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kaplan remediation of weak topics > nutrition > Flashcards

nutrition Flashcards

1
Q

Wound Healing

Primary intention

A
  • skin edges well approximated or closed

- heals quickly with minimal chance of infection or scarring

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2
Q

Wound Healing

Secondary Intention

A
  • left open
  • closes, filling in from the bottom up with scar tissue
  • severe scarring
  • longer time frame to heal
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3
Q

Wound Healing

Tertiary Intention

A
  • left open for several days before the closure

- allowed to finish closing by primary intention

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4
Q

Diet for wound healing

A 
high in: 
- protein 
- fat
 - carbohydrate 
- Vitamins A, C, E 
- minerals including zinc 
Most important--> vitamin C, protein and zinc
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5
Q

Wound assessment includes

A
  • monitor serum albumin and serum protein (indicates good nutritional status)
  • the type of wound
  • mechanism of injury (electric, burn)
  • exudate ( color amount characteristic)
  • pain associated with the wound
  • CBC
  • wound cultures
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6
Q

Risk factors for delayed wound healing

A
  • obesity
  • anemia
  • diabetes Mellitus
  • malnutrition
  • neuropathy
  • smoking
  • infection
  • medications- corticosteroids
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7
Q

Signs and symptoms of poor healing

A 
purulent exudate
enlargement of wound 
failure to decrease in size 
increased pain 
discolored or dry wound bed 
the increased amount of exudate
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8
Q

Treatment for wound healing

A

Diet–> high protein and adequate calories
Wound care–> cleaning, promoting moist wound bed, dressings (manage type and amount of exudate)
Surgical treatments–> restore blood flow
Wound closure–> minimize scarring, decrease the risk of infection
Antibiotics-> infections

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9
Q

Fat-soluble vitamins (A,D,E,K)

A

can be stored in the body in large amounts

  • absorbed better when a person takes them with higher fat foods
  • low risk of deficiency
  • the elevated risk of toxicity
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10
Q

Fat-soluble vitamins: Vitamin A (retinol)

A 
-formed in the body from carotene 
Vitamin A supports several functions throughout the body, including:
-vision (visual acuity- at night) 
-the immune system
-tooth and bone development

Animal sources of vitamin A include:
fish liver oil
beef liver
cheese, milk, egg yolks, butter fat in milk

Sources of beta carotene include:
sweet potato
kale, spinach, and other green, leafy vegetables
carrots
cantaloupe, pineapple, limes, oranges
black-eyed peas
fortified breakfast cereals
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11
Q

Fatt-soluble vitamins: Vitamin D

A
  • essential in calcium and phosphorus metabolism
  • necessity for normal development of bone and teeth
Forms: 
Vitamin D2 (FROM plant sources): milk, cod liver oil, salmon and cod liver, egg yolk and butter fat
Vitamin D3 ( in the skin-activated by exposure to sunlight or UV rays)

Deficiency- imperfect skeletal formation, bone disease, rickets, dental caries

Excess- anorexia, nausea, vomiting, anxiety, weakness, increased thirst, increased urination, pruritus, altered kidney function

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12
Q

Fat-soluble vitamins: Vitamin E

A

-is a nutrient that’s important to vision, reproduction, and the health of your blood, brain and skin and is an antioxidant

Food sources: wheat germ, vegetable oils (soybean and corn)
Deficiencies:
-immune system supression
- red blood cell hemolysis

Excess in low-birth-weight neonates

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13
Q

Fat-soluble vitamins: Vitamin K

A
  • is a group of vitamins that the body needs for blood clotting, helping wounds to heal
  • necessity for clotting factors (8,9, 10)and prothrombin in the liver
  • requires bacteria for formation in the colon
  • bile salts are necessary for vitamin K absorption

USES: conversion of osteocalcin to the active form

  • inhibits calcium oxalate stone formation in the kidneys
  • given to all newborns
  • helps decrease bleeding in surgeries

