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Krystan: Semester One Nursing School > Nursing 2750 Nutrition: Exam One > Flashcards

Nursing 2750 Nutrition: Exam One Flashcards

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1
Q

What is meant by food preference?

A

What we would choose to eat were everything equally available to us

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2
Q

What factors affect our food preferences?

A

Genetics

Environment

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3
Q

What is meant by food choice?

A

The foods that are convenient/available when it’s actually time to eat

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4
Q

What are common restrictions on food choice?

A

Time and cost

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5
Q

How has the food industry targeted our food preference, choice, and liking?

A

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.

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6
Q

What factor most significantly impacts the nutritional status of a community?

A

Economic factors

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7
Q

What are two government assistance programs to help prevent nutritional deficiencies?

A

SNAP (supplemental nutrition assistance program): formerly food stamps
WIC (women, infants, and children)

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8
Q

What shift in focus occurred in the 70s pertaining to diet?

A

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

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9
Q

What came about because of this focus shift in the 70s?

A

Dietary recommendations and guidelines

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10
Q

What is the focus of the American Heart Association as pertains to dietary recommendations?

A

Diet and exercise factors that decrease the risk of coronary artery disease

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11
Q

What is the dietary focus of the American Cancer Society?

A

Any dietary factors that might be related to cancer development

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12
Q

Which nutrients do Americans not get enough of typically?

A

Vitamin D, calcium, potassium, and fiber

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13
Q

What nutrients do Americans get in excessive amounts?

A

Fats, sugar, refined grains, sodium

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14
Q

what is the specific emphasis of the diet concept of the Dietary guidelines for Americans?

A

Portion size control
More plant based foods
Decrease of sugar, sodium, and solid fats

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15
Q

What are the food groups included on MyPlate?

A 
Grains
Veggies
Fruits
Protein
Dairy
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16
Q

What are the four themes of MyPlate?

A

Variety
Proportionality
Moderation
Activity

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17
Q

What key differences define the Healthy Eating Plate versus MyPlate?

A

It includes only whole grain options, with lots of plant proteins and limited red meat. Also includes exercise suggestions

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18
Q

What is the concept of the power plate?

A

Vegan diet pattern

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19
Q

What are some major food groups that exchange lists focus on?

A

Carbs
Meats and meat substitutes
Fats

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20
Q

What kind of patients especially benefit from exchange lists?

A

Diabetic patients (carb exchange lists)

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21
Q

What criteria should one use when evaluating future dietary guidelines?

A

Source of advice
Comprehensiveness of recommendations (does it address several health issues?)
Ease of application

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22
Q

What is the impact of availability and access on food consumption?

A

Underconsumed foods (like fruits and veggies) will be less available and therefore more expensive

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23
Q

What is a food desert?

A

Places where people do not have access to affordable or quality food sources

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24
Q

What kinds of factors should be addressed when looking at effective food shopping?

A 
Budget
Lifestyle of the household
Dietary preference
Shopping frequency
Location/types of food stores
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25
Q

Internal locus of control

A

Feeling that you control the forces you encounter

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26
Q

External locus of control

A

Feeling that outside forces control your experiences

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27
Q

How many deaths in the United States are diet related?

A

4 out of 10

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28
Q

What are unrefined grains?

A

Grains that are prepared for consumption with all original components still intact

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29
Q

What are refined grains?

A

Grains that have been taken apart with only the edible parts of the kernel included in the final product

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30
Q

How does food processing affect the nutrients in refined grains?

A

It removes fiber and nutrients like magnesium, zinc, B6, etc.

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31
Q

What are the functions of carbohydrates?

A

Energy
Fiber
Fuel for the brain and nerve tissue
Metabolic functions

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32
Q

What do carbohydrates do in metabolism?

A

They are converted to and from glucose to make ATP for all body cells

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33
Q

Where is blood glucose homeostasis?

A

Between 70 and 100 mg/dL

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34
Q

What does insulin do?

A

Regulates blood glucose uptake

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35
Q

What does glucagon do?

A

Releases glycogen from the liver

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36
Q

What are simple carbohydrates?

