LEARNING OBJECTIVES:
The relevance of nutrition in the prevention and treatment of disease -
- Screening and Assessment
- Disease Prevention
- Medical Nutrition Therapy.
KNOWLEDGE: The student should be able to describe:
- The signs and symptoms of nutritional deficiencies
- Substrate utilization in critically ill patients
- The indications for selection of feeding route (enteral versus parenteral)
- The purpose and interpretation of calculated needs estimates using indirect calorimetry and stress factors
- How to initiate and monitor nutrition support using clinical and laboratory indices in a critically ill patient
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SKILLS: The student should be able to:
- Identify nutrition findings on physical exam and history
- Assess the patient's nutritional status
- Provide accurate nutrition information to the team and the patient
- Monitor and identify complications associated with nutrition support
- Order and interpret appropriate tests and therapies that will aid the nutrition management
- Assess the patient's response to treatment and reformulate the nutrition plan
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ATITUDES: The student should consider:
- Nutritional status in the assessment of each critically ill patient
- Nutrition as a necessary component of care for the ICU patient
- The impact of medical nutrition therapy on the individual and in relationship to other therapies
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REFERENCES:
- American Gastroenterological Association: American Gastroenterological Association Technical Review on Tube Feeding for Enteral Nutrition. Gastroenterology 1995; 108(4): 1282-1301.
- Detsky AS, Smalley PS, Chang J: Is this patient malnourished? The rational clinical examination. JAMA 1994; 271(1): 54-8. Full text available from Ovid.
- Howard L: Chapter 78. Enteral and Parenteral Nutrition Therapy. In: Harrison's Principles of Internal Medicine. 14th Edition. McGraw-Hill, year.
- McClave SA and Snider HL: Use of Indirect Calorimetry in Clinical Nutrition. NCP 1992; 7(5): 207-221.
- Solomon SM and Kirby DF: The refeeding syndrome: A review. JPEN 1990; 14(1): 90-7.
- Fauci, AS, et al. (eds.): Harrison's Principles of Internal Medicine. (14th Edition) NY: McGraw Hill, 1998. Chapter 78 - Enteral and Parenteral Nutrition Therapy. (pp 472-480).
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