Report of a hidden case of overfeeding
Article Abstract:
Nutrition support is necessary to the care of very ill patients, but the amount of support must be carefully determined and monitored. While underfeeding is easily understood to be a problem, overfeeding is less obviously so, although no less serious. Among the complications of overfeeding are excessive accumulations of acids in body fluids (acidosis) caused by liver dysfunction and carbon dioxide retention, and breathing problems, including the inability to wean a patient from the respirator. Now that portable machines for bedside assessment of metabolic function are available, nutrition support can be adjusted for individual patients whenever necessary. In one case a 33-year-old female recovering from heart surgery could not be weaned from the respirator. She was being given nutrition support of 2,448 calories per day. However, a dextrose dialysis solution added another 960 calories, for a total of 3,408 calories per day. The caloric intake for a woman of moderate activity is about 1,800 calories. After a review of the metabolic assessment data, nutrition was lowered to 1,600 calories. Kidney function improved, allowing dialysis to be decreased (now providing only 230 calories), and acid levels returned to normal. The patient was weaned from the mechanical ventilator and recovered uneventfully. All sources of nutrition must be taken into account in calculating total caloric intake, including the absorption of dextrose from either an intravenous solution or an abdominal (peritoneal) dialysis solution. The number of calories in the dialysis solution is highly variable, depending on the concentration of dextrose. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Heart and Lung
Subject: Health
ISSN: 0147-9563
Year: 1990
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Critical care nurses' attitudes toward, concerns about, and knowledge of the acquired immunodeficiency syndrome
Article Abstract:
As the AIDS epidemic grows it becomes increasingly important for the medical community to assess their own feelings, fears, anxieties and prejudices about dealing with patients infected with HIV (Human immunodeficiency virus, the AIDS-causing virus). Two groups of critical care nurses, drawn from a secular teaching hospital and a religious-affiliated community hospital, were surveyed concerning their knowledge of AIDS and their attitudes about caring for patients with AIDS. The population of teaching hospital-affiliated nurses were statistically more receptive to treating AIDS patients than their colleagues in the smaller community hospital. However, despite their beliefs that patients with AIDS should receive hospital care, 45 percent of the nurses from the teaching hospital and 65 percent of the nurses at the community hospital said that, if given a choice, they would not care for AIDS patients. Both groups of critical care nurses had excellent knowledge concerning AIDS and the nursing care of patients with AIDS. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Heart and Lung
Subject: Health
ISSN: 0147-9563
Year: 1990
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