A

Monosaccharides and disaccharides,

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37
Q

Examples of monosaccharides

A

Glucose

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38
Q

What are examples of disaccharides?

A

Sucrose and lactose

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39
Q

What are some health effects of simple carbohydrates in large quantities?

A

Dental caries
Obesity
Diabetes
Hyperactivity

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40
Q

What is a polysaccharide?

A

Many monosaccharide units joined together (also called a complex carbohydrate)

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41
Q

What are two examples of complex carbohydrates?

A

Starch and fiber

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42
Q

What foods are high in starch?

A

Grains, legumes, some veggies and fruits

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43
Q

What foods are high in fiber?

A

Plant foods

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44
Q

What is fiber?

A

The indigestible part of plant foods

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45
Q

What health benefits do complex carbohydrates have?

A

Obesity maintenance
Constipation relief
Reduction of things like diverticular disease, colon cancer, heart disease
Stabilization of blood glucose

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46
Q

What are the functions of fat in our bodies?

A

Stored energy
Organ protection
Temperature regulation
Insulation

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47
Q

What type of lipid comprises adipose tissue?

A

Triglycerides

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48
Q

When is adipose tissue (stored fat) crucial to the body?

A

It’s a necessary source of energy during illness and food restriction
Also a good source of energy for muscle work

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49
Q

What do omega 3 fatty acids do in the body?

A

They reduce blood clotting and therefore lower the risk of heart disease

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50
Q

What foods are high in omega 3 fatty acids?

A 
Salmon
Tuna
Green leafy vegetables
Cod liver oil
Walnut oil
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51
Q

What are saturated fats?

A

Single bonded carbon chain that is fully loaded with fatty acids

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52
Q

Where are saturated fats found?

A

Mainly animal sources

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53
Q

What are monounsaturated fats?

A

Double bond with one open space where no fatty acid is present

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54
Q

What are some examples of monounsaturated fats?

A

Olive oil
Peanut oil
Canola oil

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55
Q

What is a polyunsaturated fat?

A

Double bonded carbon chain with 2 or more open spaces without fatty acids

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56
Q

What are some examples of polyunsaturated fats?

A 
Soybean oil
Sunflower oil
Salmon
Herring 
Trout
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57
Q

What is the only source of amino acids?

A

Food protein

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58
Q

What are complete proteins?

A

Proteins that contain all the amino acids that cannot be made by the body. Only animal proteins are complete proteins

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59
Q

What are incomplete proteins?

A

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

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60
Q

What are the four primary functions of proteins?

A

Growth and maintenance
Creation of communicators and catalysts
Immune system response
Fluid and electrolyte regulation

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61
Q

What are the communicators and catalysts that proteins help make?

A

Communicators: hormones
Catalysts: enzymes and factors

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62
Q

Lacto-vegetarian diet pattern

A

Plant based diet with inclusion of animal derived dairy products

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63
Q

Ovo-lacto-vegetarian diet

A

Only animal derived foods eaten are dairy and eggs

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64
Q

What are the health benefits of a vegetarian diet?

A

Lower total fat and cholesterol intake, high fiber, reduced obesity risk, reduced risk of CAD, diabetes, and hypertension

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65
Q

What are the potential drawbacks of vegetarianism?

A

Potential nutrient deficiencies, such as iron and zinc, calcium, omega 3s

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66
Q

What diseases are related to malnutrition? Briefly describe each

A

Marasmus: overall calorie deficiency (starvation)
Kwashiorkor: protein deficiency (characterized by swollen abdomen often)

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67
Q

What four factors can contribute to malnutrition?

A

Biological
Social
Economic
Environmental

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68
Q

What are some people groups at risk for malnutrition in America?

A 
Homeless
Working poor
Older adults
Minority groups
Hospitalized people
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69
Q

What are the functions and benefits of vitamins in the body?

A

Metabolic functions
Healthy teeth/bone/mucous membrane maintenance
Wound healing

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70
Q

What are the water soluble vitamins?

A

Vitamins C, B6, and B12, as well as thiamin, riboflavin, niacin, folacin

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71
Q

What are the fat soluble vitamins?

