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DOMAIN 2 > Medical Nutrition Therapy > Flashcards

Medical Nutrition Therapy Flashcards

1
Q

Nutrition diagnosis

A

A nutritional problem that dietitian is responsible for treating independently; changes as patients response changes
-I.e. undesirable overweight status

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2
Q

Medical Diagnosis

A

A disease or pathology that canb e treated or prevented; does not change as long as the condition exists
-Ex: T1DM

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3
Q

Clinical Diagnostic domain (NC)

A

Nutritional findings that relate to medical/physical condition

  • Functional –> difficulty swallowing
  • Biochemical –> change in metabolsim
  • Weight –> involuntary weight loss
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4
Q

Intake Diagnostic domain (NI)

A
  • Intake diagnosis is PRIORITY!
  • actual nutrition problem related to intake
  • Ex: inadequate oral intake; hypermetabolism; excessive CHO intake
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5
Q

Behavioral-Environmental Diagnostic domain (NB)

A
  • problems related to knowledge, access to food, and food safety
  • Ex: undesireable food choices
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6
Q

PES Statements

A
  • One problem, One etiology, Assessment of signs and symptoms
  • Intake diagnosis takes priority for PES statement
  • select most important and urgent problem to be addressed
  • Need to be able to document signs and symptoms and monitor them
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7
Q

Altered GI Function (NC1.4)

A

problems INSIDE the GI tract; changes in digestion, absorption, and/or elimination
-Indicators: IBS, constipation, FFS, diarrhea, abd dist

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8
Q

Impaired NUTRIENT utilization (NC 2.1)

A

Problems with METABOLISM of nutrients once they enter the circulatory system; endocrine functions
-Indicators: abnormal LFTs, hyperglycemia, renal/liver failure

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9
Q

Evidence Based Dietetics Practice

A

Systematically reviewed evidence used in making food and nutrition practice decisions

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10
Q

Health Information Portability and Accountability Act (HIPPA)

A

Medical record documentation guidelines: black pen or typed; complete, clear, legible, accurate; sign, date all entries; when diet orders are not chosen correctly, contact the person who wrote the order

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11
Q

When do discharge plans begin?

A

Day ONE of hospital stay

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12
Q

GI Disorders

A
  • ulcers
  • diarrhea
  • short bowel syndrome
  • hiatal hernia
  • dumping syndrome
  • gastroparesis
  • tropical sprue
  • celiac disease
  • constipation
  • diverticular disease
  • gastritis
  • IBD
  • IBS
  • Lactose intolerance
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13
Q

Ulcer

A
  • eroded mucosal lesion
  • caused by H.Pylori bacteria and requires antibiotics

-Diet: as tolerated w/o exacerbating symptoms; avoid late night snacks,chili powder, excess caffeine and alcohol

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14
Q

Hiatal Hernia

A
  • Protrusion of stomach above diaphragm
  • Main symptom= heart burn

-Diet: small, bland feedings, avoid late night snacks

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15
Q

Dumping Syndrome

A

-After a gastrectomy: billroth I (gastroduodenostomy) or billroth II (gastrojejunosotmy)

  • Eating too many CHO at once –> dumped into sm. intestine –> H2O drawn out of intestine for osmotic balance –> BP increases –> signs of cardiac insuff
  • 2 Hrs later – CHO is absorbed rapidly –> increase BG –> overproduction of insulin –> decrease in BG below fasting –> Reactive alimentary hypoglycemia
  • Sx: cramps, rapid pulse, dizziness, sweating
  • Anemia is common: Fe, B12, Folate deficiencies common but can be prevented with diet

-Diet: sm dry feedings; fluid before and after meals; minimal concentrated sweets; 50-60% complex CHO; protein at each meal; moderate fat; B12 injections

