refeeding syndrome, health practitioners may provide only half of the patient's energy requirement when they initiate nutrition support and gradually advance the dose over several days while monitoring (and possibly correcting) electrolyte levels.
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Which of the following carry cholesterol away from the cells and return it to the liver?
a. very low density lipoproteins - VLDLs b. low density lipoproteins - LDLs c. high density lipoproteins - HDLs d. Chylomicrons
A client may require an alternate feeding route. Which of the following statements is true?
a. Intravenous feeding can be used to allow the bowel to rest and heal. b. Intravenous feeding is preferred even if the GI tract is functioning. c. Tube feedings cannot be administered safely to a client in a coma. d. The intravenous route cannot provide for all nutritional needs.
Corn syrup and honey can be dangerous for infants because they may contain
A) parasites. B) Clostridium botulinum spores. C) too much sugar. D) Salmonella.
Why is vitamin D deficiency on the rise?
a. people spend time outdoors without the benefit of sunscreens. b. larger bones mass requires additional vitamin D. c. low consumption of milk fortified with vitamin d. d. the kidneys fail to promote vitamin D retention among the elderly.