Nurseing test 4 nutrition Flashcards
Factors that increase BMR
Basal metabolic rate
(Mucsle) Growth, infections, fever, emotional tension, extreme environmental temperatures, elevated levels of certain hormones
Factors that decrease BMR
Aging, prolonged fasting, and sleep
(starving) yourself
BMI
Body Mass Index (BMI) divide clients height by weight (m^2)
IBW
What BMI is overweight
What BMI is obese
Ideal Body Weight (IBW) – uses BMI as reference guide
BMI between 25 – 29.9 = overweight
BMI >30 = obesity
What are the six classes of nutrients?
What are the two uses of these nutrients?
Nutrients that supply energy
Carbohydrates- to many will make you fat
Protein
Fats (lipids)
Nutrients that regulate body processes
Vitamins
Minerals
Water
Carbohydrates
What are they made of?
What are their classifications if any?
What is its use in the body?
Sugars and starches
Serve as the structural framework of plants; lactose is only animal source.
Most abundant and least expensive source of calories in the world(Carbohydrates may contribute up to 90% of caloric intake in diet )
Classifications Simple CHO (sugars) Monosaccharides Dissaccharides
Complex CHO (starch, glycogen, fiber) Polysaccharides
Use
Primary source of energy (glucose) for the body
It is recommended that 45% to 65% of total calories come from carbohydrates to prevent ketosis
Ketosis
Ketosis- when fat is used to fuel the body (bad if your body thinks its starveing)
It is recommended that 45% to 65% of total calories come from carbohydrates to prevent ketosis
Carbohydrates may contribute up to __% of caloric intake in diet
Carbohydrates may contribute up to 90% of caloric intake in diet
protein
What are they made of?
What are their classifications if any?
What is its use in the body?
Protiens(eggs, dairy, products, meats are made from combinations of the 22 basic amino acids
Labeled complete (high quality Animal) or incomplete (low quality Plant) , based on amino acid composition Animal proteins are complete; plant proteins are incomplete
Protein is Required for the formation of all body structures
RDA for adults is __g/kg of body weight, __% to __% total calorie intake
RDA for adults is 0.8 g/kg of body weight,
protien intake should account for 10% to 35% total calorie intake
It is recommended that __% to __% of total calories come from carbohydrates to prevent ketosis
It is recommended that 45% to 65% of total calories come from carbohydrates to prevent ketosis
Complete Protein
Incomplete Protein
Complete Protein – contain all nine essential amino acids
Incomplete Protein – lack one or more if the essential amino acids
Nitrogen balance
Nitrogen in(protein in) = nitrogen out(protein excreted) = nitrogen balanced
Positive nitrogen balance
Negative nitrogen balance
Nitrogen intake > nitrogen output = positive nitrogen balance
Things break down if you have a negative nitrogen balance
Catabolism
Protein tissues are in a constant state of flux.
Tissues are continuously being broken down (catobolism) and being repaired (anabolism)
Anabolism
Protein tissues are in a constant state of flux.
Tissues are continuously being broken down (catobolism) and being repaired (anabolism)
Fats (lipids)
What are they made of?
What are their classifications if any?
What is its use in the body?
Most caloric dense nutrient
most concentrated source of energy in diet
Digestion occurs largely in small intestine
95% of lipids in diet are triglycerides
Contain mixtures of saturated(raise cholesteral) and unsaturated fatty acids(lower cholesteral vegstibles)
Cholesterol
What are they made of?
What are their classifications if any?
What is its use in the body?
Cholesteral is not an essential nutrient because your body makes enough of it. Consumeing more is bad
Found only in animal products
Made by the body
High levels increase risk for atherosclerosis
To decrease cholesterol levels increase amount of unsaturated fat, limit saturated fats, increase fiber
Organic substances needed by the body in small amounts
Are not synthesized by the body
Do not provide energy, but are necessary for metabolism of carbs, proteins and fats
Absorbed through the intestinal wall directly into bloodstream
Classified as water or fat soluble
Vitamins
Primary source of energy (_____) for the body
Glucose
Insoluble or soluble
Fats
Vitamins
Fats are insoluble with water
Vitamins are water soluble
What are the two types of vitamins?
Where do A B C D E K vitemins fit in those groups
Fat-soluble vitamins A D E K
Stored in body in liver and adipose tissue
Absorbed with fat into the blood stream
Attach to lipoproteins for transport
Water-soluble vitamins- C and B complex- cannot be stored in the body – need daily intake
Water
Accounts for between __% and __% of adult’s total weight
_____ of body water is contained within the cells (ICF)Intercelular fluid
Remainder of body water is (ECF)Extracellular fluid, body fluids (plasma, interstitial fluid)
water
Accounts for between 50% and 60% of adult’s total weight
Two-thirds of body water is contained within the cells (ICF)Intercelular fluid
Remainder of body water is (ECF)Extracellular fluid, body fluids (plasma, interstitial fluid)
What does water do in the boddy
Provides fluid medium necessary for all chemical reactions in body
Acts as a solvent and aids digestion, absorption, circulation, and excretion
What Growth and development factors that effect nutrition?
Infants
Rapid growth – high energy requirements
Breast feeding recommended by American Academy of Pediatrics
Reduction of food allergies
Immunity
Formula – new formulas closely parallel breast milk – boost immune function
No cow’s milk until after 1 yr old
No honey, corn syrup until after 1 yr old
What Growth and development factors that effect nutrition?
Toddlers
Toddlers
Whole milk until 2 years old
Appetite decreases
Strong food preferences
Picky eaters
Avoid hot dogs, candy, nuts, grapes, raw vegetables, popcorn
What Growth and development factors that effect nutrition?
