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fundamentals test four material > chapter 33 nutrition > Flashcards

chapter 33 nutrition Flashcards

1
Q

good nutritional status can

A

maintain health
promote normal growth and development
protect against disease

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2
Q

plays a role in healing, recovery, and reducing complications

A

nutrition

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3
Q

People at an increased risk for HCA, postop complications, and increased pressure ulcer risk are

A

malnourished people

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4
Q

required for energy, cellular metabolism, and organ function

A

food

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5
Q

No single one can provide all the nutrients needed by the body

A

food

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6
Q

nutrients NOT produced in the body or not produced in enough amounts

A

essential nutrients

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7
Q

water

macronutrients: carbs, fats/lipids, protein
micronutrients: vitamins and minerals

A

essential nutrients

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8
Q

energy is measured in

A

kilocalories

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9
Q

energy producing nutrients

A

macronutrients: carbs, proteins, fats/lipids

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10
Q

most abundant essential nutrients

A

carbs

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11
Q

individuals who are poor have a diet consisting mainly of

A

carbs

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12
Q

abundant
inexpensive
body’s main source of energy

A

carbs

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13
Q

easily stored

quickly and effectively broken down by body

A

carbs

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14
Q

only has 1 or 2 sugars

no nutritional value

A

simple carbohydrates

gummi bears

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15
Q

contains many sugars

more nutrients

A

complex carbohydrates

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16
Q 
apples
pasta
beans
broccoli
whole wheat bread
A

complex carbs

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17
Q

decrease serum cholesterol
decrease glucose absorption in SI
decreases constipation
decreases free radicals in GI tract

A

functions of fiber

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18
Q

dissolves in water and forms gel

A

soluble fiber

fruit, legumes

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19
Q

roughage
not digested
increased constipation and free radicals

A

insoluble fiber

apple peel, bran

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20
Q

recommended 5-10 grams/day but prefer 10-25 grams/day

A

fiber intake

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21
Q

to increase fiber to diet:

A

Add beans to salads
choose cereal high in fiber
eat fruit instead of drinking juice
fiber supplements

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22
Q

increase fiber ____________ to prevent ___________

A

slowly to prevent bloating and problems. have adequate intake of fluids

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23
Q

functions in WOUND healing, energy source when insufficient carbs or fat, regulates fluid balance, regulates acid base balance, necessary component of insulin, antibodies, and other enzymes/hormones

A

protein

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24
Q

essential for wound healing

A

protein

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25
Q

ONLY NUTRIENT THAT CONTAINS NITROGEN

A

PROTEIN

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26
Q

sufficient amount of essential amino acids

A

complete proteins

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27
Q

eggs, dairy products, meats

A

complete proteins

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28
Q

deficient in essential amino acids

A

incomplete proteins

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29
Q

plant proteins except SOY PROTEIN

A

incomplete proteins

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30
Q

mix 2 incomplete proteins to make one complete protein

A

complimentary proteins

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31
Q

black beans and rice

A

complimentary protein

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32
Q

body is taking in more protein than it is excreting

A

positive nitrogen balance

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33
Q

A pregnant woman or a child in a rapid growth spurt would have a positive/negative nitrogen balance

A

positive

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34
Q

patient taking in some protein, but excreting more than taking in

A

negative nitrogen balance

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35
Q

person on starvation diet or very malnourished

A

negative nitrogen balance

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36
Q

most common form of malnutrition in U.S.

A

protein energy malnutrition

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37
Q

treatment of protein energy malnutrition:

A 
increase intake of protein by: 
supplements
provide protein at each meal
patient teaching
consider economics, abilities, culture, etc.
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38
Q

insoluble in water/blood

A

fats/lipids

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39
Q 
concentrated source of energy
high satiety value
improve palatability of diet
absorption fat-soluble vitamins
protect/insulate vital organs
A

lipid function

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40
Q

95% of fat in the body is

A

triglycerides

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41
Q

triglycerides are divided into three groups:

A

saturated fat, unsaturated fat, and transfat

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42
Q

types of fat in body:

A

triglycerides
phospholipids
sterols/cholesterol

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43
Q

solid at room temperature
most originate from animal sources- whole milk, beef, butter, but also coconut and palm oils
linked to CV disease and obesity

A

saturated fats

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44
Q

originates from whole milk, beef, butter, coconut oil, palm oil

A

Saturated fats

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45
Q

remain soft/liquid at room temp

A

unsaturated fats

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46
Q

olive oil, canola oil, peanut oil

A

monounsaturated fats

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47
Q

positive effect
decrease risk of CV disease and inflammatory diseases
omega 6 and omega 3

A

polyunsaturated fats

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48
Q

monounsaturated and polyunsaturated

A

unsaturated fats

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49
Q

manufactured
partially hydrogenated liquid oils
added to foods to make more solid or stable

