Metabolism Concept
Failure to Thrive: mental, social, and physical impairments – Starvation: (MS pg.
1379-1380, 1503-1505) (Maternity pg. 369-370, 1772-1780)
▪ Inadequate growth in height and weight resulting from infant's ability to obtain or use
calories needed for growth
Causes:
▪ Organic (Physical):
- Dietary (allergy, insufficient resources)
- Hormonal
- Forced starvation
- Inadequate mother/infant attachment
▪ Inorganic (Psychological):
- Anorexia nervosa
- Depression
- Neglect/Abuse
S/S:
▪ Pale/dry skin
▪ Underweight
▪ Decreased VS
▪ Decreased muscle mass
▪ Decreased reflexes
▪ Mental confusion
▪ Prominent bony structures
▪ Depression
Assessment
▪ Dietary habits
▪ Weakness/Difficulty
▪ Apathy (lack of interest)
▪ Dysphagia
▪ Food intolerance
▪ Environmental Assessment
Diagnostic:
▪ CBC (albumin and CORRECTED CALCIUM & CALCIUM)
▪ Serum electrolyte levels
▪ BUN/CR
▪ Vitamins- MAGNESIUM, B12, Vit C, Vit D
, ▪ Albumin, prealbumin
▪ Liver enzymes
▪ And US
▪ Abd CT
▪ Radiology studies for swallowing
TX:
▪ Appetite stimulants
▪ Vitamins
▪ Mineral supplements
▪ TPN
Parenteral Nutrition (TPN)
▪ Composed of IV fat emulsion, CHO (dextrose), amino acids
▪ Change tubing and filter Q24hrs
▪ Assess site frequently
Indications:
▪ Bowel obstruction
▪ Severe UC/Crohn's disease
▪ Short bowel syndrome
▪ Congenital malformations of GI tract
▪ Hyperemesis graviderum
▪ Pre- operative nutritional improvement
Nursing Interventions:
▪ Daily weight
▪ Intake/output
▪ Monitor Glucose
▪ Metabolic labs
Liver Failure, Pancreatic and Gallbladder Diets
Pancreatitis: acute inflammatory process ranging from mild edema to severe hemorrhage
(MS pg. 1440-1499)
▪ Pancreas is located behind the stomach and has endocrine and exocrine functions
▪ Pancreatic juice contains enzymes for digesting fats, proteins and carbs (Trypsin is the
MOST abundant enzyme)
▪ Endocrine function: beta cells secrete insulin and alpha cells secrete glucagon
Failure to Thrive: mental, social, and physical impairments – Starvation: (MS pg.
1379-1380, 1503-1505) (Maternity pg. 369-370, 1772-1780)
▪ Inadequate growth in height and weight resulting from infant's ability to obtain or use
calories needed for growth
Causes:
▪ Organic (Physical):
- Dietary (allergy, insufficient resources)
- Hormonal
- Forced starvation
- Inadequate mother/infant attachment
▪ Inorganic (Psychological):
- Anorexia nervosa
- Depression
- Neglect/Abuse
S/S:
▪ Pale/dry skin
▪ Underweight
▪ Decreased VS
▪ Decreased muscle mass
▪ Decreased reflexes
▪ Mental confusion
▪ Prominent bony structures
▪ Depression
Assessment
▪ Dietary habits
▪ Weakness/Difficulty
▪ Apathy (lack of interest)
▪ Dysphagia
▪ Food intolerance
▪ Environmental Assessment
Diagnostic:
▪ CBC (albumin and CORRECTED CALCIUM & CALCIUM)
▪ Serum electrolyte levels
▪ BUN/CR
▪ Vitamins- MAGNESIUM, B12, Vit C, Vit D
, ▪ Albumin, prealbumin
▪ Liver enzymes
▪ And US
▪ Abd CT
▪ Radiology studies for swallowing
TX:
▪ Appetite stimulants
▪ Vitamins
▪ Mineral supplements
▪ TPN
Parenteral Nutrition (TPN)
▪ Composed of IV fat emulsion, CHO (dextrose), amino acids
▪ Change tubing and filter Q24hrs
▪ Assess site frequently
Indications:
▪ Bowel obstruction
▪ Severe UC/Crohn's disease
▪ Short bowel syndrome
▪ Congenital malformations of GI tract
▪ Hyperemesis graviderum
▪ Pre- operative nutritional improvement
Nursing Interventions:
▪ Daily weight
▪ Intake/output
▪ Monitor Glucose
▪ Metabolic labs
Liver Failure, Pancreatic and Gallbladder Diets
Pancreatitis: acute inflammatory process ranging from mild edema to severe hemorrhage
(MS pg. 1440-1499)
▪ Pancreas is located behind the stomach and has endocrine and exocrine functions
▪ Pancreatic juice contains enzymes for digesting fats, proteins and carbs (Trypsin is the
MOST abundant enzyme)
▪ Endocrine function: beta cells secrete insulin and alpha cells secrete glucagon
