Medical Nutrition Therapy Flashcards
(264 cards)
1
Q
What body shape is healthier: apple or pear? What’s the difference and why?
A
Pear shapes. Apple shapes store fat around the waist (problematic), while pear shapes store fat around the hips and buttocks.
2
Q
What does leptin do, as a hormone?
A
think LEPTIN - LEOPARDS - as in you’ve eaten so much a leopard could eat it
it receives signals from fat and small intestine to make you stop and is appetite-suppressing*
3
Q
What does ghrelin do, as a hormone?
A
It is a stomach hormone that signals the hypothalamus that it is TIME TO EAT!!!
4
Q
What percent of the population has an eating pattern low in veggies and fruits?
A
75%
5
Q
How have the obesity rates in male/female and ethnic groups changed?
What percent of obesity is the highest ethnic group(s)?
A
Female: stable
Male: increased
African American and Hispanic: increased, 40%
6
Q
What are the two types of fat? Which is most associated with health risks? What health risks (name 4)?
A
Subcutaneous fat (directly under the skin) and visceral fat (stored within the abdominal cavity). Cardiovascular disease, type 2 diabetes, breast cancer, gallbladder disease
7
Q
What is the formula for BMI calculation?
A
weight (in POUNDS) * 703 / height (in inches)^2
8
Q
What are the BMI underweight, healthy weight, overweight, obese ranges?
A
<18.5
18.5 - 24.9
25 - 29.9
>30
9
Q
What are some limits of BMI?
A
It may underestimate body fat in older people that have lost muscle.
It may overestimate body fat in athletic/younger people that have a muscular build.
10
Q
What is obesity now being viewed as?
A
A chronic inflammatory disease
11
Q
What are acceptable and fit body fat percentage ranges for women and men?
A
Women: 25-31% (acceptable), 21%-24%
Men: 18%-24%, 14%-17%
12
Q
What are the four most common types of bariatric surgery in the US?
A
Adjustable gastric band
Roux-en-Y gastric bypass
Vertical Sleeve Gastrectomy
Biliopancreatic Diversion with a duodenal switch
13
Q
What BMI indexes are bariatric surgery approved for?
A
BMI >= 40, BMI >= 35 with a serious health problem
14
Q
What are the complication rates for bariatric surgery now?
A
15%
15
Q
What is the diet-focus for patients who had bariatric surgery?
A
15%
16
Q
What percent chance do overweight children have in becoming overweight adults?
A
70%
17
Q
What percent chance do overweight children have in becoming overweight adults IF THEY HAVE AT LEAST PARENT THAT IS OVERWEIGHT/OBESE?
A
80%
18
Q
What can cause a person to become overweight (5 reasons)?
A
hyperthyroidism, infection, malabsorption of nutrients, tissue wasting, cancer
19
Q
What is considered a high-calorie diet?
A
low-bulk, low-fiber, high nutrient, high calorie
(NO RAW VEGGIES, NO SALADS, NO BROTH-BASED SOUPS, ULTRA-FIBER CEREALS)
(YES NUTS, SEEDS, AVOCADO, YOGURT, OLIVE OIL)
20
Q
What is safe amount of weight loss per week? When is acceptable for more weight loss?
A
1-2 pounds/week
very obese adults can lose 1% of their weight per week
21
Q
When are weight loss drugs prescribed?
A
BMI above 30, or BMI above 27 with associated disease
22
Q
What does Orlistat do?
A
It is a lipase inhibitor that prevents absorption of fat into the body
23
Q
What does Lorcaserin do?
A
acts of receptors in the brain to promote feelings of fullness, encouraging users to eat less
24
Q
What does phentermine + topiramate do?
A
both decrease appetite and produce feelings of satiety, must be used with birth control in women to prevent child-bearing defects
25
What do bupropion + naltrexone do?
target the hypothalamus, which controls hunger, associated with suicidal thoughts
26
What might liraglutide do (warningggg)?
black box warning as animal studies showed thyroid tumors
27
What are the three requirements for bariatric surgery?
BMI > 40 (obese), adult height (13+ for girls, 15+ for boys), serious health problems linked to weight
28
What are the three obesity classes?
Class I: 30-34.9
Class 2: 35-39.9
Class 3: 40+
29
What are the disease risks (hypertension, diabetes, CVD) for men and women with a waist circumference < 40 in and < 35 in ---- starting from overweight to Class 3 obesity?