A

A, D, E, and K

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72
Q

What are the risks of fat soluble vitamins?

A

Can have too much of them and cause toxicity because they are stored in the body for longer

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73
Q

What does Thiamine or B1 do?

A

Works as a coenzyme in energy metabolism and aids in muscle actions

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74
Q

What are some thiamine sources?

A

Lean pork, enriched grains, legumes

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75
Q

Who is most at risk for a thiamine deficiency?

A

Alcoholics
HIV patients
Dialysis patients
Anorexics

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76
Q

What diseases are related to thiamine deficiency?

A

Beriberi: headache, fatigue, tachycardia

Wernicke-korsakoff syndrome: CNS disorder

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77
Q

What is the function of riboflavin or B2?

A

Coenzyme to release energy from nutrients

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78
Q

What are good sources of riboflavin?

A

Milk, broccoli, asparagus, meat, eggs, fish

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79
Q

What is deficiency of riboflavin called and what characterizes it?

A

Ariboflavinosis

Characteristics: seborrheic dermatitis, cheilosis

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80
Q

What is the function of Niacin?

A

Coenzyme for many enzymes, critical for glycolysis and tricarboxylic acid cycle

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81
Q

What are good sources of niacin?

A

Protein containing foods and coffee and tea

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82
Q

What characterizes niacin deficiency?

A

Pellagra (3 Ds)
Dementia
Diarrhea
Dermatitis

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83
Q

Who is at risk for niacin deficiency?

A

Alcoholics and those with abnormal absorption

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84
Q

What are the functions of vitamin C?

A 
Antioxidant 
Coenzyme
Collagen formation
Wound healing
Helps iron absorption
Hormone synthesis (thyroid/adrenal)
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85
Q

Who is at risk for vitamin C deficiency?

A

Alcoholics, smokers, drug abusers, elderly

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86
Q

What happens in marginal vitamin C deficiency?

A

Gingivitis
Poor wound healing
Tooth/bone issues
Infection risk

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87
Q

What are the functions of vitamin A?

A 
Maintains skin and mucous membranes
Vision
Bone growth
Immune system function
Reproduction
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88
Q

What are some sources of vitamin A?

A

Fat in animal foods (milk, butter, eggs, fish)
Green, orange, and yellow vegetables and fruits
Fortified foods

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89
Q

What is xeropthalmia?

A

Night blindness due to keratomalacia due to vitamin A deficiency

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90
Q

What are some other symptoms of vitamin A deficiency?

A

Depressed immune system
Respiratory tract infections
Reduced bone growth

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91
Q

Is vitamin D technically a vitamin?

A

No it is technically a hormone and produced by the body

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92
Q

Under what conditions can the body produce vitamin D?

A

Sunlight exposure

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93
Q

What are some other sources of vitamin D?

A

Fat of animal foods

Milk, which aids in vitamin D fortification due to calcium

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94
Q

What is the risk for children of vitamin D deficiency?

A

Rickets, characterized by malformed skeleton, bowed legs, abnormal teeth

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95
Q

What is the risk of vitamin D deficiency in adults?

A

Osteomalacia, characterized by soft bones that fracture easily
Also osteoporosis, which is reduced bone density and brittle bones

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96
Q

What is the most toxic vitamin? What can it cause?

A

Vitamin D, can cause hypercalcemia and hypercalcuria

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97
Q

What are the functions of vitamin E?

A

Antioxidant that particularly protects the lungs and red blood cells. Combines to work with selenium and vitamin C

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98
Q

What are some good sources of vitamin E?

A

Vegetable oils, margarine, whole grains, green leafys

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99
Q

What are some symptoms of vitamin E deficiency?

A

Rare as primary deficiency, but can secondarily be caused by fat malabsorption disorders, neurological disorders, anemia

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100
Q

What are the functions of vitamin K?

A

Cofactors in blood clotting

Protein formation in bones, kidneys, and plasma

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101
Q

What are good vitamin K sources?

A

Dark green leafy vegetables
Dairy products
Meat

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102
Q

How is vitamin K synthesized?

