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NEP 2380 - diet therapy > NEP exam 4 > Flashcards

NEP exam 4 Flashcards

1
Q

what are 3 common intestinal conditions

A

constipation, diarrhea, malabsorption

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2
Q

what are some causes of constipation

A

low fiber diets, inadequate fluids, inactivity, neuro diseases, pregnancy, colon diseases, medication, stress

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3
Q

what are some interventions for constipation

A

gradual fiber increase, fluids, physical activity, pre/probiotics.

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4
Q

what is the AL for fiber intake in adults

A

women 25 mg/day males 38 g/day

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5
Q

what is considered acute, persistent, and chronic diarrhea

A

a- less than 2 week
p- 2-4 weeks
c- 4 or more weeks

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6
Q

when does diarrhea become a concern

A

during persistent or chronic diarrhea.

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7
Q

what are two types of diarrhea

A

osmotic and secretory

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8
Q

what is osmotic and secretory diarrhea

A

osm- resolves when pnt is NPO ( not eating)
- unabsorbed nutrients in the colon, lactose intolerance
secr- fluid secreted by the intestine that exceeds the amount that is reabsorbed by intestinal cells

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9
Q

what are some causes of diarrhea

A

GI d/o, medications, Clostridium difficile (c. diff) *most common

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10
Q

what is C. diff

A

bacterial diarrhea, from not washing hands and spreading to food/surfaces
- attacks the lining of intestines and destroyed cells

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11
Q

treatment for diarrhea

A

consume adequate water and electrolytes, avoid and limit high fiber foods gas prod foods, caffeine, milk, high sugar, and follow BRAT diet

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12
Q

what is the BRAT diet

A

foods that thicken stools, A- bananas, apple sauce (pectin) B- toast white rice (easily digestible)

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13
Q

what is malabsorption

A

unable to digest certain components of a diet,

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14
Q

what is an example of CHO, PRO, and FAT malabsorption

A

cho- lactose intolerant, pro-protein losing enteropathy, , fat- steatorrhea: excessive fat in stool, and causes loss of energy and may lead to bone disease

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15
Q

how can diet be used to alter malabsorption

A

fat restriction to 50 mg/day. use MCT ( med chain TG). consume essential FA ( long-chain TG),

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16
Q

What is celiac disease

A

immune d/o characterized by an abnormal immune response to a protein fraction in wheat and gluten and found in rye and barley and affects the small intestine

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17
Q

how do you diagnose celiac disease

A

blood test and biopsy, - no cure -

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18
Q

what signs and symptoms are related to celiac

A

GI symptoms- diarrhea, steatorrhea, flatulence, lactose intolerance,
weight loss, fatigue, vit/min def, iron def anemia, bone disease

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19
Q

what is the dietary intervention for celiac disease

A

avoid grains like rye wheat and barley, triticale, and oats if not labeled gluten-free

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20
Q

what are teo other concerns with celiac disease

A

secondary d/o with lactose intolerant and cross-contamination

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21
Q

what is an inflammatory bowel disease

A

chronic inflammatory d/o characterized by an abnormal immune response to GI bacteria

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22
Q

what is Chrons disease

A

can be anywhere in GI, malabsorption, inflammation in the intestinal wall, and characterized by active and remission,

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23
Q

what is ulcerative colitis

A

in the large intestine, minimal malabsorption, inflammation not as deep as chrons, periods of active and remission