Increased, high, very high, extremely high
30
What are the disease risks (hypertension, diabetes, CVD) for men and women with a waist circumference > 40 in and > 35 in ---- starting from overweight to Class 3 obesity?
High, very high, very high, extremely high
31
How many calories must an underweight child eat to gain a pound?
500 extra calories
32
What is metabolic syndrome and what are symptoms associated with it (4)?
an abnormal ability to metabolize;
abnormal cholesterol, excessive body fat around waist, increased bp and sugar
33
How many people have diabetes in the US?
29 million
34
What happens when hyperglycemia (an abnormally high amount of glucose in the blood) exceeds the renal threshold?
Glycosuria (glucose excreted in the urine)
35
What is polyuria and polydipsia?
(excessive urine and thirst)
36
What is ketonemia and ketonuria?
Ketones collected in the blood, ketones in the urine
37
Clients with diabetes are more likely to suffer diseases of the ___ system?
vascular (circulatory)
38
What are some symptoms of diabetes (6 symptoms) ?
urinating often, feeling thirsty, blurry vision, fatigue, cuts slow to heal, weight loss, nausea, irritability, numbness in extremities
39
What occurs in 60-70% of clients with diabetes?
Neuropathy (damage to nervous system)
40
What is retinopathy?
Damage to small blood vessels in the eye, leading cause of blindness
41
What are the three requirements for pre-diabetes?
fasting glucose of 100 - 125 mg/dl, A1C of 5.7-6.4%, OGTT level of 140-199 mg/dl
42
Pre-diabetes testing should be considered in...?
all adults overweight (BMI > 25) or have additional risk factors
43
When does type 1 diabetes occur?
also called juvenile diabetes, immune system destroys beta cells of pancreas, develops in children & young adults (5%)
44
What outcome does the American Diabetes Association prefer A1C level to be reduced to?
<7%
45
Between what weeks does gestational diabetes occur? How is it diagnosed?
24-28. OGTT.
46
What chance do women who have gestational diabetes have of developing type 2 diabetes in the next 10-20 years?
35-60%
47
How much moderate-intensity physical activity should people with pre-diabetes do?
150 minutes
48
What type of diet is recommended for the pre-diabetic/diabetic?
Low carb, high fiber
49
What does a high-fiber diet mean?
25-35 g/day
50
How much sweeter than sugar is Sucralose? Why are people hesitant about it?
600 times. A study linked it to increased leukemia in mice.
51
What are the two amino acids in Aspartame. How much sweeter is it than sucrose? Why is it the least recommended?
phenylalanine, aspartic acid, 200 times, independent studies showing cancer in rats
52
How much sweeter is Saccharin than sugar? What did studies on rodents show?
350 times, bladder cancer
53
How much sweeter than sugar is Acesulfame-Potassium?
200 times
54
How much sweeter than sugar is Advantame, and is it viewed as safe? Why?
20,000 times
yes, because such small amounts are used in foods
55
What is exogenous insulin?
Insulin produced outside the body
56
What happens if diabetic clients do not eat the prescribed diet but take insulin?
A hypoglycemic episode, coma, maybe death
57
What are the three ways to get insulin for diabetic patients?
Insulin syringes, pumps, and pens
58
What is the most common type of insulin given to patients? Why is it preferred and better than the other option?
Human insulin (not from humans, but made in a laboratory). Very similar to pancreas insulin. Cow/pig insulin contain antibodies that make them less pure.
59
How are conscious clients that had an episode treated (2 ways)?
glucose tablets or beverage containing 15-20 g sugar
60
What is an oral diabetes medication? Who is it used for?
A hypoglycemic agent given orally for type 2 diabetic patients.
61
What percent of type 2 diabetic patients are overweight?
85%
62
What is the insulin problem in type 2 diabetes?
Too little insulin or insulin resistance
63
How do oral medications help improve blood sugar (3 ways)?
stimulate pancreas to make more insulin, helping the body use insulin more efficiently, preventing the liver from releasing stored glucose
64
How do oral medications help improve blood sugar (3 ways)?
stimulate pancreas to make more insulin, helping the body use insulin more efficiently, preventing the liver from releasing stored glucose
65
How do oral medications help improve blood sugar (3 ways)?
stimulate pancreas to make more insulin, helping the body use insulin more efficiently, preventing the liver from releasing stored glucose
66
How does a myocardial infarction relate to CVD?
A sudden (acute) case of CVD is a myocardial infarction (heart attack).
67
Smokers have a _____ times more risk of dying from a heart attack than non-smokers.
2-4
68
Most heart attacks occur after the age of __.
If you are ___, you have a greater risk of coronary heart disease.
____s are more likely to have heart attacks than the rest.
65. Male. African Americans.
69
What is the difference between compensated heart disease and decompensated heart disease?
If the heart compensates for the disease (by beating unusually fast to maintain blood circulation, heart enlarges) VERSUS can't maintain circulation
70
What is the lining and outer covering of the heart called?
Lining: endocardium
Outside: pericardium
71
What is ischemia?
Reduced blood flow causing an inadequate supply of nutrients + oxygen to issues
72
What is another name for a stroke? What is a stroke?
Cerebrovascular accident. Lack of blood in the brain.
73
What are some risk factors for CVD?
Male sex, family history, age (45+ for men, 55+ for women), high stress, high bp, smoking, hyperlipidemia
74
What is the limit for mg cholesterol/day for adults?
200 mg
75
What is the fiber recommendation for men and women to prevent CVD?
38g for men, 25g for women
76
Congestive heart failure is an example of what type of heart disease?
Decompensated heart disease
77
What type of diet should be given to patients that had a heart attack?
low-fiber, low-cholesterol, low-sodium (liquid for first 24 hours)
78
What is prescribed to aid in the diet of someone with CHF? Why can these be dangerous?
Diuretics. Blood potassium can decline really quickly.
79
What is your cholesterol ratio? What is the goal to keep this ratio under?
total cholesterol/HDL, at or below 4 to 1
80
What is a blood lipid profile?
medical test that measures cholesterol, HDL, LDL, triglycerides in blood
81
What is blood serum? What is serum cholesterol, and how is different from dietary cholesterol?
watery portion of blood in which materials are suspended (including cholesterol = serum cholesterol). Dietary cholesterol is in foods.
82
What percent range of the adult population in the US does hypertension affect?
20-25%
83
In ___ percent of cases, the cause of hypertension is unknown. This is called ___ hypertension.
90%, essential
84
What are some examples of causes of secondary hypertension?
Kidney disease, adrenal gland problems, oral contraceptives
85
What is the "silent disease"?
Hypertension
86
What is the purpose of the DASH plan?
Reduce sodium, get 8-12 servings of fruits and veggies per day
87
What mineral lowers blood pressure?
Potassium
88
What mineral lowers blood pressure? How much potassium is recommended?
Potassium, 4.7 g (4700 mg)
89
What foods are okay and what foods are bad (9 okays, 6 not okays) in a sodium-restricted diet?
PERMITTED: fruit juices, fresh fruits and veggies, plain pasta or rice, fresh fish and unsalted meat, jams/jellies/honeys, coffee/tea, herbs and spices
NOT PERMITTED: canned veggies, dried/smoked meats, cheeses, ham/hot dogs, baking soda and baking powder
90
How would one treat angina pectoris (diet-wise)
by limiting saturated fats
91
What diseases would require a sodium-restricted diet?
Edema, hypertension, heart failure
92
What diseases would require a low-cholesterol or low-fat diet?
hyperlipidemia, atherosclerosis
93
A low fat-diet requires what to be taken off meat?
visible fat
94
What are polyunsaturated fats referred to?
Oils
95
What things (1 thing always, 4 things sometimes) are restricted for renal clients?
protein, sodium, water, potassium, phosphorus
96
How many nephrons are in a kidney?
1 million aprox.
97
What is a glomerulus?
The filtering unit in the kidney.
98
How is liquid waste sent through the urinary bladder?
2 ureters
99
What five waste products are end products of protein metabolism?
Urea, uric acid, creatinine, ammonia, sulfates
100
What is oliguria?
decreased output of urine to 500 mL per day
101
What are the five causes of kidney disorders?
infection, diabetes mellitus, cysts, renal stones, trauma
102
What is nephrosclerosis? What is it caused by and what age group is it most common in?