A

By bacteria in the GI tract, but still necessary to intake in diet

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103
Q

What happens in vitamin K deficiency?

A

Inhibited coagulation

Possible osteoporosis

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104
Q

What happens in vitamin K toxicity?

A

Decreased effectivity of anticoagulants and increased stroke risk

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105
Q

What is the function of calcium?

A

Structure and storage (bones)
Nerve and muscle function
Blood clotting
BP regulation

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106
Q

What are good calcium sources?

A

Dairy products
Green leafy vegetables
Small fish

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107
Q

Who is at risk for calcium deficiency?

A

Young people, pregnant and lactating women

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108
Q

What are the effects of calcium deficiency?

A

Poor bone health

Stunted growth

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109
Q

What are the functions of magnesium?

A

Structure and storage in bones
Regulates nerve and muscle functions in heart
Assists enzyme functions

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110
Q

What are good sources of magnesium?

A

Unprocessed foods like whole grains, legumes, veggies

Hard water

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111
Q

Magnesium deficiency are attributed to what causes?

A

Vomiting, diarrhea, GI disease, kidney disease, malnutrition, alcoholism

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112
Q

What are symptoms of magnesium deficiency?

A

Muscle twitching and weakness, convulsions

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113
Q

What is the function of sodium?

A

Blood pressure and volume maintenance
Nerve impulse transmission
Thirst mechanism/fluid balance

114
Q

What is the recommenced daily intake of sodium according to the American heart association?

A

Less than 1 tsp or 2300 mg daily

115
Q

What are some symptoms of sodium deficiency?

A

Headache, muscle cramps, weakness, memory loss

116
Q

What happens in sodium toxicity?

A

Hypertension and edema

117
Q

What is the function of potassium?

A

Maintaining fluid level inside cells

Muscle and nerve function

118
Q

What are symptoms of potassium deficiency?

A

Muscle weakness, confusion, lower appetite, dysrhythmias

119
Q

How can potassium toxicity happen?

A

Supplement overdose or renal disease

120
Q

What are symptoms of potassium toxicity?

A

Weakness, vomiting, cardiac arrest

121
Q

What are the functions of iron?

A

Distribution of oxygen through body in hemoglobin

Enzyme assistance

122
Q

What aids in iron absorption?

A

Vitamin c

123
Q

Who is at high risk for anemia?

A

Athletes

Menstruating women

124
Q

What are some risks of parenteral feeding?

A

Loss of digestive peristalsis
IV line greater infection risk
Air embolism
More invasive

125
Q

What are the benefits of enteral tube feeding?

A

Maintains digestive peristalsis
More comfortable
Easier to do at home/get help with from caregivers

126
Q

When is is appropriate for an enteral feeding tube to be selected?

A

When the gut is functioning normally but patient cannot get enough nutrients orally

127
Q

What are some indications for use of an parenteral feeding tube?

A 
Protein energy malnutrition 
Burns
Intestinal fistulas 
Liver failure
Acute kidney failure
128
Q

How long are parenteral nutrient bags good for?

A

24 hours, then the bag and tubing must be changed d/t potential bacterial growth

129
Q

What are the RN’s roles and limitations with a nasogastric/nasoenteric feeding tube?

A

RN can insert,but placement must be verified by X-ray before use

130
Q

What are the components of parenteral nutrient bags?

A

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

131
Q

What must the RN do before using an enteral tube on a patient (already placed, not newly placed)?

A

Verify placement

132
Q

What are the ways to verify enteral tube placement?

A

Insert air with a syringe and listen with stethoscope for air sound
Aspirate contents and check pH

133
Q

How does one give medications through an enteral tube? List steps.

A

Aspirate the tube
Flush with water
Push meds with syringe
Flush and push meds, repeating for each medication. must be given individually

134
Q

How does one check the residual stomach contents with enteral feeding?

A

Pull all contents out with a syringe, measure, put back in, flush with water, and chart findings

135
Q

If the patient is vomiting, what might the nurse decide to do as pertains to tube feeding?

A

Hold the tube feedings, but continue to give liquids to hydrate patient

136
Q

What does a lower residual stomach content mean? Higher?

