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Renna- Exam 2 > Ch 44 Nutrition > Flashcards

Ch 44 Nutrition Flashcards

0
Q

Resting energy expenditure (REE)

A

Aka resting metabolic rate, energy needed to consume over a 24 hour period for the body to maintain all of its internal working activities while at rest

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1
Q

Basal metabolic rate (BMR)

A

Energy needed to maintain life sustaining activities for a specific period of time at rest (breathing, circulation, HR, temp)

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2
Q

Amino acid

A

Simplest form of protein, it is made up of hydrogen oxygen carbon and nitrogen

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3
Q

Kilocalories

A

How energy requirements are met. When kcals ingested exceed a person’s energy demands, you gain weight when they fail to meet a person’s energy demands, you lose weight

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4
Q

Nutrients

A

Elements necessary for normal function of numerous body processes. Nutrients include carbohydrates, proteins, fats, water, vitamins, minerals

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5
Q

High-nutrient dense foods

A

Fruits and vegetables with large number of nutrients in relationship to kilocalories

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6
Q

Low – nutrient dense foods

A

Foods such as alcohol or sugar that are high in calories but low in nutrients

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7
Q

Carbohydrates

A

Main source of energy in the diet, composed of carbon, hydrogen and oxygen. Carbs produce 4 kcal/g and is the main source of fuel for the brain, skeletal muscles, erythrocyte and leukocyte production and cell function of the renal medulla.

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8
Q

Saccharides

A

Carbs are classified according to their carbohydrate units

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9
Q

Simple carbohydrates

A

Monosaccharides (glucose, fructose) and disaccharides (sucrose, lactose, maltose); found primarily in sugar

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10
Q

Fiber

A

A polysaccharide that is not broken down by the human digestive enzymes. It does not contribute calories to the diet.

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11
Q

Insoluble and soluble fibers

A

Insoluble fiber’s are not digestible including cellulose hemicellulose and lignin. Soluble fiber’s dissolve in water and include barley, cereal grains, cornmeal and oats.

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12
Q

Proteins

A

Provide a source of energy (4kcal/g) essential for synthesis of body tissue in growth maintenance and repair. Protein transports nutrients and many drugs in the blood, and maintains nitrogen balance

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13
Q

Indispensable amino acids

A

Body cannot synthesize on it’s own and need to be provided in the diet (histidine, lysine, phenylalanine)

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14
Q

Dispensable amino acids

A

Body can synthesize on it’s own (alanine, asparagine, glutamic acid)

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15
Q

Nitrogen balance

A

When intake and output of nitrogen are equal

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16
Q

Positive nitrogen balance

A

Intake of nitrogen is greater than output; required for growth, normal pregnancy, maintenance of lean muscle mass and vital organs, and wound healing; body uses nitrogen to build, repair and replace body tissues

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17
Q

Negative nitrogen balance

A

Body loses more nitrogen then it gains; occurs with infection, burns, fever, starvation, head injury, and trauma; result of body tissue destruction or loss of nitrogen containing body fluids

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18
Q

Fats (lipids)

A

Most calorie dense nutrient (9 kcal/g); composed of triglycerides and fatty acids

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19
Q

Triglycerides

A

Circulate in the blood and are composed of three fatty acids attached to a glycerol

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20
Q

Fatty acids

A

Chains of carbon and hydrogen Adams with an acid group on one end of the chain and a methyl group at the other

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21
Q

Saturated (fatty acid)

A

Each carbon chain in the chain has two attached hydrogen Adams

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22
Q

Unsaturated (fatty acid)

A

An unequal number of hydrogen atoms are attached and the carbon atoms attached to each other with a double bond

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23
Q

Monounsaturated fatty acid

A

Have one double bond

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24
Q

Polyunsaturated fatty acids

A

Have two or more double carbon bonds

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25
Q

Water

A

Critical for cell function; makes up 60-70% of total body weight; infants have greatest total body water older people have the least; meet fluid needs by drinking liquids and eating foods high in water content

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26
Q

Vitamins

A

Organic substances present in small amounts in food that are essential to normal metabolism; they neutralize substances called free radicals (produce oxidative damage to body cells and tissues)

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27
Q

Fat soluble vitamins

A

Vitamins A, D, E and K; stored in the fatty compartments of the body;

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28
Q

Hypervitaminosis

A

Megadoses of supplemental vitamins, excessive amounts in fortified food, and large intake of fish oils

29
Q

Water-soluble vitamins

A

Vitamin C and the B complex (8 vitamins); body does not store these vitamins, they need to be provided in daily food intake; easily absorbed from the G.I. tract

30
Q

Minerals

A

Inorganic elements essential to the body as catalysts in biochemical reactions

31
Q

Enzymes

A

Protein like substances that act as catalysts to speed up chemical reactions, they are essential part of digestion

32
Q

Metabolism

A

All of the biochemical reactions within the cells of the body; can be anabolic (building) or catabolic (break down)

33
Q

Anabolism

A

The building of more complex biochemical substances by synthesis of nutrients; when individual adds lean muscle through diet and exercise

34
Q

Catabolism

A

Breakdown of biochemical substances into simpler substances and occurs during physiological states of negative nitrogen balance; starvation, wasting of the body tissues

35
Q

Glycogenolysis

A

Catabolism of glycogen into glucose, carbon dioxide, and water

36
Q

Glycogenesis

A

Anabolism of glucose into glycogen for storage

37
Q

Gluconeogenesis

A

Catabolism of amino acids and glycerone into glucose for energy

38
Q

Dietary reference intakes (DRI)

