TRACEY TRUE, RDN, LD
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Clinical Experience

National Nutrition Month 2018

3/19/2018

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We are sponsoring a food drive in honor of God's Pantry Food Bank to celebrate National Nutrition Month. 
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According to the most recent data published by Feeding America®, 15.8% of Kentucky residents suffer from food insecurity.

Food insecurity refers to the USDA’s measure of lack of access or uncertain availability of nutritionally adequate foods for all household members.

This means 699,590 Kentucky residents make trade-offs between having enough food and supporting their basic needs, such as paying for housing or medical bills.
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Join your Registered Dietitians in celebrating National Nutritional Month by donating non-perishable goods to provide hunger relief to Kentuckians…
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Or go online and make a donation to God’s Pantry Food Bank at https://give.godspantry.org/
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UPDATE

Our food drive in honor of National Nutrition Month and God's Pantry Food Bank was wildly successful! Every day we received more food than the last. A special thanks to the employees of Saint Joseph Hospital, whose generosity allowed us to collect an entire barrel (plus some) of shelf stable foods for the people of the Commonwealth.
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Total Parenteral Nutrition and Glucose Utilization Rate

11/19/2017

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Total parenteral nutrition (TPN) is a method of feeding which bypasses the gastrointestinal tract,
and is an integral part of medical treatment when normal physiological means of nourishment cannot be utilized. TPN is associated with inherent risk such as hyperglycemia, electrolyte imbalances, increased oxidative stress, hepatic dysfunction, and potential infectious morbidity. The most commonly reported hepatic abnormalities include fatty liver, cholelithiasis, and cholestasis.

The primary source of energy in TPN solutions is carbohydrate in the form of dextrose
monohydrate, which is oxidized at a maximum rate of 4-7 mg/kg/min in humans. Higher dextrose
infusion rates may contribute to excess carbon dioxide production, which is undesirable for patients
with respiratory problems. Additionally, excess glucose is used by the liver for repletion of glycogen
stores and lipid synthesis, contributing to abnormal liver function test (LFT) values secondary to fatty
liver.

According to the ASPEN Guidelines of Nutrition Support Care in the Adult Critically Ill Patient,
those patients who require TPN in the ICU setting may benefit from a hypocaloric feeding strategy which also provides adequate protein. Dextrose infusion rates of 5 mg/kg/min or less is generally
recommended to prevent hyperglycemia and hepatic dysfunction. Effort should be made to avoid
energy provision that exceeds estimated energy requirements, as carbon dioxide production increases significantly with lipogenesis and may be tolerated poorly in patients prone to CO 2 retention.
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In conclusion, avoiding excessive energy intake in the critically ill patient requiring TPN Support
may reduce the potential for infectious morbidity, duration of mechanical ventilation, and hospital
length-of- stay. At Saint Joseph Hospital, Registered Dietitian Nutritionists follow ASPEN guidelines and aim to provide dextrose infusions of 4 mg/kg/min or less when recommending TPN support for critically ill patients.
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Neonatal Nutrition Support

2/26/2017

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During my dietetic internship the Neonatal Intensive Care Unit (NICU) was of most interest. The health of women, infants, and children is at the forefront of my mind, and served as the topic of nearly all of my undergraduate research.

​Recently, I have had the generous opportunity to shadow our Registered Dietitian in the NICU, and I could not be more thrilled! As a clinical dietitian, I find acute care to be especially gratifying work, which is only magnified by the opportunity to provide excellent care to our smallest patients.

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Nutrition for the Win

1/7/2017

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Adequate nutrition is important for keeping us healthy, and only becomes more important in helping us to recover from illness or injury. When a patient becomes critically ill, nutrition status has the potential to affect overall prognosis.
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Malnutrition

12/18/2016

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When most people think of malnutrition it is usually an image of undernutrition that comes to mind. However, a person can be obese and also malnourished. Malnutrition is a physical state of unbalanced nutrition, and encompasses both undernutrition and overnutrition.

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    A collection of stories from my time working as a Clinical Dietitian in an acute care setting.
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This electronic portfolio is the work of Tracey True. Contents are property of the owner and may not be used, copied or distributed without authorization. Views are my own.
© 2021 Tracey True, RDN, LD ​
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All Rights Reserved.
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  • Personal
  • Professional
  • Portfolio
  • Blogs
    • True Life
    • The Dairy Alliance
    • Clinical Dietitian, 2017
    • Dietetic Internship, 2016
    • Research & Writing, 2015
    • Extension Internship, 2014