A

Lower is good, higher means the patient is not tolerating (food not digesting)

137
Q

What are the three methods for tube feeding administration?

A

Continuous
Intermittent
Bolus

138
Q

What are the standards for peripheral parenteral nutrition?

A

Substance must be isotonic, calories and protein are limited

139
Q

When is peripheral parenteral nutrition used?

A

When short term nutrition support is needed

140
Q

What does TPN stand for?

A

Total parenteral nutrition

141
Q

Why is minimal enteral intake encouraged?

A

To maintain GI tract physiology and gut mucosal immunity

142
Q

Continuous feeding

A

Constant, even nutrition flow

143
Q

What is the benefit of pump controlled tube feeding over gravity controlled?

A

Pump will ensure steady rate for feeding, gravity has no precise control

144
Q

What is the percentage makeup of TPN mixture?

A

25% dextrose, with 5-10% amino acids, electrolytes, minerals, and vitamins

145
Q

What specifically does TPN solution help the body do?

A

Maintain positive nitrogen balance

146
Q

What might rapid infusion cause with TPN?

A

Fluid in intravascular compartment
Dehydration
Circulatory overload
Hyperglycemia

147
Q

When handling TPN infusion or changing dressing, use

A

Aseptic technique

148
Q

Why is monitoring vitals so important with TPN?

A

High infection risk

149
Q

When transitioning patient from tube to oral feeding, what techniques could be implemented?

A

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

150
Q

What can be the problem with the high osmolarity of a hypertonic formula?

A

Osmotic diarrhea

151
Q

What is the gist of the WHO definition of health?

A

Not just the absence of disease but the state of complete physical, mental, and social well-being. Dealing with more that just physiological functions

152
Q

What are the seven dimensions of health as pertains to nutrition?

A 
Physical
Intellectual 
Emotional
Social
Spiritual
Environmental 
Occupational
153
Q

How does nutrition influence emotional health?

A

Poor nutrition or lack of food can lead to anxiety, confusion, grumpiness, or the issues that go with things like hypoglycemia

154
Q

What should we ask patients about when it comes to the social dimension of nutrition?

A

Where they eat, who they eat with, the mood/atmosphere of those meals, and what is eaten normally

155
Q

What are some environmental limitations or factors for nutrition?

A

Money to buy groceries
A place to cook
Knowledge of how to cook
Living in a food desert

156
Q

How does occupation influence nutrition?

A

Where someone works often influences what they eat and when they eat, and should be assessed in a nutrition screening

157
Q

How would a nurse promote health through knowledge?

A

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

158
Q

How can techniques be health promotion factors used by the nurse?

A

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.

159
Q

What is primary disease prevention?

A

Doing activities or developing a lifestyle to avert the initial development of disease or poor health

160
Q

What are some examples of primary prevention?

A

Immunizations
Low fat, high fiber diet
Exercise
Reducing sodium intake

161
Q

What is secondary disease prevention?

A

Early detection screening to stop or reduce the effects of a disease or illness

162
Q

What are some examples of secondary prevention?

A

Screening for things like diabetes or hypertension and adjusting diet accordingly if detected

163
Q

What is tertiary prevention?

A

Minimizing further complications after a disease or illness has already developed

164
Q

What is an example of tertiary prevention?

A

Minimizing further complications after a disease has already developed

165
Q

What are examples of tertiary prevention?

A

Continued medical care

Diet therapy

166
Q

What are the three methods of education for health literacy?

A

Formal education
Non-formal education
Informal education

167
Q

What is health literacy?

A

Learning how disease develops and what can be done about it

168
Q

What is formal education? Give an example?

A

Purposefully planned and implemented in an educational setting, like a nursing class

169
Q

What is non-formal education? Give an example

A

Organized/planned teaching that occurs outside of the classroom, like instructional classes or meetings at a hospital or clinic

170
Q

What is informal education? Give an example

A

Education that occurs through daily activities, like news broadcasts or magazine articles. Characterized by not having a planned time for education to occur

171
Q

What is health context?

