Internal Medicine

(Wang) #1

P1: OXT/OZN/JDO P2: PSB


0521779407-E-01 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:10


528 Enteral and Parenteral Nutrition

➣tube displacement/obstruction
➣hypertonic dehydration
➣overhydration
➣hyper/hypo:
kalemia
phosphatemia
glycemia
➣hypercapnia
➣hypozincemia
➣essential fatty acid deficiency
constipation/diarrhea
nausea/vomiting
■parenteral
➣peripheral
>60% total energy as lipids, potential immunocompromise
peripheral vein thrombosis
limited volume/concentration, calorie goals unmet
➣central
catheter related sepsis
hyper/hypo;
volemia
natremia
kalemia
glycemia
magnesemia
calcemia
phosphatemia
hypertriglyceridemia
prerenal azotemia
➣overfeeding
➣essential fatty acid deficiency
➣abnormal LFT’s

Contraindications
■absolute
➣enteral
nonfunctioning GI tract
severe diarrhea/vomiting
high output enteric fistula (>500 ml/day)
aggressive nutrition support not desired
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