Etiology:

• Physiological causes, eg decreased needs related to low activity levels with critical illness or organ failure
• Food and nutrition related knowledge deficit on the part of the caregiver, patient/client, or clinician

S/S:

• Elevated BUN:Creatinine ratio (protein)
• Hyperglycemia (carb)
• Hypercapnia
• Elevated liver enzymes
• Weight gain in excess of lean tissue accretion
• Edema with excess fluid administration
• Reports or observations of documented intake from enteral or parenteral nutrients that is consistently above recommended intake for carbohydrate, protein, and fat (eg 36 kcal/kg for well, active adults, 25 kcal/kg or as measured by indirect calorimetry for critically il adults, 0.8 g/kg protein for well adults, 1.5 g/kg protein for critically ill adults, 4 mg/kg/min of dextrose for critically ill adults, 1.2 g/kg lipid for adults or 3 g/kg for children)
• Use of drugs that reduce requirements or impair metabolism of energy, protein, fat, or fluid
• Unrealistic expectations of weight gain or ideal weight