Dietician's Handbook of Enteral and Parenteral Nutrition

by Skipper, Annalynn

• ISBN13: 9780834209206
• ISBN10: 0834209209
• Edition: 2nd
• Format: Hardcover
• Copyright: 1998-11-01
• Publisher: Jones & Bartlett

Summary

This thoroughly revised and updated edition of a bestselling handbook provides comprehensive coverage of systems approaches to medical nutrition therapy. Expert contributors present a practical approach to the delivery of parenteral and enteral nutrition. All of the basics are covered--nutritional assessment; nutrition management, monitoring and complications; formulas; solutions and additives; and more. Special issues are also included: the team approach, the role of the dietitian, and ethical issues.

Table of Contents

Contributors	xiii	(4)
Preface	xvii	(2)
Acknowledgments	xix	(2)
Introduction	xxi
Joanne E. Wade
Annalynn Skipper
PART I: SELECTION OF CANDIDATES FOR NUTRITION SUPPORT	1	(164)
Chapter 1 Nutritional Screening and Assessment	3	(22)
Pamela J. Charney
Introduction	3	(1)
Malnutrition	4	(3)
Components of Nutritional Assessment	7	(9)
Indexes Used in Nutritional Assessment	16	(1)
Recommendations for Nutritional Risk Screening	17	(3)
Recommendations for Nutritional Assessment	20	(5)
Chapter 2 Nutrition Support: Indications and Efficacy	25	(22)
Laura E. Matarese
Cynthia Hamilton
Introduction	25	(1)
Malnutrition	26	(2)
Nutrition Support--Adjunctive versus Primary Therapy	28	(6)
Standards and Guidelines	34	(8)
Nutrition Support Efficacy	42	(1)
Conclusions	43	(4)
Chapter 3 Ethical Issues in Nutrition Support	47	(16)
Anne Marie B. Hunter
Introduction	47	(2)
Values, Morals, and Ethics	49	(6)
Legal Considerations in Nutrition Support	55	(4)
Implications for Dietitians	59	(1)
Conclusions	60	(3)
Chapter 4 Macronutrient Requirements	63	(17)
Wanda Hain Howell
Introduction	63	(1)
Macronutrient Requirements in Health	63	(7)
Macronutrient Requirements in Stress	70	(6)
Conclusions	76	(4)
Chapter 5 Micronutrients	80	(50)
Michele M. Gottschlich
Theresa Mayes
Introduction	80	(1)
Vitamin A (Retinol)	80	(2)
Vitamin D	82	(6)
Vitamin E	88	(1)
Vitamin K	89	(2)
Vitamin B(1) (Thiamine)	91	(1)
Vitamin B(2) (Riboflavin)	92	(1)
Vitamin B(3) (Niacin)	93	(2)
Vitamin B(6) (Pyridoxine)	95	(1)
Folic Acid	96	(2)
Vitamin B(12)	98	(2)
Vitamin C (Ascorbic Acid)	100	(2)
Biotin	102	(1)
Pantothenic Acid	102	(2)
Zinc	104	(2)
Copper	106	(1)
Selenium	107	(1)
Iron	108	(2)
Conclusions and Future Directions	110	(20)
Chapter 6 Fluid, Electrolyte, and Acid-Base Balance	130	(18)
David L. Paskin
Introduction	130	(1)
Body Composition	130	(4)
Sodium	134	(1)
Potassium	135	(1)
Iatrogenic Fluid and Electrolyte Abnormalities	136	(1)
Elevated Blood Glucose Levels in Critically Ill Patients	137	(1)
Acid-Base Disorders	138	(2)
Laboratory Tests for Determining Acid-Base Balance	140	(2)
Metabolic Abnormalities	142	(1)
Compensation	143	(2)
Interpreting Laboratory Results	145	(3)
Chapter 7 Indirect Calorimetry	148	(17)
Carol S. Ireton-Jones
Introduction	148	(1)
Physiology of Energy Expenditure	149	(1)
