Which of the following abnormalities would be most likely to occur with the initiation of nutrition in a severely malnourished patient who develops refeeding syndrome?
Refeeding syndrome, defined by a characteristic pattern of electrolyte abnormalities, can occur upon institution of nutritional support in severely malnourished patients (e.g., a patient with a history of alcohol abuse and malnutrition). This syndrome, if undetected, may result in severe compli-cations, including neuromuscular weakness, respiratory failure, dysrhythmias, hemolytic anemia, coma or death.
The most common electrolyte abnormalities seen in refeeding syndrome are:
Hyperglycemia occurs more commonly than hypoglycemia with refeeding syndrome.
Actions to prevent refeeding syndrome include identification of patients at high risk of developing refeeding syndrome and identification and correction of pre-existing electrolyte abnormalities. In high-risk patients, the nutritional support should be advanced slowly with frequent reevaluation of electrolyte concentrations.
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