Term
| When should patients be screened for pressure ulcer risk? |
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Definition
| On admission and periodically as their condition changes |
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Term
| What are the energy needs for optimal wound healing? |
|
Definition
- 30-35 kcal/kg
- 35-40 kcal/kg for patients who are underweight or losing weight
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Term
| What is the recommended protein intake for patients with pressure ulcers? |
|
Definition
- 1.2-1.5 g/kg
- 1.5-2 g/kg for large, multiple, or draining PUs
- Up to a maximum of 2.2 g/kg to replace protein from wound losses or malabsorption
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Term
| What are recommended fluid needs for patients with pressure ulcers? |
|
Definition
| 30-40 mL/kg or 1-1.5 mL/kcal with a minimum of 1500 mL per day |
|
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Term
| What factors should be considered when estimating fluid needs for pressure ulcer patients? |
|
Definition
- Fever
- Draining wounds
- Stool/ostomy output
- Air-fluidized beds
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Term
| How do multivitamin/multimineral supplement recommendations vary by stage of PU? |
|
Definition
- Stage 1-2: give multivitamin/multimineral supplement IF oral/enteral intake inadequate to meet 100% of RDA
- Stage 3-4: Give multivitamin/multimineral supplement at RDA/DRI level
- Maximum: multivitamin/multimineral supplement twice daily
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Term
| What are the recommendations for vitamin C supplementation for patients with pressure ulcers? |
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Definition
- Stage 1-2: 100-200 mg vitamin C per day
- Stage 3-4: up to 1000-2000 mg/d in divided doses for stressed patients or those at risk of deficiency; reassess after 10-14 days
- Maximum: 2000 mg vitamin C per day
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Term
| What are the recommendations for zinc supplementation in patients with pressure ulcers? |
|
Definition
- Stage 1-2: if deficiency suspected, give up to 220 mg zinc sulfate (50 mg elemental zinc) twice daily for 10-14 days
- Stage 3-4: 25-40 mg elemental zinc per day; same recs as for stage 1-2 if deficiency is suspected
- Maximum: if severe deficiency or significant wound/GI losses, give up to 150 mg elemental zinc per day x2 weeks
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Term
| What are the recommendations for vitamin A supplementation in patients with pressure ulcers? |
|
Definition
- Stage 1-2: If deficiency is suspected, replete with 10k-50k units daily x10 days
- Stage 3-4: Same as for stage 1-2; if concomitant use of glucocorticoids supplement with total of 10k-15k x7 days
- Maximum: 25k-50k units per day x10-14 days
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Term
| What are the recommendations for arginine supplementation in patients with pressure ulcers? |
|
Definition
| There are no evidence-based recommendations for arginine use in chronic wounds |
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Term
| What are the recommendations for glutamine supplementation in patients with pressure ulcers? |
|
Definition
| Glutamine appears to play an indirect role in wound healing, but supplementation has not been shown to have a noticeable effect on wound healing |
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|
Term
| What are the recommendations for vitamin E supplementation in the context of wound healing? |
|
Definition
| Vitamin E delays wound healing and decreases tensile strength of wounds |
|
|
Term
| Should supplemental zinc be given to patients with pressure ulcers if deficiency is not suspected? |
|
Definition
| No. Supplemental zinc should ONLY be given if deficiency is suspected. |
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