Calorimetry	150	(4)
Measurement Data	154	(2)
Clinical Applications of Indirect Calorimetry	156	(3)
Energy Equations	159	(6)
PART II: IMPACT OF ORGAN FUNCTION AND DISEASE PROCESS ON NUTRITION THERAPY	165	(274)
Chapter 8 Esophagus, Stomach, and Intestines	167	(24)
John M. Draganescu
William H. Lipshutz
Introduction	167	(1)
The Esophagus	167	(11)
The Stomach	178	(6)
The Intestines	184	(3)
Conclusions	187	(4)
Chapter 9 Pancreatic Function	191	(18)
Janet A. Furman
Introduction	191	(1)
Pancreatic Functions	191	(1)
Nutrition Management in Pancreatic Disease	192	(11)
Other Issues	203	(1)
Conclusions	204	(5)
Chapter 10 Nutrition Management of the Adult with Liver Disease	209	(30)
Ka Wong
Barbara J. Visocan Klein
Judith A. Fish
Introduction	209	(1)
Normal Functions of the Liver	209	(2)
Effects of Ethanol	211	(2)
Nutrition Aberrations in Hepatic Insufficiency	213	(2)
Nutritional Assessment of Patients with Liver Disease	215	(4)
Nutrition Therapy in Liver Disease	219	(5)
Nutrition Considerations in Hepatic Encephalopathy	224	(6)
Guidelines for Nutrition Support	230	(2)
Conclusions	232	(7)
Chapter 11 Renal Function	239	(18)
Carol Liftman
Introduction	239	(1)
Urine Formation	239	(1)
Sodium and Fluid Regulation	240	(1)
Potassium Regulation	240	(1)
Calcium Regulation	241	(1)
Acid-Base Balance	241	(1)
Renal Disease	241	(1)
Nutrition Management of Patients with Chronic Renal Failure	242	(7)
Nutrition Management of Patients with Acute Renal Failure	249	(3)
Conclusions	252	(5)
Chapter 12 Respiratory Disease and Mechanical Ventilation	257	(16)
Denise B. Schwartz
Respiratory System Function	257	(1)
Role of Malnutrition in the Respiratory Disease Process	258	(3)
Effects of Nutrition on Pulmonary Function	261	(1)
Impact of Energy Substrates on Pulmonary Function	262	(5)
Recommendations for Nutrition Support	267	(6)
Chapter 13 Bone Marrow Transplantation	273	(22)
Paula M. Charuhas
Introduction	273	(1)
Nutrition Assessment	274	(1)
Nutrient Requirements	274	(4)
Nutrition Support	278	(3)
Nutritional Considerations during Bone Marrow Transplantation	281	(7)
Long-Term Complications	288	(1)
Conclusions	288	(7)
Chapter 14 Solid Organ Transplantation	295	(29)
Jeanette M. Hasse
Sara Reek DiCecco
Introduction	295	(1)
Pretransplantation	295	(5)
Immediate Posttransplant Phase	300	(3)
Nutritional Concerns and Specific Transplant Procedures	303	(4)
Immunosuppression	307	(5)
Long-Term Posttransplant Nutritional Concerns	312	(6)
Conclusions	318	(6)
Chapter 15 HIV and AIDS	324	(16)
Stacey J. Bell
Leah M. Gramlich
Christine Wanke
Judith C. Hestnes
Bruce R. Bistrian
Introduction	324	(1)
Mechanisms of Weight Loss	324	(5)
Nutritional Assessment	329	(2)
Nutritional Requirements	331	(2)
Nutrition Support	333	(3)
Conclusions	336	(4)
Chapter 16 Burns	340	(13)
Theresa Mayes
Michele M. Gottschlich
Introduction	340	(1)
Etiology of Hypermetabolism	340	(1)
Nutritional Requirements	341	(5)
Nutritional Assessment	346	(1)
Nutrition Support Guidelines	347	(1)
Conclusions	348	(5)
Chapter 17 Metabolic Stress and Immune Function	353	(30)
