Nutrition Assessment (02:30)
Caroline Ghanbari identifies assessment candidates and outlines components for developing nutrition care plans. Goals include improving protein status, maintaining energy reserve, and avoiding laboratory parameter alterations.
Initial Measurements (04:13)
Hear how to assess energy reserve, somatic protein status, and visceral protein status for a patient nutrition assessment. Learn about serum albumin, serum transferrin, and serum pre-albumin options.
Assessing Macronutrient Requirements (03:22)
Hear how to assess a patient's protein, calorie, lipid, carbohydrate, fluid, vitamin, mineral, and electrolyte needs.
Nitrogen Balance (01:19)
Nitrogen balance is often used to determine protein utilization in critical patients. Learn about assessing for catabolism, equilibrium, and anabolism.
Refeeding Syndrome (03:18)
Nutrition assessments determine risk for severe fluid and electrolyte phosphorus shifts in malnourished patients. Hear ways to reduce this risk.
Feeding the Critically Ill Patient Parenteral Nutrition Support (06:39)
Terry Lea explains starvation with and without stress. Early enteral support should be started within 72 hours of injury or surgery. Enteral routes include oral and tube feeding; parenteral routes include peripheral and central venous access. Hear indications for each.
Parenteral Nutrition Support (02:41)
Total parenteral nutrition (TPN) occurs through central venous access; peripheral parenteral nutrition (PPN) is limited to short term, high volume, low osmolality solutions. View a standard TPN solution formula and hear contraindications.
Writing Non-Standard Parenteral Nutrition Orders (05:45)
Learn about determining amino acid solution, lipid emulsion, and dextrose solution amounts. View equations for calculating grams per nutrient and calories per gram. Determine electrolyte imbalances before adjusting the solution.
Adequate Monitoring (00:46)
Parenteral nutrition patients need to have finger stick blood glucose levels, temperature, parenteral access site, and intake and output checked.
Enteral Nutrition Support (04:17)
Melissa Cordell discusses advantages of early enteral nutrition support within 72 hours of surgery or injury. Learn about indications for short and long term access methods and continuous, bolus, intermittent or cyclic formula feedings.
Formula Selection (01:58)
Full strength isotonic formulas may be used when initiating a tube feeding; rate increases can be slowed with intolerance. Learn about polymeric, hydrolyzed and disease-specific formulas.
Potential Complications in Tube-Fed Patients (04:25)
Learn about reducing risk of diarrhea, pulmonary aspiration, drug-nutrient interactions, tube occlusion, and metabolic complications.
Case Study on Nutritional Care (11:57)
Ghanbari presents a 17 year old male suffering a closed head injury. A nutritional assessment showed good nutritional condition. View his prescribed TPN solution. He lost muscle mass, despite adequate nutrition support. Learn about his gradual transition to tube and oral feeding after surgery.
Credits: Nutrition in Critical Care Patients (00:44)
Credits: Nutrition in Critical Care Patients
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