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Question at position 26 Choose the option that INCORRECTLY describes the normal exocrine and endocrine functions of the pancreas. Choose the option that INCORRECTLY describes the normal exocrine and endocrine functions of the pancreas. Exocrine pancreas can produce enzymes that digests protein, carbohydrate, and fat. (Check Table 16.2) The exocrine pancreas produces enzymes that help to digest food The endocrine pancreas makes the hormone insulin, which helps to regulate glucose homeostasis. Exocrine pancreas is not responsible for producing enzymes that digest starch. Question at position 27 What information provided in the patient’s data supports the diagnosis of acute pancreatitis? What information provided in the patient’s data supports the diagnosis of acute pancreatitis? Elevated CRP – May represent a nonspecific response to inflammation and high levels associated with more severe pancreatic disease Elevated Lactose Dehydrogenase – Assess damage to the body’s tissues and may be used in the differential diagnosis of pancreatitis Diet: NPO Elevated lipase released into the blood due to autodigestion of pancreatic cells Patient’s weight gain Elevated amylase released into the blood due to autodigestion of pancreatic cells Question at position 28 Historically, the patient with acute pancreatitis was made NPO (nil per os, that is, nothing by mouth). Why? Historically, the patient with acute pancreatitis was made NPO (nil per os, that is, nothing by mouth). Why? To minimize pancreatic secretion in an already inflamed/injured pancreas. To starve Mr. Mahon 🙁 To decrease energy and protein intake for weight loss Question at position 29 The physician has written an order for a nutrition consult. Using the literatureDownload literature, explain the role of enteral feeding in acute pancreatitis. Why it is recommended for early enteral feeding? You can find other recommendations by this literature below: The physician has written an order for a nutrition consult. Using the literature Download literature, explain the role of enteral feeding in acute pancreatitis. Why it is recommended for early enteral feeding? You can find other recommendations by this literature below: I disagree with early initiation of enteral feeding because I don’t know how to calculate the goal rate This is because it has beneficial effect on maintenance of both function and structure of the intestinal mucosa with regards to preservation of the integrity of the intestinal epithelial cell junctions, stimulation of brush border enzymes, and prevention of bacterial translocation Question at position 30 What is his BMI, %Usual body weight (UBW), %weight change, Ideal body weight (IBW), and %IBW? Note: Use the following information and patient’s current weight to get his usual body weight “Patient states that he has gained weight over the last 5 years—almost 50 lbs. Prompt 1IBW Answer for prompt 1 IBW Prompt 2BMI Answer for prompt 2 BMI Prompt 3UBW Answer for prompt 3 UBW Prompt 4%UBW Answer for prompt 4 %UBW Prompt 5%IBW Answer for prompt 5 %IBW Question at position 31 Question at position 31 Estimate the patient’s energy needs. As the patient is in ICU, we will consider using the estimated energy ranges from acute illness clinical scenarios. Remember? In week 1, we talked about: Acutely ill adults •Normal weight: 20-35 kcal/kg actual body weight •Obese: 20-35 kcal/kg IBW Based on the patient’s BMI, which range would you use to estimate patient’s energy need? What is the estimated energy need range? Choose the correct option. Don’t forget to convert the patient’s dosing weight (in this case, are you using IBW or actual body weight?) from pounds to kg. Estimate the patient’s energy needs. As the patient is in ICU, we will consider using the estimated energy ranges from acute illness clinical scenarios. Remember? In week 1, we talked about: Acutely ill adults • Normal weight: 20-35 kcal/kg actual body weight • Obese: 20-35 kcal/kg IBW Based on the patient’s BMI, which range would you use to estimate patient’s energy need? What is the estimated energy need range? Choose the correct option. Don’t forget to convert the patient’s dosing weight (in this case, are you using IBW or actual body weight?) from pounds to kg. Approximately 2200 – 3900 kcal Approximately 1600 – 2700 kcal Question at position 32 According to the Nutrition Care Manual, “In moderate to severe pancreatitis, the metabolic response is similar to that in other clinical scenarios with stress and trauma. Estimated protein needs are 1.2 g protein/kg/day to 1.5 g protein/kg/day and up to 2.0 g protein/kg/day for more severe cases requiring intensive care unit admission (Lakananurak, 2020Links to an external site.; McClave 2016Links to an external site.; Mirtallo, 2012Links to an external site.).” Mr. Mahon is in ICU and is considered critically ill, therefore, I’d use his IBW instead of actual body weight as the dosing weight. (read more hereLinks to an external site.). How many grams of protein per kg of IBW would you recommend based on the above text? I’d start with 1.5 g protein/kg/day in this case. Calculate Mr.Mahon’s protein needs. According to the Nutrition Care Manual, “In moderate to severe pancreatitis, the metabolic response is similar to that in other clinical scenarios with stress and trauma. Estimated protein needs are 1.2 g protein/kg/day to 1.5 g protein/kg/day and up to 2.0 g protein/kg/day for more severe cases requiring intensive care unit admission (Lakananurak, 2020Links to an external site.; McClave 2016Links to an external site.; Mirtallo, 2012Links to an external site.).” Mr. Mahon is in ICU and is considered critically ill, therefore, I’d use his IBW instead of actual body weight as the dosing weight. (read more hereLinks to an external site.). How many grams of protein per kg of IBW would you recommend based on the above text? I’d start with 1.5 g protein/kg/day in this case. Calculate Mr.Mahon’s protein needs. 117g 78g 111g 223g 156g

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