Nursing 2750 Nutrition: Exam Two Flashcards
1
Q
What marks the transition (in terms of growth) from infancy into childhood?
A
Slower growth in uneven spurts
2
Q
How does the transition from infancy to childhood impact hunger and nutritional needs?
A
Nutrition needs and hunger levels will depend on how much growth is occurring, so hunger might increase and decrease accordingly
3
Q
What are the primary nutrients of concern in early childhood?
A
Protein
Calcium
Iron
Zinc
4
Q
What is the role of adults in childhood nutrition?
A
Providing food
Role modeling good food choices
Controlling the food environment
5
Q
How can snacking be beneficial in childhood? Harmful?
A
Beneficial: can boost nutrient intake
Harmful: often very sugary and replace nutrient dense foods
6
Q
What is the true concern with sugary snacks?
A
Displacing healthier foods, leading to deficiencies
Excess calories and fat
7
Q
What are two ways that TV plays a role in childhood nutrition?
A
Commercials advertise unhealthy foods
Many children eat while watching TV, which has been linked to consumption of lower quality food
8
Q
What are some concerning trends in childhood dietary intake?
A
Increase in total caloric intake
Decrease in healthy food consumption
Only 1% of children meet recommendations for all food groups
9
Q
What are some considerations for intake of fruit juice?
A
high in sugar, leading to cavities
Excess intake can fill child up, leading to decrease in nutrient (especially iron) dense foods
10
Q
What are important considerations for nutrition of children from ages 4-6?
A
Snacking can boost nutrient intake
New foods can be introduced
Children can start to be responsible for healthy choices
11
Q
What are considerations when introducing new foods into a child’s diet?
A
It may take 8-10 exposures to get the child to enjoy the food
Have backup meal plans
12
Q
What are general things to remember when considering nutrition for children ages 7-12?
A
Lots of growth happens in this time preparing for puberty
Caloric and protein needs increase
Calcium, iron, and zinc needs increase
Having healthy snack options at home is important
Many social factors involved in eating at school
13
Q
What is the impact of low zinc in childhood?
A
Decreased growth rate
14
Q
What are two categories of community support for childhood nutrition?
A
School food service
Classroom nutrition education
15
Q
What is provided by the National School Lunch Program?
A
Lunch at varying cost depending on family income
16
Q
What standards are used to regulate school lunch programs?
A
Dietary guidelines for Americans
17
Q
What foods must be provided by school lunches?
A
Fruits Veggies Whole grains Low/nonfat milk Cultural options
18
Q
What are some hindrances to school nutrition education?
A
Low funding
Unprepared teachers
Unchanging home lifestyles of students
19
Q
Where can lead be found?
A
Old paint
Porcelain fixtures
Soil
Air pollution
20
Q
Why are children at higher risk for lead poisoning?
A
They naturally absorb more minerals than adults
21
Q
What nutritional deficiencies increase lead absorption?
A
Iron, calcium, zinc
22
Q
What can be the effect of lead exposure?
A
Cognitive and perceptual issues leading to learning ability issues
23
Q
Which racial, ethnic, and gender groups are at higher risk for being overweight?
A
Black non-Hispanic girls
Mexican American boys
24
Q
What are some causes of higher childhood obesity?
A
More snacks
Eating away from home more
Bigger portion sizes
Sedentary lifestyles
25
When it is appropriate to intervene regarding the weight of a child or teen?
When the patient is motivated to do so
| Or when experiencing weight associated disorders
26
Why has the age for T2DM been getting younger?
Childhood obesity
Lack of activity
Poor quality diets
27
What helps prevent T2DM in children?
Matching energy intake with output
28
What is the goal of treatment of T2DM in children?
Maintaining current weight while growing
29
How does poverty affect the incidence of iron deficiency anemia?
Risk for lead poisoning, which decreases iron absorption
| Chronic hunger and nutrient deficiency
30
How do government nutrition programs hinder in decreasing rate of iron deficient anemia?
Many food options made available to the poor are iron poor foods, like cheese, butter, and milk
31
What are some disadvantages of cows milk for toddlers?
Low in iron
| Excess intake decreases appetite
32
How much juice should a toddler consume in a day?
Only 4-6 ounces
33
What contributes to a toddler’s decreased appetite?
Decrease in growth rate
34
What are some consequences of inadequate nutrition in children?
