Nursing 2750 Nutrition: Exam One Flashcards
What is meant by food preference?
What we would choose to eat were everything equally available to us
What factors affect our food preferences?
Genetics
Environment
What is meant by food choice?
The foods that are convenient/available when it’s actually time to eat
What are common restrictions on food choice?
Time and cost
How has the food industry targeted our food preference, choice, and liking?
The food industry develops and markets foods that appeal to our biological taste for sugar, salt, and fat. We then become hooked on these foods, and because so many people eat them they are very readily available and usually quite cheap. It increases consumption of unhealthy foods.
What factor most significantly impacts the nutritional status of a community?
Economic factors
What are two government assistance programs to help prevent nutritional deficiencies?
SNAP (supplemental nutrition assistance program): formerly food stamps
WIC (women, infants, and children)
What shift in focus occurred in the 70s pertaining to diet?
Doctors realized many chronic illnesses were occurring due to excess of certain nutrients rather than deficiencies of key nutrients, and they started looking at how to curb American intake of things like sodium and fats
What came about because of this focus shift in the 70s?
Dietary recommendations and guidelines
What is the focus of the American Heart Association as pertains to dietary recommendations?
Diet and exercise factors that decrease the risk of coronary artery disease
What is the dietary focus of the American Cancer Society?
Any dietary factors that might be related to cancer development
Which nutrients do Americans not get enough of typically?
Vitamin D, calcium, potassium, and fiber
What nutrients do Americans get in excessive amounts?
Fats, sugar, refined grains, sodium
what is the specific emphasis of the diet concept of the Dietary guidelines for Americans?
Portion size control
More plant based foods
Decrease of sugar, sodium, and solid fats
What are the food groups included on MyPlate?
Grains Veggies Fruits Protein Dairy
What are the four themes of MyPlate?
Variety
Proportionality
Moderation
Activity
What key differences define the Healthy Eating Plate versus MyPlate?
It includes only whole grain options, with lots of plant proteins and limited red meat. Also includes exercise suggestions
What is the concept of the power plate?
Vegan diet pattern
What are some major food groups that exchange lists focus on?
Carbs
Meats and meat substitutes
Fats
What kind of patients especially benefit from exchange lists?
Diabetic patients (carb exchange lists)
What criteria should one use when evaluating future dietary guidelines?
Source of advice
Comprehensiveness of recommendations (does it address several health issues?)
Ease of application
What is the impact of availability and access on food consumption?
Underconsumed foods (like fruits and veggies) will be less available and therefore more expensive
What is a food desert?
Places where people do not have access to affordable or quality food sources
What kinds of factors should be addressed when looking at effective food shopping?
Budget Lifestyle of the household Dietary preference Shopping frequency Location/types of food stores
Internal locus of control
Feeling that you control the forces you encounter
External locus of control
Feeling that outside forces control your experiences
How many deaths in the United States are diet related?
4 out of 10
What are unrefined grains?
Grains that are prepared for consumption with all original components still intact
What are refined grains?
Grains that have been taken apart with only the edible parts of the kernel included in the final product
How does food processing affect the nutrients in refined grains?
It removes fiber and nutrients like magnesium, zinc, B6, etc.
What are the functions of carbohydrates?
Energy
Fiber
Fuel for the brain and nerve tissue
Metabolic functions
What do carbohydrates do in metabolism?
They are converted to and from glucose to make ATP for all body cells
Where is blood glucose homeostasis?
Between 70 and 100 mg/dL
What does insulin do?
Regulates blood glucose uptake
What does glucagon do?
Releases glycogen from the liver
What are simple carbohydrates?
Monosaccharides and disaccharides,
Examples of monosaccharides
Glucose
What are examples of disaccharides?
Sucrose and lactose
What are some health effects of simple carbohydrates in large quantities?
Dental caries
Obesity
Diabetes
Hyperactivity
What is a polysaccharide?
Many monosaccharide units joined together (also called a complex carbohydrate)
What are two examples of complex carbohydrates?
Starch and fiber
What foods are high in starch?
Grains, legumes, some veggies and fruits
What foods are high in fiber?