School-age
Uneven, individualized growth
Diet needs supervision to allow for adequate protein and vitamins
Need proper breakfast
Increase in childhood obesity R/T sedentary lifestyle
What Growth and development factors that effect nutrition?
Adolescents
Energy needs increase R/T increased metabolic demands, therefore nutrient needs increase
Daily increases of protein
Calcium for bone growth
Iron for menstruating females, muscle development in males
What Growth and development factors that effect nutrition?
Pregnancy/Lactation
Pregnancy
Increase in protein requirements
Calcium intake critical in third trimester
Folic Acid – inadequate amounts may lead to neural tube defects
Folic Acid supplements now recommended during preconception as well as during pregnancy
Lactation
Increased requirement of calories if breast feeding
What Growth and development factors that effect nutrition?
Older Adults
Older Adults
Decreased energy need – metabolic rate slows with age
Factors affecting nutritional status
Age-related GI Changes
Presence of comorbidities increase risk for poor nutrition
Malnutrition r/t income, physical function, loneliness
Affects of medication
Cognitive impairments(I forgot to eat)
Factors Affecting Nutrition
Economic
Cost of food vs. financial income of household (fast food is cheap)
Religion
Dietary restrictions, diet specific considerations
Meaning of food
tradition, social status, serves as celebration and reward, causes yo-yo dieting and eating disorders
Culture
Represents personal beliefs and customs, effects preparation, and edible food choices
Romidom- muslim don’t eat any time from sun up to sun down
Obesity is haveing The body weight of __% or more above ideal weight or having a BMI of __ or more
obesity is The body weight of 20% or more above ideal weight or having a BMI of 30 or more
About / of adults in the US are overweight and nearly one third are considered obese
One __ of young people between ages 6 and 19 are considered overweight or obese
About two third of adults in the US are overweight and nearly one third are considered obese
One third of young people between ages 6 and 19 are considered overweight or obese
Anthropometric
Measure the size and proportion of the human body
Dysphyagia
difficulty or inability to swallow
aspiration
the misdirection of oropharyangeal secretions
NPO- Nothing by mouth
Clear liquid
Full Liquid
Pureed
Mechanical soft
Soft/Low Residue
Low-fiber –
NPO - Nothing by mouth. generally as preparation for surgery.
Clear liquid – see through – broth, coffee, tea, carbonated beverages, clear fruit juices, gelatin, popsicles
Full Liquid – ice cream, custards, refined cooked cereal (cream of wheat), vegetable juice,
Pureed – pureed foods- after oral or facial surgery for chewing and swallowing difficulties
Mechanical soft – ground meats, cottage cheese, cheese, rice, potatoes, bananas, peanut butter, steamed veggies
used for those with chewing and swallowing difficulties
Soft/Low Residue
Low-fiber – pastas, casseroles, moist tender meats, canned cooked fruits,
no nuts
What is Ideal Body Weight IBW
What is overweigh?
What is Obese?
BMI between 18.5 - 24.9 is ideal
BMI between 25 – 29.9 = overweight
BMI >30 = obesity
Enteral Tube Feedings
Nutrients given via the GI tract
Parenteral Nutrition
Nutrients given intravenously
Feeding
Temporary
X-ray before 1st feeding
Problems
Aspiration
Discomfort
nasogastric tube (NG tube)
A nasogastric tube (NG tube) is a special tube that carries food and medicine to the stomach through the nose
AKA Nasointestinal tube
PEG vs PEJ
PEG-percutaneous endoscopic gastrostomy- Tube is put in stomach
PEJ-percutaneous endoscopic jejunostomy- Tube is put in intestine
A PEJ is considered harder to maintain, long term, and used less often than a PEG.
External Feeding
Intermittent—
Intermittent—regular intervals and at equal portions several times per day (set up to run 30-90 minutes each)
External Feeding
Bolus-
Bolus- a type of intermittent feeding that uses a syringe
External Feeding
Cyclic-
Cyclic- Larger amounts over a portion of the 24 hour day (usually overnight)
External Feeding
Continuous-
Continuous- Consistent volume infused each hour.
What are some considerations for a patient with external feeding?
Promote Safety Check placement Gastric residual Sterile water flushes in immunocompromised and critically ill Know guidelines for holding feedings Assess abdomen(bowel sounds, distention) Upright during feeding Prevent contamination Proper medication administration
What are some complications that might occur from external feeding?
Aspiration Clogged tube Nasal erosion Nausea, vomiting, distention Diarrhea Distention Unplanned extubation Stoma infection
parenteral Nutrition
Administered through a line to clients who are unable to digest or absorb enteral nutrition
Delivers glucose, amino acids, lipids, minerals, electrolytes, trace elements, and vitamins
Requires continual monitoring
Parenteral Nutrition Complications
Insertion problems
Infection
Metabolic alterations
Fluid, electrolyte, and acid–base imbalances
Phlebitis
Hyperlipidemia
Liver and gallbladder disease
Specific nutrition techniques to treat Gastrointestinal Diseases
peptic ulcers
Regular Meals Antiulcer medications Avoid foods that increase acidity Caffeine, citric acid juices, seasonings, Avoid smoking, ETOH, ASA
Specific nutrition techniques to treat Gastrointestinal Diseases
Inflammatory Bowel Disease (Crohn’s)
Inflammatory Bowel Disease (Crohn’s)
Parenteral nutrition
Specific nutrition techniques to treat Gastrointestinal Diseases
Malabsorption syndrome – celiac disease
Malabsorption syndrome – celiac disease
Gluten-free diet (avoid wheat, rye, barley, oats)
Specific nutrition techniques to treat Gastrointestinal Diseases
Diverticulitis
Diverticulitis
Low-residue diet until infection subsides then high-fiber diet
