MNT Review II

Question 1

What are the three main goals in control of Diabetes Mellitus?

Answer 1

1) Control blood glucose levels (prevent hypo/hyperglycemia and reduce risk of complications) 2) Minimize risk of CVD/hypertension 3) Delay onset of renal involvement

Question 2

Describe the carbohydrate control measures that people with diabetes mellitus ought to follow

Answer 2

Control carbohydrate intake via carbohydrate counting and/or carbohydrate choices

Question 3

How many grams of carbohydrate equal 1 Carbohydrate choice?

Answer 3

15 g of carbohydrate equals one carbohydrate choice.

Question 4

MNT for Diabetes Mellitus

Answer 4

1) Control carbohydrate metabolism 2) Reduce saturated fat/sodium 3) Modify protein intake as necessary to prevent microalbuminuria and prolong adequate kidney function.

Question 5

What protein intake level is associated with patients with diabetes mellitus?

Answer 5

0.8 - 1.0 g/kg

Question 6

What two conditions should patients with metabolic syndrome/PCOS be actively trying to prevent?

Answer 6

Type II diabetes mellitus and/or cardiovascular disease

Question 7

MNT for Metabolic Syndrome/PCOS (Weight, Exercise, Diet, Alcohol, carbohydrate)

Answer 7

1) Lose Weight if overweight and/or maintain a healthy weight 2) Exercise 3) Heart Healthy Diet 4) Limit alcohol intake 5) May benefit from a moderate carbohydrate intake 6) Low glycemic index foods may benefit women with PCOS

Question 8

What are the goals for patients with Renal disease? (Edema)

Answer 8

Control edema (restrict fluid intake 750 ml in addition to previous 24 hour urine output or 1000 ml if no urine output) Allow for 4% weight gain between dialysis treatments

Question 9

What are the goals for patients with Renal disease? (Protein and energy)

Answer 9

Provide adequate protein and energy (moderate intake of protein of protein at initial stages of CKD decreasing levels as approaching stage 4 and stage 5 CKD) High proteins intake when beginning dialysis and CAPD 50% of protein should be from high biological value. Provide adequate calories.

Question 10

What are the goals for patients with Renal disease? (Vitamins, which vitamins are the most common, which vitamins and minerals need to be restricted?).

Answer 10

Provide vitamins which are diminished due to dietary restrictions and washed out by dialysis (Vitamin D, Calcium, Iron, Folic Acid are the most common). Restrict phosphorus and potassium (avoid salt substitutes with potassium).

Question 11

What are the goals for patients with Renal disease? (Edema)

Answer 11

Control edema (restrict fluid intake 750 ml in addition to previous 24 hour urine output or 1000 ml if no urine output) Allow for 4% weight gain between dialysis treatments

Question 12

What are the goals for patients with Renal disease? ( Renal Osteodystrophy and Palate)

Answer 12

4) Prevent of slow development of renal osteodystrophy ( Calcium supplementation/phosphorus restriction) 5) Make diet as palatable as possible

Question 13

Goals for Burns (subdivision of metabolic stress)

Answer 13

Meet energy/protein needs and support wound healing/prevent infections

Question 14

MNT Burns (Fluids and Protein)

Answer 14

1) Replace fluid losses first 24 - 48 hours 2) Support high protein/energy needs (utilize indirect calorimetry if available to more accurately identify needs). A tube feeding is often utilized because patient unable to consume necessary food to meet energy/proteins needs

Question 15

MNT Burns (Vitamin and supplementation)

Answer 15

1) Vitamin C and Zinc to promote wound healing and immunity 2) Supplement glutamine to speed healing

Question 16

MNT for TBI (Energy needs, protein needs, other eating considerations)

Answer 16

1) Energy needs increase (use indirect calorimetry and use a injury factor of 1.4 to calculate) 2) Protein needs (1.5 - 2.2g/kg of body weight) 3) Dysphagia may be a problem and may need encouragement to eat, because they “may not remember”

Question 17

Goals for treatment of patients with cancer

Answer 17

1) Address wasting state associated with cancer 2) Minimize nutritional deficiencies 3) Minimize weight loss

Question 18

MNT for cancer patients (Protein/Fat/Calories, stimulants, smell, temperature, side effects of chemotherapy and radiation

Answer 18

1) Emphasize protein and fat/develop strategies for adding calories and protein to foods 2) Utilize appetite stimulants - Megace 3) Odor is a real problem 4) Cold foods are better tolerated than hot foods 5) Strategies for addressing side effects of chemotherapy/ radiation treatments (nausea, dry or sore mouth, diarrhea, indigestion, and constipation)

Question 19

Goal of MNT for metabolic disorders

Answer 19

1) prevent accumulation of toxic metabolites 2) replace essential nutrients that are deficient as a result of the defective metabolic pathway 3) provide a diet that supports growth, development, and maintenance.

Question 20

MNT PKU

Answer 20

1) Restrict Phenylalanine and aspartame 2) supplement tyrosine

Question 21

MNT Fructosemia

Answer 21

1) restrict fructose, sucrose, and sorbitol

Question 22

MNT galactosemia

Answer 22

1) Restrict galactose