Notes Refeeding Kraft article.doc

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Department
Nutrition and Dietetics
Course
NUTR 344
Professor
Kristine Koski
Semester
Winter

Description
Identification of patients at risk for refeeding syndrome -Anorexia nervosa ­Classic marasmus/kwashiorkor ­Residents admitted from skilled nursing facilities ­Unfed for 7–10 days with evidence of stress/depletion Chronic diseases causing undernutrition  (eg, cancer orcardiac cachexia, chronic obstructive pulmonary disease, cirrhosis) ­History of excessive alcohol intake Morbid obesity with massive weight loss Treatment of hypokalemia Degree of hypokalemia IV potassium replacement Rate of IV infusion† Maximum concentration dosage* Serum potassium  20–40 mEq  10–20 mEq  80 mEq/L via a  concentration= 2.5– potassium/h;  peripheral vein; 3.4 mEq/L (mild to  maximum of 40 mEq  moderate  potassium/h hypokalemia,  asymptomatic) Serum potassium  up to 120 mEq/L via a  concentration= 2.5  central vein (admixed  mEq/L, or if  in 0.9% sodium  symptomatic (severe  chloride in water, or  symptomatic  0.45% sodium  hypokalemia) chloride in water) *In patients with normal renal function; patients with renal insufficiency should receive less of equal 50%  of the initial empiric dose. †Continuous cardiac monitoring and infusion via a central venous catheter are recommended for infusion  rates =10 mEq potassium per hour. 64 –70 Treatment of hypophosphatemia * Degree of hypophosphatemia IV phosphate replacement 
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