Impaired immunity
Depleted muscle mass
Depleted functional capacity
35
Why do intense food preferences emerge in preschool years?
Way to control environment
| More reactive to taste and texture in this time
36
What foods are preschoolers most likely to be allergic to?
Milk
Eggs
Peanuts
37
How could a nurse counsel parents about picky preschool aged children at mealtimes?
Don’t make it a power struggle
For the most part, food jags will not last that long or have a detrimental effect on overall nutrition
Offer options
38
Why is it important to let toddlers feed themselves as much as possible?
Promotes autonomy and motor skill development
39
Which populations of children are most likely to develop iron deficiency anemia?
Children under six months who are exclusively breastfed
Lower income families
Those in an environment with high lead poisoning risk
Cultural groups (African American, Hispanic American, Native American)
40
What factors affect food choice and differentiate it from what is popular in general culture?
```
Age
Gender
Health
Household structure
Socioeconomic status
```
41
True or False: Race, ethnicity, and region are synonymous with culture
False
Background does not automatically equate to culture
42
Assuming that culture is synonymous with background leads to...
Stereotyping
43
Acculturation
Immigrants adopting attributes of a new culture
44
What does culture determine in regards to food?
What is edible and inedible
45
How do food cultures originate?
In ones own culture and based on religion and nationality
46
What criteria must a food meet to be labeled as a food?
It must be readily available, safe, and nutritious enough to support reproduction
47
True/false: all cultures define as edible ALL sources of food that meet criteria to be called food
False, some things are edible but not socially acceptable
48
What are some cultural examples in the US of edible foods that are not acceptable culturally?
Horse meat, insects, dog/cat meat
49
CULTURE OVERRIDES FLAVOR
..
50
What should one include when planning a diet for a patient?
Patient’s favorite foods/food preferences
51
What factors influence food ranking in each culture?
Cost and availability
52
Core foods
Foods that provide a significant source of daily calories and are regularly included in the diet
53
What has replaced traditional diets high in complex carbs in much of the world?
High fat diets
54
What elements of food preparation are influenced by culture?
Cooking method, seasoning, and food choice
55
How are foods often prepared in Asian culture?
Stir fried
56
How are foods often prepared in Hispanic cultures?
Boiled
57
Why is assessing cultural needs essential to diet planning?
Because many cultural and religious groups have dietary laws that must be followed
58
What are components of cultural assessment?
Religion
Culture
Beliefs
59
When the nurse has the ability to adapt practiced skills to fit the clients cultural context, we say she is providing....
Culturally competent care
60
What is a general example of how food is used symbolically?
Food being viewed as synonymous with celebration in every culture
61
What are some specific examples of symbolic uses of foods?
Specific foods at specific holidays or celebrations
Foods being considered masculine or feminine
Foods considered “comfort foods”
Foods with links to the past
62
What are some variations in when and how food is eaten?
Frequency: at least once a day, up to five or more times a day
Varying meal times
Varying rules surrounding meal times
63
Desirable/undesirable personal and public behavior and social interactions are defined by...
Cultural values
64
What kinds of foods will patients do better with during an illness?
Foods familiar to them **so ask about favorite foods when diet planning**
65
What are orthodox Jewish beliefs about fish?
Only fish with scales and fins
66
What are Orthodox Jewish beliefs/rules about which meats can be eaten?
Vegetable eaters
Those with cloven hooves
Ritually slaughtered
67
Can dairy and meat be combined in Orthodox Judaism?
No, they cannot be combined in the same meal
68
What are food purified in the Jewish way called?
Kosher
69
What are meats slaughtered according to Islamic rules called?
Halal
70
Can Orthodox Jews eat Halal meat?
Yes, because it is prepared in the way prescribed by Judaism as well
71
Why is it important to understand the patient’s dietary preferences and medications?
Because there can be diet and medication interactions
72
True/false: almost all cultures define certain foods that promote wellness, cure disease, and impart medicinal properties
True
73
What is hot oregano tea with salt used for in Vietnamese culture?
Treating an upset stomach
74
True/false: culture shapes body image
True
75
How is being overweight/obese viewed in US culture?
As a character flaw and as being undesirable
76
Historically, what has thinness been associated with?
Risk factor for poor health and poverty
77
How do African, Mexican, Indian, and Caribbean cultures view being overweight?
As a sign of health, beauty, and prosperity
78
Is acculturation limited to immigrants?
