CNSC, Condition Specific Nutrition Support Practice Questions and Answers

Which of the following is the inpatient glycemic target for critically ill patients? 1: 80-110 mg/dL 2: 140-180 mg/dL 3: 181-210 mg/dL 4: 211-240 mg/dL2: 140-180 mg/dL For the critically ill patient, blood glucose levels should be maintained between 140-180mg/dL. Lower glucose targets may be appropriate for selected patients, but targets 110mg/dL are not recommended. References: McMahon MM, Nystrom E, et al. A.S.P.E.N. clinical guidelines: nutrition support of adult patients with hyperglycemia. JPEN J Parenter Enteral Nutr. 2013 Jan;37(1):23-36. McClave, SA, Taylor BE, Martindale RG, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) JPEN 2016;40(2): 159-211 Under conditions of sepsis and stress, which of the following metabolic alterations are most likely to occur? 1: Increased glucose production and increased glucose uptake 2: Increased glucose production and decreased glucose uptake 3: Decreased glucose production and decreased glucose uptake 4: Decreased glucose production and increased glucose uptake2: Increased glucose production and decreased glucose uptake The metabolic response to sepsis and stress is characterized by an increase in glucose production and a decrease in glucose uptake. Stress hormones induce insulin resistance and hyperglycemia is commonly observed in stressed patients. It is recommended that glucose levels be adequately controlled to avoid polyuria, electrolyte disturbances, and infectious complications. References: