MNT Flashcards
Ulcer treatment
treat with antacids, antibiotics. normally caused by H.pylori
Ulcer Diet
As tolerated. Well balanced. avoid late night snacks, omit gastric irritants
What is a hiatal hernia
Protrusion of a portion of the stomach above the diaphragm into the chest
Hiatal Hernia diet
small, bland feedings, avoid late night snacks, caffeine, chili powder, black pepper
Reactive or alimentary hypoglycemia
blood sugar rises, stimulating an overproduction of insulin causing a drop in blood sugar below fasting
Gastroparesis
small frequent meals, pureed foods, avoid high fiber, avoid high fat. liquid fat may be better tolerated. avoid caffeine, mint, alcohol and carbonation
What is a Tropical Sprue
bacterial, viral, parasitic infection
Symptoms of a tropical sprue
diarrhea, malnutrition, deficiencies of b12, and folate due to decreased HCL and instrinsic factor
How to treat a tropical sprue
antibiotics, high calorie, high protein, IM b12, oral folate supplements
Gastritis diet
inflammation of the stomach
clear liquids and advance as tolerated. avoid gastric irritants
Ulcerative Colitis
inflammation in the colon/large intestine
ulcers penetrated the inner lining of the abdomen only bleeding common during bowel movements.
Maintain fluid and electrolyte balance. antidiarrheal agents may be needed. elemental diet may be needed.
energy needs according to BMI. protein at each meal. MV. high fiber to stimulate peristalsis when flare up is under control
Crohns disease
anywhere in the GI tract. patches of inflammation. typically in the lower right abdomen. Ulcers penetrate the entire thickness of the abdominal lining. bowel rest and parenteral nutrition. Energy needs according to BMI. limit fat only if steatorrhea. protein at each meal. MV
Short bowel syndrome
consequence with significant resections of the small intestine. Malabsorption, malnutrition, fluid and electrolyte imbalances and weight loss can occur.
Jejunal resection
ileum can adapt and take over jejunal functions
Ileal resection
major complications with absorption
short bowel syndrome treatment
drink at least 1 liter more than their ostomy output daily. when ileum cant recycle bile salts, lipids are not emulsified, which leads to malabsorption of fat soluble vitamins. increased fluid and electrolyte secretion
Acute viral hepatitis
inflammation, necrosis, jaundice, anorexia, nausea, fatigue. jaundice occurs when bile ducts are blocked.
acute viral hepatitis treatment
increase fluids to prevent dehydration.
50-55% CHO to replenish liver glycogen and spare protein.
small frequent feedings
Cirrhosis
scarring of liver. blood flow is disrupted. protein deficiencies lead to ascites, fatty liver. impaired blood clotting.
hepatic steatosis to alcoholic hepatitis to cirrhosis
Cirrhosis diet
adequate to high protein .8-1.2g/kg
high calorie 25-35
moderate to low fat
low fiber if varicies are present low sodium if edema is present.
with hyponatremia=fluid restriction
alcoholic liver disease
liver injury due to alcohol and metabolic derangements.
alcoholic liver disease diet
supplement thamin and folic acid. increased need for b vitamins to metabolize alochol
increased need for magnesisum
Hepatic failure (ESLD)
liver function decreased to 25% or less.
liver cant convert ammonia into urea so it accumulates.
Hepatic failure (ESLD) treatment
moderate to high levels of protein. 30-35 calories
30-35 calories as fat with MCT if needed
low sodium if ascites
adding BCAA adds calories and proteins.
NAFLD
steatosis, more common with BMI >35. type 2 diabetes, metabolic syndrome. excess fat buildup in liver.
NAFLD treatment
managed with lifestyle changes, weight loss. Med diet, moderate alcohol, avoid sugar sweetened beverages. coffee may help.
Vasopressin
ADH from hypothalamus stored in pituitary exerts pressor effect and elevates blood pressure. increases water reabsorption from distal collecting tubules.
Renin
vasocontrictor secreted by glomerulus when blood volume decreases. stimulates aldosterone to increase sodium absorption and return blood pressure to normal
Erythropoietin- EPO
produced by kidney, stimulates bone marrow to produce RBC
low oxalate food
dark green leafy veg, chocolate, strawberries, nuts, beets, tea
to prevent acidic stones
create an alkaline ash by adding vegetables, fruits, brown sugar
to prevent alkaline stones
create an acid ash by adding meat, fish, eggs, shellfish, cheese, corn, oats, rye
AKI
sudden shut down with previously adequate capacity. decreased GFR. due to burns, accidents, obstruction, severe dehydration.
symptoms include oliguira, azotemia.
AKI diet
1-1.3g/kg protein if non catabolic without dialysis as GFR returns to normal
1.2-1.5g/kg if catabolic or with dialysis
25-40 cals/kg
low sodium 2-3g replaced loses in diuretic phase
8-15 mg phos
2-3g potassium
Nephrosis
nephrotic syndrome
albuminuria, edema, malnutrition, hyperlipidemia
excess protein will be catabolized to urea and excreted .
nephrosis diet
.8-1g/kg protein
<30% fat, low saturated fat, 200 mg cholesterol
35 calories/kg/day
modest sodium restriction
may need fluid restriction with edema
Type 1 diabetes
body does not make enough insulin. diagnosed at a young age.
increased thirst
weight loss, fruity breath, blurred vision
there is no way to prevent
insulin injections, blood sugar checks, healthy eating
type 2 diabetes
the body cant use insulin properly.
diagnosed later in life
increased thirst
weight loss
fatigue
blurred vision
frequent infections
most cases can be prevented
healthy eating and meal planning, increased physical activity
normal blood glucose
70-100
impaired fasting glucose
100-125
impaired glucose tolerance
2hPH 140-199
diabetes-fasting plasma glucose
> 126
diabetes-glucose tolerance test
> 200
symptoms of diabetes: plasma glucose
> 200
hgA1C
<6.5%
homocystinuria
treatable inherited disorder of amino acid metabolism. associated with low levels of folate, b6,b12
increase dosage of folate, pyridoxine and b12
if that doesnt work, low protein, low methionine diet
osteoclasts
resorb and remove bone
osteoblasts
reform bone
osteoporosis
hormone replacement therapy, weight bearing exercise. Vitamin D and calcium supplements. Adequate protein, moderate to low sodium. 5 or more servings of fruits and vegetables.
Allergies
ag-ab reaction occurs when antigen enters the body, antibodies react.
immunoglobulin E mediated reaction to normally harmless food protein.
food intolerance (non-igE) abnormal physiological response, GI, cutaneous, respiratory symptoms but no antibody production.
critical care and hypermetabolic states
goal is to improve outcomes regarding infection rates, days in critical care units, days on ventilator. minimize catabolic loss of body protein. initiate nutrition support within 24-48 hours. avoid overfeeding
Neoplastic disease
protein calorie malnutrition, malabsorption, fluid and electrolyte imbalance.
Thrush
avoid spicy foods, acidic foods, strongly flavored foods, provide bland liquids, soft foods or chilled or frozen foods
IDDSI level 7
black
regular diet
IDDSI level 6
blue
soft and bite sized
IDDSI level 5
orange
minced and mosit
IDDSI level 4
green
purred
extremely thick
IDDSI level 3
yellow
liquid
moderately thick
IDDSI level 2
Pink
midly thick liquid
IDDSI level 1
grey
slightly thick
IDDSI level 0
white
thin
