Podcast
Questions and Answers
Burns are injured tissue caused by ______, flame, chemicals, electricity or radiation.
Burns are injured tissue caused by ______, flame, chemicals, electricity or radiation.
heat
Energy expenditure following major burns is increased ______% above basal needs.
Energy expenditure following major burns is increased ______% above basal needs.
50-100
Losses of protein, salt and fluid take place when ______ areas of the body have been burned.
Losses of protein, salt and fluid take place when ______ areas of the body have been burned.
large
Decreased vascular volume and pressure can result from electrolyte and fluid ______.
Decreased vascular volume and pressure can result from electrolyte and fluid ______.
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Edema at the site of injury during the first hours to ______ day is noticed.
Edema at the site of injury during the first hours to ______ day is noticed.
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A ______ creates an opening from the colon through the abdominal wall.
A ______ creates an opening from the colon through the abdominal wall.
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Tube feeding or ______ may be necessary to meet energy requirements.
Tube feeding or ______ may be necessary to meet energy requirements.
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Clear to normal diet is a ______ diet that helps adjust a patient's ability to digest food.
Clear to normal diet is a ______ diet that helps adjust a patient's ability to digest food.
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The postoperative diet may include being ______ to prevent aspiration.
The postoperative diet may include being ______ to prevent aspiration.
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An ______ is created when the entire colon is bypassed and an opening is made from the ileum.
An ______ is created when the entire colon is bypassed and an opening is made from the ileum.
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Increased withdrawal of cell potassium results in increased serum ______ levels
Increased withdrawal of cell potassium results in increased serum ______ levels
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First degree classification affects the ______ and is characterized by increased warmth and tenderness.
First degree classification affects the ______ and is characterized by increased warmth and tenderness.
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Second degree classification affects both the epidermis and ______.
Second degree classification affects both the epidermis and ______.
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Third degree classification affects the epidermis, muscles, and ______.
Third degree classification affects the epidermis, muscles, and ______.
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IVF is used to ______ fluid losses.
IVF is used to ______ fluid losses.
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High ______ is important to provide energy reserves in a dietary management plan.
High ______ is important to provide energy reserves in a dietary management plan.
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High ______ intake is indicated to spare proteins and meet energy needs.
High ______ intake is indicated to spare proteins and meet energy needs.
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Iron supplements are used to correct or prevent ______.
Iron supplements are used to correct or prevent ______.
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About 90 to 95 percent of nutrient absorption takes place in the first half of the small ______.
About 90 to 95 percent of nutrient absorption takes place in the first half of the small ______.
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After resection, nutrient absorption may be ______.
After resection, nutrient absorption may be ______.
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The ______ absorbs bile salts and vitamin B12.
The ______ absorbs bile salts and vitamin B12.
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If the duodenum is resected, there may be malabsorption of calcium and ______.
If the duodenum is resected, there may be malabsorption of calcium and ______.
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Minimal consequences are expected if the remains of the ______ are intact.
Minimal consequences are expected if the remains of the ______ are intact.
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Losses of calcium, magnesium, and phosphorus occur after ______ resection.
Losses of calcium, magnesium, and phosphorus occur after ______ resection.
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Water absorption occurs in all parts of the small intestine, especially in the ______.
Water absorption occurs in all parts of the small intestine, especially in the ______.
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Fluid and electrolyte losses may lead to ______ or steatorrhea.
Fluid and electrolyte losses may lead to ______ or steatorrhea.
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A ______ is the surgical removal of the gallbladder.
A ______ is the surgical removal of the gallbladder.
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The term ______ refers to the surgical removal of the tonsils.
The term ______ refers to the surgical removal of the tonsils.
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Jejunoileostomy joins the jejunum to the ______.
Jejunoileostomy joins the jejunum to the ______.
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A ______ is a procedure that involves the surgical removal of hemorrhoids.
A ______ is a procedure that involves the surgical removal of hemorrhoids.
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After a gastrostomy, the reason for dietary changes is to rest the ______.
After a gastrostomy, the reason for dietary changes is to rest the ______.
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Cold liquid diets are recommended for ______ and tonsillectomy recovery to prevent bleeding.
Cold liquid diets are recommended for ______ and tonsillectomy recovery to prevent bleeding.
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Diet for gastric surgery should be high in protein and free from ______.
Diet for gastric surgery should be high in protein and free from ______.
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Dumping syndrome is characterized by a decrease in plasma volume due to increased ______ movement.
