Term

Definition/Description

Anion gap

Calculation of balance in electrolytes: [sodium + potassium]-[chloride+bicarbonate]; used to provide differential diagnosis for metabolic acidosis; normal levels are ; normal anion gap indicates hypercholremic acidosis through renal or gastrointestinal losses of bicarbonate or ketoacidosis during insulin treatment; high anion gap indicates possible renal failure, ketoacidosis, lactic acidosis, toxic ingestion of aspirin and other substances

Bacterial translocation

The transfer of bacteria in the gut across the intestinal wall leading to septicemia; can occur with the absence of intestinal stimulation through feeding

Body cell mass

Protein stores in the body representing mostly muscle and organ tissues and calorie-intense metabolism 

Cholestasis

The disruption of bile flow from liver to intestine that can include symptoms of jaundice, odorous and floating stools, itching, and dark urine; can result from hepatitis, alcohol and drug use, pregnancy, biliary stones, and pancreatic or biliary cancer

Continuous feeding

Administration of feeding throughout the 24 hour period with only intermittent interruptions for catheter or other maintenance

Cyclic feeding

Intermittent feeding at regular intervals; in TPN, it usually means a period of feeding each day which is transitioned to a period of time (usually 8-10 hours) without feeding

Essential fatty acid deficiency (EFAD)

A deficiency of fatty acids that are important to normal metabolism that can occur in longer-term TPN that does not include a fat source; includes linoleic, alpha-linolenic, and arachidonic acids; deficiency can affect growth, reproductive systems, and endocrine systems; clinical signs include brittle and dull hair, nail changes, dermatosis, and allergic problems; vegetable oils are a good source of EFAs

Hypercarbia or hypercapnia

Elevated levels of carbon dioxide in the blood; can result from pulmonary insufficiency and may cause acidosis

Hyperosmolar hyperglycemic non-ketotic coma

A complication of type II diabetes often precipitated by an infection that is characterized by severe dehydration leading to coma; associated with 50% mortality rate

Metabolic acidosis

Excessive addition of acid to the blood or excessive loss of bicarbonate from the blood; caused by renal inability to excrete acids and is often compensated for through respiratory hyperventilation; characterized by low blood pH level (<7.4) and bicarbonate and is often accompanied by hyperkalemia; differentially diagnosed with anion gap calculation; acidic ketone bodies result from a lack of glucose availability that leads to the breakdown of fat for energy needs; lactic acidosis, severe diarrhea, and renal failure can lead to metabolic acidosis; untreated acidosis can increase risk for respiratory failure

Metabolic alkalosis

Increased levels of bicarbonate or losses of acid in the blood; caused by insufficient provision of electrolytes, severe vomiting; characterized by increased bicarbonate and carbon dioxide in the blood; symptoms include pH greater than 7.45, alkaline urine, apnea, headache, muscle cramps, nausea/vomiting, tachycardia, shallow and slow respiration, tetany, and others

Metabolic bone disease

Osteomalacia related to altered metabolism of nutrients, including vitamin D, aluminum, calcium, protein, and glucose; clinical symptoms include back and lower extremity pain and can be a complication of long-term TPN; can result in fractures

Nitrogen balance

The balance between nitrogen intake and nitrogen losses; most nitrogen is associated with body protein; positive nitrogen balance suggests anabolism of protein tissues and negative nitrogen balance suggests catabolism or wasting

Osteopenia/osteoporosis

Abnormal loss of bone minerals that can lead to fractures; occurs in sedentary or bed-bound persons, long-term steroid use, and post-menopausal women; characterized by lower back pain, loss of height, and fractures

Parenteral nutrition

Nutrients provided other than through the alimentary canal, usually through a catheter directly into the bloodstream;

Peripheral parenteral nutrition (PPN)

Peripheral parenteral nutrition is provided into peripheral vessels and is generally supplemental and incomplete;

Refeeding syndrome

A potentially life-threatening complication of TPN that may occur within a few days of initiation of therapy; it involves alterations in fluid, electrolyte, and micronutrient imbalances and may include hemolytic anemia, cardiac arrhythmias, parethesias, and tetany;

Respiratory acidosis/alkalosis

Respiratory acidosis is an accumulation of carbon dioxide that reduces blood pH usually caused by hypoventilation and is appropriately compensated by renal retention of bicarbonate; respiratory alkalosis is a raise in blood pH caused by the loss of carbon dioxide during hyperventilation

Septicemia

Infection spread from other tissues that is in circulating blood characterized by headache, nausea, vomiting, diarrhea, fever, chills, hypotension, pain, and/or other symptoms of infection; diagnosis includes blood cultures and treatment may require aggressive antibiotic therapy

Steatosis

The accumulation of fat in organ tissues

Total parenteral nutrition (TPN)

Central or total parenteral nutrition is usually provided into central veins, usually the superior vena cava and can supply the volume necessary to provide complete nutrition support

Transitional feeding

The process of transition between parenteral and enteral or oral feeding or between enteral and oral feeding.