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SUMMED2 > GI Nutrition > Flashcards

GI Nutrition Flashcards

1
Q

Compliment to ES, AA

What is the difference between macronutrients and micronutrients?

A

Micronutrients DO NOT provide energy. -minerals and vitamins.

Macronutrients provide energy. - lipids, proteins, and carbohydrates.

Water, CO2, PH, NA, CA, K, CL- all provide cellular FX

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2
Q

What are the simple carbohydrates?

A

Monosaccharides:

  1. glucose,
  2. galactose
  3. fructose.

Disaccharides:

  1. maltose glucose-glucose
  2. sucrose- candy, corn syrup, fructose-glucose, 3. lactose galactose-glucose.
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3
Q

What are complex carbohydrates and Fiber?

A

Polysaccharides:

  1. starch : amylose, amylopectin- carrot, bread potato
  2. cellulose,
  3. glycogen-chain of glucose

FIBER:
Insoluble- long stringy like, bulk
2-Soluble- binds bile salt, so bile cant make cholesterol

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4
Q

What are the 9 essential amino acids?

A

body cannot make, so you must get them from your diet.

1. Histidine 2. Isoleucine 3. Leucine 4. Lysine 5. Methionine 6. Phenylalanine 7. Threonine 8. Tryptophan 9. Valine

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5
Q

What is a non-essential amino acid? Conditionally non-essential?

A

Non-essential amino acids are made by the body. Conditionally non-essential AAs are able to be made by the body using essential amino acids.
- Alanine - Aspartate - Cysteine - Glutamate

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6
Q

What is the structure of a fatty acid?

A

A glycerol backbone -3 glucose molecules+ fatty acid tails.

When broken down Glycerol goes to LIVER to make glucose

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7
Q

What is the breakdown of types of fatty acids?

A
  • Trans fats -BAD (coconut oil+/-)
  • Saturated fats -BAD, stacks solid in room temp
  • Unsaturated fats-Good double bonds kink, so no stacking:polyunsaturated-2 DBs: omega 3-6 FA, :monounsaturated (Omega 9 FA)
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8
Q

Calories = energy. How many calories are there per gram of carbohydrates, proteins, and fats?

A

Carbs: 4 calories/gram
Protein: 4 calories/gram
*Fats: 9 calories/gram- 2x more calorically dense
ETOH- 9 cal

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9
Q

If someone is trying to maintain their weight, how many calories should they be having?

A

25-35 kcal/kg.Lose weight: 20-25 kcal/kg. Gain weight: 35-45 kcal/kg.
DM Pt Goal 40% cutting
EX. 20kcal x 100kg (220lb)= 200kcal -2000daily=800/4= .

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10
Q

What percent of your daily diet should be made up of carbs, proteins, and fat?

A

45-65% carbohydrates,
10-35% protein,
25-35% fat.

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11
Q

If a pt is a recreational exerciser, how much protein should they be eating daily?

A

0.8-1.5g/kg of body mass. (Ex: 75 kg x 0.8g/kg = 60g/day).

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12
Q

What is the upper limit of daily protein for anyone, no matter how much exercise they are doing?

A

2g/kg of body mass.

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13
Q

Based on the “choosemyplate” set up, how much should be fruits and vegetables and how big is the plate?

A

9 in plate with half being fruits and vegetables.

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14
Q

Is diet or exercise more important for someone trying to lose weight?

A

Diet! Exercise is important for many reasons, including maintaining weight, but it is very difficult to lose weight purely off of exercise.

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15
Q

When should you consider adding a weight loss medication to someone’s weight loss regimen?

A

1.BMI of 30 or greater
2. BMI of 27 + at least 1 weight-related comorbid condition (i.e. T2DM).
Contrave (naltrexone-bupropion)
● Qsymia (phentermine-topiramate)
● Belviq
● Saxenda (liraglutide = GLP 1)
● Orlistat

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16
Q

What are the 4 types of bariatric surgeries?

