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Unit 1 Clin Med III > L3: Nutritional Care > Flashcards

L3: Nutritional Care Flashcards

1
Q

1 g of carbohydrates

A

4 kcal

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2
Q

1 g of fat

A

9 kcal

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3
Q

1 g of protein

A

4 kcal

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4
Q

breaks down carbohydrates into monosaccharides

A

amylase

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5
Q

breaks down proteins into amino acids

A

proteases

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6
Q

breaks down fats into monoglycerides and fatty acids

A

lipase and bile

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7
Q

Micronutrients function

A

Support cellular metabolic processes, biochemical reactions, hormone function, nerve impulse propagation and muscle function

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8
Q

Water soluble vitamins

A 
Thiamine (B1)
Riboflavin (B2) 
Niacin (B3)
Pantothenic Acid (B5) 
Pyridoxine (B6), 
Biotin
Folate
Cobalamin (B12, binds IF in stomach, absorbed in ileum) 
Ascorbic acid (Vit C)
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9
Q

B1

A

thiamine

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10
Q

B2

A

riboflavin

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11
Q

B3

A

niacin

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12
Q

B5

A

pantothenic acid

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13
Q

B6

A

pyridoxine

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14
Q

B12

A

cobalamine

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15
Q

Vit C

A

ascorbic acid

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16
Q

Aids in iron absorption

A

Vit C

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17
Q

Sources of Niacin (B3)

A

Grains, legumes

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18
Q

Sources of Folate

A

Leafy vegetables, citrus fruits

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19
Q

Sources of cobalamin (B12)

A

dairy, meat, poultry, eggs, fish

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20
Q

Thiamine (B1) deficiency

A

Beriberi→ peripheral neuropathy +/- heart failure

Wernicke-Korsakoff syndrome (neuro sequela)

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21
Q

Riboflavin (B2), Niacin (B3), Pantothenic Acid (B5) deficiencies

A

Angular cheilitis (fissures at corner of mouth)
Angular stomatitis
Atrophic glossitis

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22
Q

Specific to Niacin (B3) deficiency

A

Pellagra→ diarrhea, dermatitis, dementia

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23
Q

Folate deficiency

A

Macrocytic anemia

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24
Q

B12 (cobalamin) deficiency

A

Macrocytic anemia + peripheral neuropathy

Atrophic glossitis

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25
Q

Vitamin K and C deficiency

A

Petechiae/purpura

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26
Q

Fat soluble vitamins

A

Vitamins A, D, E, K

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27
Q

Vitamin A is important for

A

Vision

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28
Q

Vitamin D is important for

A

calcium absorption

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29
Q

Vitamin K is important for

A

blood clotting

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30
Q

Sources of Vitamin A

A

dark green, yellow/orange fruits/vegetables

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31
Q

Sources of Vitamin D

A

Fortified dairy products, eggs

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32
Q

Sources of Vitamin E

A

vegetable oils, nuts, leafy vegetables

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33
Q

Vitamin A deficiency

A

Night blindness, poor wound healing, dry skin

Bitot spots→ abnormal squamous cell proliferation and keratinization of the conjunctiva

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34
Q

Vitamin D deficiency

A

Rickets, osteomalacia

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35
Q

Vitamin E deficiency

A

Sensory and motor neuropathy

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36
Q

Bitot spots

A

Vitamin A deficiency

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37
Q

Major minerals

A 
Sodium
Chloride
Potassium
Calcium
Magnesium
Phosphorus
38
Q

Trace elements

A 
Iron
Zinc
Iodine
Manganese
Chromium
Copper
Selenium
39
Q

Sources of potassium

A

Bananas, tomatoes, potatoes, oranges, melons, leafy green vegetables

40
Q

Sources of calcium

A

Dairy produces, leafy vegetables

41
Q

Sources of magnesium

A

Green leafy vegetables, whole grains, beans, nuts

42
Q

Sources of phosphorus

A

Dairy, nuts, peanut butter, dried beans, cocoa, beer, cola drinks

43
Q

Sources of Iron

A

meats, egg yolk, fish, dark green leafy vegetables

44
Q

Sources of zinc

A

meat, eggs, legumes

45
Q

Iodine deficiency

A

Goiter, hypothyroidism

46
Q

Calcium deficiency

A

Tetany

47
Q

Major minerals are absorbed in the _____

A

duodenum

48
Q

B12 is absorbed in the ____

A

ileum

49
Q

Iron deficiency

A

Pallor, pale conjunctiva, koilonychia

Atrophic glossitis

50
Q

Zinc deficiency

A

Hypoguesia

impaired wound healing

51
Q

Supplement _____ in pregnancy

A

Folate to prevent neural tube defects

52
Q

Avoid ______ foods in pregnancy

A 
cured/deli meats
unpasteurized/undercooked products
fish
alcohol
tobacco
53
Q

How long does an infant breastfeed/drink formula?

A

4-6 months

54
Q

Infants exclusively breastfeeding need _____

A

Vitamin D supplementation

55
Q

Foods to limit/avoid

A

Avoid processed foods, refined sugars

Limit trans fat, saturated fat, dietary cholesterol

56
Q

Daily sodium limit is _____

A

<2300 mg

57
Q

Describe the “MyPlate Method”

A

Replace refined grains→ whole grains
>5 servings fruits/vegetables daily
25-35 g/day fiber
Protein-rich foods→ seafood, lean meat, eggs, beans, unsalted nuts/seeds, low-fat dairy

58
Q

What are some reasons why the elderly face unique dietary problems?