A

transfat

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50
Q

doughnuts, French fries

A

transfat

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51
Q

contributes to CV disease

increases free radicals-cancer

A

transfat

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52
Q

component of bile salts that assist in fat digestion

A

cholesterol

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53
Q

necessary of brain and nerve cell function and steroid production

A

cholesterol

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54
Q

increased levels increase atherosclerosis

A

cholesterol

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55
Q

intake should be limited
keep intake less than 200 mg a day
desirable serum level less than 200 mg/dl

A

cholesterol

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56
Q

good cholesterol

A

HDL or high density lipoprotein

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57
Q

bad cholesterol

A

LDL or low density lipoprotein

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58
Q

circulates from liver to tissues to get caught in veins, etc.
increases CV disease, plaques in arteries

A

LDL

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59
Q

energy value of carbohydrates

A

4 cal/gm

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60
Q

energy value of protein

A

4 cal/gm

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61
Q

energy value of fat

A

9 cal/gm

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62
Q

most concentrated source of energy

A

fat

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63
Q

What are the fat soluble vitamins:

A

A, D, E, K

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64
Q

What is necessary for the absorption of fat soluble vitamins:

A

fats

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65
Q

What are some functions/common sources of Vitamin A?

A

carrots, sweet potatoes,

eyes, skin, hair

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66
Q

What are some functions/sources of Vitamin D?

A

calcium absorption, healthy bones

eggs, milk, yogurt

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67
Q

What are some functions/common sources of Vitamin E?

A

corn, nuts, olives

antioxidant, heart health

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68
Q

what are some functions/sources of vitamin K?

A

green leafy vegetables, broccoli, squash, tomatoes, peppers, parsley, kale, olive oil
functions in clotting

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69
Q

Limit which vitamin if taking Coumadin

A

vitamin K

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70
Q

water soluble vitamins

these are not stored

A

B & C

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71
Q

which type of vitamins are more likely to build up and cause toxicity

A

fat soluble

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72
Q

which vitamins are stored

A

fat soluble

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73
Q

Show signs of deficiency early with which type of vitamins:

A

water soluble

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74
Q

sources of vitamin C

A

limes, kiwi, tomatoes

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75
Q

B1

A

thiamine

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76
Q

B vitamin that is decreased in alcoholics

A

B1/thiamine

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77
Q

B2

A

riboflavin

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78
Q

B3

A

niacin

79
Q

B vitamin often used for hypercholesteremia

A

B3/niacin

80
Q

B6

A

pyridoxine

81
Q

b12

A

cobalamin

82
Q

gastrectomy patients have to take which B supplement

A

b12

83
Q

requires intrinsic factor and HCl acid for absorption

A

B12

84
Q

deficiency of B12 leads to

A

pernicious anemia
neuritis
sore mouth or tongue
nerve damage

85
Q

sources of B12

A

animal products

liver or lean meat

86
Q

A vegan would have which B deficiency

A

B12

87
Q

Needed for RBC development, energy and oxygen transport

A

iron

88
Q

food sources of iron

A

organ meats, red meat, and raisins

89
Q

side effects of iron supplements

A

black or dark green stools
gastric upset
can discolor tooth enamel

90
Q

do not crush, chew, or break oral tablets

A

iron

91
Q

if liquid supplement, use a straw

A

iron

92
Q

vitamin C will increase absorption of

A

iron

93
Q

DO NOT ADMINISTER WITH DAIRY PRODUCTS, CAFFEINE, CHOCOLATE, EGGS, ANTACIDS, OR PROTON PUMP INHIBITORS; it will cause a decrease in the absorption

A

IRON

94
Q

required for survival
infants/geriatrics most vulnerable to deprivation
50-60% total body weight in adult
2/3 in intracellular fluid

A

water- essential nutrient

95
Q

weight at regular-daily intervals
most accurate
1 liter of fluid = 1 kg of weight
get adequate I&O

A

assessment of water loss

96
Q

amount of nutrients needed to prevent disease

A

Recommended Daily Allowances (RDA)

97
Q

amount of nutrient necessary to promote/optimize health

A

Dietary reference intake (DRI)

98
Q

No meat, eggs, or dairy

A

vegan-total vegetarian pyramid

99
Q

vegan plus eggs diet

A

Ovo-vegetarian

100
Q

vegan plus dairy diet

A

Lacto-vegetarian

101
Q

vegan plus dairy, eggs, and fish

A

presco-vegetarian

102
Q

vitamins very important in vegans

A

B12, iron, and protein

103
Q

promote awareness of nutrients found in food

comparison of nutritional values for products

A

product labels

104
Q

foodborne disease from improperly home-canned foods, smoked and salted fish, ham, sausage, shellfish