Dumping syndrome is characterized by a decrease in plasma volume due to increased ______ movement.
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Study Notes
### Nutrient Absorption and Consequences of Intestinal Surgery
- The majority of nutrient absorption occurs in the first half of the small intestine
- The duodenum/jejunum is responsible for absorbing simple carbohydrates, fats, amino acids, vitamins, minerals, and water
- Resecting the duodenum can lead to calcium and iron malabsorption
- The ileum absorbs bile salts, vitamin B12, water, and some carbohydrates, proteins, calcium, magnesium, and phosphorus
- Resecting the ileum can lead to fat and protein malabsorption, vitamin B12 deficiency, and electrolyte imbalances, ultimately resulting in fluid and electrolyte losses, diarrhea, and steatorrhea
- The colon absorbs water, electrolytes, and short-chain fatty acids
- Resecting the colon in addition to the ileum will compound fluid and electrolyte losses and increase diarrhea
### Post-Operative Diet
- A patient recovering from surgery may begin with a diet of nothing by mouth (NPO) to prevent aspiration
- The diet will gradually progress from clear liquids to normal foods as the patient's ability to digest food improves
- Patients may require tube feeding or total parenteral nutrition (TPN) if they are unable to meet their energy requirements through oral intake
### Specific Surgical Conditions
- Colostomy is a surgical procedure that creates an opening from the colon to the surface of the skin to allow for defecation when feces cannot pass through the rectum and anus
- Ileostomy bypasses the entire colon and creates an opening from the ileum to the anus
- Jejunoileostomy involves connecting a short segment of the jejunum to the terminal ileum, effectively bypassing 90% of the small bowel
- Tonsillectomy is the surgical removal of the tonsils
- Cholecystectomy is the surgical removal of the gallbladder
- Hemorrhoidectomy is the surgical removal of hemorrhoids
### Dietary Management
- A cold liquid diet is recommended for tooth extraction, tonsillectomy, and other procedures to prevent bleeding
- Gastrostomy feeding is used to rest the esophagus after removal
- A low-fiber, dry meal diet with restricted carbohydrates is recommended to avoid dumping syndrome
- A high-protein diet with no simple sugars is recommended for gastric surgery
### Dumping Syndrome
- Dumping syndrome is characterized by a decrease in plasma volume due to increased peristaltic movement
### Nutrition Therapy in Burns
- Burns are injured tissue caused by heat, flame, chemicals, electricity, or radiation
- Burns can result in decreased blood volume, plasma loss, edema, damaged vessel walls, increased metabolic rate, weight loss, nitrogen and nutrient losses, and hyperglycemia.
### Metabolic Changes
- Burns cause a loss of tissue which leads to dehydration and fluid imbalances, both intracellularly and extracellularly.
- Loss of protein, salt, and fluid can occur, leading to electrolyte and fluid imbalances, decreased vascular volume and pressure, and decreased urinary output
- Energy expenditure is increased significantly in patients with major burns, exceeding basal needs by 50-100%.
- Edema usually presents within the first 1-2 days after the burn.
- Gastric atony can occur, resulting in delayed gastric emptying
- Patients are at high risk of weight loss.
- Cellular potassium withdrawal is increased, leading to increased serum potassium levels.
### Burn Classification
- First-degree burns affect the epidermis and present as warmth, tenderness, and pain.
- Second-degree burns affect the epidermis and dermis.
- Third-degree burns affect the epidermis, dermis, and subcutaneous fat.
Burn Management
- Medical Management involves pain relievers, anti-infective drugs, and medications to promote tissue regeneration
- Dietary Management begins with IV fluids to replace fluid losses.
- Tube feeding is used to meet energy requirements when oral intake is not possible.
- Fluid and sodium intake is closely monitored to control water retention.
- Providing high-calorie, high-carbohydrate, and high-protein diets are essential to meet increased energy demands, spare protein, and promote tissue regeneration.
- Supplementation with vitamins (vitamin C and B complex) and minerals are crucial for energy metabolism, wound healing, tissue regeneration, and to support oxidative enzyme systems to metabolize extra carbohydrates and proteins
- Iron supplements are recommended to prevent or correct anemia.
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Description
Explore how intestinal surgeries impact nutrient absorption and the consequences of such operations on dietary needs. This quiz covers the roles of the duodenum, jejunum, ileum, and colon, highlighting the risks of malabsorption and the importance of a proper post-operative diet.
