Exam 4 Flashcards
Albumin
keeps fluid from leaking out of vessels into other tissues, synthesized in the liver
Fat is essential for
brain and nerve function
types of macronutrients
carbs, lipids, and protein
types of micronutrients
vitamins and minerals
types of fatty acids
saturated and unsaturated- saturated
LDL is
transports cholesterol to the body’s cells, “bad cholesterol”, saturated fats increase LDLs
HDL is
High Density Lipoproteins remove cholesterol from the bloodstream and return it o the liver where it is used to produce bile. “good cholesterol”
What is nutrition?
study of food and how it affects the body
What is metabolism?
process by which the body converts food to energy
What is the estimated average requirement?
amount of a nutrient that is estimated to meet the requirement of half of all healthy individuals in a certain age and gender group
What are the parts of a food label?
serving size, servings per container, calories, and percentages of nutrients based on daily value
What is the daily calorie amount that food labels are based on?
2000
Types of carbohydrates (CHOs)
simple carbs(sugars), complex carbs
What is a simple sugar? Example
corn syrup, honey, milk, table sugar, fruits
What is a complex carb? Ex
vegetables, bread, pasta, grains
What do carbs do?
give the body energy, enhance insulin production, increase satiety (fullness and satisfaction), improve absorption of sodium and excretion of calcium
What are proteins made out of?
amino acids
What are the kcals for carbs, proteins, and fats?
4-carbs, 4-proteins, 9-fats
What do proteins do for the body?
tissue building, metabolism, help with immune system function, fluid balance, acid-base balance, secondary to carbs for energy source
What do lipids (fats) do for the body?
supply the body with essential fatty acids and aid in the absorption of fat soluble vitamins, energy source when engaging in sustained light activity, give food flavor, body fat is insulating, cholesterol is a component of every cell in the body-it lends suppleness and support
What are the fat soluble vitamins?
(remember a fat dek of cards) Vitamin A, D, E, and K
Which type of vitamin is stored in the body?
Fat soluble
Which types of vitamins need to be eaten daily as they are excreted out of the body in urine?
Water soluble
What are the water soluble vitamins?
thiamin, riboflavin, niacin, b6, pantothenic acid, folic acid, b12, and C
What does Vitamin A do in the body?
maintains healthy skin and vision. growth of skeletal and soft tissues, reproduction
Importance of Vitamin K
synthesis of clotting factors and bone development
Importance of Vitamin D
regulates calcium and rate of deposit and reabsorption of calcium in bone
Where is vitamin K made in the body?
Bacteria in the intestines synthesize vitamin K
Why do Infants need a vitamin K shot after birth?
Bacteria in the gut helps form vitamin K. Infants do not yet have this bacteria and vitamin K helps with clotting factors
What is vitamin K an antidote for?
Coumadin-blood thinner
What is the test needed for Coumadin or Warfarin?
I&R
Foods that help with vitamin K
green leafy veg, liver
Foods that help with Iron
meats, eggs, beans, fortified cereal. If eaten with source of vitamin c, absorption is increased
What helps the body absorb iron?
Vitamin C-educate pt to take supplement or with orange/juice
Importance of Iron
Hemoglobin production (RBCs), metabolism of glucose, antibody production, drug detoxification
Importance of Vitamin C
collagen synthesis, cementing substance for capillary walls, antioxidant, iron absorption, and immune function
Importance of Vitamin B12
metabolic reactions, maintains myelin sheath, hemoglobin synthesis
What does vitamin D help with the absorption of?
Calcium
Importance of calcium
Helps with bone strength
What time of a woman’s life does she need to begin a calcium supplement or upping calcium intake and why?
Menopause. Lower estrogen can cause bone weakness leading to osteoporosis or brittle bones
Why do pregnant women or women of child bearing age need to take a folate supplement?
Helps to prevent neural tube defects
What are the macrominerals?
Minerals body need in amounts of 100mg/daily, calcium, Magnesium, phosphorus, potassium, sodium
What are the trace minerals?
