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Integ Final Exam Material > Chapter 9 > Flashcards

Chapter 9 Flashcards

1
Q

Water is vital to wound healing, healthy individuals should drink _____mL of water/kg of BW daily.

A

30-35 mL

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2
Q

Patients with open wounds should drink _____L/day of water.

A

2.7-3.7 L/day

even more for patients with large burns

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3
Q

Patients on air-fludized beds need _____mL of water/kg of BW daily.

A

40-60 mL

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4
Q

Protein can be lost through wound drainage but the main cause for deficiency is

A

inadequate intake

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5
Q

Protein is `___% nitrogen; it is desirable to maintain an adequate nitrogen balance for proper wound healing.

A

16%

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6
Q

Is recommended to maintain a positive nitrogen balance which is noted by intake of what amount of protein? _____kg/BW daily

A

1.25-1.5 g protein/kg BW daily

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7
Q

We receive energy from carbohydrates primarily in the form of-______?

A

GLUCOSE, which provides energy needed for tissue reapir, regeneration, and phagocytosis

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8
Q

If sufficient energy is NOT attained from the patients diet, the body will convert fat and protein to energy. This is known as

A

the protein sparing effect , this process solves energy problems, but if protein sources are not replenished, the patient will develop a protein defecit, which slows/halts wound healing.

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9
Q

What is the recommended daily intake for carbs?

A

30-35kcal/kg Bw daily

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10
Q

What provides a needed energy source when carbohydrates have been depleted and assists in thermoregulation?

A

Fats

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11
Q

Which vitamins are considered fat-soluble

A

A, E, K

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12
Q

Fats, in the form of free fatty acids are vital components of _______and are required for ______.

A

cell membranes, synthesis of new cells

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13
Q

If a patient reaches a point where fats are being used and carbs are depleted, they are likely in what state?

A

severely nutritionally compromised

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14
Q

With Fat-soluble vitamins what caution do individuals need to take with supplementation?

A

the vitamins can accumulate within the body and become toxic

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15
Q

Which vitamin maintains healthy skin and epithelial integrity. Decreases the risk of dehiscence by increasing wound tensile strength and revere inihibitory effects of corticosterioids.

A

Vitamin A

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16
Q

Which vitamin is systemic supplementation not recommended because it may conteract with prescribed steriods?

A

Vitamin A

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17
Q

Which vitamin helps the body absorb iron, builds and maintains tissue, controls infection and limits free radications.

A

Vitamin C

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18
Q

Pretreatment with irradiated skin with ____vitamin may limit skin damage from radiation therapy.

A

Vitamin C

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19
Q

Which vitamin may help enhance wound healing in malnourished patients and patients with pressure ulcers?

A

Vitamin C

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20
Q

This vitamin is essential for blood clotting. Deficiency may prolong the inflammatory phase or cause the wound to bleed.

A

Vitamin K

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21
Q

Which vitamin should a supplement not be recommended if the patient is on anticoagulants without an MD clearance?

A

Vitamin K

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22
Q

Which vitamin is required for normal immune function and energy metabolism. Aides in WBC function, antibody formation, and resistance to infection. Can facilitate fibroblast function and collagen synthesis?

A

B-complex vitamins

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23
Q

This vitamin is considred an ANTIOXIDANT decreases inflammatory phase of wound healing, enhances immune function and decreases platelet adhesion.

A

Vitamin E

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24
Q

List all the Microminerals

A

Iron
Zinc
Copper
Magnesium

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25
Q

List all the Macrominerals

A

Calcium
Phosphorous
Selenium

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26
Q

This mineral the skin contains about 20% and is vital to collagen and protein synthesis, cell proliferation, epithelialization and immune function.

A

Zinc

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27
Q

This mineral is a component of hemoglobin. required for antibody production and immune function and is required for DNA and collagen synthesis, and is a co-factor in many enzyme systems.

A

IRON

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28
Q

Iron deficiency can be caused by

A
  1. Excessive blood loss
  2. Decreased iron absorption by GI
  3. reallocation of iron stores to assist in other functions
  4. Inadequate dietary intake
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29
Q

What can Anemia lead to?

A

Hypoxia–>decreased immune function, cell replication and wound tensile strength

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30
Q

This mineral is required for hemoglobin synthesis and iron absorption/transport.

A

Copper

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31
Q

Deficiencies in this mineral may lead to poor wound healing and decreased immune function.

A

copper

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32
Q

This mineral is considered a co-factor in over 300 enzyme systems. It is important for bone and protien synthesis

A

Magnesium

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33
Q

Deficiencies in this mineral can lead to HTN and vasoconstriction. Deficiency is usually caused by what 4 condditions?

A

Magnesium.

  1. Diabetes
  2. Alcoholism
  3. Chronic diarrhea
  4. dehydration
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34
Q

This mineral is essential for bone formation and remodeling, muscle contraction, fibrin synthesis, blood clotting, NT.
And Together with phosphorous it accounts for 50% of minerals in the body.

A

Calcium

35
Q

Hypercalemia is caused by what 3 conditions

A
  1. Hyperparathyroidism
  2. skeletal tumors
  3. drug toxicity
36
Q

This mineral is essential for bone formation, normal metabolism and fluid balance.

A

Phosphorous

37
Q

Homeostasis of phosphate is primarily controlled by what

A

the kidenys

38
Q

Hypophosphatermia is caused by

A
  1. Vitamin D deficiency
  2. Prolonged respiratory alkalosis
  3. GI malabasorption
  4. excessive use of antacids
39
Q

Which mineral assists in normal immune system function and supplemation is not recommended due to adverse effects that decreases the ability to fight infection.

