Nursing Therapeutics Flashcards
Therapy
the treatment of disease or disorders, as by some remedial, rehabilitating, or curative process.
How do we assess nutritional status?
- anthropometry - height and weight
- lab tests (CBC, anemia or low Hgb, Iron, folate, or vit B deficiencies)
- biochemical analysis (serum proteins, albumin, transferrin, transthyretin and retinol binding protein, C reactive protein)
Serum proteins
liver function
Albumin
most abundant serum protein in the blood. Most commonly measured to determine how nourished the individual is. Longer half-life. Good snapshot of nutrition status over a period of time.
Transferrin
protein that transports iron. If someone has a low iron level, the body increases the amount of transferrin. If there is low iron, there will still be a deficiency. So if transferrin is high there is indication that iron levels are low.
Transthyretin and retinol binding protein
respond very quickly to changes in nutrition. really expensive and can be affected by many other factors
C-Reactive protein
indicator of infection and inflammation. A source of metabolic stress that is telling us the body is going to need a higher amount of nutrition to fight this infection
Nitrogen Balance
- estimate protein requirements
- should be zero balance in adults
- nitrogen balance = nitrogen intake - nitrogen loss
- growing infants, children, adolescents, pregnant women, and those recovering from illness should have positive nitrogen status
- negative is a sign of malnutrition.
Dietary History
- dietary restrictions
- allergies
- natural supplements
- vegetarian/vegan
- comorbidities
- any other diseases that might be affecting their diet
- person and social histoyr
- socioeconomic status
Dietary Assessment
- 24-hour recall (guided interview)
- food frequency (food intake over a year)
- food record (written account of food consumed)
- Direct observation (monitoring what they’re taking in)
Usual/Ideal Body Weight
- provides estimate of what a person should weigh and rapid weight gain would indicate fluid shifts.
Anthropometric Assessment in Adults
- weight loss of more than 2% within one week or 5% over one month suggest beginning malnutrition. Evaluate carefully, as weight gain can come from fluid retention which can mask weight loss associated with malnutrition
Body Mass Index
- a person’s weight in kilograms divided by the square of height in meters
- a valid measurement of weight in realtion to health but does not differentiate between excess fat or muscle or bone
Underweight
BMI < 18.5
Normal or healthy weight
BMI: 18.5-24.9
Overweight
BMI: 25.0-29.9
Obese or morbidly obese
BMI: 30.0 and above
Diet/Drug Interactions: Medications Can
- reduce appetite
- increase appetite and weight gain
- alter absorption metabolism and excretion
- be toxic with some food
Diet/Drug Interactions: Drugs Can:
- induce nausea and vomiting
- cause diarrhea or constipation
- alter taste sensation
- suppress appetite
- dry the mouth
- cause inflammation and lesions in the mouth
- sedate the patient
- some stimulate food intake (weight gain)
Drug Effects on Absorption: Stomach emptying rate
- meals delay absorption
- Empty stomach enhances absorption
Drug Effects on Absorption: Stomach acidity
- some drugs need an acidic environment
- others may need enteric coating
Drug Effects on Absorption: Interactions between Drugs and Dietary components
- some foods can bind to drugs and decrease absorption
- calcium can bind to some antibiotics and prevent antibiotics
Vitamin K rich food
Can weaken the effect of blood thinner
Grapefruit juice
- increases blood concentrations of some drugs
- cautions same for tangelos and seville oranges
Herbs that enhance blood thinners
- St. johns wort
- garlic
- ginseng
- Dong quai
- Danshen
Drug Effects on Nutrient Excretion
- some medications may: alter mineral reabsorption in the kidneys leading to waste of nutrients from systems
- concern regarding calcium, magnesium, potassium, and thiamin - may require supplements
- cause an increase or decrease in urinary loss
Interactions between food components and drugs can cause toxicity or exacerbate a drugs side effects
- tyramine in foods and MAO inhibitors
- interactions can be fatal
- alcohol and drugs can be fatal combinations
- interactions are listed in drug manuals