A

botulism

caused by clostridium botulinum

105
Q

symptoms vary from mild discomfort to death in 24 hours, initially nausea and dizziness, progressing to motor (respiratory)paralysis

A

botulism

106
Q

disease from undercooked meat (ground beef)

A

E. coli

caused by Escheririchia

107
Q

severe cramps, nausea, vomiting, diarrhea (may be bloody), renal failure; appears 1-8 days after eating, lasts 1-7 days

A

E. Coli

108
Q

disease from soft cheese, meat (hot dogs, pate, lunch meats), unpasteurized milk, poultry, seafood

A

listeriosis

caused by Listeria

109
Q

severe diarrhea, fever, headache, pneumonia, meningitis, endocarditis, appears 3-21 days after infection

A

listeriosis

110
Q

disease from cooked meats, meat dishes held at room or warm temperature

A

Perfringens enteritis

caused by Clostridium

111
Q

disease caused my milk, custards, egg dishes, salad dressings, sandwich fillings, polluted shellfish

A

salmonellosis

caused by salmonella

112
Q

mild to severe diarrhea, cramps, vomiting; appear 12-24 hours after ingestion, last 1 -7 days

A

salmonellosis

113
Q

disease caused by milk, milk products, seafood, salads

A

shigellosis

caused by shigella

114
Q

mild diarrhea to fatal dysentery; appear 7-36 hours after ingestion; lasts 3-14 days

A

shigellosis

115
Q

caused by custards, cream fillings, processed meats, ham, cheese, ice cream, potato salad, sauces, casseroles

A

staphylococcus

caused by staph aureus

116
Q

severe abdominal cramps, pain, vomiting, diarrhea, perspiration, headache, fever, prostration; appear 1-6 hours after ingestion, lasts 1-2 days

A

Staphylococcus

117
Q

who is at risk for malnutrition

A

burn patients, chemo patients

118
Q

involuntary loss/gain of greater than 10% usual body weight within 6 months
or
greater than 5% usual body weight in 1 month
20% over/under ideal body weight
chronic disease
altered diets/diet schedules
inadequate nutrient intake for greater than 7 days

A

People at risk for malnutrition

119
Q 
disease
eating poorly
tooth loss/mouth pain
economic hardship
reduced social contact
multiple medications
involuntary weight loss
needs assistance in self-care
any disease that makes it hard to swallow or digest
elder above age 80
A

risk factors for malnutrition

120
Q

has a positive effect on appetite

A

socialization

121
Q 
difficulty chewing-dentures
decreased economic status
decreased ability to cook, shop
decreased hand function hand/eye coordination
decreased senses of taste/smell
social isolation/loneliness
function of the GI tract
polypharmacy
A

problems affecting nutrition of older adult patients

122
Q

The need for calories decreases/increases with aging adults.

A

decreases

123
Q

height, weight, waist to hip ratio, skin fold measurements, mid arm muscle circumference

A

anthropometric measurements

124
Q

measures fat stores in body

A

skin fold measurements

125
Q

very important

measures amount of lean body mass

A

mid-arm muscle circumference

126
Q

most widely used measure of nutritional status

A

weight

127
Q

poor indicator of nutritional status when edema or ascites present

A

weight

128
Q

desire waist to hip ratio for men and women

A

female 0.8 or less

male 1 or less

129
Q

is pear or apple shaped healthier

A

pear shaped

130
Q

ratio of height to weight

A

BMI formula

131
Q

normal BMI is

A

19

132
Q

BMI of 40 indicates

A

obesity

133
Q

BMI of less than 18.5 indicates

A

underweight

134
Q

BMI of 25-29.9 indicates

A

overweight

135
Q

normal BMI range is

A

18.5-24.9

136
Q

BMI of 30-39.9 indicates

A

obesity

137
Q

BMI of greater than 40 indicates

A

EXTREME obesity

138
Q

walking at a vigorous pace on level ground

A

moderate activity level

139
Q

seated and standing activities

A

sedentary activity level

140
Q

walking at a comfortable pace on level ground

A

light activity level

141
Q

walking uphill, manual labor

A

heavy activity level

142
Q

no coffee, tea, or alcohol in this culture’s diet

A

Mormons

143
Q

No beef! Cows are sacred in this culture

A

Hindus

144
Q

Pork is restricted in this culture

A

Islamic or Muslim

145
Q

Pork is restricted in this culture also

A

Jewish/Kosher

146
Q

long term nutritional status is indicated by this test

A

albumin

147
Q

not a good indicator of individuals response to nutritional support
takes around 3 wks for significant changes to be reflected in lab work

A

albumin

148
Q

3.5-5.0 g/dL normal range

A

albumin

149
Q

this lab value increases in dehydration and decreases in malnutrition, overhydration, or trauma

