Which action is part of preventing refeeding syndrome?

• A. Initiating nutrition support cautiously with hypocaloric feedings
• B. Start full caloric feedings immediately
• C. Withhold electrolyte monitoring
• D. Increase caloric intake rapidly

Answer: (A)

Preventing refeeding syndrome hinges on reintroducing nutrition slowly in someone who has been malnourished. When nutrition is started after a period of starvation, insulin rises and drives electrolytes like phosphate, potassium, and magnesium into cells. That sudden intracellular shift can cause dangerous electrolyte disturbances, cardiac and respiratory problems, edema, and neurologic issues. By initiating nutrition at a low, hypocaloric level and advancing gradually, you give the body time to adapt and you reduce the risk of these shifts. It’s also essential to replete thiamine and monitor electrolytes closely (especially phosphate, potassium, magnesium, and calcium) so any imbalances can be corrected promptly as feeding increases. Starting full calories, withholding electrolyte monitoring, or pushing calories up rapidly all increase the risk of refeeding complications.