Nutrition, Fluids, and Metabolic Disorders Flashcards

What is the recommended caloric intake to support adequate growth in a stable premature neonate?

Answer: 110-130 kcal/kg/day

Stable premature neonates require 110-130 kcal/kg/day to achieve intrauterine growth rates of approximately 15-20 g/kg/day.

Which carbohydrate is the primary energy source in human breast milk and most neonatal formulas?

Answer: Lactose

Lactose is the primary carbohydrate in human milk and most standard infant formulas, providing approximately 40% of total caloric intake.

A VLBW neonate has a serum sodium of 128 mEq/L on day 3 of life with urine output of 6 mL/kg/hr. What is the most likely cause?

Answer: Excessive free water administration (dilutional hyponatremia)

Excess free water (hypotonic fluids) in premature neonates with high insensible losses creates dilutional hyponatremia; urine output reflects appropriate fluid response.

Necrotizing enterocolitis (NEC) is most common in which neonatal population?

Answer: Premature infants, especially those <32 weeks or <1500g

NEC primarily affects premature infants with immature gut immunity, motility, and mucosal barrier function, with greatest risk in those <32 weeks or <1500g.

Which finding on abdominal X-ray is pathognomonic for necrotizing enterocolitis?

Answer: Pneumatosis intestinalis (gas in the bowel wall)

Pneumatosis intestinalis—gas produced by bacteria within the bowel wall—is the pathognomonic radiologic sign of NEC.

Total parenteral nutrition (TPN) in neonates typically starts with which amino acid concentration to promote anabolism?

Answer: 3-4 g/kg/day starting on day 1

Current evidence supports early, aggressive protein provision of 3-4 g/kg/day from day 1 to promote positive nitrogen balance and prevent catabolism in preterm neonates.