Deficiency: prolonged clotting and bleeding times

Food sources:
alfalfa, fats, oats, wheat, rye

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14
Q

A high calcium diet includes

A

Your body needs calcium to build and maintain strong bones. Your heart, muscles and nerves also need calcium to function properly
Examples:
extra milk products, green leafy vegetables, eggs

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15
Q

High-Calorie diet

A

extra servings of carbs

examples are: whole grains, fruits, honey, starches, refined sugars, potato, legumes (peas and beans), vegetables

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16
Q

High fiber diet

A

for clients with constipatiton
-maximizes the bulk in stools
Encourage: fresh fruits and vegetables, whole grain cereals and breads, foods high in fiber

Examples: apples, oatmeal, bran muffin, grapefruit, lima beans, cracked wheat bread, minestrone soup, asparagus, brussel sprouts

Not allowed: white bread, cakes, pies

17
Q

High protein diet

A

extra servings of protein

indicated for: Your body may need extra protein if you have certain health conditions, such as cancer, burns, or injuries. You may also need to follow this diet to get stronger after a surgery or illness.
Found in: fish, chicken, pork, beef, cheese, eggs, soybeans, some veggies

18
Q

Low calorie diet

A 
decrease meat 
increase fish 
decreases calorie intake 
grill, broil and microwave food
limit sweet deserts

Normal calories: women (1500-1800) men (1500-1800)

encourage–> dietary journal

19
Q

Low cholesterol diet

A

indicated for people with:

  • heart disease
  • arteriosclerosis
  • high cholesterol

*cholestterol is a fat-like substance found in foods of animal origin
Foods included- healthy foods without animal origin
Foods contraindicated- milk, egg yolk, organ meats

20
Q

Low potassium diet

A

used for: fluid balance, acid-base balance, nerve impulse transmission, skeletal muscle contractility control, metabolic reaction catalyst

Foods not allowed: soy nuts, pistachios, peanuts, cantaloupe, apricots, orange, banana, raisins, plantains, prunes, apple juice, sweet potato, baked potato, peas, tomato juice, avocado, spinach, asparagus fish, lamb, beef, clams, yogurt, molasses

21
Q

Low protein diet

A

for patients with kidney or hepatic damage
-decreases the workload of the liver in metabolizing nitrogen to urea and of the kidney excreting urea

Diet–> fat and carbs
Encourage these proteins in small amounts:
-yogurt, soy, poultry, milk, meat, fish, eggs, cheese

22
Q

Low sodium diet (140 mg or less)

A

lower body water and excretion
lowers blood pressure

Foods not allowed
-preserved meats, cheese, fried fruits, milk products, canned foods, added salt

23
Q

What percent of daily caloric intake comes from fats?

A

25%

24
Q

Lab data that determine nutritional status

A
  • serum protein level
  • albumin
  • pre-albumin
  • cholesterol levels
25
Q

Education on a low-fat diet to avoid foods high in fat

A
  • whole milk products
  • fried foods
  • baked products
  • regular salad dressing
  • meats with fats
  • encourage to monitor weight
  • consult dietician
26
Q

Water-soluble vitamins

vitamin B1 (thiamine) , B2 (ribofalvin), B3 (niacin), B6 (pyridoxine), B12 (cyanocolbalamin), Vit C (ascorbic acid

A

organic substances found in food

  • used in small quantities
    - growth
    - transformation of food substances into tissues
27
Q

Vitamin B1 (thiamine)

A

treat

  • beriberi (Beriberi is a disease caused by a vitamin B-1 deficiency, also known as thiamine deficiency)
  • anorexia from thiamine deficiency
  • Pellagra is a systemic disease that results from severe vitamin B3 (Niacin) deficiency. Mild deficiency may go unnoticed, but a diet chronically low or without Niacin may result in the 4 D’s: diarrhea, dermatitis, dementia, and possibly even death.
  • alcoholism
  • neuritis of pregnancy
28
Q

B2 ( riboflavin)