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24
Q

what is the treatment for IBD

A

medication and nutrition

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25
what is IBS
chronic and recurring symptoms that are not explained by specific abnormalities 7-10% of Americans
26
what are symptoms of IBS
diarrheas and or constipation, bloating, gas, abdominal pain,
27
what are triggers for IBS
gut sensitization. food intolerance, stress.
28
Treatment for IBS includes
individualization, stress management, behavioral therapy, medication, and diet
29
what diet therapy is given for IBS
small frq meals, probiotics, and FODMAPs
30
what is a foodmap
``` chos that are not easily indigestible, F- fermentable o- oligosaccharides d- disaccharides m- monosaccharides and p- polyols (alcohol) eliminated all food above for 2 weeks, and slowly add back in and look at symptoms with foods ```
31
what is a diverticular disease in the colon
dvlpt of pebble-sized herniations in the intestinal wall \ | - more as age increase and most often in the sigmoid colon
32
what is diverticulosis
have diverticular disease and increase fiber gradually
33
colostomy
removal of all or part of the large intestine
34
ileostomy
entire colon removed
35
ostomy diets
post op- clear liquids, | reintroduce foods gradually starting with low fiber, encourage fluids and watch foods that can cause obstruction
36
what are the major functions of the liver
metabolism, catabolism, anabolism, | - storage of excess cho and fat , detoxification, bile production
37
what is a fatty liver
accumulation of excess fat in the liver,
38
causes of fatty liver
excess alcohol ingestion, insulin resistance, and exposure to toxins,
39
what is NAFLD
non-alcoholic fatty liver disease with fat accumulation with no damage
40
what is NASH
inflammation of the liver with cell damage
41
what is cirrhosis
advance stage of liver disease, scar tissue replaces healthy liver tissue and liver cells then lose function - can cause death
42
causes of cirrhosis
alcoholic liver disease, fatty liver disease, chronic hepatitis B/C infection
43
why is liver disease linked with malnutrition?
reduces nutrition intake and leads to malabsorption through diarrhea ns vomiting,
44
what nutrition therapy can help cirrhosis
high energy increases, small freq meals, moderate protein intake throughout the day, lower fat intake and CHO depends if diabetic, restricted sodium (edema, and kidney function, Vit and Min supplementation
45
what are some consequences of Cirrhosis
portal HTN, Collaterals and gastroesophageal varies, ascites, jaundice, hepatic encephalopathy,
46
what is diabetes mellitus
sweet urine, and increase glucose levels - | - metabolic disorder caused by alter glucose regulation and utilization, and you are unable to secret enough insulin
47
type 1 diabetes-
5-10% cases, onset in younger than 30 years, little or no insulin prod from pancreas- insulin injections required.
48
type 2 diabetes
90-95% onset, individuals older than 40 - indi is insulin resistant and can prod it but not used effectively, - may need infections
49
how do you dvlp insulin resistance,
blood glucose increases after meal and insulin is released then body cells don't respond to it and the pancreas secrets more insulin which is then able to keep blood glucose normal
50
how to diagnose insulin resistant
fasting blood glucose(>126mg/dl), random blood glucose(>200), oral glucose tolerance test(75), glycerite hemoglobin (HbA1c) (6.5%)
51
CHO, PRO, FAT metabolism and acute complications of insulin insufficiently
CHO- lower glucose uptake an increased glycogen breakdown-- hyperglycemia and exceeds the renal threshold FAT- increase TG breakdown in adipose tissue- increase blood TG and increase the use of TG for energy- hypertriglyceridemia, ketones produced PRO- increase protein breakdown, and decrease synthesis ( muscle wasting)- increase blood AA- increase liver glucose prof and blood glucose
52
signs and symptoms of hyperglycemia
glucosuria, polydipsia, polyuria, polyphagia, weight loss, fatigue, blurred vision, ketoacidosis(type 1), hyperosmolar hyperglycemic syndrome(type 2),
53
glucosuria
glucose in urine
54
polydipsia
increase thirst
55
polyuria
increase urine
56
polyphagia
increase appetite
57
ketoacidosis
acetone breathe, labored breathing
58
hyperosmolar hyperglycemic syndrome
DEHYDRATION- muscle weakness, speech complication, HIGH blood sugar
59
treatment for hypoglycemia (low Blood sugar)
raise BS, 15 g carbs, glucose tablets
60
signs and symptoms of hypoglycemia
shakes, sweats, confusion, palptation, weakness, dizziness
61
cho intake in therapy for diabetes
if on insulin- cho intake needs to match insulin to maintain Blood glucose within the ideal range. if NO insulin- equal CHO distribution throughout the day with portion control - carb counting, diabetes plate
62
portion for carb counting and what it does
1 cho portion is 15 g, x amt per meal, teaches the client to focus mainly on cho content in food, uses tables, portion control,