Plant foods
What is fiber?
The indigestible part of plant foods
What health benefits do complex carbohydrates have?
Obesity maintenance
Constipation relief
Reduction of things like diverticular disease, colon cancer, heart disease
Stabilization of blood glucose
What are the functions of fat in our bodies?
Stored energy
Organ protection
Temperature regulation
Insulation
What type of lipid comprises adipose tissue?
Triglycerides
When is adipose tissue (stored fat) crucial to the body?
It’s a necessary source of energy during illness and food restriction
Also a good source of energy for muscle work
What do omega 3 fatty acids do in the body?
They reduce blood clotting and therefore lower the risk of heart disease
What foods are high in omega 3 fatty acids?
Salmon Tuna Green leafy vegetables Cod liver oil Walnut oil
What are saturated fats?
Single bonded carbon chain that is fully loaded with fatty acids
Where are saturated fats found?
Mainly animal sources
What are monounsaturated fats?
Double bond with one open space where no fatty acid is present
What are some examples of monounsaturated fats?
Olive oil
Peanut oil
Canola oil
What is a polyunsaturated fat?
Double bonded carbon chain with 2 or more open spaces without fatty acids
What are some examples of polyunsaturated fats?
Soybean oil Sunflower oil Salmon Herring Trout
What is the only source of amino acids?
Food protein
What are complete proteins?
Proteins that contain all the amino acids that cannot be made by the body. Only animal proteins are complete proteins
What are incomplete proteins?
Proteins that contain some but not all of the amino acids needed by the body. Usually plant proteins, but can be combined to get all essential amino acids
What are the four primary functions of proteins?
Growth and maintenance
Creation of communicators and catalysts
Immune system response
Fluid and electrolyte regulation
What are the communicators and catalysts that proteins help make?
Communicators: hormones
Catalysts: enzymes and factors
Lacto-vegetarian diet pattern
Plant based diet with inclusion of animal derived dairy products
Ovo-lacto-vegetarian diet
Only animal derived foods eaten are dairy and eggs
What are the health benefits of a vegetarian diet?
Lower total fat and cholesterol intake, high fiber, reduced obesity risk, reduced risk of CAD, diabetes, and hypertension
What are the potential drawbacks of vegetarianism?
Potential nutrient deficiencies, such as iron and zinc, calcium, omega 3s
What diseases are related to malnutrition? Briefly describe each
Marasmus: overall calorie deficiency (starvation)
Kwashiorkor: protein deficiency (characterized by swollen abdomen often)
What four factors can contribute to malnutrition?
Biological
Social
Economic
Environmental
What are some people groups at risk for malnutrition in America?
Homeless Working poor Older adults Minority groups Hospitalized people
What are the functions and benefits of vitamins in the body?
Metabolic functions
Healthy teeth/bone/mucous membrane maintenance
Wound healing
What are the water soluble vitamins?
Vitamins C, B6, and B12, as well as thiamin, riboflavin, niacin, folacin
What are the fat soluble vitamins?
A, D, E, and K
What are the risks of fat soluble vitamins?
Can have too much of them and cause toxicity because they are stored in the body for longer
What does Thiamine or B1 do?
Works as a coenzyme in energy metabolism and aids in muscle actions
What are some thiamine sources?
Lean pork, enriched grains, legumes
Who is most at risk for a thiamine deficiency?
Alcoholics
HIV patients
Dialysis patients
Anorexics
What diseases are related to thiamine deficiency?
Beriberi: headache, fatigue, tachycardia
Wernicke-korsakoff syndrome: CNS disorder
What is the function of riboflavin or B2?
Coenzyme to release energy from nutrients
What are good sources of riboflavin?
Milk, broccoli, asparagus, meat, eggs, fish
What is deficiency of riboflavin called and what characterizes it?
Ariboflavinosis
Characteristics: seborrheic dermatitis, cheilosis
What is the function of Niacin?
Coenzyme for many enzymes, critical for glycolysis and tricarboxylic acid cycle
What are good sources of niacin?
Protein containing foods and coffee and tea
What characterizes niacin deficiency?