A

The influence of cultural, social, and individual factors of the environment on the patient’s health

172
Q

What is health literacy actualization?

A

Being able to use acquired knowledge and skills

173
Q

What does DRI stand for?

A

Dietary reference intake

174
Q

What are DRIs based on?

A

Best available scientific data

175
Q

What is the estimated average requirement?

A

Amount of nutrients needed to meet the basic requirements of at least half the individuals in a population

176
Q

What is a recommended dietary allowance?

A

Level of nutrient intake to meet the needs of almost all healthy individuals in a life stage and gender group

177
Q

What is adequate intake?

A

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

178
Q

What must the nurse keep in mind when using DRIs in patient care?

A

The dietary recommendations must be tailored to the individual patient (diagnosis, age, gender, other factors)

179
Q

What is the estimated energy requirement?

A

DRI for dietary energy intake. Very dependent on the individual

180
Q

When establishing an adequate eating pattern, what general guidelines should be adhered to?

A

Assortment
Balance
Nutrient density

181
Q

What is the definition of nutrient density?

A

Nutrients per kcal (empty calories or not?)

182
Q

Why are nurses in a good position to recognize patients that need nutritional services?

A

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

183
Q

What are some red flags for nutritional decline?

A

Decreased appetite

Unintentional weight loss

184
Q

What does RDN stand for?

A

Registered Dietician-Nutritionist

185
Q

What are the minimum necessary credentials to be an RDN?

A

Bachelors degree
1200 hours of supervised practice
Passing a national exam

186
Q

What is the RDN specifically qualified to conduct?

A

The nutrition care process or NCP

187
Q

What is the NCP?

A

A detailed nutrition assessment, complete with diagnosis and directives for therapies, monitoring, and outcomes

188
Q

What does DTR stand for?

A

Dietetic Technicians, Registered

189
Q

What does the DTR do?

A 
Assists RDT by:
Taking diet histories
Getting information
Working with struggling patients
Doing basic nutrition education
190
Q

What can a DTR not do?

A

Give diagnoses

Counsel patients with complex disease diet modifications

191
Q

What are two forms of hidden hunger?

A

Undernutrition

Chronic micronutrient deficiencies

192
Q

What are some possible consequences of nutritional risk?

A 
Poor wound healing
Longer stay in hospitals/nursing homes
Health decline
Appetite loss
Depression
Stunted growth 
Perception changes
193
Q

What diet deficiencies are especially bad for growing children?

A

A diet low in quality protein and amino acids

194
Q

What is the focus of a nutritional risk assessment?

A

Whether the patient has the potential to become malnourished, either by primary or secondary factors

195
Q

How can acute hospitalization disrupt someone’s normal nutritional intake?

A

Their normal routine is thrown off by medications, procedures, illnesses, and psychological stress. Also the food is different from what they are used to.

196
Q

What are some reasons of why cultural assessment is important in nutrition?

A

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

197
Q

How quickly does the joint commission mandate that a nutritional screening happen?

A

Within 48 hours of hospitalization

198
Q

Who is qualified to execute a nutrition screening?

A 
Nurse
RD
DTR
Dietary managers
Physicians
199
Q

How is a nutritional assessment different from a nutritional screening?

A

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

200
Q

What are the ABCD components of nutrition assessment?

A

Anthropometrics
Biochemical tests
Clinical observations
Dietary evaluation

201
Q

What measurements are included in anthropometric assessment?

A

Height
Weight
Head circumference
Skinfold thickness

202
Q

What is the importance of an accurate height in anthropometric assessment?

A

Determining calorie, protein, and energy needs are all done using height and weight

203
Q

What is important to remember when it comes to patient height measurement?

A

Height declines with age

204
Q

What must one do to ensure an accurate weight?

A

Minimal clothing
Measure at same time daily after voiding
Standing still with evenly distributed weight

205
Q

What is body mass index?

A

Ratio of weight to height

206
Q

What is BMI associated with?

A

Overall mortality

Nutrition risk

207
Q

What are some limitations of BMI measurements?

A

Not validated with acutely ill patients
Underestimates body fat in elderly/those who have lost muscle
Overestimates body fat in muscular people

208
Q

What is the desired BMI range?