The hardening of the renal arteries. Arteriosclerosis and hypertension. Older people.
103
What is polycystic kidney disease? When does renal failure develop if untreated?
Rare, hereditary, cysts form on kidneys. Age 50.
104
What is nephrolithiasis and what are the 5 stone classifications?
Stones form in the kidneys. Calcium oxalate, uric acid, cystine, calcium phosphate, and magnesium ammonium phosphate (known as struvite).
105
Why is protein limited for those with renal disease?
To reduce the amount of excretory work demanded of kidneys and prevent uremia (too much urea in the blood)
106
Why is fluids and sodium limited for those with renal disease?
To prevent edema, hypertension, CHF.
107
Why might phosphorus be limited for those with renal disease?
To prevent osteomalacia. Phosphorus is very well-absorbed in those with renal disease, so too much phosphorus and not enough calcium can cause bone problems.
108
Why might potassium be restricted for those with renal disease?
Hyperkalemia (excess potassium) tends to occur in those with end-stage renal disease.
109
What three vitamins (and 1 mineral) should be given to renal diseased patients and what should not?
B, C, D. A should not be given because level of A tends to be elevated during uremia. E and K are not necessary. Anemia frequently develops so iron is prescribed.
110
What are the two types of dialysis? Which is more common.
Hemodialysis, peritoneal dialysis. Hemodialysis is more efficient and uses a machine that contains semipermeable membranes for cleansing. Peritoneal dialysis uses the client's peritoneum as a semipermeable membrane.
111
Do dialysis patients need additional protein?
Yes, 1.2 g/kg of body weight
112
What percent of renal stones are calcium oxalate stones?
80%
113
What are some purine-rich foods?
meats, fish, poultry (organ meats, anchovies, sardines, broths)
114
What diet is prescribed for struvite stones?
Low-phosphorus
115
What foods may contribute to calcium oxalate stones? What intake might decrease stones?
beets, wheat bran, chocolate, tea (lots of oxalate), spinach. Increased calcium intake.
116
What is a typical prescribed renal diet?
80-3-3, 80g protein, 3g sodium, 3g of potassium a day
117
What are the 5 primary organs in the GI system? What are the 3 accessory organs in the GI system?
mouth, esophagus, stomach, SI, LI.
liver, gallbladder, pancreas
118
What is dyspepsia and what are the symptoms?
Indigestion - heartburn, bloating, pain
119
What is esophagitis caused by? What are some common symptoms?
causes: acute gastroesophageal reflux disease
symptoms: heartburn, regurgitation, dysphagia
120
What is hiatal hernia and how can the symptoms be alleviated?
A condition in which part of the stomach protrudes through the diaphragm into the thoracic cavity.
Small, frequent meals. Avoid irritants to the esophagus (carbonated beverages, chocolate, citrus fruit, spicy foods, coffee). Avoid late-night dinner. Lie down for 2-3 hours after eating.
121
What are ulcers? Where might they occur? How are they developed? How are they treated?
erosion of the mucosal membrane, gastric (stomach) or duodenal (duodenum)
Developed by helicobacter pylori, genetic predisposition, excessive use of aspirin/ibuprofen, stress.
Antibiotics (kill bacteria), cimetidine (inhibits acid secretion)
122
What is diverticulosis? What is diverticulitis? What is the cause? What diet is recommended?
intestinal disorder with pockets in the side of the LI
inflammation in the pockets caused by bacteria and fecal matter
high-diet fiber (this occurs when diet is too low in fiber)
123
What is the diet therapy for diverticulitis?
clear-liquid, low-residue diet to allow bowel to rest and heal
THEN, high-fiber diet
124
What is irritable bowel syndrome? What foods aggravate symptoms?
cramping, bloating as the GI doesn't function properly
foods high in fat, milk products, beans/cabbages (gas-producing foods), drinks with alcohol and caffeine
125
What would a low FODMAP diet restrict (think sugars poorly absorbed in the SI and ferment in the colon)?
honey, corn syrup, fruits with pits and seeds, milk, wheat, onion, garlic
126
What does ulcerative colitis? What is Crohn's disease?
inflammation and ulceration of the colon
autoimmune disease that can penetrate both SI and LI
CROHN'S DISEASE HAS ULCERS IN COBBLESTONED PATCHES
127
What do clients with UC or C's need to do to defecate?
a surgical opening in the abdominal wall (called a stoma) about the size of a nickel.