Pellagra (3 Ds)
Dementia
Diarrhea
Dermatitis
Who is at risk for niacin deficiency?
Alcoholics and those with abnormal absorption
What are the functions of vitamin C?
Antioxidant Coenzyme Collagen formation Wound healing Helps iron absorption Hormone synthesis (thyroid/adrenal)
Who is at risk for vitamin C deficiency?
Alcoholics, smokers, drug abusers, elderly
What happens in marginal vitamin C deficiency?
Gingivitis
Poor wound healing
Tooth/bone issues
Infection risk
What are the functions of vitamin A?
Maintains skin and mucous membranes Vision Bone growth Immune system function Reproduction
What are some sources of vitamin A?
Fat in animal foods (milk, butter, eggs, fish)
Green, orange, and yellow vegetables and fruits
Fortified foods
What is xeropthalmia?
Night blindness due to keratomalacia due to vitamin A deficiency
What are some other symptoms of vitamin A deficiency?
Depressed immune system
Respiratory tract infections
Reduced bone growth
Is vitamin D technically a vitamin?
No it is technically a hormone and produced by the body
Under what conditions can the body produce vitamin D?
Sunlight exposure
What are some other sources of vitamin D?
Fat of animal foods
Milk, which aids in vitamin D fortification due to calcium
What is the risk for children of vitamin D deficiency?
Rickets, characterized by malformed skeleton, bowed legs, abnormal teeth
What is the risk of vitamin D deficiency in adults?
Osteomalacia, characterized by soft bones that fracture easily
Also osteoporosis, which is reduced bone density and brittle bones
What is the most toxic vitamin? What can it cause?
Vitamin D, can cause hypercalcemia and hypercalcuria
What are the functions of vitamin E?
Antioxidant that particularly protects the lungs and red blood cells. Combines to work with selenium and vitamin C
What are some good sources of vitamin E?
Vegetable oils, margarine, whole grains, green leafys
What are some symptoms of vitamin E deficiency?
Rare as primary deficiency, but can secondarily be caused by fat malabsorption disorders, neurological disorders, anemia
What are the functions of vitamin K?
Cofactors in blood clotting
Protein formation in bones, kidneys, and plasma
What are good vitamin K sources?
Dark green leafy vegetables
Dairy products
Meat
How is vitamin K synthesized?
By bacteria in the GI tract, but still necessary to intake in diet
What happens in vitamin K deficiency?
Inhibited coagulation
Possible osteoporosis
What happens in vitamin K toxicity?
Decreased effectivity of anticoagulants and increased stroke risk
What is the function of calcium?
Structure and storage (bones)
Nerve and muscle function
Blood clotting
BP regulation
What are good calcium sources?
Dairy products
Green leafy vegetables
Small fish
Who is at risk for calcium deficiency?
Young people, pregnant and lactating women
What are the effects of calcium deficiency?
Poor bone health
Stunted growth
What are the functions of magnesium?
Structure and storage in bones
Regulates nerve and muscle functions in heart
Assists enzyme functions
What are good sources of magnesium?
Unprocessed foods like whole grains, legumes, veggies
Hard water
Magnesium deficiency are attributed to what causes?
Vomiting, diarrhea, GI disease, kidney disease, malnutrition, alcoholism
What are symptoms of magnesium deficiency?
Muscle twitching and weakness, convulsions
What is the function of sodium?
Blood pressure and volume maintenance
Nerve impulse transmission
Thirst mechanism/fluid balance
What is the recommenced daily intake of sodium according to the American heart association?
Less than 1 tsp or 2300 mg daily
What are some symptoms of sodium deficiency?
Headache, muscle cramps, weakness, memory loss
What happens in sodium toxicity?
Hypertension and edema
What is the function of potassium?
Maintaining fluid level inside cells
Muscle and nerve function
What are symptoms of potassium deficiency?
Muscle weakness, confusion, lower appetite, dysrhythmias
How can potassium toxicity happen?
Supplement overdose or renal disease
What are symptoms of potassium toxicity?
Weakness, vomiting, cardiac arrest
What are the functions of iron?
Distribution of oxygen through body in hemoglobin
Enzyme assistance
What aids in iron absorption?