A

18.5-24.9

209
Q

What other measurements can be done to assess body composition?

A

Waist circumference
Waist to hip ratio
Waist to height ratio

210
Q

Which body composition measurement is the best indicator for diabetes, hypertension, and cardiovascular risk?

A

Waist to height ratio

211
Q

What are the components of a nutrition focused physical exam?

A

Fluid assessment
Functional status
Wound status
Clinical signs of nutrition issues

212
Q

What does poor muscle quality often predict?

A

Mortality

213
Q

What are the limitations of biochemical assessments?

A

No single test can evaluate short term success of nutrition therapy
Tests assume normal system functioning
Serial testing will give more accurate results

214
Q

What are two tests that can estimate visceral protein status?

A

Serum albumin

Prealbumin

215
Q

What are some conditions that can lower albumin levels?

A 
Renal failure
Heart failure
Hepatic cirrhosis
Inflammation
Infection
216
Q

Why is prealbumin better for monitoring short term changes?

A

Has a half like of two days instead of the 14-20 days of albumin

217
Q

What does low hemoglobin indicate?

A

Iron deficient anemia

218
Q

What are some effects of iron deficient anemia?

A 
Cognition issues
Stunted growth in children
Low energy
Weakness 
Cold skin
219
Q

What nutrients are measured when evaluating immune function?

A

Zinc
Vitamin A
Omega 3s
Vitamin D

220
Q

What are clinical factors that would be signs of nutritional factors?

A

Recent surgery or wounds
Blood loss
Skin and hair changes

221
Q

What are three methods that could be used to collect information on a patient’s dietary intake?

A

24 hour diet recall
Food records (1-7 days)
Calorie counts

222
Q

What are some physical disorders that can benefit from tertiary prevention strategies?

A

Ulcers
Diverticulitis
Celiac disease

223
Q

Why is nutrition counseling and therapy especially important for patients undergoing chemo?

A

Because good nutrition and nourishment is especially important to aid in the healing/recovery process

224
Q

What are some ways alternative medicine is used as related to nutrition?

A

Using herbal supplements or diet to treat cancer instead of chemo

225
Q

What are functional foods?

A

Foods that contain physiologically active (bioactive) substances

226
Q

What kind of things are considered dietary supplements?

A 
Vitamins
Minerals
Herbs
Botanicals
Amino acids
227
Q

Who is able to write the diet order?

A

Only the physician or privileged RD

228
Q

What are two nursing functions related to nutrition?

A

Nutrition assessment and education

229
Q

What is meant by medical nutrition therapy?

A

(Under medicare): nutrition treatment for diabetic/pre-renal failure patients

230
Q

What does the textbook definition of nutrition therapy include?

A

Providing food
Nutrition education and counseling
Coordination of care

231
Q

What is a regular diet intended to do?

A

Maintain optimal nutrition in people who need no modifications

232
Q

What is a qualitative diet?

A

A diet modified in consistency, texture, or nutrients

233
Q

Give examples of qualitative diets

A

Mechanical diet
Puréed diet
Liquid diet

234
Q

What is a quantitative diet?

A

A diet modified in number or size of meals or amount of nutrients

235
Q

Who is responsible for food service in a healthcare setting?

A

Director of food and nutrition services

236
Q

What are some types of modified diets?

A

Low sodium
No/low carb
Low fat

237
Q

What are some characteristics of passive communication?

A

Avoids conflict
Submissive
Apologetic
Allows others to lead

238
Q

What are some characteristics of aggressive communication?

A

Forces others to lose/seeks to win
Wants control
Manipulative

239
Q

What is assertive communication/

A 
Direct
Open and honest
Spontaneous 
Recognizes rights of self and others
Problem solving
Seeks compromise/win-win
240
Q

What are some assertive communication strategies?

A 
Using “I” statements
Focus on issue, not participants
Good non-verbal cues
Workable compromise
“Fogging” to accept criticism
241
Q

What is the meaning/purpose of CUS language?