No, it can also apply to moving from one community or area to another
79
What sorts of things are adopted culturally when someone acculturates?
Beliefs
Values
Attitudes
Behaviors
80
What is dietary acculturation?
When eating habits of immigrants change to resemble those of the host country
81
What is acculturation linked to in the United States?
Increased risk of chronic disease and obesity
82
Intake of what increases with acculturation?
Sweets and fats
83
Dietary acculturation is most likely to change food choices for what meals?
Breakfast and lunch
**so focus on these in education and assessment**
84
What is a better option than advising someone to completely eliminate a culturally important food from their diet?
Advising portion control of that food, or a lower sodium/fat option of that food
85
How does frequency of consumption change the impact of that food?
If it is unhealthy but only consumed rarely or on special occasions, it has very little impact on the total diet and probably does not need to be addressed
86
DONT ASSUME THE CLIENT KNOWS WHICH AMERICAN FOODS ARE HEALTHY
DO ADVISE CLIENT TO EAT FRUITS/VEGGIES THAT ARE SIMILAR TO CULTURAL NORM BUT PERHAPS UNAVAILABLE
87
What kind of food is common for those of African American heritage?
Soul food
88
What are the health risks of soul food?
High in fat, cholesterol, and sodium
89
What are nutrition related problems common with African Americans?
High fat intake
Higher obesity prevalence
Higher mortality rate from heart disease and strokes
90
What cultures influence traditional Mexican diets?
Spanish and Native American cultures
91
What are defining characteristics of Mexican American diets?
Low fat
High fiber
Lots of complex carbs
Lots of vegetable proteins
92
What are staple foods of the Mexican American diets?
Corn
Corn products
Beans
Rice
93
Why is milk not widely used in Mexican American diets?
Lactose intolerance is common
94
Is salsa a good source of veggies?
Yes
95
What are Mexican American beliefs in regards to illness?
It is inevitable and to be endured
| Hot and cold foods may be used for healing purposes
96
True/false: Mexican American beliefs include prayer for illness and lighting candles on behalf of a sick person
True
97
How does Mexican American intake of fruits and veggies compare to other cultures?
They consume a lot compared to other cultures
98
Mexican Americans may not get enough of what nutrient?
Fiber
99
As they acculturate, Mexican Americans consume too much what?
Fast food
| Salty snacks
100
Mexican Americans have high percentages of what health issues?
Obesity
| Type 2 diabetes
101
What are some staple foods in Chinese American cuisine?
Vegetables, sea veggies, fish, nuts, seeds, beans, soy, herbs, spices, tea, beer
102
How does Asian American risk for obesity and diabetes compare to other ethnic cultures?
They have the lowest risk of those complications
103
How do Asian cultures use dairy?
Sparingly, lactose intolerance is common
104
Why is calcium intake high in Asian diets?
High calcium in tofu
| Also in the bones of small fish, which are eaten, and soups with those bones dissolved in them
105
What does Asian sodium intake usually look like?
High intake, because of things like soy sauce
106
**most Asian cultures eat a lot of soup in their diet**
**soup is low in fat** YAY
107
What are Asian beliefs about health and illness?
Related to the balance of yin and yang in the body
108
What does yin represent in Asian cultures?
Female
Cold
Darkness
109
What does yang represent in Asian culture?
Male
Hot
Light
110
How would one cure disease caused by yin forces?
Yang foods
111
Is pregnancy considered yin or yang? How would this be treated with diet?
Yang, so eat yin foods like fruits, veggies, cold drinks, juice, rice water
112
What are some examples of yang food?
```
Chicken
Meat
Pigs feet
Nuts
Fried food
Coffee
Spices
```
113
What is the traditional Chinese diet low/high in?
Low in fat and dairy
| High in complex carbs and sodium
114
How do Asian diets change as people acculturate?
It becomes higher in fat, protein, sugar, and cholesterol
115
Is obesity prevalence high or low among Asian Americans?
Low (11.6%)
116
How do diabetes rates compare between Asian Americans and caucasians?
The same rate of incidence
117
What is the leading cause of death among Asian Americans?
Cancer
118
What are the statistics about how many Russians are in Minnesota?
Largest Russian community in the Midwest
119
How are Russian families usually structured?
The strongest personality is usually the head of the family
120
What are some characteristics of the typical Russian diet?
High in fat, carbohydrates, and sodium
121
What are typical religions in Russian culture?