A
  1. Roux-en-Y Gastric Bypass (pouch inserted —> duodenum attached here, reducing amount one can eat greatly).
  2. Vertical Sleeve Gastrectomy (part of stomach is physically removed).
  3. Laparoscopic adjustable gastric banding (balloon placed around the stomach).
  4. Biliopancreatic -MOST wt loss diversion with duodenal switch (bypass most of small intestine, leading to less absorption).
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17
Q

What is the most common complication of bariatric surgery?

A

Micronutrient deficiencies. Most commonly B1-12, D, and Iron.

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18
Q

What is the mainstay of diabetes nutrition therapy?

A

Portion control of grains and starchy vegetables, fruit, and dairy. Limit ALOT sweets.

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19
Q

What is the mainstay of dyslipidemia nutrition therapy?

A
  • Avoid trans fat- shortening
  • Limit saturated fats -butter etc. DEC= DEC LDL
  • Focus on mono- and polyunsaturated fats-oils
  • Limit simple carbohydrates- sweets, soda, and juice for hypertriglyceridemia.

INC Exercise= INC HDL

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20
Q

What is the mainstay of kidney disease nutrition therapy?

A
  • CKD4- Low sodium (< 2000mg/day).
  • Phosphorus restriction- kidney excrete if cannot problem. Limit dairy, soda, shrimp, organ meats, chocolate, broccoli).
  • Fluid restriction
  • Protein —> DEC CKD4/5, INC with dialysis.
  • Low potassium (2g/day) - hyperkalemia deadly in CKD. bananas, oranges, spinach, tomatoes.
  • Reduce magnesium (nuts, seeds, grains, spinach).
  • **Vitamin D- Give Calciferol. none in CKD d/t last step to convert
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21
Q

What is the mainstay of CHF nutrition therapy?

A
  • Low sodium (<2g/day)
  • Fluid restriction (~1-1.5L daily)
  • Increased potassium if on K wasting diuretics - Limit alcohol, fat.
  • DASH diet MC HTN and CHF
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22
Q

What is the mainstay of Afib nutrition therapy?

A

Vitamin K CONTROL only consistent d/t Warfarin Tx

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23
Q

What is the nutrition therapy for cirrhosis?

A
  • Fluid restriction-ascites albumin leaks out
  • Low sodium
  • High calorie -small, frequent, calorically dense meals
  • Avoid alcohol
24
Q

If a patient is postop and is failing to thrive, what micronutrients must you supplement?

A

Malnutrition- impairs wound and INC mortality

INC needs for: Zinc sulfate, Vitamin C, and Vitamin A

25
Q

If an elderly patient is failing to thrive, how should you maintain their nutrition?

A

With small, frequent meals that are calorically-dense. *Add healthy fats and oral supplements (i.e. Ensure, Boost).

26
Q

If a pediatric patient is failing to thrive, how should you approach their nutrition therapy?

A

With creativity! new foods. Goal: 1 tbs/yr of food group each meal.

27
Q

Nutrition therapy for Celiac disease?

A

Gluten avoidance

28
Q

Nutrition therapy for pancreatitis?

A

NPO. Pancreatic rest enzymes and AquaDEKs.

29
Q

Nutrition therapy for seizure patients?

A

Ketogenic diet —> very low carb, high fat, high protein. CHO major source for brain. Less sugar less activity

30
Q

Nutrition therapy for biliary colic?

A

Temporary fat limitation.

31
Q

Nutrition therapy for cystic fibrosis?

A

No restrictions!!!

32
Q

Nutrition therapy for diverticulosis?

A

High fiber- fruits, veggie, non gluten grains, legumes. Need easily digestable

33
Q

Nutrition therapy for diverticulitis?

A

Low fiber- rest colon

34
Q

Nutritional therapy for GERD?

A

Portion control. limit coffee, tea, chocolate, spicy foods, citrus, fried foods, peppermint, and alcohol.

35
Q

Nutritional therapy for cancer or transplant patients?