A

Presents evidence-based criteria for an acceptable range of amounts of vitamins and nutrients for each gender and age group

40
Q

Dietary reference intakes (four components)

A

Estimated average requirement (EAR)
Recommended dietary allowance (RDA)
Adequate intake (AI)
Upper intake level (UL)

41
Q

Measure Gastric Residual Volumes (GRVs) every __ to __ hrs for continuous feedings and ____ before the feeding for intermittent feedings

A

Measure Gastric Residual Volumes (GRVs) every 4 to 6 hrs for continuous feedings and _immediately___ before the feeding for intermittent feedings

42
Q

Delayed gastric emptying is a concern if ____ mL or more remains in a patients stomach on two consecutive assessments ( 1 hr apart)

A

250 mL

43
Q

Which Enteral Access tubes used for use less than 4 weeks

A

nasogastric or nasojejunal feeding tubes

44
Q

Most health care setting use Small or Large bore feeding tubes?

A

Small bore feeding tubes because they create less discomfort for a patient

45
Q

Adult size and length of tube

A

8 - 12 Fr and 36-44 in

46
Q

Wait at least ____ hr after medication admin by tube or mouth to aspirate for pH measurement

A

1 hr

47
Q

Draw back ___ to ___ mL of gastric aspirate

A

5 to 10 mL

48
Q

Gastric fluid from patient who has fasted for at least 4 hrs usually has pH range of ____ to ____.

A

pH 1 to 4

49
Q

Fluid from nasointestinal tube of fasting patient usually has pH greater than or = to _____

A

6

50
Q

Patient with continuous tube feeding often has pH of ___ or higher.

A

5

51
Q

pH of pleural fluid from tracheobronchial tree is generally greater than ____

A

6

52
Q

Enteral Tube feeding Complications (44-7) Possible Cause - Pulmonary aspiration

A

Regurgitation of formula, feeding tube displaced, deficient gag reflex, delayed gastric emptying.

53
Q

Enteral Tube feeding Complications (44-7) Possible Cause - Diarrhea

A

Hyperosmolar formula or meds
Antibiotic therapy
bacterial contamination
malabsorption

54
Q

Enteral Tube feeding Complications (44-7) Possible Cause - Constipation

A

Lack of fiber
Lack of free water
Inactivity

55
Q

Enteral Tube feeding Complications (44-7) Possible Cause - Tube occlusion

A

Pulverized meds given per tube
Sedimentation of formula
Reaction of incompatible meds or formula

56
Q

Enteral Tube feeding Complications (44-7) Possible Cause - Tube Displacement

A

Coughing, vomiting, not taped securely

57
Q

Enteral Tube feeding Complications (44-7) Possible Cause - Abdominal cramping, vomit

A 
high osmolality of formula
rapid increase in rate/volume
lactose intolerance
intestinal obstruction
high fat formula
cold formula
58
Q

Enteral Tube feeding Complications (44-7) Possible Cause - delayed gastric emptying

A

diabetic gastroparesis
serious illness
inactivity

59
Q

Enteral Tube feeding Complications (44-7) Possible Cause - serum electrolyt imbalance

A

excess gi losses
dehydration
presence of disease states (ex cirrhosis, renal insufficiency)

60
Q

Enteral Tube feeding Complications (44-7) Possible Cause - Fluid overload

A

Refeeding syndrome in malnutrition,

excess free water

61
Q

To prevent infection, change the TPN infusion tubing every ___ hrs.

A

24 hrs

62
Q

Do not hang a single container of PN for more than ___ hrs or lipids more than ___ hours

A

24 hrs; 12 hours

63
Q

Max hang time for formula is ___ hrs in an open system and ___ to ___ hours in a closed ready to hang system

A

8 hrs; 24 to 48 hrs

64
Q

Anorexia nervosa

A

Refusal to maintain body weight, body weight less than 85% of ideal body weight; intense fear of gaining weight or becoming fat, although underweight; disturbing idea of body being too fat when body is underweight; females who have absence of at least three consecutive menstrual cycles

65
Q

Bulimia nervosa

A

Recurrent episodes of binge eating; lack of control over eating; regularly engaging in self induced vomiting, use of laxatives or diuretics, strict dieting or fasting, vigorous exercise to prevent weight gain; minimum average of two binge eating episodes a week for at least three months

66
Q

Identifying risk factors for malnutrition

A

Combine objective data and subjective data related to nutrition to screen for problems; notice any risk factors such as weight loss, presence of a modified diet, presence of altered nutritional symptoms (nausea, vomiting, diarrhea, constipation)

67
Q

Anthropometry

A

Measurement system of the size and make up of the body; height and weight is taken the same exact way every day and compared

68
Q

Dysphasia (signs of)

A

Difficulty swallowing. Signs include cough during eating, changing voice tone or quality after swallowing, abnormal movements of the mouth tongue or lips, and slow weak imprecise or uncoordinated speech, abnormal gag, to late swelling, incomplete oral clearance or pocketing, regurgitation

69
Q

Silent aspiration

A

Occurs in patients with neurological problems that lead to decreased sensation; often occurs without a cough and symptoms do not usually appear for 24 hours; accounts for most of the 40 to 70% of aspiration in patients with dysphasia following stroke

70
Q

How do you check the pH for proper placement of a feeding tube? What should the pH range be?

A

Aspirate the gastric contents and check the pH with a strip. The pH should be 0 to 4.

Renna- Exam 2 (3 decks)

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