Essential in much lower concentration, copper, fluoride, iodine, iron, zinc
Why is water essential to the body?
Makes up about half of body weight- solvent for body’s chemical processes, transport oxygen, nutrients, and metabolic wastes, fills in spaces in the body tissues, temperature regulation, lubricant for joins and abdominal cavities, catalyst for many reactions
What is the necessary amount of water daily?
8-10 8 oz glasses of water daily
Why do men have more water content in their body?
Higher muscle mass
Iodine’s importance
synthesis of thyroid hormone (thyroxine), can be obtained easily through iodized table salt
What is basal metabolic rate?
measure of energy used by the body when it is at rest- required for vital organs to function
How do you measure bmr in a woman?
0.9 kcal multiplied by weight in kg
How do you measure bmr in a man?
1 kcal multiplied by body weight in kg
What factors affect a bmr?
body composition (more muscle=greater BMR), growth periods, body temperature, environmental temperature, disease processes, prolonged physical exertion
How many calories a day should a sedentary woman or an older adult take in?
1600 kcals
How many calories should a child, teenage girl, active woman, or sedentary man take in daily?
2200 kcals
Teenage boys, active men, and very active women should take in ____ calories daily
2800 kcals
top two most rapid growth stages
Infant (1st) and adolescence (puberty)
Why shouldn’t infants have honey before 1 year of age?
Chance of botulism which can be fatal in an infant
When do an infants iron stores deplete after birth? And how do you prevent low iron in infants?
4-6 months and an iron supplement or iron fortified formula
What changes should older adults make to their diets?
Slightly more calcium and slightly less of other groups, complex carbs for bowel function, plenty of water
What vitamin do smokers use quicker?
Vitamin C
How do you calculate BMI?
weight in kg/height in meters^2
How do you convert inches to meters?
Divide the length in inches by 39.37
What are the issues that alcoholics might have with getting proper nutrition?
Poor appetite, intestines don’t absorb nutrients as well
What is gastroperesis?
Stomach paralysis-not emptying. Increases vomiting
What is the normal Albumin level?
3.4-4.8
How long can pt be NPO without needing TPN or tube feeding?
3 days
How can you prevent aspiration?
Monitor the level of consciousness, have pt sip water before eating, assess gag reflex
What is TPN?
total parenteral nutrition that is put through a large central vein
What is lavage?
Cleaning until aspirations are clear
How do you verify the placement of an NG tube?
Best way is the complete a chest xray, at bedside, aspirate stomach contents and check PH (should be between 1-5.5)
3 types of fats
glycerides (true fats), sterols (cholesterol), and phospholipids
What is the difference in essential and non essential amino acids?
Essential need to be supplied by food or nutritional supplements as the body can not make them, non essential are synthesized in the body
Where are the kidneys located?
retroperitoneal (back of the abdomen)
What do the kidneys do?
Filter wastes, toxins, drugs, hormones, regulate blood volume and blood pressure and electrolyte levels, a secondary function of the kidneys is to produce RBCs and active vitamin D3
What is the filtration unit of the kidney called? (helps with formation of urine)
Nephrons
What is a nephron composed of?
Bowman capsule which encloses the glomerus, filtrating tubules, loop of Henle and a collecting duct
Where does filtration take process
Glomeruli
What are the parts of the kidney?
Cortex (Neprons), Medulla (renal pyramids), Hilum, and ureter
What is the hilum?
the area where the blood vessels, nerves, and ureters leave the kidneys
What is the glomuler filtration rate? What is the normal?
How good the nephrons are filtering, the higher the better. 60+ is normal
How much urine can a bladder hold?
500 mL
Where is the pituitary gland?
In the brain
What does the pituitary gland do in relation to the urinary system?
Secretes anti-diuretic which prevents urination and loss of fluid. tells the kidneys to reabsorb water if the body needs fluid
What part of the nephron reabsorbs?
tubules
Where are the adrenal glands?
On top of the kidneys
What do the adrenal glands do?
