3rd Edition, 2005 Walter Reed Army Medical Center Washington, DC
Nutrition Support Handbook Third edition, 2005 Authors: Sandra E. Smith, MS, RD, CNSD Nutrition Support Dietitian 202-782-3297 LR pager: 113-2696 Nagla Wahab, PharmD Nutrition Support Pharmacist 202-782-6621 LR pager: 158-5061
Information in this booklet should be used as a guide only. It is designed to assist medical professionals in the nutritional care of adult patients at Walter Reed Army Medical Center. The evolving nature of nutrition science mandates that the care of each patient be individualized.
Table of Contents
Introduction Nutrition Assessment: History, Conditions, Physical Findings, Wt Loss Body Weight Assessemnt Serum Protein Assessment ICD Codes for Protein-Energy Malnutrition Effect of Selected Drugs on Nutritional Status Major Components of Nutritional Assessment Nutritional Requirements: Energy and Protein Requirements Macronutrients (Protein, Carbohydrate, Fat) Vitamins Electrolytes Trace Elements (Minerals) Normal Fluid Requirements Oral Diets and Supplements Nutrition Support (NS): Indication for NS Early vs Delayed NS; How Much to Feed? Ethical and Legal Issues Enteral versus Parenteral Nutrition Enteral Nutrition (EN) Indications/Contraindications/Access for TF Formula Selection Administration Guidelines WRAMC Enteral Formulary Potential Complications with EN
1 2 3 4 5 6 6 7-9 10 11 12-13 14 14 15-18 19 20 21 22-23 24 24 25 26-27 28-29 30
Table of Contents Nutrition Support (cont.) uport…………………….... (continued) Parenteral Nutrition (PN) Indications for PN Constituents of PN and acid-base considerations Peripheral Parenteral Nutrition (PPN) Central Parenteral Nutrition (CPN) Standard CPN, Individualized CPN Ordering Guidelines Standard Chemistry Monitoring Medication Additions Tips on WRAMC PN Complications with PN Adverse Rx Ca/Phos LFTs Discontinuing PN Evaluating Nutrition Support Effectiveness Weight Nitrogen Balance... [continues]
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