Answer to Question 1
Severely malnourished patients who are aggressively fed may develop refeeding syndrome, characterized by fluid and electrolyte imbalances and hyperglycemia. These effects occur because dextrose infusions raise levels of circulating insulin, which promotes anabolic processes that quickly remove phosphate, potassium, and magnesium from the blood. The altered electrolyte levels can lead to fluid retention and life-threatening changes in various organ systems. Heart failure and respiratory failure are possible consequences. Refeeding syndrome generally develops within 2 weeks of beginning parenteral infusions. The patients at highest risk are those who have experienced chronic malnutrition or substantial weight loss. Symptoms include edema, cardiac arrhythmias, muscle weakness, and fatigue. To prevent refeeding syndrome, health practitioners may provide only half of the patient's energy requirement when they initiate nutrition support and gradually advance the dose over several days while monitoring (and possibly correcting) electrolyte levels.
Answer to Question 2
A
Cushing’s syndrome. A photograph of a woman with the characteristic facial features of Cushing’s syn
The nonionic form does not occur in significant amounts in aqueous solutions
Children with Down syndrome have a small head, short, thick neck, flattened face, and a distinctive ...
Dermatological changes with myxedema can occur behind the eyes or in the lower leg, as shown here.
Fetal Alcohol Syndrome Children born with fetal alcohol syndrome often have facial abnormalities
Down syndrome