Vitamin c
Who is at high risk for anemia?
Athletes
Menstruating women
What are some risks of parenteral feeding?
Loss of digestive peristalsis
IV line greater infection risk
Air embolism
More invasive
What are the benefits of enteral tube feeding?
Maintains digestive peristalsis
More comfortable
Easier to do at home/get help with from caregivers
When is is appropriate for an enteral feeding tube to be selected?
When the gut is functioning normally but patient cannot get enough nutrients orally
What are some indications for use of an parenteral feeding tube?
Protein energy malnutrition Burns Intestinal fistulas Liver failure Acute kidney failure
How long are parenteral nutrient bags good for?
24 hours, then the bag and tubing must be changed d/t potential bacterial growth
What are the RN’s roles and limitations with a nasogastric/nasoenteric feeding tube?
RN can insert,but placement must be verified by X-ray before use
What are the components of parenteral nutrient bags?
The main bag has all essential nutrients except for fat and can be infused continuously
Lipids must be infused separately and are usually given on specific days
What must the RN do before using an enteral tube on a patient (already placed, not newly placed)?
Verify placement
What are the ways to verify enteral tube placement?
Insert air with a syringe and listen with stethoscope for air sound
Aspirate contents and check pH
How does one give medications through an enteral tube? List steps.
Aspirate the tube
Flush with water
Push meds with syringe
Flush and push meds, repeating for each medication. must be given individually
How does one check the residual stomach contents with enteral feeding?
Pull all contents out with a syringe, measure, put back in, flush with water, and chart findings
If the patient is vomiting, what might the nurse decide to do as pertains to tube feeding?
Hold the tube feedings, but continue to give liquids to hydrate patient
What does a lower residual stomach content mean? Higher?
Lower is good, higher means the patient is not tolerating (food not digesting)
What are the three methods for tube feeding administration?
Continuous
Intermittent
Bolus
What are the standards for peripheral parenteral nutrition?
Substance must be isotonic, calories and protein are limited
When is peripheral parenteral nutrition used?
When short term nutrition support is needed
What does TPN stand for?
Total parenteral nutrition
Why is minimal enteral intake encouraged?
To maintain GI tract physiology and gut mucosal immunity
Continuous feeding
Constant, even nutrition flow
What is the benefit of pump controlled tube feeding over gravity controlled?
Pump will ensure steady rate for feeding, gravity has no precise control
What is the percentage makeup of TPN mixture?
25% dextrose, with 5-10% amino acids, electrolytes, minerals, and vitamins
What specifically does TPN solution help the body do?
Maintain positive nitrogen balance
What might rapid infusion cause with TPN?
Fluid in intravascular compartment
Dehydration
Circulatory overload
Hyperglycemia
When handling TPN infusion or changing dressing, use
Aseptic technique
Why is monitoring vitals so important with TPN?
High infection risk
When transitioning patient from tube to oral feeding, what techniques could be implemented?
Assess swallowing ability
Stop tube feedings one hour before meal to promote appetite
Oral intake increases, tube feeding decreases
Stop tube feeding when oral intake exceeds 2/3 of estimated energy needs
What can be the problem with the high osmolarity of a hypertonic formula?
Osmotic diarrhea
What is the gist of the WHO definition of health?
Not just the absence of disease but the state of complete physical, mental, and social well-being. Dealing with more that just physiological functions
What are the seven dimensions of health as pertains to nutrition?
Physical Intellectual Emotional Social Spiritual Environmental Occupational
How does nutrition influence emotional health?
Poor nutrition or lack of food can lead to anxiety, confusion, grumpiness, or the issues that go with things like hypoglycemia
What should we ask patients about when it comes to the social dimension of nutrition?
Where they eat, who they eat with, the mood/atmosphere of those meals, and what is eaten normally
What are some environmental limitations or factors for nutrition?
Money to buy groceries
A place to cook
Knowledge of how to cook
Living in a food desert
How does occupation influence nutrition?
Where someone works often influences what they eat and when they eat, and should be assessed in a nutrition screening
How would a nurse promote health through knowledge?