Judaism
| Eastern Orthodox Christianity
122
What are some main medical conditions for Russians?
```
Diabetes
Hypertension
Coronary disease
GI issues
Mental illness
Alcohol/substance abuse
```
123
What are some Russian beliefs about disability and illness?
Believe it is caused by something the person did not do right
124
What do Russians believe about bad health news?
That it shouldn’t be given to a person who is ill or disabled, because they dont want them to get anxious or have their condition worsen
125
Where are the Hmong people from originally?
Mountains of south china
126
What are key foods in the Hmong diet?
```
Rice
Noodles
Fish
Meat
Green vegetables
Hot chili sauces
```
127
What does the shaman do in hmong culture?
Make decisions related to spiritual healing
| Conducts religious ceremonies
128
What are the most common medical conditions among the Hmong?
COPD
Diabetes
Congestive heart failure
Hypertension
129
**avoid direct eye contact with older hmong**
It is considered rude
130
How much fruit and dairy do Hmong usually consume?
Very little, compared to other ethnic groups
131
What is normal for water intake in Asian cultures?
Typically only drink warm/hot water
132
What must a sick person eat in Hmong culture?
Hot foods with certain vegetables
133
Adoption of a western diet has led to a dramatic increase in what among Hmong people?
Diabetes
134
True/false: Minnesota has the largest Ethiopian refugee population in the world
True
135
What are some social rules to follow when interacting with those of Ethiopian heritage?
Speak softly and politely and match the genders of interpreter and patient
136
What are the major religions among Ethiopian people?
Half are Muslim, half are Christian
137
What are some areas of concern for medical care of Ethiopians in Minnesota?
Long term effects of malnutrition
Trauma from war
Infection diseases (including STIs)
138
What does the term “Hispanic” refer to?
Language, not place of origin
139
What are dietary trends of Hispanic people in Minnesota?
Lots of flour tortillas, white rice, and processed foods
140
What is the main medical concern among Hispanic people in Minnesota?
Diabetes (twice as prevalent as in white population)
141
What should a nurse remember when interacting with Hispanic patients and families?
Establish a relationship with the family before care begins
| Acknowledge male family members who are present
142
What are the stats about Somalis in Minnesota?
Largest population in the US
143
What are the main foods in Somali culture?
Rice, bananas, meat (sheep, goats, cattle)
| Very little fresh fruits or veggies
144
What religious group do most Somalis belong to?
Sunni Muslims
145
What are medical concerns among recent Somali immigrants to US?
Malnutrition
Iron deficient anemia
Vitamin A deficiency
Scurvy
146
How are Somali families structured?
Families normally live in multi-generational households
Father is decision maker and wage earner
Men can have as many as four wives and men must support their children
147
What is Ramadan?
Most important Muslim holiday
A month long
People dont eat, drink, or take medications during daylight hours
148
Who is exempt from Ramadan practices?
Pregnant women
Very ill
Young children
149
What languages do Cambodians speak?
Khmer, Chinese, Vietnamese, French
150
What religion do most Cambodians practice?
Buddhism, particularly Theravada buddhism
151
What do Cambodians believe about pain?
Must be endured stoically
152
Who can act as spokesperson in a Cambodian family?
Father, eldest son, or eldest daughter
153
What medical procedures may Cambodians fear? Why?
Surgery and giving blood, due to belief that these things result in heat loss
154
What are two functions of food labels?
Help consumers select the healthiest foods
| Motivate food companies to enhance the nutritional values of foods
155
Which food products are NOT required to have nutrition labels?
```
Fish
Fresh Meat
Poultry
Milk
Eggs
Produce
```
156
Which nutrients are now also required to be listed on food labels?
Added sugars
Vitamin D
Potassium
157
What else has recently been changed on food labels?
Calories and serving size now large and bolded
| Portion size changed to the amount most usually consumed
158
Why was “added sugars” added to the nutrition label?
Because less than 10% of daily calories should come from added sugars
159
What can help lessen the effects of too much sodium?
Increased potassium
160
Why are percent daily values useful?
It allows people to make comparisons
| It also shows people how much they are eating of a certain nutrient
161
How can one use percent daily value to balance nutritional intake?
You can combine foods that are low in %DV with foods high in %DV of something to ensure that you get enough of that nutrient
162
What must be similar to compare nutrition labels?
Similar foods with the same serving size
163
What are some food descriptor terms that must now have uniform descriptions?