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16
Q

Gastroparesis

A
  • delayed gastric emptying

- prokinetics given to increase stomach contractility

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17
Q

Tropical Sprue

A
  • Bacterial, fungal, parasitic infection
  • chronic intestinal lesions that may also affect the stomach
  • deficiencies in folate and B12 due to decreased IF and HCl
  • Tx: antibiotics (tetracycline)
  • Diet: high kcal, high pro with IM B12 and folate supp
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18
Q

Non-Tropical Sprue aka Celiac disease

A
  • Allergic reaction to gliadin in gluten
  • affects only the intestinal tract –> malabsorption and macrocytic anemia (B12)

-Diet: gluten free; NO wheat rye, barly; rice and corn are okay

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19
Q

Constipation

A

Treated with high fluid, high fiber, and exercise

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20
Q

Diverticular Disease

A
  • Diverticulosis: presence of sm. mucosal sacs called diverticula on intestinal wall
  • ->Diet: high fiber diet; rapid transit
  • Diverticulitis: inflammation of diverticuli
  • ->Diet: clears + Low resider –> gradual return back to high fiber diet
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21
Q

Fiber: oat bran + soluble fiber _____ serum cholesterol by binding _______ causing more cholesterol to be converted into bile

A
  • decreases serum cholesterol

- bile acids

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22
Q

Gastritis

A
  • Inflammation of stomach

- Diet: clears –> advance as tolerated

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23
Q

Inflammatory bowel disease: CROHNS

A
  • when body’s immune system attacks and destroys healthy tissue
  • chronic inflammation of gi Tract
  • can affect mouth all through gi tract to anus
  • most likely to be involved= terminal ileum –> leads to B12 deficiency –> megaloblastic anemia

Sx: anorexia, diarrhea, weight loss

Tx: acute flare ups –> bowel rest, PN
Non flare ups: high kcal, high pro, moderate fat; only limit fat with steattorrhea

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24
Q

IBD: Chronic Ulcerative Colitis

A
  • Ulcer disease of the colon
  • Fx of colon is to reabsorb water and electrolytes

-Major symptom = chronic bloody diarrhea

  • Tx: elemental diet to decrease fecal volume
  • High fiber diet in remission to increase perstalsis
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25
Q

IBS

A

chronic abdominal discomfort

-Diet: tailored to specific GI issues

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26
Q

Lactose intolerance

A
  • lactase deficiency
  • Sx: bloating, distention, diarrhea because lactose not broken down
  • Lactose Tolerance Test:
  • -> intolerance= BG rise < 25mg/dL above fasting called the “flat curve”
  • -> Tolerance = BG rise > 25 mg/dL –> normal glucose curve

-Diet: no animal milk or milk product; yogurt and small amount of aged cheese might be tolerated

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27
Q

Diarrhea

A
  • Infants and Children:
  • ->Acute: aggressive and immediate rehydration of fluids and electrolytes
  • ->Chronic: insignificant malabsorption; give 40% kcal as fat balanced with limited fluids; restrict/dilute juices with high osmolar loads (i.e. apple juice)

-Adults: bowel rest ; replace lost fluids and electrolytes

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28
Q

Steattorrhea

A
  • Consequence of malabsorption
  • normal stool fat = 2/5 gm
  • Malabsorption of fat = > 7 gm

-Diet: high protein, high complex CHO, fat as tolerated; fat soluble VIT, MCT

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29
Q

Short Bowel Syndrome

A
  • Consequences related to significant resections of SB
  • Major concern: loss of distal 1/3 of ileum, loss of ileocecal valve, loss of colon
  • Loss of Distal ileum: where B12, IF, and bile salts are absorbed and a major portion of fluid; not able to recycle bile salts if no ileum –> malabsorption of fat and fat-soluble vitamins
  • Loss of Jejunum: normal balance of nutrients
  • Loss of ileum: limit fat, use MCT oil; supplement fat soluble vitamins, Ca, Mg, and Zn; parenteral B12, likely require PN initially
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30
Q

