What is the primary cause of refeeding syndrome in TPN patients?
High fat content in the diet
Rapid reintroduction of carbohydrates
Excess protein intake
Vitamin deficiency
The Correct Answer is B
Rationale:
A. High fat content does not directly cause refeeding syndrome; fat is less likely to trigger the electrolyte shifts seen in this condition.
B. Rapid reintroduction of carbohydrates in malnourished patients stimulates insulin release, which drives phosphate, potassium, and magnesium into cells, leading to potentially life-threatening electrolyte imbalances—the hallmark of refeeding syndrome.
C. Excess protein intake can strain kidney function but is not the primary cause of refeeding syndrome.
D. Vitamin deficiencies, such as thiamine, can worsen complications, but the immediate trigger is the rapid carbohydrate load.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is []
Explanation
Rationale:
- Potential Condition: The client with acute pancreatitis developed positive Chvostek and Trousseau signs, both classic indicators of hypocalcemia. Pancreatitis often causes calcium to bind to necrotic fat (saponification), lowering serum calcium.
- Actions to Take:
- Increasing IV fluids may be prescribed to improve intravascular volume and help stabilize electrolytes.
- Requesting a STAT ECG is essential because hypocalcemia can prolong the QT interval and predispose to life-threatening arrhythmias.
- Parameters to Monitor:
- Intake and output helps assess hydration status, especially with diarrhea and ongoing fluid/electrolyte losses.
- Bowel sounds should be monitored because hypocalcemia may cause abdominal cramping and changes in GI motility.
Correct Answer is C
Explanation
Rationale:
A. Magnesium levels may actually drop, not rise, during refeeding syndrome due to intracellular shifts.
B. Calcium levels are typically not elevated as a direct result of refeeding syndrome.
C. Refeeding syndrome occurs when malnourished patients receive rapid carbohydrate reintroduction, triggering insulin release. This drives phosphate, potassium, and magnesium into cells, with phosphate depletion being the hallmark and most clinically significant electrolyte disturbance. Hypophosphatemia can cause muscle weakness, respiratory failure, and cardiac dysfunction.
D. Sodium levels may fluctuate, but hyponatremia is not the primary concern in refeeding syndrome.
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