128
What is an ileostomy and a colostomy?
opening from ileum to abdomen surface
open from colon to abdomen surface
129
What syndrome may result if clients have surgical removal of SI?
Short Bowel Syndrome - patient lacks sufficient bowel length/function to support nutrient needs
130
Clients with ileostomies....
need more salt and water because of excess losses, vitamin C and B12 supplement/injection
131
What is celiac disease? What are two other names? What three grains have gluten?
Gluten-sensitive enteropathy or sprue. Gluten is found in wheat, barley or rye.
132
What fraction of people carry the genes necessary for celiac disease?
1/3 of all people
133
What percent of the population test negative for celiac disease but have some degree of gluten sensitivity?
6%
134
What grains should be avoided and what should not?
Barley, rye, wheat, spelt, triticale
Rice, wild rice, millet, corn, soy
135
What are the functions of the liver?
metabolism, most nutrients that are absorbed return to the liver
synthesizes cholesterol
stores iron, copper, zinc, magnesium and fat-soluble vitamins, turn simple sugars to glycogen
136
What is cirrhosis and what are some causes?
Liver disease characterized by cell loss (usually caused by alcohol abuse, congenital defects, infections). Fibrosis (hard, stringy tissue) often develops. Ascites (abnormal collection of fluid in abdomen may occur).
137
What is ascites?
Abnormal collection of fluid in the abdomen
138
What is hepatitis? What are some cause? What might result? What are the three types?
inflammation of the liver - caused by viruses, drugs, alcohol
necrosis (death of cell tissue) may result
hepatitis A - contaminated drinking water, sewage (fecal-oral route)
hepatitis B/C - blood, semen, blood products
139
What is cholecystitis and cholelithiasis? What forms the gallstones?
inflammation of gallbladder
inflammation of gallstones
cholesterol that hardens due to cholecystitis causing changes in tissue
140
What diets treat cholelithiasis?
clear-liquid diet followed by fat-restricted diet
141
What is pancreatitis? What are some symptoms?
inflammation of the pancreas
abdominal pain, nausea, steatorrhea (too much fat in the feces)
142
What is a high-fiber diet and what does it prevent?
30g or more of dietary fiber
prevents diverticulosis, constipation, hemorrhoids, colon cancer
143
What are the recommended foods for a high-fiber diet?
whole-grain breads and cereals, all fruits, veggies, legumes --- MEAT, MILK, FATS HAVE NO FIBER
144
What should be consumed along with the fiber in a high-fiber diet?
Eight 8oz glasses of water
145
What is the low-residue diet? What are foods eaten/not eaten?
5-10 g of dietary fiber in cases of severe diarrhea, diverticulosis, ulcerative colitis, intestinal blockage
milk, buttermilk, butter, soup broth, applesauce, canned fruits, REFINED breads/cereals, custard, lettuce, salt, sugar, few spices
146
What is the difference between food intoxication and foodborne infection?
foodborne infection: pathogens
food intoxication: toxins (from pathogens)
147
What is the difference between enterotoxins and neurotoxins?
Enterotoxins: mucous membranes in the digestive tract
Neurotoxins: nervous system
148
One in ___ Americans experience food poisoning every year.
6
149
What bacteria is thought to be one of the most prevalent causes of diarrhea? Where is it most commonly found? What are the symptoms?
Campylobacter jejuni
intestinal tracts of pigs, cattle, sheep
diarrhea, fever, headache, abdominal pain
150
What foods are campylobacter jejuni associated with?
contaminated water, raw/unpasteurized milk, raw/undercooked meat, poultry or shellfish
151
What foods are clostridium botulinum associated with?
improperly canned foods, garlic in oil, vacuum packed and tightly wrapped food
152
What are some symptoms of botulism?
As the rarest but most deadly, double vision, speech difficulty, paralysis occurs.
153
How can one ensure foods have no botulism spores?
Boiling foods for 6 hours to destroy spores (and home canned goods for 10 minutes)
154
What percent of all botulism cases are fatal?
5-10%
155
What is clostridium perfringens? What are the symptoms? How to prevent it?
cafeteria/buffet germ
nausea, diarrhea, inflammation
hot foods > 140*F and cold foods <40*F
leftovers heated to 165*F
156
What is cryptosporidium? What is the most common symptom? How is it found?
