Author Question: What physiologic responses are associated with a high fat infusion? I. increased pulmonary artery ... (Read 58 times)

audragclark · **on:** Jul 16, 2018

What physiologic responses are associated with a high fat infusion? I. increased pulmonary artery pressure II. decreased arterial Pao2 III. increased Paco2 IV. increased pulmonary vascular resistance

A. II, III only
B. I, II, IV only
C. II, III, IV only
D, I, II, III, IV

Question 2

While performing indirect calorimetry on a mechanically ventilated patient who is unable to achieve steady state. What should the therapist do to obtain a resting energy expenditure measurement?

A. Obtain data for at least 15 minutes, and extrapolate the value to 24 hours.
B. Obtain data for three 15-minute intervals, determine the average, and extrapolate the value to 24 hours.
C. Obtain a mean value over the time of the testing period, and extrapolate the value to 24 hours.
D. No useful value for the resting energy expenditure can be obtained.

CAPTAINAMERICA · **Reply #1 on:** Jul 16, 2018

Answer to Question 1

ANS: A
A. Correct response: Excess fat infusion over a short time can have deleterious effects on respiratory function. High fat infusion may clog the reticuloendothelial system (RES) with deposition of fats in leukocytes and macrophagesan effect that suppresses phagocytosis and bacterial killing. The rate of clearance from fat from the RES decreases a patient's stress technique. The rate of clearance of fat from the RES decreases as patient stress increases. There may be cumulative dose effects on the RES over several days of fat infusion. The overinfusion of fat may lead to (1) increased mean pulmonary arterial pressure, (2) increased shunting, (3) increased pulmonary vascular pressures, and (4) decreased arterial PO2 to hyperlipemia.
B. Incorrect response: See explanation A.
C. Incorrect response: See explanation A.
D. Incorrect response: See explanation A.

Answer to Question 2

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: When a critically ill patient undergoes an indirect calorimetry test, achieving a steady state may be difficult for the patient. The achievement of a steady state ensures a greater degree of validity in terms of the resting energy expenditure (REE) measurement. For patients who fail to achieve steady-state conditions, obtaining a mean value for the REE over the time of the study is acceptable. This value is extrapolated over 24 hours.
D. Incorrect response: See explanation C.