Applied Nutrition Flashcards
What equation is used to predict BEE?
Harris Benedict Equation
When should more calories be given?
- peritonitis
- trauma
- sepsis/ multiple traumas
- burns
When should more fluids be given?
- gastric losses
- wound drainage
- Ileostomy drainage
What medications lead to increased electrolyte requirements?
Diuretics
Cisplatin
Amphotericin B
What are causes of GI losses?
- nasogastric suctioning
- vomiting
- high ostomy or fistula output
- diarrhea
When should sodium be decreased?
- HF
- edema
- corticosteroids
When should potassium, phosphorous, and sodium be decreased?
renal dysfunction
Why is it difficult to have toxicity from water-soluble vitamins?
extensively renally cleared
What is the cause of Wernicke’s?
B1 (thiamine deficiency)
What is the dosage regimen for treatment of wernicke’s?
500mg TID for 3 days
What does thiamine deficiency in infants lead to?
beriberi –> HF
What are complications of B2 (riboflavin) deficiency?
- mucositis, cheilosis
- photophobia, night blindness
- decreased tearing (infants)
- birth defects (cleft lip, transverse limbs)
What are complications of B3 (niacin) deficiency?
- pellagra (raw skin)
- digestive system
- nervous system (disorientation/ memory loss)
What can induce vitamin B3 deficiency?
chronic Isoniazid use
What are complications with B6 (pyridoxine) deficiency?
- limb numbness/ weakness
- confusion
- irritability
- seizures
- glossitis
- cheilosis
- dermatitis
What are causes of B6 deficiency?
- atrophic gastritis
- alcohol abuse
- liver dysfunction
- RA
- sickle cell
- celiac
- Isoniazid
What vitamin deficiency is always checked with worsening mental status in the elderly because presentation is identical to Alzheimers/dementia?
vitamin B12 (cyanocobalmin) deficiency
How is B12 deficiency monitored?
Acute: high MCV, B12 level
Chronic: methylmalonic acid, homocystine
What should be done if a patient cannot absorb B12?
- give intrinsic factor
- SL instead of oral
What does folic acid deficiency cause?
- megaloblastic anemia
- diarrhea
- neural tube defects
What can cause folic acid deficiency?
- alcohol use
- diuretics
- phenytoin
- sulfasalazine
- methotrexate
What are complications of Vitamin C deficiency?
- fatigue
- muscle pain
- infections
- decreased wound healing
- gingivitis
What is needed to absorb fat-soluble vitamins?
bile
What are complications of vitamin A deficiency?
- xerophthalmia –> Bitot’s spots
- night blindness
- infections
Why is vitamin A CI in dialysis?
nephrotoxic
What is the dose of vitamin D for deficiency?
600 IU daily
800 IU daily in elderly
How is vitamin D supplemented in kidney failure/ dialysis?
active form must be used
What can vitamin E deficiency lead to?
- shorten lifespan of RBCs
- neuropathy
What does vitamin K deficiency lead to?
prolonged clotting time
Why does every baby get a vitamin K injection within 1 hour of birth?
to prevent hemorrhagic disease of newborn
What are signs of copper toxicity?
cardiac/ renal failure
hepatic necrosis
What agent is used to manage copper toxicity?
penicillamine (chelating agent)
What are signs of zinc deficiency?
taste changes
decreased wound healing
What are signs of selenium deficiency?
cardiomyopathy leading to HF
What are signs of selenium toxicity?
nail changes
peripheral neuropathy
What are signs of chromium deficiency?
glucose intolerance
What are signs of manganese toxicity?
Parkinson’s like symptoms
What vitamin deficiencies can achlorhydria lead to?
calcium
iron
What vitamin deficiencies can atrophic gastritis lead to?
B6
B12
folic acid
