concentrations. Potassium requires careful monitoring for acute and chronic
renal failure, abnormal acid base status, abnormal glucose status and during the
use of certain drug therapies such as digoxin, amphotericin, high dose beta
agonists, insulin drips and diuretics such as furosemide.
Chloride is an anion that is provided in parenteral solutions to balance the
cations such as potassium and sodium. An overabundance of chloride can lower
serum pH, causing a low anion gap metabolic acidosis.
IV. Enteral Nutrition
Enteral nutrition is the safest and most economical means of providing
calories and nutrients, avoiding the complications of parenteral feeding such as
the need for central catheter insertion, with all its complications such as
mechanical malfunction, sepsis, and metabolic problems. Management of fluid
and electrolytes as well as acquisition of all macronutrients (carbohydrates,
lipids, proteins) and micronutrients are facilitated by the normal function of
gastrointestinal absorption. Infectious complications are diminished by direct
nutritional support of the intestinal mucosa. [ 4 ] Pediatric formulas can be given
orally or by enteral feeding tube. A gastrostomy should be considered for any
patient for whom it is anticipated that oral feeding is not possible or safe for a
prolonged period of time.
Many special diets are available for patients with specific needs. For
patients with inadequate digestive function due to intestinal loss, predigested or