```
Lean
Extra lean
“Free” (like fat free)
“Low”
Reduced
Light
```
164
How do uniform food descriptors help consumers?
It helps people who are trying to limit intake of certain nutrients
165
What must a food product contain to be labeled as “100% whole grain”?
All grain ingredients must be whole grain
| Each serving must have at least 16 grams of whole grain
166
What must a product have to use the basic whole grain stamp?
At least 8 grams of whole grain
167
What makes an animal derived food organic?
No antibiotics or growth hormone used on the animal
168
What requirements must produce meet to be labeled organic?
No pesticides, synthetic fertilizer, bioengineering, or radiation used
169
What is the difference between natural and organic foods?
Organic foods must meet very specific standards, while natural foods don’t have uniform standards. Natural foods are usually less processed and more wholesome, but do not have to address how the food was grown/raised
170
What must a food product have to be labeled 100% organic?
All ingredients must meet or exceed USDA standards
171
What must a product be to be labeled organic?
At least 95% of ingredients must meet or exceed USDA standards
172
The ability to interact with people in an acceptable manner and sustain relationships with family members, friends, and colleagues is defined as...
Social health
173
People with adequate income generally eat more..
Protein and fats
174
Protein energy malnutrition is also known as...
Starvation
175
What is one standard of practice for Muslims regarding protein?
No pigs
176
What are some standards of practice for Judaism regarding protein?
No pigs
Only some birds
Fish with scales
177
Chronic hunger is also defined as...
Continual undernutrition
178
What is positive nutrition behavior? Give an example
Linking of two behaviors, such as always eating a piece fruit with a sandwich
179
What are two goals of healthy people 2020?
Increase quality and years of healthy life
| Eliminate health disparities
180
What are some disease burdens common in lower income areas?
```
Obesity
Diabetes
Asthma
Cancer
Heart disease
Stroke
```
181
What are some things a nurse can teach patients in lower income areas regarding nutrition?
```
Buy seasonal foods
Avoid prepared convenience food (more expensive)
Substitute beans for meat
Establish family meal times
Cook and freeze healthy meals
```
182
What are some functions of the Minnesota department of health?
Provide information and services, such as WIC, food stamps, elderly meal care/options, community clinics, etc
183
What are some functions of the National Institute of Health?
Rules and regulations
Research grants
Recommendations for social welfare issues
184
What are some functions of the Center for Medical Services?
Medicare and Medicaid
| Investigating abuses of resources or services
185
What are some functions of the Department of Human Services?
Rules and regulations to help with human services, like refugee settlement, housing, and food
186
When was public health developed as a discipline, and where?
Mid 19th century in Europe and the US
187
What are some legal and economic risk factors that contribute to health disparities?
```
Dietary changes and culture
Lack of activity
Transportation issues
Smoking
Stress
Chronic disease
Obesity
Urbanization
SES
Lack of food or shelter
```
188
What are some reasons for the high prevalence of smoking among those of lower SES?
```
Stress
Readily available
Coping mechanism
Social pressure
Meal replacement
Family norms
```
189
True or false: self concept increases with socioeconomic status
True
190
What kind of response is a food allergy?
An immune response
191
What is the pathophysiology of food allergies?
The immune system overreacts to a particular protein in that food
192
Most food allergies are diagnosed when?
Early childhood
193
What are the eight most common food allergens?
```
Eggs
Milk
Peanuts
Tree nuts
Wheat
Soy
Fish
Shellfish
```
194
What is the difference between allergies and intolerances?
Allergies trigger immune responses and can be life threatening, while intolerances do not trigger immune responses and more often just have GI symptoms
195
What is cross reactivity?
Immune system thinking one protein is closely related to an allergy-causing protein
196
What is an example of cross-reactivity?
People with ragweed allergies also reacting to bananas and melons
197
What are three methods for diagnosing allergies?
Medical history
Allergy skin tests
Food challenges
198
What is oral allergy syndrome?
Cross reactivity involving foods
199
What does FPIES stand for?
Food Protein-Induced Enterocolitis Syndrome
200
Which foods most often trigger FPIES?
Milk,soy, grain
201
What is eosinophilic esophagitis?
Allergic condition causing esophageal inflammation
202
In the body, what happens when an allergen is ingested?
Immunoglobin E is released, attaching to body cells. At the next encounter of the allergen (and all subsequent encounters) histamine is released
203
What does cooking do for intolerance of milk and eggs?