A

Multiple medical problems
Malignancy, dementia
Polypharmacy→ nausea/vomiting decrease intake
Physiological changes
Decreased functional status
Varying ability to access and prepare food
Social implications→ poverty, depression, isolation

59
Q

Treating elderly dietary issues focuses on….

A

Optimize medical care, reconcile medications

Liberalize diet, incorporate high calorie foods, add oral nutrition supplements

60
Q

5 components of a nutrition assessment

A
  1. Food and nutrition related history
  2. Patient history
  3. Anthropometric measures
  4. Nutrition focused exam
  5. Labs
61
Q

Alcohol abuse can cause

A

thiamine deficiency

62
Q

Medical conditions with nutritional implications

A

Critical illness or chronic disease
Immunocompromised/malignancy
Eating disorders
GI disorders→ malabsorption: pancreatic insufficiency, celiac disease, IBD
Alcohol use disorder→ thiamine deficiency
Physical disabilities
Medication and complementary or alternative medicine use

63
Q

Anthropometric measures

A

Height, weight, BMI
Usual vs. Ideal body weight
Weight pattern/unintentional weight loss
Body composition

64
Q

Confusion is a sign of _____ deficiency

A

thiamine

65
Q

Edema, ascites are signs of _____ deficiency

A

protein

66
Q

Sunken appearance of the orbital area is a sign of _____

A

dehydration

67
Q

Temporal muscle wasting, muscle wasting decreased strength are signs of _____ deficiency

A

protein, caloric

68
Q

Poor wound healing/pressure ulcers are signs of _____ deficiency

A

protein, zinc, Vitamins A, C

69
Q

Labs for a nutrition assessment

A 
Hydration status, acid base assessment
CBC, Iron studies, B12, folate
Serum albumin and prealbumin→ interpret with caution, increase with inflammation
CRP/ESR
Glucose
BMP/CMP, Na+, K+, Ca++, PO4, Mg++
Vitamins, mineral, trace elements
70
Q

Oral nutritional supplements

A

Concentrated source of kcals, protein, vitamin/minerals
Liquids/shakes/snacks
Disease specific
Tailored per patient

71
Q

_____ is the preferred nutritional support if nutrition needs can’t be met by mouth as is it _______

A

enteral

physiologic

72
Q

Refeeding syndrome

A

Intracellular shift of lytes: Mg, PO4, K
Transaminases, Bilirubin, triglyceride
monitor while using nutrition support

73
Q

Post-op diet

A

clear or full liquid

74
Q

Poor dentition, difficulty swallowing diet

A

pureed/soft

75
Q

Constipation/diarrhea diet

A

High fiber

76
Q

Gut rest diet is….

A

low-residue (fiber)

77
Q

Enteral nutrition routes and formulas

A

Stomach→ bolus feeds
Small bowel→ continuous feeding
Formula→ standard, pre-digested, concentrated, lyte-restricted

78
Q

Complications of enteral nutrition

A

lTube misplacement→ confirm placement with xray
Tube displacement or obstruction
Hyperglycemia, unstable fluid/lyte status
Intolerance
Emesis, diarrhea (formula, abx, c diff)
Pulmonary aspiration

79
Q

When does serum ablumin/pre-albumin increase?

A

With inflammation

80
Q

Indications for parenteral nutrition

A 
Prolonged ileus
Bowel obstruction
Small bowel resection
Short gut syndrome
High output enterocutaneous fistula
IBS, GI bleed
Ischemic bowel
81
Q

Parenteral nutrition formula includes….

A 
Dextrose
amino acids
lipid emulsion
fluid
electrolytes
vitamins/minerals
82
Q

Parenteral nutrition complications

A

Catheter-related sepsis, venous thrombus, air embolus, pneumothorax

Hyperglycemia, lyte abnormalities, azotemia (nitrogen waste in blood)

Fatty liver secondary to cholestasis

83
Q

Food drug interactions: Coumadin

A

maintain vitamin K+ consistency→ green leafy vegetables

84
Q

Food drug interactions: Statins

A

Avoid grapefruit juice

85
Q

Food drug interactions: MAO inhibitors

A

avoid tyramine: chocolate, aged/mature cheeses, smoked/aged meats, hot dogs

86
Q

Food drug interactions: Thyroid meds

A

administer calcium separately

87
Q

Drug-nutrient implications: ACEI/ARBs

A

hyperkalemia

88
Q

Drug-nutrient implications: Diuretics

A

Hyponatremia, hypokalemia, low Mg

89
Q

Drug-nutrient implications: Cholestyramine

A

Decreased fat soluble vitamins

90
Q

Drug-nutrient implications: Sulfasalazine, methotrexate

A

folic acid deficiency

91
Q

Drug-nutrient implications: Isoniazid

A

Vitamin B6

92
Q

Drug-nutrient implications: Metformin

A

Vitamin B12

Unit 1 Clin Med III (7 decks)

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