A parasite. Watery diarrhea. Contaminated water, soil from infected stools of animals/humans.
157
How is E.coli transmitted?
What are the symptoms?
What can result from this in children?
contaminated water, unpasteurized milk/apple juice, raw or rare ground beef
severe abdominal cramps, diarrhea, nausea
hemolytic uremic syndrome (HUS)
158
Where is listeria monocytogenes found? What are symptoms? What can it develop into?
leafy vegetables, intestines
fatigue, fever, chills, diarrhea, backache
spontaneous abortion, meningitis
159
Where can salmonella be found? How is it transmitted? One species of salmonella causes what?
raw eggs, poultry, meat, unpasteurized milk, cheese, seafood
eating contaminated food or contact with a carrier
typhoid fever
160
How is shigella usually passed on by?
an infected food handler who did not practice proper hand washing after using the toilet
161
Where on the human body is staphylococcus aureus found? Where is it found? What are the symptoms?
found on human skin, infected cuts, pimples, nose, throats
meats, poultry, fish, egg dishes
vomiting, diarrhea, abdominal cramps
162
What toxin do molds produce that can causes cancer? Where does it develop? What are some symptoms?
aflatoxin
spoiled peanuts and peanut butter, soybeans, grains, rice
163
How is trichinella spiralis transmitted?
Eating badly cooked beef or pork
164
What is dysentery caused by? What is it?
Protozoa. Severe diarrhea
165
How should one handle and store food to minimize nutrient losses (5)?
keep freezer temps below 0, avoid thawing, stored canned foods in a cool/dry area, store milk in opaque containers, store veggies in a crisper
166
What is the primary treatment for most foodborne illnesses?
replacing lost fluids and electrolytes to prevent dehydration
167
What is constipation?
occurs when chyme moves very slowly through the large intestine, too much water becomes reabsorbed, feces becomes hard
168
Should anti-diarrheal medications be used for patients with bloody diarrhea?
NO (loperamide, bismuth)
169
What are 8 typical signs of allergies?
hay fever, urticaria (hives), edema, headache, dermatitis, nausea, dizziness, asthma
170
What foods are most likely to cause anaphylaxis?
peanuts, tree nuts, seafood, shellfish
171
What is a food intolerance called?
A nonallergenic food hyperinsensitivity
172
What are the three most common food intolerances?
lactose (milk) gluten (celiac disease) histamine/tyramine (AGED CHEESE, processed meats, wine)
173
What is a fomite?
an OBJECT (doorknob, etc) that is contaminated with bactera/viruses and serves in transmission
174
How do most food poisonings occur?
Inappropriate handling/processing of food from people in commercial factories
175
What should leftover foods be done with?
refrigerated as SOON AS meals are done and covered when it is cold
NO COOLING TO ROOM TEMP
176
The FDA is in charge with all foods except....
meat, poultry and eggs
177
What should you never do to frozen meat?
Thaw under room temp.
Instead, defrost them in the fridge or place them under cool running water.
178
Using a bleach solution of ___ will help eliminate bacteria?
bleach solution of 3/4 teaspoon to a quart of the water
179
What should be done with frozen foods?
cooked from frozen state or thawed in the refrigerator
180
What are the top eight allergens?
Milk, wheat, eggs, tree nuts, peanuts, soybeans, fish, shellfish
181
What is the simplest treatment for allergies ?
Remove the allergen from diet.
182
What is the point of an elimination diet?
To pinpoint the allergies
183
Why is PEM so bad for hospitalized clients? What are the symptoms?
delay wound healing, contribute to anemia, depress the immune system
weight loss and dry, pale skin
184
What is the term for when malnutrition occurs as a result of hospitalization?
iatrogenic malnutrition
185
Before surgery, what 8 nutrients should be given to patients?
5 vitamins, 1 mineral, 2 groups
Extra protein for wound healing, extra carbs for energy (glycogen), B (increased metabolism), A/C/Zinc (for wound healing), D (for calcium absorption), K (for blood clotting)
186
What is the amount of calories per kg of body weight for adults after surgery?
35-45 calories
187
What syndrome might happen 15-30 minutes after gastric surgery?