A
  • Low microbial diet —> avoid unpasteurized foods, undercooked meats, and raw grains/nuts.
  • Calorically-dense foods
  • Filtered water
36
Q

What additional nutrient needs are required during pregnancy?

A
  • 300 additional calories. - Folate, Iron, and Calcium
37
Q

Breast milk reduces the risk of what diseases in babies?

A
  • Infections: ear, GI, and lungs - Asthma, dermatitis, and allergies - Obesity, diabetes, SIDS - Childhood cancer - Baby being stressed.
38
Q

Breast feeding reduces the risk of what diseases in mom?

A
  • Ovarian and breast cancer
  • Type 2 diabetes and heart disease
  • Postpartum depression - Osteoporosis
  • Helps lose weight by burning 500 calories/day *Also saves money and time!
39
Q

What are the symptoms of a Vitamin A deficiency?

A

Night blindness, hyperkeratosis, and keratomalacia.

OD=Hypervitaminosis A —> Toxicity!!, Elderly, developing nations. Acutan order VA
ADEK- Fat soluble stored
Other- eat daily b/c w/ excrete

40
Q

Overdose of what vitamin can lead to liver damage?

A

Vitamin B3

VitB meat, dairy

41
Q

If a patient suddenly stops vitamin C supplements, what can occur?

A 
Rebound Scurvy (bleeding).
OD- possible
42
Q

What type of anemia is caused by an iron deficiency?

A

Microcytic hypochromic anemia (MCV<80)

KID DDX- Lead poisoning

43
Q

What is Kwashiorkor malnutrition?

A

Protein malnutrition characterized by children with thin extremities and **large bellies.

44
Q

What is marasmus?

A

Calorie and protein malnutrition —> starving.

45
Q

If someone has a balanced diet, should they be taking vitamin supplements?

A

NO! ONLY deficiency.

FDA no approved- saw dust and rat poop

46
Q

Who should be taking prenatal vitamins?

A

All pregnant/breastfeeding women and females of childbearing age.

47
Q

What are the 4 types of tube feeding access points?

A
  1. Nasogastric - nose post pyloric
  2. Orogastric - mouth post pyloric
  3. Gastrostomy (G tube) - stomach
  4. Jejunostomy (J-tube) - jejunum

Methods: Pumps, syringe, gravity, bag

48
Q

What is a G-J tube?

A

Enteral nutrition with 2 access points, into the stomach and into the jejunum.

49
Q

What is the most common brand of enteral nutrition?

A

Jevity 1.2 (with fiber).
**Tons of other options ; specific to diabetes or renal disease.

Tube Requirement- 1.0kcal/ml of enteral food x Ideal kcal/day

50
Q

With what type of enteral nutrition should you NEVER do bolus/one time amount feeds?

A

J tubes or the J-port on a G-J tube!

**Large amount into the small bowel will kill the bowel!!

51
Q

What are possible complications of enteral nutrition?

A
  • Tube related (i.e. blockage or dislodgment)
  • Aspiration
  • Refeeding syndrome-can cause death on malnurished pt. Slow
  • Intolerance —> diarrhea
52
Q

What qualifies as diarrhea to be concerned about as a complication of enteral nutrition?

A

Watery diarrhea! **Not concerned if just soft.

53
Q

What are the indications for PPN, Peripheral parenteral nutrition?

A
  • Short term nutrition support -2 weeks**
  • Modest needs - Bowel rest
    Risk- phlebits/Thrombosis
54
Q

What are the indications for TPN, Total parenteral Nutrion?

A
  • Central access
  • Long-term
  • Non-functioning GI tract** - Severe malnutrition.

RISK-sepsis

55
Q

How should you calculate parenteral nutrition?

A

Ask your TPN pharmacist and dietitian!! **Start nutrition early —> better healing and outcomes.

56
Q

If a patient has a functional GI tract, how should they be getting their nutrition?

A

Orally if they can swallow safely, or enteral nutrition if unsafe swallow.

SUMMED2 (38 decks)

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