Monitoring nutritional

Since the 1960s, NHANES has been monitoring nutritional and clinical factors in the U.S. population chemicals in blood and urine were included recently. In addition, CDC s National Reports on Human Exposure to Environmental Chemicals, based on NHANES data, have been influential in setting priorities for future biomonitoring research (Schober 2005). 

De Block J. et al. Monitoring nutritional quality of milk powders capillary electrophoresis of the whey protein fraction compared with other methods. Inti. Dairy J., 13, 87, 2003. 

Body composition and intra-/extraceUular fluid indexes can be determined for monitoring nutrition and physical training. Small portable loggers for heart rate and respiration rate during, for example, bicycling or treadmill exercise have found a large market as a part of the instrumentation for sports medicine. 

A 30 to 60 percent increase in visits to monitor nutritional status for infants up to two years of age and by 25 to 45 percent for children aged three to five (between 1997 and 1999, the first two years of the program)... 

Matrix Components The term matrix component refers to the constituents in the material aside from those being determined, which are denoted as analyte. Clearly, what is a matrix component to one analyst may be an analyte to another. Thus, in one hand for the case of analyses for elemental content, components such as dietary fibre, ash, protein, fat, and carbohydrate are classified as matrix components and are used to define the nature of the material. On the other hand, reference values are required to monitor the quality of determinations of these nutritionally significant matrix components. Hence, there is a challenging immediate need for certified values for dietary fibre, ash, protein, fat, and carbohydrate. Concomitantly, these values must be accompanied by scientifically sound definitions (e.g. total soluble dietary fibre, total sulpha-ted ash, total unsaturated fat, polyunsaturated fat, individual lipids, simple sugars, and complex carbohydrates). 

Nutritional considerations Contains soy bean oil, egg lecithin, and glycerol. Provides 1.1 kcal/mL of emulsion may need to adjust nutritional regimen. One formulation contains EDTA. Prolonged therapy with the EDTA-containing product may decrease serum zinc levels. May need to monitor serum zinc levels and supplement. 

Vitamin K content of enteral nutrition formulas may affect pharmacological activity. Monitor and titrate dose to maintain therapeutic international normalized ratio (INR)... 

Monitor short- and long-term nutritional status through evaluation of height, weight, and body mass index. Ideally, parameters should be near the normals for non-CF patients. 

Monitor patients for adequate oral intake. If the patient has weight loss, assess whether enteral or parenteral nutrition is needed. 

D/C all antiretrovirals symptomatic support with fluids some patients require IV bicarbonate, hemodialysis, parenteral nutrition, or mechanical ventilation once syndrome resolves, consider using NRTIs with 4- mitochondrial toxicity (ABC, TDF, 3TC, or FTC) monitor lactate after restarting NRTIs some clinicians use NRTI-sparing regimens. 

Patients receiving PN should have specific laboratory values checked to assess electrolyte status, organ function, and nutritional status, and these parameters should be monitored as indicated clinically. 

The goal is to transition the patient to enteral or oral nutrition and taper off PN as soon as feasible clinically. When initiating enteral or oral nutrition, monitor the patient for glucose, fluid, and electrolyte abnormalities. Perform calorie counts to determine the adequacy of nutrition via the oral or enteral route. When the patient is tolerating more than 50% of total estimated daily calorie and protein requirements via the oral or enteral route, wean PN by about 50%. PN can be stopped once the patient is tolerating more than 75% of total estimated daily calorie and protein requirements via the oral or enteral route, assuming that intestinal absorption is maintained. 

TABLE 97-8. Suggested Frequency of Monitoring Parameters in Hospitalized Patients Receiving Parenteral Nutrition... 

Thereafter, the preceding parameters and other nutritional parameters should be monitored routinely or as indicated (Table 97-8). Random capillary blood glucose concentrations also should be monitored every 6 to 8 hours when initiating PN, and regular insulin should be administered to control glucose as needed (either by intermittent administration per sliding scale or as a continuous infusion). 

Formulate a monitoring plan for an enteral nutrition (EN) patient. 

---