DIET THERAPY AND BURNS Fluid, electrolyte, and protein losses are tremendous from the burned surfaces. Edema at the burn site, failure to obtain satisfactory skin growth, atony of the gastrointestinal tract, vomiting, and diarrhea are frequently encountered. The excretion of large amounts of nitrogen, potassium, and other wastes places a tremendous load upon the kidneys. [...]

NUTRITION IN SURGICAL CONDITIONS: TUBE FEEDINGS A tube feeding is a nutritionally adequate allowance of liquefied foods that can be administered through a tube in the stomach or duodenum. A tube feeding is used in paralysis or obstruction of the esophagus, in anorexia nervosa, following mouth or gastric surgery, in severe burns, for unconscious patients, [...]

NUTRITION IN SURGICAL CONDITIONS: POSTOPERATIVE DIET, PARENTERAL NUTRITION Postoperative diet The dietary progression depends upon the nature of the surgery. Food and fluids cannot be given orally until peristalsis has returned. Parenteral fluids maintain fluid and electrolyte balances. When gastric secretions have begun and peristalsis resumes, clear fluids are given with the initial amounts being [...]

NUTRITION IN SURGICAL CONDITIONS: PREOPERATIVE DIET Sometimes it is possible to improve the state of nutrition prior to surgery. Obesity presents a hazard to surgery. Whenever possible, the obese patient should lose some weight before surgery is attempted. Other patients are malnourished prior to surgery because of lack of appetite, pain, digestive discomfort, or fear [...]

NUTRITION IN SURGICAL CONDITIONS: NUTRIENT REQUIREMENTS Energy, protein, and ascorbic acid are major needs for rapid wound healing-and convalescence from surgery. Energy If the caloric intake is inadequate, protein will be used to supply energy rather than for wound repair and tissue building. Even very small amounts of glucose as in a parenteral feeding can [...]

NUTRITION IN SURGICAL CONDITIONS: METABOLISM FOLLOWING SURGERY Good nutrition prior to surgery leads to effective wound healing, increases resistance to infection, shortens the period of convalescence, and lowers the mortality rate. On the other hand, poor nutrition prior to surgery results in excessive weight loss, poor wound healing, edema or dehydration, reduced motility of the [...]

CYSTIC FIBROSIS This is an inherited disease that affects the exocrine glands (glands that excrete to the outside of the body). There is excessive secretion of thick mucus which often blocks the ducts of the liver, pancreas, and lungs. Large amounts of sodium chloride are excreted in the perspiration. If the pancreatic ducts are blocked, [...]

PANCREATITIS Disease of the pancreas interferes with the normal production of pancreatic enzymes, and therefore the digestion of fats, protein, and starches is reduced. Undigested fat, starch, and protein are present in the stools in increased amounts. Fat-soluble vitamins are poorly absorbed. Such losses if not corrected lead to general malnutrition. Acute pancreatitis is often [...]

DISEASES OF THE GALLBLADDER Function The gallbladder concentrates the bile and stores it. Upon entering the duodenum, fat stimulates the secretion of a hormone, cholecystokinin. This hormone is carried by the blood stream to the gallbladder and forces contraction, so that the bile is released into the common duct and then into the duodenum. Bile [...]

DISEASES OF THE LIVER: HEPATIC COMA This is a complication of severe liver disease caused by a high blood level of ammonia. The ammonia is produced in the intestinal tract by bacterial action. It is especially likely to occur following gastrointestinal hemorrhage, surgery, or the use of a high-protein diet in severe liver disease. The [...]