GI Nutrition Lecture Powerpoint Flashcards
Essential nutrients
Those that the body cannot make in sufficient quantities to meet physiologic needs
Carb/protein/fat kcals per gram
4/4/9
2 formulas for calculating kcals
- Harris benedict formula
- Mifflin St Jeor formula
Nutrient transport in the GI system upon absorption
- Water soluble enter the blood stream
- fat soluble vitamins and other fats form chylomicrons and are released into the lymphatic system
Secretin
Hormone in small intestine that is released upon chyme entering the duodenum which stimulates pancreatic release of bicarb juices into duodenum
Cholecystokinin
Hormone triggered when fat enters small intestines that stiulates gallbladder to release bile for fat emulsification
Subjective global assessment
A 5 criteria guide to assessing presence of malnutrition alongside other tools such as a good physical exam
Clinical assessment of malnutrition (4)
- muscle wasting (temporalis muscle)
- fat wasting (hollow sunken in eyes)
- edema and ascites
- alopecia
Marasmus
Protein and calorie deficiency resulting in wasting but NO edema
Kwashiorkor
Protein deficiency but not caloric deficiency resulting in extreme edema
Risks for malnutrition (4)
- critical illness
- impaired bowel function
- alcoholism
- obesity
Thiamine B1 deficiency common groups and clinical manifestations and treatment
- alcoholism, poverty, crohns, GI surgery
- beriberi (wet cardiovascular heart failure, late stage dry beriberi neurologic wernicke and korsakoff syndrome)
- IV then oral thiamine
Riboflavin B2 deficiency common groups and clinical manifestations and treatment
- Undeveloped countries, malabsorption or malnutrition
- cheilosis/angular stomatitis, glossitis (swollen shiny tongue), corneal vascularization
- IV then oral riboflavin
Niacin B3 deficiency common groups and clnical manifestations and treatment
- alcoholism, poverty, PPD rxn
- pellagra (dermatitis, diarrhea, and dementia)
- oral supplementation
Vit A deficiency common groups and clinical manifestations and treatment
- children, elderly, poor
- night blindness, bitot spot, xerosis (dry skin)
- oral supplementation and refer to opthalmology
Vit C deficiency common groups and clinical manifestations and treatment
- those without access to fresh fruits and veggies
- scurvy (poor wound healing), petechiae (small red spots), splinter hemorrhage
- oral supplementation
Vit D deficiency common groups and clinical manifestations and treatment
- inadequate sunlight, inadequate dietary intake
- rickets (kids) and osteomalacia (adults)
- sun exposure or oral supplementation
Vit E deficiency common groups and clinical manifestations and treatment
- those on anticoagulants or malnutrition
- excess bleeding
- oral/im/subQ supplementation
Clinical manifestations of lactose intolerance
30-2 hours after ingestion get bloating, abdominal cramps, flatulence, and in high amounts diarrhea, treated with lactaid or avoidance
Phenylketonuria (PKU) and treatment
Autosomal recessive disorder where a pt is unable to metabolize phenylalanine tested at newborn screening as delay in diagnosis will lead to potential brain injury, treated with low phenylalanine diet and tyrosine supplementation, strict protein control for life
Benefits of enteral nutrition (3)
- more physiologic with preservation of gut mucosa
- fewer complications
- cheaper
Peripheral parenteral nutrition
Short term use of nutrition admission thru a peripheral vein that can supplement those with low intake despite being unable to meet caloric needs on own
Total parenteral nutrition
Use for patients who require extended period of tie (>7 days) using the superior vena cava to meet high calorie requirements
