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What is the primary cause of refeeding syndrome in TPN patients?

A.

High fat content in the diet

B.

Rapid reintroduction of carbohydrates

C.

Excess protein intake

D.

Vitamin deficiency

Answer and Explanation

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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Related Questions

Correct Answer is []

Explanation

Rationale:

  • Potential Condition: The client developed new onset of severe, frequent diarrhea after receiving IV antibiotics (cefazolin), along with fever, abdominal cramping, dehydration (dry mucous membranes), and hyperactive bowel sounds. These are hallmark features of Clostridioides difficile colitis.
  • Actions to Take:
    • Contact precautions (gown and gloves) are essential to prevent transmission since C. difficile is highly contagious.
    • IV fluids help correct dehydration and electrolyte losses caused by frequent diarrhea.
  • Parameters to Monitor:
    • Serum potassium should be monitored because diarrhea causes large potassium losses, risking hypokalemia.
    • Blood pressure should be tracked closely since dehydration and electrolyte loss can lead to hypotension and hemodynamic instability.

Correct Answer is B

Explanation

Rationale:
A. Ulcerative colitis always begins in the rectum and progresses proximally, but Crohn’s disease can occur anywhere in the GI tract.
B. Ulcerative colitis and Crohn’s disease are both types of inflammatory bowel disease (IBD) characterized by chronic intestinal inflammation.
C. Surgery may be needed in severe cases, but ulcerative colitis can sometimes be cured with colectomy, while Crohn’s disease is not cured by surgery and tends to recur.
D. Fistulas are common in Crohn’s disease but not in ulcerative colitis.

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