Mr. Stanley Edward, a 58-year-old African American male, was admitted to the emergency room of the medical center and resuscitated after being found unconscious in his car in a parking lot. His history was obtained by contacting his daughter. The patient presents with:
end-stage adenocarcinoma of the gastroesophageal juncture.
chronic malnutrition and significant weight loss × 1 year. Low BMI, loss of muscle, loss of subcutaneous fat, bitemporal wasting.
acute pancreatitis with intractable vomiting.
Medical Hx: Hypertension; S/P stroke @ age 56; cataract surgery. Meds: antilipemic medication, antihypertensive medication.
Hx: Lifelong chain smoker (2 packs per day); alcohol abuse since his late 20s.
Ht: 5'8". Admission Wt: 107 lbs. Usual Wt, 1 year ago: 170 lbs.
Social Hx: Lives alone; cooks and shops for himself despite illness.
Dietary Hx: Previously followed a low-cholesterol, low-sodium, high-potassium diet.
Mr. Edward is not being actively treated for cancer at his request. Plan is to keep Mr. Edward NPO and place a peripheral line for hydration and nutrition support.
-Which parenteral infusion complication is Mr. Edward at risk of developing?

Question

Mr. Stanley Edward, a 58-year-old African American male, was admitted to the emergency room of the medical center and resuscitated after being found unconscious in his car in a parking lot. His history was obtained by contacting his daughter. The patient presents with:
end-stage adenocarcinoma of the gastroesophageal juncture.
chronic malnutrition and significant weight loss × 1 year. Low BMI, loss of muscle, loss of subcutaneous fat, bitemporal wasting.
acute pancreatitis with intractable vomiting.
Medical Hx: Hypertension; S/P stroke @ age 56; cataract surgery. Meds: antilipemic medication, antihypertensive medication.
Hx: Lifelong chain smoker (2 packs per day); alcohol abuse since his late 20s.
Ht: 5'8". Admission Wt: 107 lbs. Usual Wt, 1 year ago: 170 lbs.
Social Hx: Lives alone; cooks and shops for himself despite illness.
Dietary Hx: Previously followed a low-cholesterol, low-sodium, high-potassium diet.
Mr. Edward is not being actively treated for cancer at his request. Plan is to keep Mr. Edward NPO and place a peripheral line for hydration and nutrition support.
-Which parenteral infusion complication is Mr. Edward at risk of developing?​

Quizplus · Accepted Answer

Mr. Edward is at risk of developing refeeding syndrome due to his chronic malnutrition and significant weight loss. Refeeding syndrome can occur when a malnourished individual is given excessive nutrition support, causing metabolic and electrolyte imbalances that can lead to serious complications such as cardiac failure and seizures. It is important to start nutrition support slowly and monitor electrolyte levels closely to prevent refeeding syndrome. Other complications listed (hypoglycemia, hypernatremia, hypovolemia, and metabolic bone disease) may also occur with parenteral nutrition but are not specifically related to Mr. Edward's medical history and current condition.

Mr Stanley Edward, a 58-Year-Old African American Male, Was Admitted