Liver, Biliary Tract, and Pancreatic Disorders

A
  • Acute viral hepatitis
  • Cirrhosis
  • Alcoholic Liver Disease
  • Hepatic failure
  • gallbladder disease
  • pancreatitis
  • Cystic fibrosis
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31
Q

Liver Enzymes (LFTs

A
  • elevated LFTs = damage to liver tissues
  • ALP, LDH, AST (SGOT), ALT (SGPT)
  • In liver disease: ALL FOUR ELEVATED

-In uncontrolled diabetes, AST (SGOT) is LOW

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32
Q

Acute Viral Hepatitis

A
  • Major symptom = anorexia
  • Hep A= fecal-oral transmission
  • Heb B= sexually transmitted
  • Hep C= blood to blood

Diet: high protein needs to help prevent fatty liver; small frequent feedings due to anorexia

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33
Q

Cirrhosis

A
  • Damaged liver tissue –> scar tissue –> disrupts blood flow through liver
  • Protein deficiencies –> ascites, fatty liver, impaired blood clotting
  • Diet: high calorie, high protein, mod-low fat; low fiber if varices; low Na if ascites or fluid restriction
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34
Q

Complications of cirrhosis

A
  • Ascites: when blood can’t LEAVE liver due to connective tissue overgrowth –> accum of excess fluid and Na it carries in peritoneal cavity
  • Esophageal Varices: blood cant ENTER the liver due to connective tissue overgrowth; blood backs up in portal vain increasing pressure –> increased BP (*PORTAL HTN); varices are fragile and can break open with roughage
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35
Q

Alcoholic Liver Disease

A
  • Hepatic steatosis –> alcoholic hepatitis –> cirrhosis
  • alcohol converted into acetaldehyde + H2 –> H2 replaces fat as fuel in TCA cycle –> fat builds up in liver –> fatty liver and in blood –> increased TG
  • Alcohol = decreased absorption of thiamin, B12, folate, and Vit C
  • LT Thiamin deficiency: Wernicke-Korsakoff Sx
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36
Q

Hepatic Failure (ESLD)

A
  • Liver fx decreased to 25% or less
  • Liver can’t convert NH3 –> urea = Increased NH3
  • Diet: Very high calorie, very high protein
  • Hepatic encephalopathy = decreased BCAA and increased AAA because liver can’t clear them –> last resort tx option = add BCAA to correct imbalance
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37
Q

Gallbladder Disease

A
  • usually caused by infection
  • Cholecystitis: inflammation of the gallbladder
  • Cholycystectomy: surgical removal of gall bladder –> *bile now secreted by LIVER directly into intestine
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38
Q

Pancreatitis

A

Common characteristic = premature activation of enzymes in pancrease –> autodigestion of pancreas

  • Diet for acute: NPO –> low fat as tolerated
  • Diet for Chronic: PERT= pancreatic enzymes with meals and snacks to minimize fat malabsorption; avoid large meals with fat and alcohol to avoid pain
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39
Q

Cystic Fibrosis

A
  • PERT: pancreatic enzymes at all meals and snacks
  • Diet: very high protein, very high calorie, very high fat and high salt
  • Increased protein needs due to malabsorption related to pancreatic enzyme deficiency
  • Supp: H2O soluble vitamins and minerals;
  • Supplement with water soluble form of fat soluble vitamins –> esp vit A because still poorly absorbed with enzymes
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40
Q

CVD, Coronary Artery Disease, and Ischemic Heart Diseases

A
  • hypertension
  • atherosclerosis
  • heart failure
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41
Q

Hypertension

A

Systolic > 140 (contraction)
Diastolic > 90 (relaxed)

  • Management:
  • -> Thiazide diuretics – may cause K wasting
  • -> DASH diet: dietary approaches to stop HTN; F,V, whole grains, mod salt, fish, poultry
  • Mediterranean diet: rich in omega 3 and MUFA
  • Obesity = major factor in cause and treatment
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42
Q