Dumping syndrome (dizziness, weakness, cramps, vomiting, diarrhea)
188
What does enteral nutrition mean?
Bringing nutrients directly into the digestive tract
189
What is tube feeding and when is it used?
Feeding by tube directly into stomach or intestine via vein, if client can't take food by MOUTH but has a functioning GI
190
What happens if the client cannot have enteral nutrition through a nasogastric tube (through nose)?
gastrostomy or jejunostomy (holes directly into stomach or jejunum)
191
What is the difference between polymeric and (elemental/hydrolyzed) formulas?
Polymeric: contains intact proteins, carbs, fats
Elemental/Hydrolyzed: products of digestion of these nutrients
192
When is parenteral nutrition used?
If the GI system isn't functional
193
How are nutrient solutions in TPN administered for less than two weeks and more than two weeks?
Less: peripheral
More: central
194
Where is TPN inserted into? Why?
A subclavian vein or vena cava. To dilate the solution, reducing the chance of thrombosis or phlebitis.
195
Where is TPN inserted into? Why?
A subclavian vein or vena cava. To dilate the solution, reducing the chance of thrombosis (blood clot) or phlebitis (vein inflammation).
196
What is a possible complication of TPN?
Sepsis (infection at site of catheter).
197
For patients with burns, what is given immediately and what is not?
Immediately: fluids and electrolytes to prevent shock, protein (for adults - 1.5-2g/kg body weight, children -2.5-3g)
Not Immediately: glucose to avoid hyperglycemia (first three days)
198
What diet is given for patients with burns?
high-protein, high-calore
199
What 3 vitamins and 1 mineral, and 2 amino acids are given to patients with burns?
C and zinc for wound healing, B for metabolism, A for immune system, amino acids arginine for wound healing and glutamine to prevent bacterial infection
200
Every degree of fever (in F) raises the BMR by ___ percent.
7
201
What intake should be increased for clients with a fever and why?
Protein, infections.
202
High doses of antibiotics can lead to....
oral thrush (caused by yeast).
203
What is an opportunistic infection?
Microorganisms that are usually harmless to humans with HEALTHY IMMUNE SYSTEMS cause infections
204
What are some AIDS symptoms? What syndrome may AIDS patients experience?
headache, fatigue, night sweats, diarrhea, cough, fevers
PEM/body wasting (referred to as HIV wasting syndrome), hypoalbuminemia (low protein)
205
How should one feed a blind client?
Arrange the food as if the plate were a clock.
206
What may occur in bedridden clients? How to treat this?
Pressure ulcers. High-calorie diet with protein, C/zinc supplements.
207
During trauma, there is a ____ response in the body...
hypermetabolic
208
How should one help a client who requires feeding assistance?
small amounts of food placed on the back of mouth with slight pressure on tongue with spoon/fork
209
Dysphagia means ____? What can it result from? What should the diet look like? How should they eat?
Difficulty swallowing. Stroke, closed head trauma, Alzheimer's. Liquids, pureed foods (NO STRAWS). Should eat in an upright position to prevent aspiration.
210
What are crash diets?
weight-loss diets that provide less than 1200 calories
211
What is weight-cycling?
pattern of repeatedly losing and gaining weight over time, also called yo-yo syndrome
212
What is the percent range for calories coming from carbs for athletes?
60-65%
213
How many milligrams of calcium per day do teen girls need?
1300
214
What is a good pre-sport diet plan?
high-carb meal 3-4 hours before competition, bread/rice cakes/potatoes/juice
215
What small snacks during a long sports even can help improve performance?
peanut butter crackers, fig bars, date snacks
216
How many pounds of water can athletes lose at an event? How much water should they drink?
4-6 pounds
500-600 mL before event, 200-300 mL every 10-20 min during an event, 600-700 mL for every one pound lost through sweat
217
What is appropriate body fat percentages for male and female athletes?
10-15% body fat male
18-24% body fat female -- most females stop menstruating at 17% or below
218
How many calories does a teen male and female athlete need a day?
