LEARNING OBJECTIVES:

The relevance of nutrition in the prevention and treatment of disease -

1. Screening and Assessment
2. Disease Prevention
3. Medical Nutrition Therapy.

KNOWLEDGE:  The student should be able to describe:

• The signs and symptoms of nutritional deficiencies
• The indications for selection of feeding route (enteral versus parenteral)
• Recognize refeeding syndrome
• Describe complications of parenteral nutrition

SKILLS: The student should be able to:

• Identify nutrition findings on physical exam and history
• Assess the patient's nutritional status
• Provide accurate nutrition information to the team and the patient
• Monitor and identify complications associated with nutrition support
• Order and interpret appropriate tests and therapies that will aid the nutrition management
• Assess the patient's response to treatment

ATITUDES: The student should consider:

• Nutritional status in the assessment of each critically ill patient
• Nutrition as a necessary component of care for the ICU patient
• The impact of medical nutrition therapy on the individual and in relationship to other therapies

REFERENCES:

1. Elder J, Perone J, Branski L, Brown K. Nutrition in critical care: a modified team-based learning exercise. MedEdPORTAL Publications. 2016;12:10386
2. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition.  Jnl of Parenteral and Enteral Nutrition 2016; 40(2): 159-211.
3. Nutrition in the Acute Phase of Critical Illness.  NEJM 2014; 370(13): 1227-1236.
4. American Gastroenterological Association: American Gastroenterological Association Technical Review on Tube Feeding for Enteral Nutrition. Gastroenterology 1995; 108(4): 1282-1301.
5. Detsky AS, Smalley PS, Chang J: Is this patient malnourished? The rational clinical examination. JAMA 1994; 271(1): 54-8. Full text available from Ovid.
6. Howard L: Chapter 78. Enteral and Parenteral Nutrition Therapy. In: Harrison's Principles of Internal Medicine. 14th Edition. McGraw-Hill, year.
7. Solomon SM and Kirby DF: The refeeding syndrome: A review. JPEN 1990; 14(1): 90-7.

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