Atherosclerosis

A
  • Dysipidemia: high TG and low HDL

- Metabolic Syndrome

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43
Q

Metabolic syndrome

A

-3 or more risk factors linked to insulin resistance and increased risk for coronary evens

-Risk factors:
high BP, high TG, fasting glu > 110 mg/dL, low HDL, waist >40 for men >35 for women

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44
Q

Heart Failure

A

Weakened heart = poor output and decreased blood flow
-Fluid is held in tissues –> edema

  • Tx: diuretics are common
  • Diet: Low Na, DASH diet, Fluid Restriction if needed
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45
Q

National Cholesterol Education Program (NCEP)

A
  1. diet therapy:
    TLC: therapeutic lifestyle change: up to 35% kcal from total fat, < 7 % from sat fat, <200 mg chol; fiber, stanols/sterols; exercise
  2. Medications
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46
Q

Normal Lipid Panel

A 
TG = < 150mg/dL
LDL = < 100
Chol = < 200
HDL = < 40 for men, < 50 for women
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47
Q

High homocysteine level is an independent risk factor for _______________

A

Coronary Heart Disease

48
Q

Renal Disease

A 
Renal calculi
Acute renal failure 
nephrosis
chronic kidney disease
end stage renal disease
chronic renal failure
49
Q

Nephrone

A

Contains the:

  • glomerulus
  • proximal convoluted tubule (where major nutrient absorption takes place)
  • loop of henle
  • distal tubule
50
Q

Kidney filters everything EXCEPT ______ and ______

A

Red blood cells and protein

51
Q

Hormones involved in renal function

A
  • Vasopressin: (ADH) elevates BP (secreted by pituitary)
  • Renin: vasoconstrictor and increases BP; secreted when blood volume decreases (secreted by the kidney)
  • Erythropoietin: stimulates bone marrow to produce RBCs (secreted by the kidney)
52
Q

Renal Biochemical Markers in renal disease

A

URINE TESTS

  • Decreased GFR
  • Low creat clearance

BLOOD TESTS

  • elevated serum creatinine
  • elevated BUN
53
Q

What does renal solute load measure

A

mainly nitrogen and Na

54
Q

Renal Calculi

A
  • Kidney stones
  • 1.5-2L fluid/day to dilute urine and prevent further stone formation
  • Most common stone = calcium stone
55
Q

Acute Renal Failure

A
  • Sudden kidney sut down likely due to trauma
  • Sx: oliguria (urine output < 500 ml) and azotemia (increased urea N2 in the blood)

Diet: restrict protein initially then increase intake as able

56
Q

Nephrosis (Nephrotic Syndrome)

A
  • Defect causes protein to enter filtrate moving thru the tubules
  • Sx: albuminuria and hyperlipidemia, hypercholesterolemia, edema, malnutrition
  • Diet: RESTRICT Fat AND protein; restrict protein to 0.8-1.0 gm/kg
57
Q

Chronic Kidney Disease

A

-Protein restricted when the GFR FALLS!

58
Q

Protein restriction based on GFR

A

CKD 1, 2, 3: GFR < 60 = 0.8 gm pro/kg

CKD 4, 5: GFR < 25 = 0.6 gm pro/kg

59
Q

End Stage Renal Disease (ESRD)

A

-few functioning nephrons remain

Diet: VERY LOW protein

-Giovanetti Diet: 20 grams HBV protein and increased kcal intake

60
Q

Chronic Renal Failure

A
  • Diet can be liberalized with dialysis

- Hemodialysis and peritoneal dialysis

61
Q

Hemodialysis calorie/protein needs

A

30-35 kcal/day

1.2 gm pro/kg (>/= 50% HBV)

62
Q

Peritoneal dialysis calorie/protein needs

A

< 60 y.o. = 35kcal/kg including dialysate
> 60 y.o. = 30-35 kcal/kg

1.2-1.3 gm pro/kg BW or adj BW (> 50% HBV)