A

Stands for “Concerned, Uncomfortable, Safety”

Seeks to advocate for patient safety and best practices

242
Q

What are the steps of SBAR?

A

Situation
Background
Assessment
Recommendation

243
Q

What is the purpose of SBAR?

A

Standardized, effective communication in healthcare

244
Q

What type of simple carbohydrate is most easily used by the body?

A

Glucose

245
Q

As a group, B vitamins are crucial to…

A

Metabolism

246
Q

What is the average minimum amount of carbohydrates needed to fuel the brain?

A

130 grams/day

247
Q

Describe how glucose gets converted and used in the body

A

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

248
Q

What is the stored carbohydrate energy source called?

A

Glycogen

249
Q

Where is glycogen stored?

A

The liver and muscle tissue

250
Q

How are blood glucose levels maintained between meals?

A

Liver glycogen is broken down and released as glucose

251
Q

How much energy do carbohydrates supply?

A

4 kcal/gram

252
Q

What are complementary proteins?

A

Incomplete proteins combined to make complete proteins

253
Q

What is the RDA of protein for healthy adults?

A

0.8 g/kg

254
Q

Sterols are another name for..

A

Cholesterol

255
Q

How much of total calories should come from saturated fat?

A

10% or less

256
Q

What do lipoproteins do?

A

Move lipids like cholesterol and triglycerides around in the body

257
Q

How much energy do lipids provide?

A

9 kcal/g

258
Q

How much energy do proteins provide?

A

4 cal/g

259
Q

What might limit an older adult’s water intake?

A

Avoiding drinking due to incontinence or excessive urination at night
Decreased thirst sensation

260
Q

What are signs of dehydration?

A 
Confusion
Weakness
Hot/dry body
Rapid pulse
High urine sodium
Furrowed tongue
261
Q

What two serious complications can arise in older adults due to dehydration?

A

UTI and sepsis

262
Q

What signs and symptoms should one first look for with a UTI in an older adult?

A

Confusion

Mood changes

263
Q

What is the recommended daily water intake for older adults?

A

8 cups/day

264
Q

What is the recommended protein intake for older adults?

A

30 grams per meal or 90 grams/day

265
Q

What might cause an older adult to have inadequate protein intake?

A

Increased protein use in body
Lower appetite
Lower mobility
Lack of money for groceries

266
Q

What can happen in marginal zinc deficiency?

A

Altered taste receptors: reduction in sweet and salty sensations

267
Q

How can marginal zinc deficiency change nutrient intake in older adults?

A

Decreased appetite due to food not tasting good

Increased sugar or salt consumption to try to make food taste better

268
Q

What are some possible causes of constipation in older adults?

A

Medications
Dehydration
Lack of dietary fiber

269
Q

What happens to vitamin D synthesis with age?

A

Reduction of synthesis

270
Q

How does aging affect vitamin B12 absorption?

A

It decreases the production of intrinsic factor necessary for vitamin B12 absorption

271
Q

What are some good sources of B12?

A

Eggs
Milk
Meat

272
Q

What diseases does menopause increase the risk for?

A

Coronary artery disease and osteoporosis

273
Q

What dietary changes are recommended to decrease risk of coronary artery disease?

A

Low fat/red meat
High in unrefined grains
High in lean protein
High in omega 3s

274
Q

What are some risk factors for malnutrition in older adults?

A 
Alcoholism
Chewing/swallowing problems
Eating too little
Medications
Depression
Diabetes
275
Q

What living environments might increase the risk of malnutrition in older adults?

A

Living on their own
Long term care
Hospitalization

276
Q

When are elemental formulas used?

A

When the GI tract is dysfunctional

277
Q

What is an elemental formula?

A

Formula with partially or fully hydrolyzed nutrients

278
Q

When is a modular formula used?

A

To supplement nutrition needs

279
Q

What does a modular formula usually contain?

A

One main macronutrient and then other products as needed

280
Q

What do speciality enteral formulas do?

A

Meet certain nutrition demands for diseases

281
Q

Can vitamin K be administered paraenterally?

A

No, it must be given IM or in an IV injectable

Krystan: Semester One Nursing School (6 decks)

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