We cannot assume that patients have adequate knowledge, and as patients gain knowledge they are more likely to implement healthy behaviors and choices. The nurse can educate the patient
How can techniques be health promotion factors used by the nurse?
What is learned can only be applied if there is a technique for it. Change cannot usually be made all at once, so giving techniques for small changes is something important that the nurse can do.
What is primary disease prevention?
Doing activities or developing a lifestyle to avert the initial development of disease or poor health
What are some examples of primary prevention?
Immunizations
Low fat, high fiber diet
Exercise
Reducing sodium intake
What is secondary disease prevention?
Early detection screening to stop or reduce the effects of a disease or illness
What are some examples of secondary prevention?
Screening for things like diabetes or hypertension and adjusting diet accordingly if detected
What is tertiary prevention?
Minimizing further complications after a disease or illness has already developed
What is an example of tertiary prevention?
Minimizing further complications after a disease has already developed
What are examples of tertiary prevention?
Continued medical care
Diet therapy
What are the three methods of education for health literacy?
Formal education
Non-formal education
Informal education
What is health literacy?
Learning how disease develops and what can be done about it
What is formal education? Give an example?
Purposefully planned and implemented in an educational setting, like a nursing class
What is non-formal education? Give an example
Organized/planned teaching that occurs outside of the classroom, like instructional classes or meetings at a hospital or clinic
What is informal education? Give an example
Education that occurs through daily activities, like news broadcasts or magazine articles. Characterized by not having a planned time for education to occur
What is health context?
The influence of cultural, social, and individual factors of the environment on the patient’s health
What is health literacy actualization?
Being able to use acquired knowledge and skills
What does DRI stand for?
Dietary reference intake
What are DRIs based on?
Best available scientific data
What is the estimated average requirement?
Amount of nutrients needed to meet the basic requirements of at least half the individuals in a population
What is a recommended dietary allowance?
Level of nutrient intake to meet the needs of almost all healthy individuals in a life stage and gender group
What is adequate intake?
Recommendation made when there is insufficient data to set an RDA. Usually based on observation of particular groups of people and how much they consume
What must the nurse keep in mind when using DRIs in patient care?
The dietary recommendations must be tailored to the individual patient (diagnosis, age, gender, other factors)
What is the estimated energy requirement?
DRI for dietary energy intake. Very dependent on the individual
When establishing an adequate eating pattern, what general guidelines should be adhered to?
Assortment
Balance
Nutrient density
What is the definition of nutrient density?
Nutrients per kcal (empty calories or not?)
Why are nurses in a good position to recognize patients that need nutritional services?
Nurses are often the first point of contact with a patient and also often do basic nutritional screening and can use that to figure out how to proceed
What are some red flags for nutritional decline?
Decreased appetite
Unintentional weight loss
What does RDN stand for?
Registered Dietician-Nutritionist
What are the minimum necessary credentials to be an RDN?
Bachelors degree
1200 hours of supervised practice
Passing a national exam
What is the RDN specifically qualified to conduct?
The nutrition care process or NCP
What is the NCP?
A detailed nutrition assessment, complete with diagnosis and directives for therapies, monitoring, and outcomes
What does DTR stand for?
Dietetic Technicians, Registered
What does the DTR do?
Assists RDT by: Taking diet histories Getting information Working with struggling patients Doing basic nutrition education
What can a DTR not do?
Give diagnoses
Counsel patients with complex disease diet modifications
What are two forms of hidden hunger?
Undernutrition
Chronic micronutrient deficiencies
What are some possible consequences of nutritional risk?
Poor wound healing Longer stay in hospitals/nursing homes Health decline Appetite loss Depression Stunted growth Perception changes
What diet deficiencies are especially bad for growing children?
A diet low in quality protein and amino acids
What is the focus of a nutritional risk assessment?
Whether the patient has the potential to become malnourished, either by primary or secondary factors
How can acute hospitalization disrupt someone’s normal nutritional intake?
Their normal routine is thrown off by medications, procedures, illnesses, and psychological stress. Also the food is different from what they are used to.
What are some reasons of why cultural assessment is important in nutrition?
