Final Exam

Question 1

What are the interventions for dyspepsia?

Answer 1

• Diet as Tolerated
• Avoid offending foods
• Eat slowly
• Chew thoroughly
• Small Meals

Question 2

What is Dyspepsia?

Answer 2

Indigestion - Non-specific upper GI symptoms (pain, bloating, early satiety, nausea)

Question 3

How is Nausea/Vomiting assessed?

Answer 3

A: involuntary weight loss, acute weight changes
B: electrolyte imbalances (due to dehydration)
C: symptoms related to nutrient deficiencies or dehydration; type and timing of vomiting
D: food aversions, co-morbidities

Question 4

Types and Timing of Vomiting?

Answer 4

-regurgitation of undigested food
-partially digested food
-bilious (yellow/green)
- bloody, tarry black

-early morning
-projectile
-periodic
-postprandial
-during meals

Question 5

Nausea/Vomiting Red Flags

Answer 5

-vomiting blood
-vomiting fecal matter
-vomiting black, tarry substances
-severe weight loss
-electrolyte imbalances

Question 6

Type and Timing of Fluid Introduction After Vomiting?

Answer 6

• Water
• Apple Juice/Lemonade
• Sports drink, ORS
• Warm or cold tea

-Suck on ice chips (>3 years old)
- 1 tsp every 10 minutes
- 1 tbsp every 20 minutes
- Double the amount of fluid every hour
- Progress to other liquids as tolerated

Question 7

Type and Timing of Food Introduction for Nausea/Vomiting?

Answer 7

-no vomiting for 8 hours
- one solid food at a time
-avoid food high in fat or fibre
-avoid gas-producing foods
- ginger may help
- SFM
- plain and dry grains
- yogurt and sherbet
- clear broths, baked chicken, and eggs

Question 8

Medical Interventions for Nausea/Vomiting?

Answer 8

-maintain hydration (IVF and/or PN)
-correct electrolyte imbalances
-anti-nausea/anti-emetic agents

Question 9

Causes of Dental Carries?

Answer 9

• Streptococcus mutans Bacteria
• Tooth Structure
• Immunologic response to bacteria
• Salvia composition

Question 10

Risk Factors for Dental Carries?

Answer 10

Increases:
-frequent and prolonged intake of foods high in simple sugars
-sticky, retentive foods
-sipping sugar-sweetened beverages for prolonged periods

Decreases:
-space food and beverage intake at least 2 hours apart
- select fresh, whole, unprocessed foods to stimulate salivary output
-chew sugarless gum for a brief period after eating

Question 11

Nutritional Implications of Dental Caries?

Answer 11

• dental caries, tooth loss, and ill-fitting dentures lead to inadequate intake
• malnutrition and weight loss may contribute to loss of teeth and poor fitting of dentures
• difficulty chewing or edentulous individuals may rely on soft foods of limited variety in their diet leading to inadequate nutrient intake

Question 12

Prevention of Dental Caries?

Answer 12

-Fluoride use
-Nutritional choices:

• fiber-rich vegetables and whole grains
  -limit added sugars or caloric sweeteners
• rinse te mouth after meals and snacks
  -chew xylitol gum after meals
  -practice good oral hygiene
  -consume sugar and starch-containing foods and beverages less frequently

Question 13

What is stomatitis?

Answer 13

-inflammation of the mucous membranes
- associated with fungal infections
-may lead to open ulcerations

Question 14

Nutrition interventions for stomatitis?

Answer 14

-room temperature food
-avoid carbonated beverages
-avoid caffeine/alcohol/tobacco
-avoid acidic/spicy foods
-oral glutamine supplementation (10g 3x/day)
-EN if needed

Question 15

Medical interventions for stomatitis?

Answer 15

-oral topical agents, mouth rinses, anesthetics
- medications for fungal infections
- prevention is key

Question 16

What is Xerostomia?

Answer 16

Decreased saliva production and dry mouth

Question 17

Causes of Xerostomia?

Answer 17

• Infection
• Medical Treatment (radiation or surgery)
• Medications
• Blocked salivary glands/ducts
  -Dehydration’
  -Sjogren’s Syndrome