Chapter: Nutrition Support in Critically Ill Patients

1. Distinguish which critically ill patients require nutrition intervention based on the degree of malnutrition.
2. Evaluate the appropriate route and timing of nutrition support initiation, based on degree of malnutrition, degree of illness, and GI function.
3. Distinguish between different types of access for parenteral nutrition (PN) and enteral nutrition (EN) and considerations for long-term versus short-term therapy.
4. Develop a care plan with an appropriate balance of macronutrients, based on substrate use, to avoid overfeeding and to manage refeeding syndrome.
5. Apply monitoring parameters to assess both EN and PN tolerance.
6. Distinguish between updates from the 2016 and 2021 guidelines and apply changes to current practice. 

Chapter: Parenteral Nutrition Controversies

1. Discover discrepancies among existing nutrition support guidelines for critically ill patients.
2. Evaluate timing of parenteral nutrition (PN) initiation in critically ill adult patients.
3. Distinguish clinical scenarios that warrant cautious initiation of PN in critically ill adult patients.
4. Design appropriate PN regimens in critically ill adult patients.
5. Examine adverse effects historically associated with PN use in critically ill adult patients.
6. Distinguish PN use in terminally ill ICU patients. 

Chapter: Nutrition Support in Surgical Patients

1. Justify the importance of early nutrition intervention in critically ill surgical patients.
2. Assess for nutrition support contraindications in critically ill surgical patients.
3. Assess calorie and protein requirements of critically ill surgical patients.
4. Evaluate the impact of nutrition support on outcomes in critically ill surgical patients.
5. Develop an appropriate nutrition plan for critically ill surgical patients. 

Chapter: Nutrition Support in Patients Requiring Complex Care

1. Distinguish how extracorporeal support used in ICU patients affects calorie and protein goals.
2. Devise strategies for monitoring micronutrient therapy in patients receiving extracorporeal support.
3. Analyze nutrition support considerations in critically ill adults with different types of liver failure and disease.
4. Develop nutrition support plans for patients admitted to the ICU with severe pancreatitis.
5. Evaluate strategies to optimize nutrition support in the setting of chronic critical illness.

Chapter: Enteral Nutrition and Drug-Nutrient Interactions

1. Evaluate appropriate indications and methods for the provision of enteral nutrition (EN).
2. Develop EN regimens according to individual patient characteristics.
3. Distinguish whether medications are appropriate for administration through an enteral access device (EAD).
4. Apply strategies for appropriately administering medications through an EAD. 

Chapter: Micronutrient Deficiencies in Critically Ill Patients

1. Apply an understanding of the scientific basis of micronutrient (MN) therapies to patients with critical illness.
2. Distinguish the difference between assays used to analyze MN concentrations.
3. Evaluate MN concentrations to assess deficiency states and determine indications for replacement therapy.
4. Assess the merits and limitations of published clinical trials evaluating MN therapies in critical illness.
5. Evaluate the appropriate route, timing, and dosing of MNs in relationship to the patientspecific factors.
6. Develop a care plan based on clinical situations needing close attention to MN supplementation. 

Chapter: Parenteral Nutrition Safety

1. Develop a care plan for an appropriate parenteral nutrition (PN) order according to safety and compatibility standards.
2. Apply standardized strategies to minimize PN prescription, transcription, and typographic errors.
3. Design a plan for dosing, administration, and monitoring of lipid injectable emulsion (ILE) therapy for a critically ill adult patient to prevent essential fatty acid deficiency (EFAD) and other complications.
4. Assess appropriate values and frequency of PN monitoring to ensure the safety of therapy and prevent potential complications. 

Case Series: Parenteral Nutrition Transitions of Care

1. Apply the rationale for assessing a parenteral nutrition (PN) formula upon transition of care (TOC).
2. Assess patient-specific characteristics that should be considered during TOC in patients receiving PN.
3. Implement strategies according to best practices for safe TOC for critically ill patients receiving PN. 

Case Series: Probiotics and Stress Ulcer Prophylaxis

1. Distinguish between different risk factors for GI bleeding to determine when stress ulcer prophylaxis (SUP) is indicated.
2. Apply the existing evidence supporting use of the available agents for SUP to select an optimal regimen.
3. Account for potential adverse effects associated with acid-suppressive agents when determining the appropriateness of therapy.
4. Analyze the clinical impact of disruptions of the gut microbiota secondary to critical illness.
5. Justify the role of probiotics in the prevention and management of clinical conditions in the ICU.
6. Evaluate potential challenges to the use of probiotics in clinical practice.