A

Selenium

40
Q

Define Cahexia

A

loss of weight due to wasting of muscle tendon, fat

41
Q

Define Petechiae

A

small amounts of blood vessel hemorrhage

42
Q 
What is considered Signficant weight loss within
1 week
a month
3 months
6 months
A

1 week: 1% decrease
1 month: 5% decrease
3 months: 7.5%
6 mo: 10%

43
Q

T/F obese patients are at increased risk for poor wound healing

A

true

44
Q

BMI:

18.5-24.9

A

Normal weight

45
Q

BMI:

25.0-29.9

A

OVerweight

46
Q

BMI:

30.0-34.9

A

Obese class 1

47
Q

BMI:

17-18.4

A

Underweight mild protein energy malnutrition

48
Q

BMI

16.0-16.9

A

Underweight moderate protein energy malnutrition

49
Q

Clinical Manifestations of a patient who appears dehydrated.

A

Dry skin, hair, poor skin turgor, increased HR and RR, OH, confusion

50
Q

Clinical Manifestation of a patient who lack adequate protien in their diet?

A

Dull, dry hair
peripheral edema
Pressure ulcers, repeated or multiple

51
Q

Clinical Manifestation of a patient that lacks adequate carbs in their diet?

A

decline in body weight, poor dentition

52
Q

Clinical Mainfestation of a patient that lacks fats in their diet?

A

epidermal flaking, fissuring of the skin, dandruff

53
Q

Clinical manifestation of a patient that lacks vitamin A?

A

night blindness
difficulty adapting to light intensity
dry eyes
gigivitis

54
Q

Clinical manifestation of a patient that lacks vtramin C?

A

swollen gums, transparent skin, delayed wound healing and weakness

55
Q

Clinical manifestation for vitamin k deficiency?

A

petechiae and would bleeds readily

56
Q

Clinical manifestation for B-complex vitamin deficiency?

A

pale eye membranes, hyperpig, mouth sores, purple discoloration of the tongue, swollen gums

57
Q

Clinical manifestation for zinc deficiency?

A

decreased sense of taste, thin hair, dryness and redness of face.

58
Q

Clinical manifestation for iron deficiency?

A

yellow skin, easily fatigued, dypnea, anemia,pallor

59
Q

Clinical manifestation for copper deficiency?

A

thin hair, may have pigment changes

60
Q

Clinical manifestation for magnesium deficiency?

A

Dehydration, neuromuscular hyperexcitabiliy

61
Q

Clinical manifestation for calcium deficiency?

A
  1. acute neuromuscular hyperexcitability, dysrhythmias
  2. kyposcolosis
  3. compression fx
  4. bone pain
  5. brittle nails
62
Q

clinical manifestation for phosphorus deficiency?

A

skeletal deformities, idopathic fx, bone pain

63
Q

Clinical manifestation for selenium deficiency?

A

decreased ability to fight infection and muscle pain and wasting

64
Q

This lab value measures kideny function and protein status and malnutrion decreases levels.

A

creatine

65
Q

What are the normal values for creatine?

A

0.8-1.5 mg/dL

66
Q

Low levels of this lab value is correlated with pressure ulcer severity. Decreasaed levels lead to _____and increased levels are due to_____.

A

Serum Albumin

  1. edema
  2. dehydration
67
Q

What is the normal value for Serum albumin?

A

3.5-5.5 g/dl

68
Q

Mortality risk increases as this the level drops in this lab value?

A

prealbumin. normal is 16-40 mg/dl

69
Q

An increase in this lab value indicates the patient has iron deficiency

A

Serum Transferrin

70
Q

A decrease in this lab value indicates the patient has protein deficiency

A

Serum transferrin

71
Q

Which lab value is a sensitive indicator of protein status

A

Serum transferrin (Normal greater than 170)

72
Q

The lab value is a good indicator of renal function. Elevated levels are associated with decreased wound healing

A

BUN

73
Q

What are the normal values for BUN

A

5-25 mg/dl

74
Q

This lab value is an indirect measure of nutritional status and immune function

A

TLC (total lymphocyte count)

75
Q

Decreased TL is associated with

A

delayed wound healing and increased mortality. Normal is greater than 1,800 cell/mm3

76
Q

Increased levels of this lab value will result in increased risk of ulceration and impaired wound healing

A

Blood glucose (70-110 mg/dL, typical level after 1 hour of eating).

77
Q

What are the 3 main causes of malnutrition?

A
  1. Lack of knowledge
  2. Proverty
  3. Health problems
78
Q

If a patient’s gut is not functioning what should the prationer include in the plan of care

A

TPN (total protein nutrition, given as an iv when gut is not working)

79
Q

Pressure ulcer formation is associated with

A

protein-calorie deficiency

80
Q

Poor glycemic control can result in

A

Neuropathic ulcer

81
Q

Extensive burns can greatly increase a patient’s metabolic rate and therefore what may be necessary

A

High cal, high protein, high carb, low fat diet, tube feeding or TPN feeding may be necessary.

82
Q

Implies a ONE-Way interaction in which clinician directs the patient

A

Compliance

83
Q

Implies that the patient freely chooses to follow suggested guidelines

A

Adherence

84
Q

Causes for Non-Adherence can be due to the Patient, Task, or Clinician and can be due to

A
  • Forgetfulness
  • Unintentional
  • Misunderstandng
  • Intentional

Integ Final Exam Material (1 decks)

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