More than half of those with this intolerance can have milk and eggs if thoroughly heated/baked
204
Some people with pollen allergies also have reactions to...
Some fruits and vegetables, usually just in raw form
205
What are some questions a nurse would ask in allergy diagnosis process?
Food eaten
Frequency, severity, nature of symptoms
Time between eating and reaction
206
What are the issues with IgE blood testing for allergies?
It can cause false diagnoses and is unproven currently
207
How severe are the risks to airborne food allergens?
Not too severe, usually doesnt cause anaphylaxis
208
ALWAYS if an epi-pen is used...
Call 911, go to hospital, follow up with allergist
209
What is the relationship between vitamin D levels and food allergies?
Vitamin D deficiency has increased with allergy rates
210
What is the role of vitamin D in good health?
Maintaining healthy bones
| Maintaining good immune function
211
What influence do geography and birth month have on childhood food allergies?
Children born farther from the equator and in the fall/winter have much higher rates of allergies, anaphylaxis (up to six times the risk)
212
What is the link between age of introducing eggs into a child’s diet and allergy rates?
If eggs are introduced to a child’s diet after 6 months of age, they are more likely to be allergic
213
Infants with low vitamin D levels are more likely to have...
Allergies to eggs or peanuts
| Multiple allergies
214
Can vitamin D reverse food allergies?
No, but more research is needed
215
Can vitamin D protect against food allergies?
Potentially yes
216
Why should a pregnant woman be advised to consume adequate amounts of vitamin D?
Because an infant’s vitamin D stores in the first year of life depend on the mother’s stores before birth
217
How severe is oral allergy syndrome considered to be?
Fairly mild, rarely causes severe throat swelling
218
In OAS, those with birch tree allergy often react to...
Apples and celery
219
Why do those with birch allergies often react to some fruits and veggies?
There are similar proteins in some fruits and vegetables and birch tree pollen
220
What are the most common symptoms of OAS?
Itchiness
| Swelling of mouth/face/lips/tongue/throat
221
When do OAS symptoms usually appear?
Immediately after consuming food
222
People with OAS typically respond more strongly to fruits or veggies in what form?
Raw
223
What foods are usually associated with birch tree pollen allergies?
```
Pitted fruits
Carrots
Peanuts
Almonds
Apples
Celery
```
224
What foods are usually associated with grass allergies?
```
Peaches
Celery
Tomatoes
Melon
Oranges
```
225
What foods are usually associated with ragweed allergies?
Bananas
Cucumbers
Melons
Zucchini
226
What suggestions would a nurse provide to people with OAS?
Don’t eat those foods raw, especially in allergy season
Bake/heat the foods to break down allergy protein
Eat canned version of that food
Peel the food: protein usually found in the skin of the fruit or veggie
227
In childhood, how much of dietary intake should consist of dietary fat?
30%
228
How many exposures does it take for a child to accept a new food into their diet?
Sometimes 8-10 exposures
229
What are the two types of eligibility to receive free or reduced price school lunches?
Categorical (receiving some form of assistance)
| Income based
230
What are the functions of water in the body?
Structural component of cells
| Solvent to transport nutrients and eliminate waste
231
What is the AHA recommendation for daily sodium intake?
Less than 2300 mg daily
232
What are the most common causes of sodium deficiency?
Dehydration or excessive diarrhea
233
What are some good sources of potassium?
```
Bananas
Oranges
Meat
Dairy products
Green leafy vegetables
Legumes
```
234
What are some common causes of potassium deficiency?
Vomiting
Diarrhea
Diuretics
Misuse of laxatives
235
Over what period of time are I&O’s recorded?
24 hour time period
236
What fluids should be included in I&Os?
All fluids, including:
Paraenteral fluids
Fluid gained through food and drink
```
Fluid lost as:
Vomit
Diarrhea/stool
Urine
Sweat
Insensible
Blood
Wound drainage
```
237
What amount of difference between intake and output is cause for concern?
A difference greater than 200 mL over a 24 hour time period
238
What are some causes of fluid loss and dehydration?
```
Heavy exercise and sweating
Limited fluid intake
Severe vomiting and diarrhea
Severe burns
Anorexia/bulimia
Some medications
Hormone imbalances
```
239
What are some things that can cause electrolyte imbalance?
Anything that causes fluid loss, plus
kidney damage/failure
Cancer
240
What are some dietary guidelines for a patient with acute glomerulonephritis?
