You deliver D.Z.’s dietary tray, and he comments how hungry he is. As you leave the room, he is rapidly consuming the mashed potatoes. When you pick up the tray, you notice that he hasn’t touched anything else. When you question him, he states, “I don’t understand it. I can be so hungry, but when I start to eat, I have trouble breathing and I have to stop

.” One theory for the

increased work of breathing is based on carbohydrate (CHO) loading. Explain

this phenomenon based on your knowledge of the breakdown of CHO.

CHO breaks down into CO2, which is eliminated by the respiratory

system; increased CO2 levels stimulate the respiratory system to

increase respirations. The respiratory system is already taxed and is

unable to meet the increased workload of the additional CHO. The

patient experiences SOB and becomes anorectic.

Another theory is that food mechanically presses upward on the

diaphragm and limits VT and worsens SOB

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