Andrea M. Hutchins
Eva Politzer Shronts
Introduction	353	(1)
The Metabolic Response to Injury	353	(6)
Estimating Nutritional Needs	359	(4)
Roles of Specific Nutrients	363	(12)
Providing Nutrition and Metabolic Support for Patients with Metabolic Stress	375	(3)
Monitoring and Preventing Complications	378	(1)
Conclusions	379	(4)
Chapter 18 Surgery and Wound Healing	383	(35)
Marion F. Winkler
Introduction	383	(1)
Nutritional Assessment and Monitoring of Critically Ill Patients	384	(2)
Feeding the Surgical Patient	386	(2)
The Role of Preoperative and Postoperative Nutrition Support	388	(1)
Surgical Anatomy	389	(9)
Wound Healing	408	(2)
Role of Specific Nutrients	410	(2)
Conclusions	412	(6)
Chapter 19 Short-Bowel Syndrome	418	(21)
Peter L. Beyer
Definition and Description	418	(1)
Nutritional Implications	419	(1)
Normal Gastrointestinal Secretion, Digestion, and Absorption	420	(4)
Nutritional Assessment	424	(1)
General Considerations with Major Bowel Resection	425	(2)
Considerations for Specific Types of Resection	427	(6)
Massive Small-Bowel Resection	433	(2)
Patient Education	435	(4)
PART III: THE DELIVERY OF NUTRIENTS	439	(94)
Chapter 20 Enteral Nutrition	441	(40)
Annalynn Skipper
Natalie B. Ratz
Introduction	441	(1)
Enteral versus Parenteral Nutrition	441	(1)
Patient Selection	442	(1)
Enteral Formulas	442	(1)
Nutrient Composition	443	(4)
Regulation of Formula Manufacture	447	(1)
The Enteral Formulary	447	(1)
Generic Formulas	447	(1)
Initiation of Enteral Feeding	448	(2)
Formula Administration	450	(1)
Monitoring	451	(2)
Complications of Enteral Feeding	453	(6)
Conclusions	459	(8)
Appendix 20-A: Enteral Formulas	467	(12)
Appendix 20-B: Modular Formulas	479	(2)
Chapter 21 Management of Total Parenteral Nutrition	481	(45)
Polly Lenssen
Indications for Total Parenteral Nutrition	481	(4)
Prescription of Total Parenteral Nutrition	485	(7)
Monitoring	492	(9)
Complications of Parenteral Nutrition	501	(13)
Determining of an End Point to Therapy	514	(2)
Conclusions	516	(10)
Chapter 22 Transitional Feeding	526	(7)
Annalynn Skipper
Introduction	526	(1)
Initiation of Nutrition Support	526	(2)
Discontinuing Total Parenteral Nutrition	528	(5)
PART IV: ORGANIZATIONAL CONSIDERATIONS IN NUTRITION SUPPORT	533	(44)
Chapter 23 The Nutrition Support Team and the Role of the Dietitian	535	(12)
Annalynn Skipper
The Nutrition Support Team	535	(2)
Role of the Dietitian	537	(2)
Unique Aspects of Nutrition Support Practice	539	(1)
Preparation	540	(1)
Role Expansion	541	(2)
Conclusions	543	(4)
Chapter 24 Nutrition Support in Home Care	547	(30)
Nancy H. Westbrook
Introduction	547	(1)
Trends in the Home Care Industry	547	(2)
Types of Home Care Organizations	549	(1)
Payers of Home Care Services	550	(5)
Documentation	555	(8)
Other Payers of Home Nutrition Support	563	(6)
Maintaining the Home Care Clinical Record	569	(2)
Provision of Nutrition Products to the Home Care Patient	571	(1)
Role of Nutrition Support Professionals	572	(1)
Joint Commission Standards	573	(1)
Conclusions	574	(3)
Index	577