Secrete aldosterone which tells the kidneys to hold onto sodium. Water follows sodium, so body holds onto water and sodium and excretes potassium
How can the prostate cause urinary issues for men?
Can become enlarged which causes issues with passing urine
What does a high specific gravity mean?
More solutes in the urine- can be caused by dehydration
What is the normal range for specific gravity?
1.002 to 1.030
What is the specific gravity of water?
1
What is enuresis?
Involuntary passage of urine
How does age affect urination?
By 75, only 2/3 of nephrons work-not filtering and creating urine as normal, loss of bladder and muscle tone which can cause stagnant urine (infection)
How do loop diuretic work?
Acts of loop of Henle- pushes reabsorption in that area so it will go into tubules and out of body
What is an anticholinergic?
Promotes urinary retention
How does anesthetic affect urinary elimination?
Can decrease blood pressure and glomerular filtration which decreases urine formation
When would pink tinged urine be normal?
After bladder or Urinary tract surgery-due to trauma of the area
What is the normal BUN?
8-21
What is the normal creatinine?
0.8-1.2
What are post procedure work ups you need to complete?
Vitals, I&O, new urine characteristics, encourage fluid intake
Why do you need to encourage fluid intake post op?
to flush contrast
What is a pyelogram?
When contrast is put into the kidney so that it can be seen in xray
What is a retrograde pyelogram?
When dye is put in the bladder
What are the two allergies that need to be watched for when dealing with contrast?
Iodine and shellfish
How is dye contraindicated by kidney disease or failure?
Dye is very harmful to the kidneys (nephrotic)
Why do you need to discard the first sample when collecting a sterile specimen?
there may be bacteria in the urinary tract
What is the function of the GI tract?
to digest and absorb the nutrients present in food and to eliminate food waste products as feces
What is the span of the GI tract?
Mouth to anus
What does food leave the stomach as?
Chyme ( four hours after eating)
What is in the stomach to aid with digestion?
Hydrochloric acid
How does the stomach, small and large intestine connect?
From the stomach into the duodenum, jejunum, ileum, ileocecal valve, ascending colon, transverse colon, descending colon and sigmoid colon
What does the ileocecal valve do?
Prevents backflow from colon into ileum
What is the purpose of the appendix thought to be?
Immune function
How do hemorrhoids occur?
When someone strains or hard fecal matter are in the very vascular rectum, blood vessels may be damaged
What is considered normal bowel function?
When someone can go without excessive urgency with minimal effort and no straining, without blood loss, without laxatives
Why doesn’t fiber help with opioid caused constipation?
Bulks feces, pt has decreased peristalsis due to opioid use, which can lead to bowel obstruction
What does magnesium supplements do to stool?
Can loosen stool
What is paralytic ileus?
no bowel sounds, most likely after abdominal surgery
What is an illeostomy?
A bowel diversion that bypasses the large intestine entirely, feces are constant and liquid
What is a continent illeostomy?
An illeal pouch is created, patient inserts tube into stoma to drain fecal matter
What does a healthy stoma look like?
Pink or brick red, shiny and moist
How long post ostomy surgery is a stoma its permanent size?
6-8 weeks
What is melena?
Black tarry stool that may be indicative of an upper GI bleed
How do you collect a stool sample?
Have pt void first and then pass stool into a “hat” or bedpan, using gloves and tongue blades-collect at least 1 inch of stool and put into container, double bag in biohazard bag
What is the difference in an abdominal flat plate and ultrasonography?
With a flat plate, xray view of the abdomen is used to detect gallstones, fecal impaction, and distended bowel. Ultrasound detects tissue abnormalities.
What is a barium enema?
Barium is instilled into the rectum or ostomy, radiographs are obtained
What is a low residue diet?
Easily digested and bland
After a barium enema, you should educate the pt that their stool will be:
white or light colored for 2-3 days
Before a CT with contrast, what medication should be held and why?
Glucophage, both are hard on kidneys
What is a normal potassium level?
3.6-5.2
What type of diet is advised with diarrhea?
BRAT-bananas, rice, apple sauce, and toast)
