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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
Q

what is IBS

A

chronic and recurring symptoms that are not explained by specific abnormalities 7-10% of Americans

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26
Q

what are symptoms of IBS

A

diarrheas and or constipation, bloating, gas, abdominal pain,

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27
Q

what are triggers for IBS

A

gut sensitization. food intolerance, stress.

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28
Q

Treatment for IBS includes

A

individualization, stress management, behavioral therapy, medication, and diet

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29
Q

what diet therapy is given for IBS

A

small frq meals, probiotics, and FODMAPs

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30
Q

what is a foodmap

A 
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
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31
Q

what is a diverticular disease in the colon

A

dvlpt of pebble-sized herniations in the intestinal wall \

- more as age increase and most often in the sigmoid colon

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32
Q

what is diverticulosis

A

have diverticular disease and increase fiber gradually

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33
Q

colostomy

A

removal of all or part of the large intestine

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34
Q

ileostomy

A

entire colon removed

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35
Q

ostomy diets

A

post op- clear liquids,

reintroduce foods gradually starting with low fiber, encourage fluids and watch foods that can cause obstruction

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36
Q

what are the major functions of the liver

A

metabolism, catabolism, anabolism,

- storage of excess cho and fat , detoxification, bile production

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37
Q

what is a fatty liver

A

accumulation of excess fat in the liver,

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38
Q

causes of fatty liver

A

excess alcohol ingestion, insulin resistance, and exposure to toxins,

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39
Q

what is NAFLD

A

non-alcoholic fatty liver disease with fat accumulation with no damage

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40
Q

what is NASH

A

inflammation of the liver with cell damage

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41
Q

what is cirrhosis

A

advance stage of liver disease, scar tissue replaces healthy liver tissue and liver cells then lose function
- can cause death

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42
Q

causes of cirrhosis

A

alcoholic liver disease, fatty liver disease, chronic hepatitis B/C infection

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43
Q

why is liver disease linked with malnutrition?

A

reduces nutrition intake and leads to malabsorption through diarrhea ns vomiting,

44
Q

what nutrition therapy can help cirrhosis

A

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
Q

what are some consequences of Cirrhosis

A

portal HTN, Collaterals and gastroesophageal varies, ascites, jaundice, hepatic encephalopathy,

46
Q

what is diabetes mellitus

A

sweet urine, and increase glucose levels -

- metabolic disorder caused by alter glucose regulation and utilization, and you are unable to secret enough insulin

47
Q

type 1 diabetes-

A

5-10% cases, onset in younger than 30 years, little or no insulin prod from pancreas- insulin injections required.

48
Q

type 2 diabetes

A

90-95% onset, individuals older than 40 - indi is insulin resistant and can prod it but not used effectively, - may need infections

49
Q

how do you dvlp insulin resistance,

A

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
Q

how to diagnose insulin resistant

A

fasting blood glucose(>126mg/dl), random blood glucose(>200), oral glucose tolerance test(75), glycerite hemoglobin (HbA1c) (6.5%)

51
Q

CHO, PRO, FAT metabolism and acute complications of insulin insufficiently

A

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
Q

signs and symptoms of hyperglycemia

A

glucosuria, polydipsia, polyuria, polyphagia, weight loss, fatigue, blurred vision, ketoacidosis(type 1), hyperosmolar hyperglycemic syndrome(type 2),

53
Q

glucosuria

A

glucose in urine

54
Q

polydipsia

A

increase thirst

55
Q

polyuria

A

increase urine

56
Q

polyphagia

A

increase appetite

57
Q

ketoacidosis

A

acetone breathe, labored breathing

58
Q

hyperosmolar hyperglycemic syndrome

A

DEHYDRATION- muscle weakness, speech complication, HIGH blood sugar

59
Q

treatment for hypoglycemia (low Blood sugar)

A

raise BS, 15 g carbs, glucose tablets

60
Q

signs and symptoms of hypoglycemia

A

shakes, sweats, confusion, palptation, weakness, dizziness

61
Q

cho intake in therapy for diabetes

A

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
Q

portion for carb counting and what it does

A

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
Q

diabetes plate uses

A

good for T2 diabetes, simple, emphasizes portion control and healthy choices.

