Nutrition Flashcards
Define nutrients
organic+ inorganic
substances found in foods that are required for the body to function
Define nutritive value
nutrient content of a specific amount of food (no single food provides all essential nutrients)
What are the major functions of nutrition?
- Energy
- Structural material for body tissues (seen in wound healing after surgery)
- Regulating body processes
Describe macronutrients (grams) (essential nutrients)
Needed in large amounts:
water (important for survival)
carbohydrates
proteins
fats
some vitamins and minerals
Describe micronutrients (mg// mcg) (essential nutrients)
Needed in small amounts:
vitamins
minerals
Carbohydrates (CHO) are made up of what?
Sugar
Starch
Fiber
Energy providing nutrients are:
carbohydrates
fats
protein
Describe empty calories and provide an example
High in sugar and solid fat
Low in nutrients in relation to the calories they contain
Alcoholic beverages
Describe what simple sugars (carbohydrates) are
Monosaccharides
Disaccharides
-ose (glucose [easy to digest] , fructose, galactose)
Lactose (animal milk)
Provide examples of natural sugar (CHO)
fruits
sugar cane
sugar beets
Provide examples of process or refined sugars
table sugar
molasses
corn syrup
Describe starches
non sweet CHO
insoluble
polysaccharides
List examples of starches
grains
legumes [beans and peas]
potatoes
cereal
bread
flour
pudding
Describe what fiber is
cannot be digested by humans
keeps GI tract functioning effectively and helps eliminate waste
Where and what foods is fiber located?
On the outer layer of grains, bran, and in the skin, seeds, and pulp of many vegetables and fruit
Describe the chemicals in carbohydrate digestion
amylase (salivary and pancreatic)
enzymes
the desired end product is monosaccharides and absorbed by the small intestine
Describe what is happening in carbohydrate metabolism
metabolism is a major source of body energy
after eating, the body breaks down carbohydrates into glucose.
some glucose continue to circulate in the blood to mx blood levels and be ready to provide energy.
the other glucose is actually used as energy or stored.
Insulin helps transport glucose into the cells.
Describe what is occurring when carbohydrates are stored and coverted
Stored as glycogen (liver) or converted into fat
Glycogen [chief carbohydrate stored in the body especially in the liver and muscles where is stays on standby to get converted back into glucose]
Glucose that cant be stored as glycogen gets converted into fat,
Which essential amino acid (protein) has a role in the immune system?
Arginine (10th AA)
9 are necessary for tissue growth and mx
What type of amino acid can the body make?
Non-essential
What type of AA can the body NOT make?
Essential AA
These are essential to get into the diet.
Compete proteins include and what are examples?
Essential AA and non essential AA
meats
poultry
fish
dairy
eggs
Incomplete proteins and what are examples?
corn (incomplete) + beans (incomplete) = complete protein
eating two or more vegetables with small animal protein
rice + pork
cereal + milk
spaghetti + cheese
What is occurring during protein digestion and storage?
begins in stomach where pepsin breaks protein down
Most protein is digested in the small intestine
Pancreas secretes protein rocks (protein enzymes) like trypsin and peptidase [a protein]
Which can be synthesized into albumin and globulin
OR
transported into tissues to make protein for cell structures
Describe what is occurring during protein metabolism?
Anabolism - building tissue from AA
Catabolism (catastrophizing) - breaking down AA for energy or conversion to fat
Nitrogen balance - measure of protein anabolism and catabolism (the net result of intake and loss of nitrogen)
What makes nitrogen balance?
when the N intake equals N output
What does a (-) N balance indicate?
the body is NOT getting enough protein
What makes up lipids?
Fats (solid at room temp)
Oils (liquid at room temp)
Fatty acids (saturated [butter] and unsat - [vegetable oil])
Glycerides (triad [triglycerides] butter, olive oil, corn oil)
Cholesterol - produced by our body and we cant live without it
List examples where cholesterol (lipid) is found
milk
egg yolk
organ meats
What is occurring during lipid digestion
Begins in the stomach and digested in the small intestine by bile and lipase (pancreatic and enteric)
SI and liver must convert into soluble compounds called lipoproteins
What is occurring during lipid metabolism
Converting fat into usable energy
1lb of fat = 3500 kcal
Describe vitamins (micronutrients)
Vitamins canNOt be made by the body
Water soluble vitamins
Fat soluble vitamins
List examples and explain what water soluble vitamins are
B and C complex
B1 (thiamine)
B2 (riboflavin)
B3 (niacin)
B6 (pyridoxine)
B9 (folic acid)
B12 (biotin)
The body cannot store water soluble vitamins. A daily supply is needed.
List examples of fat soluble vitamins
ADEK
(all dogs eat [fat soluble] kibble]
which can be stored by the body
What is a risk with minerals (micronutrient)
low iron
low bone calcium
What are common problems associated with mineral nutrients?
iron deficiency - anemia
loss of bone calcium - osteoporosis
For oral nutrition what is the energy after carbs, proteins, and fats are metabolized?
4 calories per (g) or CHO and protein
9 calories per (g) of fat
What is the term that described the expenditure of energy required to maintain body functions (to stay alive)
Resting Energy Expenditure
Where do you measure percent body fat?
waist circumference
skin fold testing (triceps// most common)
Define BMR
The rate at which the body metabolizes food to mx energy when awake and at rest
What is the range of a normal BMI?
18.5 - 24.9
What is the range of an overweight BMI?
25 - 29.9
What is the range of an obese BMI?
