*Module 9: Nutrition Flashcards
What is the ideal percentage of carbohydrates in a healthy adult’s nutrition?
45-65%
What is the ideal percentage of proteins in a healthy adult’s nutrition?
10-35%
What is the ideal percentage of fats in a healthy adult’s nutrition?
20-35%
What is a calorie?
A unit of energy equivalent to the heat energy needed to raise the temperature of 1 kg of water by 1°C.
What are macronutrients?
Carbohydrates, proteins, fats, and water.
What is the role of proteins in the body?
Essential for growth, repair, and enzyme function.
What is the function of fats (lipids)?
Energy storage, cell membrane structure, and hormone production.
Why is water vital for the body?
It is vital for hydration, metabolism, and temperature regulation.
What are the main metabolic fuels?
Mainly carbohydrates, lipids, and proteins.
What is the role of fiber in digestion?
Provides bulk in the intestinal lumen.
What are minerals?
Basic elements needed for metabolic function.
What are vitamins and fatty acids?
Organic compounds needed for life-sustaining metabolic and physiological functions.
What is mechanical digestion in the mouth?
Chewing, which breaks food into smaller pieces.
What is chemical digestion in the mouth?
Involves salivary amylase and lingual lipase.
What does salivary amylase do?
Begins carbohydrate digestion, converting starches to maltose.
What is the role of lingual lipase?
Has a minor role in starting lipid digestion.
How is food moved in the esophagus?
By peristalsis.
What type of digestion occurs in the stomach?
Protein and lipid digestion.
What is mechanical digestion in the stomach?
Churning mixes food with gastric secretions to create chyme.
What are the chemical digestion components in the stomach?
Pepsin and gastric lipase.
What does pepsin do?
Activated by HCl, it converts proteins to peptides.
What is the role of gastric lipase?
Involved in lipid digestion.
What is the primary site of digestion and absorption?
The small intestine.
What is the duodenum?
The first part of the small intestine, where pancreatic enzymes and bile from the liver/gallbladder act.
What are the parts of the small intestine?
Duodenum, jejunum, and ileum.
What are pancreatic enzymes?
Amylase, proteases, and lipases.
What is the function of bile from the liver/gallbladder?
Emulsifies fats.
What are brush border enzymes?
Maltase, sucrase, lactase, and peptidases.
What nutrients are absorbed in the jejunum?
Carbohydrates, proteins, lipids, water-soluble vitamins, fat-soluble vitamins, and some water and electrolytes.
What nutrients are absorbed in the ileum?
Vitamin B12, bile salts, remaining nutrients, and water.
What does the ascending colon do?
Receives chyme and absorbs 80% water and electrolytes.
What is the function of the transverse colon?
Absorbs water and electrolytes.
What is the protein RDA?
0.8-1.0 g/kg/day.
How many calories are provided from proteins?
4 kcal/gram.
What does protein metabolism depend on?
Kidney and liver function.
What are dietary sources of protein?
Fish, meats, soy, casein, and whey.
How do you calculate nitrogen intake?
Grams of protein intake / 6.25.
Where is nitrogen found?
In protein.
What does a nitrogen balance study measure?
Intake of protein and outtake of protein (urine, feces, sweat, and skin).
What is the RDA for carbohydrates?
130 g/day.
What are the principal dietary carbohydrates?
Polysaccharides (starch), disaccharides (lactose, sucrose), and monosaccharides (fructose and glucose).
What is the only polysaccharide that is digested in the human GI?
Starch.
What are dietary sources of carbohydrates?
Bread, rice, and corn syrup.
How many calories are from carbohydrates?
4 kcal/gram.
What is the RDA for lipids (fatty acids) in men?
14-17 g/day.
What is the RDA for lipids (fatty acids) in women?
11-12 g/day.
What are the types of fatty acids?
Saturated (animal fats, dairy), unsaturated (linoleic acids, oleic acids), and essential (not synthesized in our bodies).
What are essential fatty acids?
Linoleic, DHA, and EPA.
How many calories are from lipids (fatty acids)?
9 kcal/gram.
What are the fluid needs for adults?
30-40 mL/kg.
What is the target urine output (UOP) for adults?
0.5 mL/kg/hr.
What is the target UOP for pediatrics?
1 mL/kg/hr.
What are macrominerals?
Calcium, magnesium, and phosphorous.
What are trace minerals/elements?
Zinc, copper, iron, and selenium.
What is the definition of minerals?
Inorganic elements required by the body for various physiological functions.
What is the definition of electrolytes?
A subset of minerals that dissolve in body fluids to produce charged ions.
What is the function of electrolytes?
Maintain osmotic balance, acid-base homeostasis, fluid balance, nerve function, and muscle contraction.
What are examples of electrolytes?
Sodium, potassium, chloride, calcium, magnesium, and phosphorous.
What is hyponatremia?
< 135 mEq.
What is hypernatremia?
> 145 mEq.
What are the standard daily sodium requirements?
1-2 mEq/kg.
What causes primary hyponatremia?
GI loss, fistula drainage, diuretics, and adrenal insufficiency.
What is the normal serum potassium concentration?