63
Q

Endocrine Disorders

A 
diabetes
Gestational diabetes 
postprandial/reactive hypoglycemia
Addison's disease 
Thyroid disorders
Goiter
Gout
64
Q

T1DM

A
  • T1DM: insulin deficient
  • Management strategies: consistency of CHO recommended with fixed daily doses of insulin; planned exercise, reduce insulin dosage
65
Q

Normal BG levels

A

70-110 mg/dL

< 140 mg/dL 2hours post prandial

66
Q

Diabetic BG levels

A
  • Fasting plasma glucose: >/= 126 mg/dL
  • GTT >/= 200 mg/dL
  • HbA1c >/= 6.5%
67
Q

Glycosylated Hgb A1c

A
  • Measures % of Hgb that has glucose attached
  • goal for diabetics = < 7%
  • At risk for developing DM = 5.7-6.4%
  • Measures LT control of BG –> over the last 60-90 days
68
Q

Gestational Diabetes

A
  • Risk factors: BMI > 30, history of GDM

- Increased risk for fetal macrosomia (LGA) and fetal hypoglycemia at birth

69
Q

Types of insulin

A

Rapid Acting: take 15 min before meal
-ex: novalog, humalog

Short acting: take before meal; one unit covers 10-15gm CHO; burst of insuline
-ex: Regular

Intermediate Acting: lasts 10-18 hours
-Ex: NPH

Long Acting: Lasts 18-24 hours
-Ex: Lantus, levemir

70
Q

Oral glucose lowering medications

A
  • Insulin Secretagogues: promote insulin secretion; ex=sulfonylureas; glycotrol
  • Biguanides: enhance insulin action; ex=metformin and glucophage
71
Q

Dawn Phenomenon

A
  • Increase in morning BF and insulin needs due to increase glucose production in liver
  • Increased need for insulin at dawn
72
Q

Acute ketoacidosis

A
  • complication of uncontrolled diabetes
  • hyperglycemia, dehydration
  • Tx: insulin and rehydration
73
Q

Acute hypoglycemia

A

due to excess insulin or lasck of eating

  • Tx: glucose
    1) 15 gm CHO from juice, sugar, or tablets
    2) Wait 15 min, if still < 70 take another 15gm CHO until BG is normalized
74
Q

Postprandial/Reactive Hypoglycemia

A
  • Increased insulin sensitivity
  • BG falls <50 mg/dL 2-5 hrs after eating
  • Goal: prevent major rise in glucose that would stimulate more insulin
  • Diet: Avoid simple sugars, 5-6 small meals, spread CHO intake throughout the day
75
Q

Addison’s Disease

A
  • Adrenal cortex insufficiency
  • Absence of adrenal hormones and adrenal cortex atrophies
  • Decreased cortisol: glycogen depletion, hypogly
  • Decreased aldosterone: Na loss, K retention
  • Decreased androgenic: tissue wasting

-Diet: High protein, high salt, frequent feedings

76
Q

Hyperthyroidism

A
  • Excess thyroid hormone secretion
  • Increased T3 AND T4
  • Increased BMR = weight loss
77
Q

Hypothyroidism

A
  • thyroid hormone deficiency
  • Normal or LOW T3 and LOW T4
  • Decreased BMR = weight gain
78
Q

Goiter

A

-Enlargement of thyroid gland due to insufficient thyroid hormone

79
Q

Gout

A
  • Disorder of purine metabolism
  • increased serum uric acid levels may lead to gout

-Diet: Low purine may not be effective; Avoid high purine foods –> i.e. anchovies, broth, and sardines

80
Q

Inborn Errors of Metabolism

A 
Galactosemia
Urea Cycle Defects 
Phenylketonuira
Homocysteinurias
Maple Syrup Urine disease
81
Q