Maximize nutritional intake
| Fluid/salt/protein are not restricted unless necessary d/t symptoms
241
What are some other causes of renal failure?
Nephrotoxic drugs
Septicemia
Streptococcal infection
242
What are the three stages of acute renal failure?
Oliguria
Diuretic
Recovery
243
How long does the oliguria stage last and what are the dietary guidelines?
Lasts between 7 to 21 days and requires fluid restriction
244
How long does the diuresis phase of AKI last and what are the dietary guidelines?
Lasts between 7 and 14 days and requires lots of fluid replacement (to make up for fluid lost in excessive urination)
245
What are the food guidelines in acute kidney injury?
Protein restricted (0.6 to 0.8g/kg/day)
246
How long does AKI recovery last and what are some dietary guidelines?
Takes 3 to 12 months and requires restricted protein, potassium, phosphate, sodium, and fluid
247
What are two things to monitor for a patient on diuretic pills?
Monitor for falls (can cause BP decrease)
| Monitor potassium levels (can cause potassium depletion)
248
What are clinical findings of diabetes insipidus?
Dilute urine
Increased serum sodium and plasma osmolality
Signs of dehydration
249
Why should someone with diabetes insipidus avoid alcohol?
Because it suppresses ADH production, which is needed for fluid retention
250
Define fluid volume deficit
Decrease in water and sodium from ECF in similar proportions
251
Define fluid volume excess
Body retains water and sodium in similar proportions (increased blood volume)
252
What kind of patients will be placed on calorie restricted diets?
Those needing weight loss
253
What is a regular/balanced diet and what modifications might be made to it?
A diet that would sustain/nourish a normal and healthy person
It could be modified in the hospital to be slightly calorie reduced or with lower fat
254
What conditions might require a liquid diet?
```
Heart attack recovery
Infection and recovery
Digestive problems
Malnutrition or someone who has not taken anything by mouth in a long time
Pre and post operation
Fever/vomiting/diarrhea
```
255
What is included in a full liquid diet?
All clear/non-clear liquids and Anything that is liquid at room temperature
256
What conditions might require a mechanical soft diet?
Chewing difficulties from jaw issues, missing teeth, or extreme fatigue
257
What foods would be included in mechanical soft diets?
```
Liquids
Soft veggies and fruits
Ground/shredded meat
Eggs
Soft cheese and soft breads
```
258
What is included in a puréed diet?
Can include any food, but all will be blended to allow for little or no chewing
259
What conditions might require a puréed diet?
```
Ulcers of mouth or gums
Oral surgery
Dysphasia
Stroke
Numbness of mouth or throat
```
260
What is eliminated from a low cholesterol diet?
Creams, fats, rich foods, fried foods, whole milk, chocolate
261
What conditions might require a low cholesterol diet?
Gallbladder/liver disease
Obesity
Heart disease
262
What foods should be eliminated from low sodium diets?
```
Processed foods
Canned foods
Processed cheeses
Smoked/pickled foods
Olives
```
263
Who might be put on a high protein diet?
Kids and teens
Pregnant and lactating women
Those recovering from surgery
Recovering from burns, fevers, and infections
264
What patients might be placed on a bland diet?
Those with stomach/intestinal ulcers and digestive diseases
265
What is a low residual diet?
A diet low in fiber
266
What foods would be considered low residual?
```
Refined white breads and crackers
Cooked cereals
Cold cereals
White rice
Noodles
Refined pasta
Peeled vegetables
Well cooked vegetables and veggies without seeds
```
267
What might require a patient to adopt a low residual diet?
Narrowing of the bowel
Bowel surgery
Treatment that irritates the digestive tract
268
**avoid seeds in a low residual diet**
**also cook all veggies**
269
What are some fluid and electrolyte considerations for infants?
They dehydrate easier, due to...
Immature kidneys that cannot retain water
Higher proportion of water to body weight
Reliance on others to feed them
More rapid respirations
270
What are some fluid and electrolyte considerations for the elderly?
Multiple medications that can dehydrate
Decreased kidney ability to respond to ADH and conserve water
Decreased renal blood flow
Decreased thirst
271
How much body water needs to be lost to affect thinking and physical performance?
Only 1-2%
272
How much digestive fluid is secreted by the GI tract every day?
Approximately 8000 mL, but pretty much all is reabsorbed