30 - 35
What is extreme obesity?
40+ BMI
Why do mean need more calories and women need more iron (factors that effect nutrition)
Men need more calories because of their body composition
Women need more calories due to reproduction
Religious practices are a factors effecting nutrition how
Judaism and Islam = no pork
Catholics = no meat on certain days (Ash Wednesday / Good Friday/ Lent)
Which meds cause constipation (factors that effect nutrition)
Morphine
Thiazide diuretic
Antihypertensive
Which meds cause diarrhea (factors that effect nutrition)
Thiazide diuretic
Antihypertensive
Antineoplastics
chemotherapy - diarrhea + oral ulcer + bleeding
Milk affects which two medications
hinders tetracycline [has to be taken on an empty stomach to be affective]
and
enhances erythromycin (antibiotic)
What nutrition concerns are related to the young adult
the need for teaching
concerned about calcium intake and obesity
What is the nutrition concern for middle adults?
Protein + Calcium
List pt nutrition teaching topics for the older adult
Including each food group on MyPlate
Reduce caloric intake (due to decreased activity)
Reduce fat consumption
Use leaner meats - needs to be sufficient [4-6oz / day]
Low fat milk and cheese
Limit salad dressing/ butter
Reduce empty calories - eat fruit and pudding rather than pastry and cookies
Reduce sodium (HTN / cardiac problems)
Need adequate calcium
Need adequate vitamin D
Needs adequate iron
Fiber rich foods
Potential problems with older adults
Some foods interact with their medications (vitamin K + coumadin)
Some meds increase or decrease appetite
Need to consult PCP before changing their diet significantly
Certain tablets shouldnt be crushed and given by mouth or gtube
Aspiration and safety are a priority
Use chin tuck method for pts with dysphagia
Use foods of prescribed consistency
Focus on pt food preferences
Make meal time positive and social
Dietary guidelines for americans
Shift to plant based (veggies, grains, fruits)
Reduce foods with added sugars and solid fat
Engauge in regular activity
Consume foods with vitamin D, Ca, potassium and fiber
< 2300 Na/ day
20% - 35 % total fat intake of total calories, < 10% of saturated fatty acids
< 300 mg cholesterol
Vegetarian diets need complete proteins (or complementary foods) to make a nutritionally sound diet, these foods
grains + legumes + nuts and seeds
any type of beans + corn
almonds
cashew
pecan
whole wheat
oat/ corn meal
Lact-ovo meaning
will eat milk and eggs
True or false: obese pts (BMI > 30) can be undernourished in certain nutrients?
True
List signs of undernutrition
inadequate food intake
weight loss
weakness
delayed wound healing
List the components of a nutritional assessment
Anthropometric data (H&W / BMI / tape testing - triceps skin fold)
Biochemical data (Hgb albumin lymphocyte)
Clinical data (skin hair nails activity level)
Dietary data (food frequency record)
Risk factors for nutritional problems
diet hx (budget, chewing / swallowing difficulties, physical disabilities)
medical hx (chronic illness, GI problems fluid and electrolyte imbalance)
Medical hx (anti-acid-depressant-inflammatory-hypertensive-neoplastic/ aspirin, laxatives)
Using the national screening tool, what are the nutritional assessment scores
0-2: Good!
3-5: Moderate nutritional risk
6 and above: High nutritional risk
Unintentional weight loss or gain of ____ within____ months is a risk factor for nutritional problems
10% within 6 months.
Complementary foods are
beans and corn
List problems associated with nutrition in older adults
difficulty chewing
lowered glucose tolerance
decreased social interaction
loss of appetite, smell and taste
limited income
difficulty sleeping
Which two labs help determine nitrogen balance?
Urinary nitrogen and creatine
What are signs associated with malnutrition
dry flakey skin
brittle nails and dry hair
red cracks at the edge of the mouth
swollen beefy tongue
c/d/v/a
decreased reflexes
underdeveloped muscles
swollen and inflamed gums
List foods in a clear liquid diet
gives calories but is inadequate
coffee (regular + decaf)
tea
fat free broth
soda (carbonated bevies)
Clear fruit juice (apple, cran, grape)
Popcicles
Gelatin
sugar/ honey
hard candy
List foods on full liquid diet
liquid at body temperature
Milk
pudding
custard
ice cream / sherbet
veggie juices
refined cereals / strained cereals
cream / butter/ margarine
eggs
smooth peanut butter
yogurt
List foods on a soft diet
easily chewed foods
lean meat (fish / poultry)
spaghettie sauce with ground meat over pasta
chopped veggies / (soft) mashed and sweet potatoes/ avocado
cooked or canned fruits
applesauce
soft cake bread puddng
Nurses are the first to notice this
dysphagia (difficulty swallowing)
What is IDDSI and what is the importance?
International Dysphagia Diet Standardization Initiative
Describes and ranks textures of foods and thickened liquids for people with dysphagia for all ages, care settings and cultures
Gastric contents are which pH
pH1-5
a pH 6 or higher indicates
lower intestinal tract
At what rate do you pass the tube with each swallow?
2-4 inches or 5-10cm
Timeframe of cyclic feeding
continuous but less than 24 hours
Timeframe for open system (open top container with no more than 4 hours of reconstituted formulat)
bag + tubing replaced in 24 hours
Timeframe of closed system (prefilled container than is spiked and sterile)
can be hung for 48 hours (2 days)
How often is NGT equipment changed?
q 24 h
How frequently are bowel sounds assessed before each feeding or continuous feeding
q4-8hrs
