Which of the following statements concerning perioperative nutrition is true concerning the above-described patient?
- Since the patient’s weight had been stable with no preoperative nutritional deficit, 5% dextrose intravenous solutions are adequate for the initial postoperative source of nutrition
- Preoperative immunologic status should be determined including total peripheral lymphocyte count and delayed hypersensitivity reaction to determine skin-test response to common antigens
- Routine postoperative fluid administration with intravenous 5% glucose solutions can provide the calories to meet basal energy requirements
- A jejunal feeding catheter should be placed at the time of surgery for postoperative enteral feeding
Medicine
a. Since the patient’s weight had been stable with no preoperative nutritional deficit, 5% dextrose intravenous solutions are adequate for the initial postoperative source of nutrition
Most patients undergoing elective operations are adequately nourished. Unless the patient has suffered significant preoperative malnutrition, characterized by weight loss greater than 10–15%, or has major intraoperative or postoperative complications, solutions containing 5% dextrose may be administered for five to seven days before initiation of enteral nutrition, with no detrimental effect on outcome. The usual postoperative surgical patient is given intravenous glucose at 125 cc/hour receives about 500 kcal/day, far less than the actual number of kcal needed to meet energy requirements. The increased cost of feedings and potential complications associated with intravenous nutrition cannot be justified. Although the use of jejunal feedings in the postoperative period may be useful in some patients, especially those undergoing extensive gastrointestinal surgery, this technique would not appear indicated in the patient described above.
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