A

found in milk products, whole grains, liver, fortified or enriched grains

Deficiency- inflammation of membranes–> mouth, skin, eyes, GI tract

29
Q

B3 (niacin) - take with food or milk, take aspirin 30 min before taking, change positions slowly, eat low fat low cholesterol diet

Food sources: meats, eggs, dairy, milk

A

lipid-lowering agent, causes peripheral vasodilation
Uses–> treat and prevent –> Niacin deficit (pellagra) and hyperlipidemia

Actions–> coenzymes required in lipid metabolism, glycogenolysis, tissue respiration
-inhibits free fatty acid from adipose tissue

Decreases: hepatic lipoprotein, triglyceride, lipoprotein synthesis

Adv effects: hepatotoxicity (dark urine, jaundice), GI upset (bloating, nausea, diarrhea), pruritus, flushing of face and neck,

30
Q

Vitamin B6 (pyridoxine)

toxicity–> diminished sensory function

Food sources: meat, fish, poultry, liver, kidneys, nuts, bran, yeast, egg yolks, bananas

A

HgB synthesis

  • interferes with levodopa
  • tryptophan metabolization to vitamin B3
  • prevents adverse effects of isoniazid
  • assists with the metabolism of amino acids and proteins

Uses: high protein diet

  • isoniazid therapy
  • early pregnancy
  • oral contraceptive
31
Q

Vitamin B12 ( cyanocobalamin)

food sources: meat, milk, eggs, cheese, liver, fortified cereal,

A

actions–> binds with intrinsic factor in the stomach and absorbed in the intestines

Coenzyme required for the synthesis of amino acids, heme, nerve function

32
Q

Vitamin C (ascorbic acid)

Food sources: celery, onions, raw cabbage, young carrots, raw cabbage, lettuce, tomato, radish, strawberries, apples, pears, plums, peaches, apricots, citrus fruits, green peppers

A

uses: formation of cartilage in connective tissue, maintain the integrity of intracellular cement in many tissues especially capillary walls

Deficiency: scurvy, anorexia, anemia, defective teeth, injury potential to bones, cells, and blood vessels

Excessive doses: interfere with absorption of vitamin B12, uricosuria, promote the formation of renal oxalate calculi

33
Q

Chronic kidney disease

A

diet:
- low protein
- low potassium
- low sodium

34
Q

Promote the environment when feeding patient

A
  • keep the environment free of odors
  • oral hygiene before and after meals
  • maintain comfort
  • encourage interaction with others at this time as this is a social time
35
Q

Nursing considerations before feeding

A
  • toileting before
  • provide hygiene measures before
  • monitor for aspiration
  • allow the client to chew and swallow before offering the next bite
  • document intake and output
  • allow the client to select the order of food to be eaten
  • encourage the patient to feed self if able
  • may need dietician referral if the patient is not consuming
  • uses special utensils as ordered for patient (OT)
36
Q

Clear liquid diet
(easily digested and leaves no undigested residue in the intestinal tract)
* Does not provide adequate calories and nutrients

A

maintains fluid balance

Uses–> surgical clients, acute vomiting, and diarrhea

Example: boullion, tea with lemon, ice pops, gelatin, ginger ale, fruit juice without pulp

Prohibited foods: milk products, fruit juices with pulp

37
Q

Full liquid

A

uses only liquids
All clear liquids plus–> smooth textured dairy products, yogurt and ice cream, refined cooked cereals, vegetables, and fruit juices, pureed vegetables

38
Q

Mechanical soft

A
  • for clients with difficulty chewing
  • clear and full liquids
  • pureed foods
  • sweets
  • dairy products
  • foods that are easy to chew
39
Q

Postoperative diet

A 
clients NPO until gag reflex returns 
Returns in this order: 
-clear liquids 
-full liquids 
-soft diet 
-regular diet
  • if client gets nauseated or vomits, progress down the last ordered diet tolerated

kaplan remediation of weak topics (1 decks)

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