A

albumin

150
Q

Lab tests to check nutritional status:

A

Albumin, pre-albumin, transferrin, TLC, BUN/creatinine, UA

151
Q

reflects short term nutritional status

1/2 life of 2 days

A

pre-albumin

152
Q

20-40 mg/dL normal range

A

pre-albumin

153
Q

expensive test
increases with nutritional intake, renal failure
decreases with poor diet intake
levels drop rapidly with sudden demands for protein synthesis

A

pre-albumin

154
Q

loss of muscle mass related to aging and strength

A

sarcopenia

this is a normal finding

155
Q

severe muscle wasting
involuntary
not related to aging
related usually to malnourishment

A

cachexia

156
Q

this finding indicates iron deficiency

A

spoon shaped nails (koilonychia)

157
Q

beefy red tongue indicates

A

a decrease in b12 vitamin

158
Q

neurological symptoms indicate

A

decrease in thiamine or b12

159
Q

ecchymoses indicates

A

decrease in Vitamin K

160
Q

dry rough skin is an indicator of

A

decrease in Vitamin A

161
Q

bone abnormalities indicate a deficiency of

A

vitamin D or calcium

162
Q

if assisting patient in feeding him/herself

A

use pattern of clock

163
Q

medication to stimulate appetite

A

Megestrol acetate or Megace

164
Q

NPO should/should not be ordered for extended periods of time

A

should not

165
Q

regular therapeutic diet is how many calories

A

2000

166
Q

diet for dysphagia patients

A

mechanical soft with thickened liquids

167
Q

decreased fried foods and red meat

A

low fat and low cholesterol diet

168
Q

carbs counted, number of calories usually specified

A

diabetic diet

169
Q

decreased fiber diet

A

low residue/soft diet

for patients with gastric distress

170
Q

blenderized liquid-used with oral/facial surgery or chewing and swallowing disorders

A

pureed diet

171
Q

bland diet

A

BRAT- bananas rice applesauce toast

172
Q

high in fruits and vegs. high fiber, low sodium

A

DASH diet

173
Q

use of certain foods to control/treat illness or disease

A

MNT- medical nutritional therapy

174
Q

food liquid at room temp

tea, chicken broth, jello, lemon-lime soda, coffee

A

clear liquid diet

often for postop patients

175
Q

has substance, no solids
liquid at room temp
pudding, ice cream and all included on clear

A

full liquid diet

176
Q

patient is ready to advance diet if:

A

absence of nausea
no pain or abdominal distention
patient feels hungry
patient can consume 1/2 to 3/4 of meal tray

177
Q

no added salt: whatever occurs naturally in food, nothing added in cooking or at table

A

no added salt/sodium restricted diet

178
Q

sources of sodium in our diet

A

deli meats/processed foods
1/4 tsp of salt=500 mg
canned goods

179
Q

foods high in sodium

A

soy sauce, Wendy’s grilled chicken Caesar salad, V-8 juice, beef salami, marinara sauce, raisin brain cereal, cottage cheese

180
Q

study used to diagnose problem with aspiration

A

barium swallow

181
Q

easiest thing to aspirate is

A

water/thin fluids

182
Q

to prevent aspiration:

A

teach chin tuck method when swallowing

thicken liquids

183
Q

nutrients necessary for wound healing

A

protein
fat
carbs/sufficient calories
vitamin C and zinc

184
Q

what is the preferred method of feeding:

A

oral

185
Q

stimulates and maintains the normal activity of the GI tract

A

oral feeding

186
Q

feeding through a tube- NG, NJ, PEG

GI tract must be functioning

A

enteral feeding

187
Q

intravenous route
GI system may/may not be intact
through a central IV line

A

Parenteral: TPN (total parenteral nutrition)

188
Q

for long term nutritional support

Patient doesn’t have to have general anesthesia

A

PEG tube

189
Q

Care for patient on enteral feeding:

A 
Check abd distention/discomfort/nausea
monitor BMs
Daily weight
monitor edema
monitor I&O
monitor residual tube feeding
monitor serum electrolytes
monitor for aspiration
190
Q

provides calories, lipids, fluids, vitamins, electrolytes, minerals, and trace elements
highly concentrated- hypertonic
use central venous device to infuse
risk for infection is very high
risk for hypoglycemic reaction if stopped suddenly- hang concentrated glucose

A

TPN

191
Q

High osmolality
always through a central line
bag must be changed every 24 hours

A

TPN

192
Q

care of patient receiving TPN

A

use surgical aseptic technique
monitor dressing and change per policy
use infusion pump
solution should hang no longer than 24 hours
monitor blood sugar and serum electrolytes
daily weight

193
Q

not as concentrated as TPN

can be infused into peripheral line

A

PPN (peripheral parenteral nutrtion)

fundamentals test four material (5 decks)

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