63
diabetes plate uses
good for T2 diabetes, simple, emphasizes portion control and healthy choices.
64
what does physical activity do for indi with diabetes
increase glucose uptake into muscles and liver, increase insulin sensitivity, can Improve blood glucose levels,
65
oliguria (kidneys)
diminished urine production
66
anuria (kindeys)
no urine production
67
causes of acute kidney injury
critical illness, sepsis (infection), major surgery
68
treatment for an acute kidney injury
dialysis, diet, meds
69
a major function of the kidney
filter blood, reg blood pressure, stimulate RBC, maintain bone structure (vit D activation)
70
when the kidneys filter blood what is happening
elim fluids, maintain electrolytes, form urine, metabolic waste filtration,
71
what is chronic kidney disease
characterized by gradual irreversible deterioration of kidneys
72
common cuases of chronic kidney disease
44% diabetes, 38% HTN, affects 15% of adults
73
3 tests to determine Chronic kidney disease
blood tests, urine albumin, glomerular filtration rate.
74
CKD blood test
uses blood urea nitrogen(BUN) and creatine
75
CKD urine albumin
increased with kidney disease
76
CKD filtration rate
calc from how much creatinine and lowers as kidney disease worsened.
77
CKD BUN
blood urea nitrogen and creatinine increases in CKD
78
consequences of CKD
lower GFR (ability to filter blood), cardiovascular complication, anemia, bone disease, growth failure (malnutrition), GI disturbance, uremia,
79
what happens when GFR decreases
potassium phosphorus all increase in blood, and there is an increase in pro in blood
80
treatment for CKD
manage causes first, transplant, then dialysis
81
dietary intervention in CKD
varies on the individual but energy needs are often very high
82
dietary intervention in CKD - pro-energy malnutrition
primary - poor dietary intake | secondary- vomiting, nausea, uremia, medication
83
dietary intervention in CKD - phosphorus
restricted, given phosphorus binders make phosphorus not absorbable.
84
dietary intervention in CKD - fluids
urine output plus 500-1000 ml/day | dialysis- 2 lbs water gained per day
85
dietary intervention in CKD - protein `
pre-dialysis- some restriction | after- no restriction
86
dietary intervention in CKD - sodium
some restriction
87
dietary intervention in CKD - potassium
depends on serum k levels, | hemodialysis- restricted to 2000-3000 mg day, restricts some fruits and vegs,
88
what are the 8 dietary recommendations for cardiovascular disease
limit sat fat intake, decrease trans fat, replace sat fat with unsat fats, including omega 3 FA, include soluble fiber, dietary cholesterol, decrease sodium intake
89
What foods can you limit when having cardiovascular disease
sugar, sweet drinks, sweets, fatty meats, highly processed and high sodium, partially hydrogenated oils, and tropical oils
90
hypertriglyceridemia
starts to decrease tg, reduce ETOH, decrease refined ETOH, weight control, physical activity `
91
what is hypertension
blood pressure- force exerted against artery walls, | affected by the volume of blood pumped by <3, and resistance in blood vessels
92
systolic number
blood pressure when the heart muscle contracts, top number
93
diastolic number
blood pressure when the heart muscle relaxes, the bottom number
94
normal BP
sys- less than 120 dis- less than 80
95
elevated BP
sys- 120-129 dis- less than 80
96
high BP- stage 1
sys- 130-139 dis- 80-89
97
high BP - stage 2
sys- 140+ dis- 90+
98
Hypertensive crisis
sys- higher than 180 dis- higher than 120
99
consequences of HTN
heart attacks, stroke, aneurysm, kidney disease, peripheral artery disease, retinopathy, dementia
100
unmodifiable risk factors of HTN
race age family hx, gender
101
modifiable risk factors of HTN
obesity, physical inactivity, metabolic syn, tobacco, sodium, low pot, stress, diabetes
102
treatment for HTN
weight reduction, reg physical activity, drug therapies, dietary trmt DASH
103
what is the DASH diet
focuses on less processed foods, and more whole grains, fruits, veg, low fat milk, poultry, fish, nuts, limit red meats, sweets, sugar drinks, sat fats, cholesterol Na+ restriction o <1500 mg/day high potassium
104
definition of cancer
group of diseases characterized by the uncontrollable growth and spread f abnormal cells.,
105
dvlpt of cancer
normal cell--initiation-- genetic mutation -- promotion-- proliferation of altered cells, forms tumor, --- dvlpt tumor-- cancerous tumor release cells into blood stream and lymph sys
106
what percent of cancer deaths are preventable
50% smoking, obesity, carcinogens, insufficient activity
107
10 rec to prevent cancer
health weight, physically active, eat a diet with whole grains, fruits, and veg, limit fast food consumption, limit processed meats, limit sugar-sweet drinks, don't rely on supplements, limit alcohol, breast feed if poss, after trmt follow all rec

NEP 2380 - diet therapy (3 decks)

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