Some cultures view certain foods as good or bad
Food has different meaning and significance in different cultures
Different cultures have different cooking and eating environments
Religious factors often tie into diet
How quickly does the joint commission mandate that a nutritional screening happen?
Within 48 hours of hospitalization
Who is qualified to execute a nutrition screening?
Nurse RD DTR Dietary managers Physicians
How is a nutritional assessment different from a nutritional screening?
A screening looks for patients at risk for nutrition problems. An assessment goes in depth and determines proper nutrition therapy based on identified patient needs
What are the ABCD components of nutrition assessment?
Anthropometrics
Biochemical tests
Clinical observations
Dietary evaluation
What measurements are included in anthropometric assessment?
Height
Weight
Head circumference
Skinfold thickness
What is the importance of an accurate height in anthropometric assessment?
Determining calorie, protein, and energy needs are all done using height and weight
What is important to remember when it comes to patient height measurement?
Height declines with age
What must one do to ensure an accurate weight?
Minimal clothing
Measure at same time daily after voiding
Standing still with evenly distributed weight
What is body mass index?
Ratio of weight to height
What is BMI associated with?
Overall mortality
Nutrition risk
What are some limitations of BMI measurements?
Not validated with acutely ill patients
Underestimates body fat in elderly/those who have lost muscle
Overestimates body fat in muscular people
What is the desired BMI range?
18.5-24.9
What other measurements can be done to assess body composition?
Waist circumference
Waist to hip ratio
Waist to height ratio
Which body composition measurement is the best indicator for diabetes, hypertension, and cardiovascular risk?
Waist to height ratio
What are the components of a nutrition focused physical exam?
Fluid assessment
Functional status
Wound status
Clinical signs of nutrition issues
What does poor muscle quality often predict?
Mortality
What are the limitations of biochemical assessments?
No single test can evaluate short term success of nutrition therapy
Tests assume normal system functioning
Serial testing will give more accurate results
What are two tests that can estimate visceral protein status?
Serum albumin
Prealbumin
What are some conditions that can lower albumin levels?
Renal failure Heart failure Hepatic cirrhosis Inflammation Infection
Why is prealbumin better for monitoring short term changes?
Has a half like of two days instead of the 14-20 days of albumin
What does low hemoglobin indicate?
Iron deficient anemia
What are some effects of iron deficient anemia?
Cognition issues Stunted growth in children Low energy Weakness Cold skin
What nutrients are measured when evaluating immune function?
Zinc
Vitamin A
Omega 3s
Vitamin D
What are clinical factors that would be signs of nutritional factors?
Recent surgery or wounds
Blood loss
Skin and hair changes
What are three methods that could be used to collect information on a patient’s dietary intake?
24 hour diet recall
Food records (1-7 days)
Calorie counts
What are some physical disorders that can benefit from tertiary prevention strategies?
Ulcers
Diverticulitis
Celiac disease
Why is nutrition counseling and therapy especially important for patients undergoing chemo?
Because good nutrition and nourishment is especially important to aid in the healing/recovery process
What are some ways alternative medicine is used as related to nutrition?
Using herbal supplements or diet to treat cancer instead of chemo
What are functional foods?
Foods that contain physiologically active (bioactive) substances
What kind of things are considered dietary supplements?
Vitamins Minerals Herbs Botanicals Amino acids
Who is able to write the diet order?
Only the physician or privileged RD
What are two nursing functions related to nutrition?
Nutrition assessment and education
What is meant by medical nutrition therapy?
(Under medicare): nutrition treatment for diabetic/pre-renal failure patients
What does the textbook definition of nutrition therapy include?
Providing food
Nutrition education and counseling
Coordination of care
What is a regular diet intended to do?
Maintain optimal nutrition in people who need no modifications
What is a qualitative diet?
A diet modified in consistency, texture, or nutrients
Give examples of qualitative diets
Mechanical diet
Puréed diet
Liquid diet
What is a quantitative diet?
A diet modified in number or size of meals or amount of nutrients
Who is responsible for food service in a healthcare setting?
Director of food and nutrition services
What are some types of modified diets?