Galactosemia

A
  • Due to missing enzyme that converts galactose into glucose
  • Tx by DIET ONLY! NO Galactose or lactose!!!
82
Q

Urea Cycle Defects

A
  • Unable to synthesis urea from ammonia = increase ammonia in the blood
  • Diet: protein restriction (based on tolerance) to lower blood NH3 levels
83
Q

Phenylketonuria (PKU)

A
  • Missing enzyme phenylalanine hydroxylase –> converts phenylalanine into tyrosine
  • Accum of phylalanin can result in poor brain function
  • Need for PHE decreases with age and infection
  • Children with PKU have higher incidence of dental caries due to high CHO and LOW protein diet

-Diet: restrict PHE – but still need some to promote growth

84
Q

Homocysteinurias

A
  • Disorder of AA metabolism
  • Increase in methionine and homocysteine in blood
  • Increased homocysteine in urine
  • Associated with LOW levels of FOLATE, B6, B12

-Tx: Provide folate, B6, B12 at high doses

85
Q

Maple Syrup Urine Disease

A

Error of metabolism of BCAA (leucine, isoleucine, and valine)
-Diet: Restrict BCAA

86
Q

Arthritis

A

inflammation of peripheral joints

  • Diet: wel balanced with vitamin intake to meet min of DRI
  • Anemia is common – NOT due to diet –> duet to inflammation of joints preventing reuse of iron, supp does not Tx this
87
Q

Systemic Lupus Erythematosus (SLE)

A
  • Anemia r/t disease, not diet

- May have symptoms of celiac disease

88
Q

Osteoporosis

A
  • Loss of bone tisue
  • Lower incidence in black than white wmn
  • Highest risk: old, frail, white women
  • Causes: protein malnutrition, lack of exercise, decline in estrogen

-Tx: hormone replacement therapy and weight bearing exercise; vit D 400-800 mg and Ca >1200mg supp

89
Q

Osteomalacia

A
  • Adult rickets
  • Decreased bone density due to vit D deficiency
  • Vit D and Ca supp
90
Q

Neurological Disorders

A 
Epilepsy 
Cerebral palsy
paralysis
hyperkinesis/hyperactivity
alzheimers disease
91
Q

Epilepsy (seizures)

A
  • Anticonvulsants: phenobarbital and phenytoin interfere with Ca absorption
  • -> may need Ca and Vit D supp
  • ->EN decreases bioavailability of phenytoin – hold TF >2 hours after administration of med
  • Ketogenic Diet: HIGH fat, LOW carb (4:1)
  • ->ketone bodies as as inhibitory neurotransmitters and may stop seizures
  • Supp: Ca, D, folate, B6, B12
92
Q

Cerebral Palsy

A
  • Spastic Form: rigid, limited acitivty – obese
  • Non-spastic form (athetoid): constant, spastic, irregular motions – weight loss
  • Diet: high kcal, high protein; likely need finger foods
93
Q

Paralysis

A

Can result in pressure ulcers:

  • High kcal and high protein (1.2-2gm/kg)
  • Normal intake of Ca
  • Adequate fluids
  • May supp: vit c, Zn, Vit A
94
Q

Microcytic Hypochromic Anemia

A

SMALL (low MCV) and PALE (low MCH) cells

  • Due to iron deficiency
  • R/t chronic infections, malignancies, renal disease
95
Q

Macrocytic Megaloblastic Anemia

A

FEW LARGE (high MCV) and RED (high MCH) cells

  • Due to folate OR B12 deficiency
96
Q

Schilling Test

A

-Tests for B12 deficiency – pernicious anemia

97
Q

MCV = mean corpuscular volume

A 
Normal = 80-95
Low = small cells
High  = large cells
98
Q

MCH= mean corpuscular hemoglobin

A 
Normal = 27-32 pg
Low = pale
High = bright red
99
Q

Foods high in iron

A

Liver, kidney, beef, dried fruit, leafy greens, fortified whole grains

100
Q

Allergies

A
  • Immunoglobumin E = food allegy
  • Most common food allergens: wheat, soy, shellfish, peanuts, tree nuts, milk, eggs
  • Cows milk = most common allergen for infants
  • Introduce eggs at 24 mo of age
  • Introduce nuts/fish at 36 mo of age
  • Rice: least likely food to cause allergy