64
Q

what does physical activity do for indi with diabetes

A

increase glucose uptake into muscles and liver, increase insulin sensitivity, can Improve blood glucose levels,

65
Q

oliguria (kidneys)

A

diminished urine production

66
Q

anuria (kindeys)

A

no urine production

67
Q

causes of acute kidney injury

A

critical illness, sepsis (infection), major surgery

68
Q

treatment for an acute kidney injury

A

dialysis, diet, meds

69
Q

a major function of the kidney

A

filter blood, reg blood pressure, stimulate RBC, maintain bone structure (vit D activation)

70
Q

when the kidneys filter blood what is happening

A

elim fluids, maintain electrolytes, form urine, metabolic waste filtration,

71
Q

what is chronic kidney disease

A

characterized by gradual irreversible deterioration of kidneys

72
Q

common cuases of chronic kidney disease

A

44% diabetes, 38% HTN, affects 15% of adults

73
Q

3 tests to determine Chronic kidney disease

A

blood tests, urine albumin, glomerular filtration rate.

74
Q

CKD blood test

A

uses blood urea nitrogen(BUN) and creatine

75
Q

CKD urine albumin

A

increased with kidney disease

76
Q

CKD filtration rate

A

calc from how much creatinine and lowers as kidney disease worsened.

77
Q

CKD BUN

A

blood urea nitrogen and creatinine increases in CKD

78
Q

consequences of CKD

A

lower GFR (ability to filter blood), cardiovascular complication, anemia, bone disease, growth failure (malnutrition), GI disturbance, uremia,

79
Q

what happens when GFR decreases

A

potassium phosphorus all increase in blood, and there is an increase in pro in blood

80
Q

treatment for CKD

A

manage causes first, transplant, then dialysis

81
Q

dietary intervention in CKD

A

varies on the individual but energy needs are often very high

82
Q

dietary intervention in CKD - pro-energy malnutrition

A

primary - poor dietary intake

secondary- vomiting, nausea, uremia, medication

83
Q

dietary intervention in CKD - phosphorus

A

restricted, given phosphorus binders make phosphorus not absorbable.

84
Q

dietary intervention in CKD - fluids

A

urine output plus 500-1000 ml/day

dialysis- 2 lbs water gained per day

85
Q

dietary intervention in CKD - protein `

A

pre-dialysis- some restriction

after- no restriction

86
Q

dietary intervention in CKD - sodium

A

some restriction

87
Q

dietary intervention in CKD - potassium

A

depends on serum k levels,

hemodialysis- restricted to 2000-3000 mg day, restricts some fruits and vegs,

88
Q

what are the 8 dietary recommendations for cardiovascular disease

A

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
Q

What foods can you limit when having cardiovascular disease

A

sugar, sweet drinks, sweets, fatty meats, highly processed and high sodium, partially hydrogenated oils, and tropical oils

90
Q

hypertriglyceridemia

A

starts to decrease tg, reduce ETOH, decrease refined ETOH, weight control, physical activity `

91
Q

what is hypertension

A

blood pressure- force exerted against artery walls,

affected by the volume of blood pumped by <3, and resistance in blood vessels

92
Q

systolic number

A

blood pressure when the heart muscle contracts, top number

93
Q

diastolic number

A

blood pressure when the heart muscle relaxes, the bottom number

94
Q

normal BP

A

sys- less than 120 dis- less than 80

95
Q

elevated BP

A

sys- 120-129 dis- less than 80

96
Q

high BP- stage 1

A

sys- 130-139 dis- 80-89

97
Q

high BP - stage 2

A

sys- 140+ dis- 90+

98
Q

Hypertensive crisis

A

sys- higher than 180 dis- higher than 120

99
Q

consequences of HTN

A

heart attacks, stroke, aneurysm, kidney disease, peripheral artery disease, retinopathy, dementia

100
Q

unmodifiable risk factors of HTN

A

race age family hx, gender

101
Q

modifiable risk factors of HTN

A

obesity, physical inactivity, metabolic syn, tobacco, sodium, low pot, stress, diabetes

102
Q

treatment for HTN

A

weight reduction, reg physical activity, drug therapies, dietary trmt DASH

103
Q

what is the DASH diet

A

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
Q

definition of cancer

A

group of diseases characterized by the uncontrollable growth and spread f abnormal cells.,

105
Q

dvlpt of cancer

A

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
Q

what percent of cancer deaths are preventable

A

50% smoking, obesity, carcinogens, insufficient activity

107
Q

10 rec to prevent cancer

A

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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