Low sodium
No/low carb
Low fat
What are some characteristics of passive communication?
Avoids conflict
Submissive
Apologetic
Allows others to lead
What are some characteristics of aggressive communication?
Forces others to lose/seeks to win
Wants control
Manipulative
What is assertive communication/
Direct Open and honest Spontaneous Recognizes rights of self and others Problem solving Seeks compromise/win-win
What are some assertive communication strategies?
Using “I” statements Focus on issue, not participants Good non-verbal cues Workable compromise “Fogging” to accept criticism
What is the meaning/purpose of CUS language?
Stands for “Concerned, Uncomfortable, Safety”
Seeks to advocate for patient safety and best practices
What are the steps of SBAR?
Situation
Background
Assessment
Recommendation
What is the purpose of SBAR?
Standardized, effective communication in healthcare
What type of simple carbohydrate is most easily used by the body?
Glucose
As a group, B vitamins are crucial to…
Metabolism
What is the average minimum amount of carbohydrates needed to fuel the brain?
130 grams/day
Describe how glucose gets converted and used in the body
The liver converts fructose and galactose into glucose
Glucose enters the bloodstream, raising blood glucose levels
This causes insulin release
Insulin unlocks the cells so glucose can enter and be used by the cell
What is the stored carbohydrate energy source called?
Glycogen
Where is glycogen stored?
The liver and muscle tissue
How are blood glucose levels maintained between meals?
Liver glycogen is broken down and released as glucose
How much energy do carbohydrates supply?
4 kcal/gram
What are complementary proteins?
Incomplete proteins combined to make complete proteins
What is the RDA of protein for healthy adults?
0.8 g/kg
Sterols are another name for..
Cholesterol
How much of total calories should come from saturated fat?
10% or less
What do lipoproteins do?
Move lipids like cholesterol and triglycerides around in the body
How much energy do lipids provide?
9 kcal/g
How much energy do proteins provide?
4 cal/g
What might limit an older adult’s water intake?
Avoiding drinking due to incontinence or excessive urination at night
Decreased thirst sensation
What are signs of dehydration?
Confusion Weakness Hot/dry body Rapid pulse High urine sodium Furrowed tongue
What two serious complications can arise in older adults due to dehydration?
UTI and sepsis
What signs and symptoms should one first look for with a UTI in an older adult?
Confusion
Mood changes
What is the recommended daily water intake for older adults?
8 cups/day
What is the recommended protein intake for older adults?
30 grams per meal or 90 grams/day
What might cause an older adult to have inadequate protein intake?
Increased protein use in body
Lower appetite
Lower mobility
Lack of money for groceries
What can happen in marginal zinc deficiency?
Altered taste receptors: reduction in sweet and salty sensations
How can marginal zinc deficiency change nutrient intake in older adults?
Decreased appetite due to food not tasting good
Increased sugar or salt consumption to try to make food taste better
What are some possible causes of constipation in older adults?
Medications
Dehydration
Lack of dietary fiber
What happens to vitamin D synthesis with age?
Reduction of synthesis
How does aging affect vitamin B12 absorption?
It decreases the production of intrinsic factor necessary for vitamin B12 absorption
What are some good sources of B12?
Eggs
Milk
Meat
What diseases does menopause increase the risk for?
Coronary artery disease and osteoporosis
What dietary changes are recommended to decrease risk of coronary artery disease?
Low fat/red meat
High in unrefined grains
High in lean protein
High in omega 3s
What are some risk factors for malnutrition in older adults?
Alcoholism Chewing/swallowing problems Eating too little Medications Depression Diabetes
What living environments might increase the risk of malnutrition in older adults?
Living on their own
Long term care
Hospitalization
When are elemental formulas used?
When the GI tract is dysfunctional
What is an elemental formula?
Formula with partially or fully hydrolyzed nutrients
When is a modular formula used?
To supplement nutrition needs
What does a modular formula usually contain?
One main macronutrient and then other products as needed
What do speciality enteral formulas do?
Meet certain nutrition demands for diseases
Can vitamin K be administered paraenterally?
No, it must be given IM or in an IV injectable