-RAST: mixes serum and allergen on a paper disk and measures specific IgE antibodies

101
Q

Fever/Infection

A
  • Excessive fluid loss –> dehydration
  • Tx: IV fluids of dextrose and water; progress towards high calorie high protein diet
  • BMR INCREASES 7% for each degree increase in temp above 98.6
102
Q

Burns

A
  • Immediate shock period = catabolism, BMR 50-100x normal

- First goal = replace fluids and electrolytes lost and then increase kcal and protein intake

103
Q

Body’s Response to Trauma

A

-Hypermetabolic and catabolic response following trauma

Release of catabolic hormones:

  • catecholamines, epinephrine, norepinephrine
  • ACTH
  • Aldosterone
  • ADH
104
Q

Marasmus

A
  • Protein AND calorie starvation
  • diagnosed with anthropometric data
  • pt. appears starved
105
Q

Kwashiorkor

A
  • Protein deficiency only
  • Diagnosed with lab values
  • Increased mortality rate
106
Q

iatrogenic Malnutrition

A

-Protein-calorie malnutrition due to treatments, hospital stay, and medications

107
Q

Bariatric Surgery

A
  • Class III obesity with BMI >/= 40 or >/= 35 with comorbidities
  • Roux-en-y: small gastric pouch connected directly to the jejunum; dumping syndrome, supplementation is needed
  • Sleeve (gastroplasty) -> staples to the stomach to make it smaller
  • Gastric Band: band tigthened aroudn stomach; B12, folate, and Fe supp not needed
108
Q

Prader Willi Syndrome

A
  • congential disorder
  • elevated grehlin levels = increased growth hormone, appetite, intake, and fat mass depletion
  • they don’t sense satiety
  • Obesity at 2-3 years + FTT

Best Tx: control access to food

109
Q

Dental Caries

A
  • Enzymes ferment CHO deposits on plaque -> increases acid that demineralizes surface
  • pH in mouth is 5.5 –> enough acid to damage enamel
  • Low cariogenic foods: high protein, moderate fat, min fermentable CHO –> cheddar cheese, nuts, meat
  • Potato chips and peanut butter = cariogenic
110
Q

Stomatitis

A
  • inflammation of the mouth
  • associated with riboflavin deficiencies
  • avoid hot, cold, spicy, sour
111
Q

Esophagitis

A
  • Decreased gastric acidity/reflux
  • Achalasia: lower esophageal sphincter doesn’t relax or open upon swallowing –> dysphagia

-NDD= National Dysphagis Diet: begins with smooth pureed and moist, thick foods

112
Q

Pregnancy Induced Hypertension

A
  • Pre-Eclampsia –> Eclampsia
  • HTN, edema, proteinuria, wt. gain

-Diet: Na restriction NOT recommended; increased Na needed due to expansion of tissue and fluid during pregnancy

113
Q

AIDS

A
  • Diarrhea, weight loss
  • Preserve lean body mass
  • Diet: high kcal, high protein, high fluids upon Dx to help boost immunity
  • Peds HIV: high protein, high calorie, supplement for weight gain
  • Neutropenic diet for some patients to protect against infection
114
Q

COPD

A
  • Persistent obstruction of airflow through lungs
  • Emphysema and chronic bornchitis

Tx: maintain stable weight; increased energy to breath; replete but DON”T overfeed

115
Q

ARDS

A

-Meet basic nutritional requirements and maintain weight to facilitate weaning from vent

DOMAIN 2 (5 decks)

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