3000 and 2200 calories daily
219
What is Maslow's Hierarchy?
five basic levels, lower needs should be met before higher
220
What is self-actualization?
reaching full potential
221
What are some physical responses to stress?
pituitary responses hormones, eyes widen, pupils dilate, muscles tense and hearing sharpens
222
What are ergogenic acids?
substances used to enhance strength and substance
223
What are two examples of drugs interfering with other things?
laxatives can reduce the absorption of fat-soluble vitamins
antacids can affect the absorption of iron
224
What are amphetamines?
stimulants
225
What are two groups of depressants?
barbiturates and tranquilizers
226
What is the chief-altering ingredient in Marijuana?
THC
227
What can LSD cause?
flashbacks
228
What is alcohol?
a depressant
229
What are anabolic steroids?
artificial hormones used to build a more muscular body
230
What are some negative effects of anabolic steroids?
Females: deeper voice, facial hair growth, infertility
Males: enlarged breasts, decreased testicle size and sperm count
231
What is the difference between pasteurization and ultrapasteurization?
ultra is higher temp, shorter time (2 seconds compared to 15)
both can affect food flavor and destroy heat-sensitive nutrients
232
What is food irradiation?
exposing foods to ionizing/radiant energy
233
What three diseases/disorders have been linked to foodborne illness?
spontaneous abortions, kidney failure, arthritis
234
What are the 3 most common symptoms of foodborne illness?
vomiting, stomach cramps, diarrhea
235
What is the Supplemental Nutrition Assistance Program?
food stamp program
236
How is fat absorbed in the GI?
absorbed in a bile complex package called a MICELLE and then travels through the lymph
237
What is flatus?
intestinal gas caused by secretions of colonic bacteria (CO2, methane, H2)
238
Why are sugar alcohols kind of weird?
they do not form dental caries (sorbitols, mannitols, etcera)
239
Lack of glycogen can cause....
ketoacidosis
240
What is the length range of an oligosaccharide?
3-10 glucose units
241
What is the ONLY DIETARY FIBER that is not a carbohydrate?
Lignin
242
How many conditionally dispensable essential amino acids are there?
6 (can't be synthesized in enough amounts)
243
How many dispensable nonessential amino acids are there?
5 (fully synthesized in body)
244
Where is most fat in the body? What are fat cells called? How much (%) is needed for men and women?
subcutaneous (directly under skin)
adipocytes
3% for men, 12% for women
245
What are the four categories of disorders that LEAD to weight-related problems?
anatomic, metabolic, neoplastic (tumors), degenerative
246
What bacteria is a major cause after surgery?
listeria monocytogenes (gram-positive rod bacteria)
247
What is the difference between food poisoning and food infection?
poisoning - eating food with lots of bacteria
infection - toxins in bacteria before food was eaten
248
What virus type is responsible for more than 1/2 of all gastro-enteritic cases?
noroviruses (NO CURE, FRUITS/VEGGIES/SHELLFISH)
249
What is a fetus scientifically?
offspring from 7-8 weeks after gestation to birth
250
What is infertility scientifically?
trying to conceive after 12 months with no birth control with FAILURE
251
What is the most common outcome of gestational diabetes for the infant?
macrosomia (larger than average body size), jaundice
252
What is sarcopenia?
loss of muscle mass due to aging (usually for 40 years and above)
253
What is the difference between primary and secondary amenorrhea?
primary is delay of FIRST PERIOD after 16, secondary is stopping of period after first period
254
What is a menarche?
first period
255
How many appetite-suppressing medications are approved by the FBI?
6
256
Before surgery, how should nutrition be provided? How much carbs should be given?
enterally, 150 g/day
257
What are some indications for parenteral (veinous) nutrition?
obstructions to intestinal tract, persistent diarrhea
258
What is anastomosis?
surgical joining of two ducts to allow flow from one to another
259
What is a vagotomy and what is its purpose?
cutting parts of the vagus nerves (which secrete gastric acids) to control gastric ulcers
260
What is paresthesia?
strange sensations like skin crawling or prickling
261
What can cruciferous veggies inadvertently cause?
the compounds in veggies like cauliflower, broccoli --- called INDOLES -- can cause increases in drug metabolism
262
What is pyrosis?
medical term for heartburn
263
What are the four names for types of strokes?
coronary thrombosis (blood clot develops in blood vessel)
coronary embolism (piece of clot or other substance get stuck in blood vessel and cause clot)
subarachnoid hemorrhage (on surface)
cerebral hemorrhage (in brain)
264
What is hypercapnia?
excess carbon dioxide in the blood
