Chat with AIExam 22: Metabolic and Respiratory Stress
Discuss the systemic effects of inflammation.
(71) 
VerifiedThe cytokines released during acute inflammation produce a number of systemic effects. Within hours after inflammation, infection, or severe injury, the liver steps up its production of certain plasma proteins, including C-reactive protein, complement proteins, hepcidin, blood-clotting proteins such as fibrinogen and prothrombin, and others. At the same time, plasma concentrations of albumin, iron, and zinc fall. The acute-phase response is accompanied by muscle catabolism to make amino acids available for glucose production, tissue repair, and immune protein synthesis; consequently, negative nitrogen balance (and wasting frequently results. Other clinical features of the acute-phase response may include fever, an elevated metabolic rate, increased pulse rate and blood pressure, increased blood neutrophil levels, lethargy, and anorexia. If inflammation does not resolve, the continued production of pro-inflammatory cytokines may lead to the systemic inflammatory response syndrome (SIRS, which is diagnosed when the patient's signs and symptoms include substantial increases in heart rate and respiratory rate, abnormal white blood cell counts, and/or fever. If these effects result from a severe infection, the condition is called "sepsis." Complications associated with severe cases of SIRS or sepsis include fluid retention and tissue edema, low blood pressure, and impaired blood flow. If the reduction in blood flow is severe enough to deprive the body's tissues of oxygen and nutrients, multiple organs may fail simultaneously.
Which of the following factors does NOT influence risk of MODS?
(79) VerifiedC
What effect does an increase in the release of catecholamines have on the body?
(80) VerifiedB
Case Study Questions
Forty-three-year-old Joseph Delgado is an electrician for a utility company. His medical history is unremarkable, with no problems. He is admitted to the ICU (intensive care unit) with severe electrical burns to his hands, arms, and chest (20 to 30% of body surface area).
-What is the main nutritional goal for Joseph?
(70) Multiple organ dysfunction syndrome (MODS) most often affects the kidneys, lungs, and ____.
(85) Calculate the resting metabolic rate (RMR) for this patient (Hint: Hypocaloric feedings are recommended for critically ill obese patients)
(82) How many grams of protein would a 120-lb woman require after major physiological stress?
(72) Complications that result from refeeding syndrome include ____.
(73) Which substance is an acute-phase protein produced by the liver?
(79) A patient has severe respiratory failure and is unable to eat much. The nurse notices a decrease in body weight and severe generalized weakness. The dietitian recommends ____.
(83) Which condition is characterized by persistent inflammation and excessive secretions of mucus in the main airways of the lungs?
(82) Which nonessential amino acids are sometimes supplemented in patients undergoing metabolic stress?
(78) Effects of elevated cortisol levels during prolonged stress include ____.
(75) Dave has 2nd-degree burns on his back torso, left arm, and left leg. This represents about ____ percent of his TBSA.
(73) To decrease the risk of aspiration in patients with respiratory failure who need nutrition support, the health care provider should ____.
(83) Verified (87) When determining the resting metabolic rate, a patient's energy needs would generally be increased by which condition?
(86) 
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