3.5-5.3 mEq.
What are the standard daily potassium requirements?
0.5-1 mEq/kg.
What are common losses of potassium?
GI fluid loss, hypomagnesemia, diuretics, polyuria, and renal excretion.
How do you evaluate hyperkalemia?
Traumatic blood draw, excessive intake (IV), altered distribution (acidosis), cellular breakdown (burns, crush injuries), and renal excretion.
What is the normal magnesium serum concentration?
1.8-2.4 mEq.
What are the usual daily magnesium requirements?
8-20 mEq.
What are the functions of magnesium?
Coenzyme in metabolism of carbohydrates and protein; needed in ATP reactions.
What are common losses of magnesium?
Diarrhea, alcohol use disorder (renal excretion), sepsis, pancreatitis, refeeding syndrome, and thermal injuries/TBI.
What is the primary intracellular anion?
Phosphorous.
What is the normal serum phosphorous concentration?
2.5-4.5 mEq.
What is the usual daily IV intake of phosphorus?
20-40 mmol.
What is phosphorous a constituent of?
Nucleic acids, phospholipid membranes, and nucleoproteins.
Where is the majority of calcium stored?
In bones and teeth.
What is the usual IV dose of calcium as gluconate?
10-15 mEq/day.
What percentage of calcium is bound to albumin?
60%.
What is the normal range for ionized calcium (iCal)?
1.12-1.3 mmol/L.
What is iCal?
The free, biologically active form of calcium.
Why is calcium essential?
For normal muscle contraction, nerve function, blood coagulation, and bone formation.
What are the deficiencies in iron?
Fatigue, anemias, and decreased resistance to infection.
What are dietary sources of copper?
Shellfish, nuts, seeds, and whole grains.
What are the effects of copper deficiency?
Anemias and neutropenia.
What are dietary sources of iodine?
Iodized salt, seafood, and eggs.
What are the effects of iodine deficiency?
Goiter and hypothyroidism.
What are dietary sources of selenium?
Seafood, eggs, meat, and whole grains.
What are the effects of selenium deficiency?
Cardiomyopathy.
What are dietary sources of zinc?
Meat, shellfish, legumes, nuts, and dairy.
What are the effects of zinc deficiency?
Dermatitis, alopecia, anorexia, impaired wound healing.
What are water-soluble vitamins?
Vitamin C and vitamin B.
How are water-soluble vitamins absorbed?
Directly into the bloodstream through the digestive system.
How are water-soluble vitamins stored?
Not stored in the body.
What happens with water-soluble vitamin deficiency?
Typically appears quickly when intake is too low due to lack of storage in the body.
Is water-soluble vitamin toxicity common?
Very rare.
What are fat-soluble vitamins?
Vitamins that dissolve in fat and are stored in the liver and adipose tissue.
What are examples of fat-soluble vitamins?
Vitamins A, D, E, and K.
What can antacids reduce?
The absorption of B12 by altering stomach acidity.
What can anticonvulsants increase?
The metabolism of folate, leading to folate deficiency and interfering with vitamin D metabolism.
How does alcohol affect thiamine?
It interferes with the utilization of thiamine (vitamin B1), leading to Wernicke-Korsakoff syndrome.
What do ACE inhibitors do?
Increase urinary zinc losses.
What do ARBs do?
Increase urinary zinc losses.
What can antacids cause?
Thiamine deficiency.
What do corticosteroids decrease?
Vitamin A, D, and C.
What do loop diuretics cause?
Thiamine deficiency.
What do thiazide diuretics do?
Increase urinary zinc losses.
What do histamine-2 antagonists cause?
Vitamin B malabsorption.
What does methotrexate inhibit?
Folic acid’s effect.
What does orlistat cause?
Vitamin ADEK malabsorption due to fat malabsorption.
What does phenytoin increase?
Vitamin D metabolism and decreases folic acid concentration.
What do proton pump inhibitors (PPIs) decrease?
Iron and B12 absorption.
What does valproic acid affect?
Zinc and carnitine.
What does malnutrition result in?
Changes in subcellular, cellular, or organ function that increases morbidity and mortality.
What is malnutrition?
Inappropriate nutrition, either too high or too low.
What is the impact of malnutrition?
Respiratory and cardiac dysfunction, prolonged length of stay, increased cost, reduced immune function, increased infections, compromised musculoskeletal strength, and impaired wound healing.
When must nutrition screening be performed after inpatient admission?
Within 24 hours.
What are risk factors for undernutrition?
Recent unintended weight loss, presence and severity of acute/chronic diseases, medications/medical treatments, socioeconomic factors, and altered nutrient absorption or metabolism.
What are risk factors for overnutrition?
Family history of obesity, medical diagnosis (PCOS, Cushing’s syndrome), poor dietary habits, inadequate exercise, and medications.
What does a nutrition-focused physical examination include?
Anthropometrics, patient history, current clinical presentation, biomarkers/lab data, nutrient intake data, and functional status.
What is a low nutric score?
0-4.
What is a high nutric score?
5-9.
What are serum visceral proteins?
Albumin, prealbumin, transferrin, and C-reactive protein.
