Mr. Page's serum glucose increased to 172 mg/dL. Why do you think ...

[cartlidgeashley]

Mr. Page's serum glucose increased to 172 mg/dL. Why do you think this level is now abnormal? What should be done about it?
 
  What will be an ideal response?

Question 2

What should the nutrition support team monitor daily while on PN? What should be monitored weekly? Explain your answers.
 
  What will be an ideal response?

[dmurph1496]

Answer to Question 1

 It is not unusual for serum glucose to be elevated as a result of stress, surgery, and his nutrition support.
 Research indicates serum glucose should be managed aggressively as those patients with hyperglycemia have more complications during the hospitalization.
 Insulin can be added to his parenteral nutrition, or the hyperglycemia can be managed by use of short-acting insulin within a sliding-scale regimen.

Answer to Question 2

 Daily: electrolytes, serum glucose, vital signs, weight, intake and output (hydration status)
 Weekly: CBC, PT, PTT, prealbumin, triglycerides, TG, ALT, AST, ALP, total bilirubin, nitrogen balance
 It is essential to monitor electrolytes and glucose daily to ensure tolerance to the feeding regimen.
 This also provides the framework from which serum electrolytes can be managed through changes in the parenteral solution. Refeeding status is a serious concern and requires monitoring of Mg, Phos., and K levels.
 Monitoring weight and intake/output records allows the team to monitor hydration status and to ensure tolerance to the fluid load that the parenteral solution provides.
 Weekly laboratory values provide data needed to monitor changes in nutritional status.
- These would include the prealbumin and the nitrogen balance.
 Other labs allow the team to evaluate organ function and any potential intolerance to the nutrition support.