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Pathophysiology 2 > MNT 2 Respiratory Disease > Flashcards

MNT 2 Respiratory Disease Flashcards

1
Q

What are some of the contributing factors of reduced intake?

A
  • Flud restrictions
  • Shortness of breath
  • Decreased oxygen saturation when eating
  • Anorexia due to chronic disease
  • Gastrointestinal distress and vomiting
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2
Q

How poor nutrition affects pulmonary function

A

Malnutrition adversely:
* Decrease muscle mass and strength
* Decrease elasticity
* Decrease surfactant
* Affects lung immune function
* Affects control of breathing

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3
Q

What are some of the biochemical data that should be taken notice of?

A
  • Elevated blood glucose
  • Na, K, Ca, Mg
  • Decreased hemoglobin, serum prealbumin and albumin
  • Elevated C-reactive protein
  • Low cholesterol and triglycerides
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4
Q

What are some of the potential nutrition diagnosis?

A
  • Inadequate protein-energy intake
  • Increased energy expenditure
  • Swallowing difficulty
  • Underweight
  • Poor nutrition QoL
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5
Q

What are some MNT objectives to be achieved in COPD?

These are just some important objectives.

A
  • Screen early and correct any malnutrition
  • Promote intake of a nutrient dense diet rich in antioxidant foods.
  • Alleviate difficulty in chewing or swallowing related to SOB.
  • Help improve QoL
  • Eat while sitting up to lessen discomfort
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6
Q

What are some food aspects that should be taken care of in COPD?

Stuff like protein, fiber and the healthy stuff

A
  • 1.2 - 1.7g protein/kg
  • 30 - 35kcal/kg
  • No tough/stringy foods
  • Increased omega-3 fatty use (salmon, haddock, mackerel, tuna, other fish sources)
  • Fluid intake is recommended (1 mL/kcal)
  • Limit salt intake
  • Fiber should be increased gradually

Salt intake should be limited as too much sodium can cause fluid retention/peripheral edema, which may interfere breathing.

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7
Q

What are some nutrition education and counselling tips when dealing patients with COPD?

A
  1. Choose foods that are easy to prepare
  2. Try to have main meal early in the day
  3. Small, attractive meals are encourages
  4. Limit fluid intake in meals - decreases early satiety
  5. If using oxygen, cannula must be worn during and after meals
  6. Maintain relaxed atmosphere when eating
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8
Q

What are the MNT objectives of asthma?

A
  • To identify and control allergens
  • Prevent lung infection and inflammation
  • Promote adequate hydration
  • Optimize nutritional status
  • Prevent distention of stomach from large meals
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9
Q

Food and Nutrition in Asthma

A
  • Aim weight loss
  • Provide balanced, nutrient dense small meals
  • Infants should be exclusively breastfed
  • Omit food that trigger allergies
  • Modifying fatty acid intake - if tolerated, can consume fish 2-3 times weekly to reduce leukotriene synthesis.

  • Modifying fatty acid intake - Omega 6 fatty acids may increase asthma risk. High Omega-6 to Omega-3 ratio intake has been significantly associated with asthma risk.
  • Leukotriene - Leukotrienes (LTs) are a group of inflammatory mediators, most notably, the bronchoconstriction that results from the action of leukotrienes plays a vital role in the pathophysiology of asthma.
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10
Q

Nutrition Education and Counselling for Asthma

A
  • Emergency pack should be carried at all times.
  • Work with patient/family to avoid triggers
  • Discuss exercise, rest and nutrition.
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11
Q

MNT objectives for CF

AGAIN, CF IS CYSTIC FIBROSIS, NOT CHRISTIAN FELLOWSHIP FOR CRYING OUT LOUD

A
  • Achieve/maintain desirable BMI
  • Provide optimal amounts of protein for growth
  • Achieve adequate enzyme replacement to bring about near-normal digestion.
  • Correct edema, diarrhea, anemia, steatorrhea
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12
Q

Food and Nutrition for CF

A
  • Need to be given 120-150% more calories
  • 45-65% CHO, 20-30% fat, 10-35% protein
  • Encourage omega-3 fatty acids intake, seleniumto reduce inflammation and enhance immunity.
  • If cheilosis present, include riboflavin and vitamin C
  • Soft foods useful! (if chewing is tiring)
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13
Q

Nutrition Education and Counselling in CF

A
  1. Diet must be reevaluated periodically to reflect growth
  2. Behavoiural ann nutrition intervention can be used to enhance weight and height velocities.
  3. Educate on nutrient dense food
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14
Q

MNT objectves for Tuberculosis

weiwei HAHAHAHA

A
  • Maintain/prevent losses in weight
  • Hypo/hypercalcemia may occur - normalize serum calcium and vitamin D3 levels
  • Micronutrient supplementation may improve treatment outcome.
  • Prevent dehydration
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15
Q

Food and nutrition for TB

A
  • High calorie, high protein diet required
  • Vit D treatment - may improve lung function
  • Iron, vit C - hemoglobin formation and wound healing.
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15
Q

Nutrition Education and Counselling of TB

A
  • Add protein powders/nonfat dry milk to beverages and soups to increase protein, calcium intake
  • Prepartion of small, appetizing meals.
  • Discuss tips for managing anxiety relating to weight loss
  • Promote QoL
16
Q

What are the types of RF

A
  1. Type 1 Respiratory Failure (hypoxemic) - lung tissue damage, preventing adequate oxygenation of blood. Low oxygen and low carbon dioxide
  2. Type 2 Respiratory Failure (hypercapnic): insufficient alveolar ventilation in excreting CO2. Affects lung, hence CO2 accumulates.
17
Q

RF: Objectives of MNT

A
  • Oxygenate tissues and relieve breathlessness; decrease CO2 production.
  • Prevent respiratory muscle dysfunction by ensuring patient is well nourished
18
Q

RF: Food and Nutrition

A
  • Ambulatory adults about 30kcal/kg daily
  • ICU 20-25kcal/kg
  • 1.2-1.5g protein/kg/day
  • Supplement diet with a multivitamin supplement.
  • Include antioxidant rich foods

Patients with pulmonary oedema should have their sodium intake reduced if needed.

19
Q

RF: Nutrition Education and Counselling

A

Discuss proper feeding postion

Biggest risk is aspiration

20
Q

Lung Cancer: Objectives of MNT

A
  • Meet energy needs, which are often elevated as much as 30% above normal.
  • Improve QoL
  • Prepare patient for therapy (e.g., surgery, radiation, or chemotherapy).
21
Q

Lung Cancer: Food and Nutrition

A
  • Tube feeding recommended
  • Small, frequent meals
  • If oral diet is possible, promote a protective diet. For example, include more omega 3 fatty acids from fish, shellfish, flaxseed, and walnuts.
22
Q

Lung Cancer: Nutrition Education and Counselling

A
  • A diet high in antioxidant rich foods (fruits, vegetables, and spices) is protective and a prudent preventive strategy
  • Avoid smoking prior to or with meals (smoking may decrease appetite)
  • Explore the use of ONS if needed
23
Q

Dietary tips for breathing difficulty

A
  • Eat meals when energy levels are at highest
  • Small, nutrient-rich meals are recommended
  • Eat slowly and chew foods thoroughly
  • Easy to chew foods are also recommended
  • Limit salt intake
  • Eat while sitting up
  • Wear cannula if continuous oxygen is being prescribed

Pathophysiology 2 (3 decks)

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