Nutrition Flashcards
Metabolism
Total of all physical and chemical processes
Definition of Nutrition
Study of nutrients and how body utilizes the nutrients in food
Total of all processes involved in the taking in and utilization of food substances for proper growth functioning & maintenance of health
Catabolism
Process of breaking down, disintegrating, or tearing substances into simpler substances (breakdown of larger molecules into smaller ones)
Energy is often released during this process.
Anabolism
Building up, assimilation, or conversion of ingested substances
Synthesis of substances to form new, larger substances
Role of Organs of the GI Tract
Digestion Absorption Metabolism Storage Elimination of nutrients
General good nutrition status:
Alert Responsive Sleeps well Energetic Seldom ill
Good weight nutrition status:
Appropriate for:
Age
Height
Body build
Good skeleton nutrition status:
Good posture
No malformations
Good skin nutrition status:
Good color Smooth Moist Good turgor No rashes Swelling
Good muscle nutritional status:
Firm
Good tone
Good nail nutritional status
Pink
Firm
Good eye nutritional status
Clear
Bright
Moist
Good hair nutritional status
Shiny
Smooth
Good elimination nutritional status:
Regular
Soft
General inadequate nutritional status:
Apathetic
Easily fatigued
Looks tired
Often ill
Inadequate weight nutritional status:
Overweight
Underweight
Inadequate skeleton nutritional status:
Poor posture
Inadequate skin nutritional status:
Rough
Dry
Pale
Poor turgor
Inadequate muscle nutritional status:
Flaccid
Poor tone
Inadequate nail nutritional status:
Brittle
Pale
Inadequate eye nutritional status:
Dull
Pale
Dry
Inadequate hair nutritional status:
Dull
Dry
Brittle
Inadequate elimination nutritional status:
Diarrhea
Constipation
Substances (chemical compounds) are needed for:
Growth, maintenance and repair of the body
Basic functions of chemical compounds:
Provide energy
Build/repair tissue
Regulate body processes
Define essential nutrients
Nutrients our body cannot make in amounts necessary for good health
Must obtain them through food
6 classes of essential nutrients:
Carbohydrates Fats Proteins Vitamins Minerals Water
Substances that are thought to protect cells from the damage caused by free radicals:
Antioxidants
Nitrogen Balance
When the body takes in more nitrogen than it excretes, to use excess nitrogen to build new tissue
Simple Carbs
One or two molecules of sugar that are absorbed and burned very quickly; they raise BG level, causing dumping of insulin, causing BG level to plummet
Essential Amino Acids
Cannot be made by the body and must be ingested through food
Complex Carbs
Are starches and fiber
Made of long chains of 3 or more molecules of sugar
Take longer to digest than shorter chains
Help stabilize BG levels
Satiety
By slowing gastric emptying, satisfies hunger and leads to overall decrease in caloric intake
Estimated average dietary intake for active adolescent and young man:
2,400 calories
Adults 50+ should include food sources or supplements that are fortified with:
Crystalline form B12
Salivary amylase begins to break down:
Fat and simple carbs
Most absorption of nutrients occurs in the:
Duodenum and jejunum
The digestive enzymes needed to digest starches and proteins are released from the:
Liver
Gallbladder
Pancreas
Small intestine
Nutrients absorbed into the bloodstream from the GI tract travel to the liver via the:
Portal vein
What individual requires the highest level of water intake for optimal health?
Nursing mothers
Protein is required by the body for:
Producing energy and heat
Building new tissue
Manufacturing hormones and enzymes
Forming antibodies
Increasing your fiber intake too much too quickly can cause:
Excessive GI gas
The avg. adult needs how much fiber per day?
25-30 grams
Fat-soluble vitamins
A
D
E
K
This nutrient cannot be digested and retain their original chemical identities in the body:
Minerals
Older children, active women, and sedentary men need how many calories a day?
2,000 calories
What should a healthy diet provide?
An adequate amount of each essential nutrient to support growth and development
What are the 3 things for a healthy diet?
Moderation, Variety, and Balance
Dietary Guidleines (6)
Eat a variety of food
Balance what you take in with physical activity to maintain or improve weight
Choose plenty of grain prodcuts, vegetables, and fruits
Choose foods low in fat (especially saturated)
Choose diet moderate in sugars, salt, and sodium
Consume alcohol in moderation
What does DRI’s stand for?
Dietary reference intakes
What are the 6 major components of labeling?
Food amount and energy content Macronutrient content Vitamin and Mineral content Daily reference value Health claims Labels for special needs
What are the components that are MANDATORY for food labels (6)?
Total calories Calories from fat Total fat Saturated fat Cholesterol Sodium
What are purines?
They help us break down uric acid
What is a Kilocalorie
Unit of measurement that specifies the heat energy in a particular amount of food
Amount of heat required to raise temperature of 1 kg of water, 1 degree C
Calorie values of energy nutrients
1g of carbohydrates yelds how many kcals?
4 kcals
1g of fat yields how many kcals?
9 kcals
1g of protein yeilds how many kcals?
4 kcals
The amount of energy (calories) a helathy individual needs depends on what?
Age Sex Weight Body composition Activity level
What is REE (resting energy expenditure)?
Most of the energy used in a typical day
- Higher in men because of muscle mass
- Younger adults need more due to growth
- Pregnancy, lactation, and fever also affect REE
What are empty calories?
Foods that supply calories with few or no nutrients
ex: candy, soda, alcohol
How many calories does the average sedentary adult male need?
2000
How many calories does the average sedentary woman need?
1600
How many calories does a young child need?
1600
How many calories does the average active adult adolescent boy need?
2400
What does IBW stand for?
Ideal body weight
General body weight assessment for a woman
100 pounds for 5 ft of height, add five pounds for each additional inch
General body weight assessment for a man
106 pounds for 5 ft of height, add 6 pounds for each additional inch
What does BMI measure?
Weight in relationship to height
Underweight BMI classification
Less than 18.5
Healthy BMI classification
18.5-24.9
Overweight BMI classification
25-29.9
Obese BMI classification
30 or greater
Very obese BMI classification
> 40
How is obesity determined?
In terms of BMI
Special nutritional considerations for infancy
Need a lot of calories for development
Feed on demand (trust vs. mistrust)
Double weight in first 6 months, usually triple in 1 year
Introduction of solid food (usually at 6 months)
Breast milk or iron fortified infant formula is generally recommended for 1 year
Breast feeding should be encouraged
Introducing solid food too early can increase risk for allergies and choking
When introducing solid foods, how should you do it?
Single ingredient foods should be chosen and introduced one at a time at weekly intervals
Special nutritional considerations for childhood
Permanent eating habits are formed
If offered nutritious foods in pleasant surroundings, will most likely be adequately nourished
Parents decide which foods to serve at what times and child decides what and how much to eat
Need frequent small meals
Fat is an important energy source
What is a clear liquid diet?
Liquids that are see-through
(tea, coffee, clear broths, etc)
Noniritating liquids, easily digested and absorbed and leaves little residue in the GI tract
Special nutritional considerations for adolescence
Snacking (diets of filled with kcal rich and nutrient poor snacks)
Skipping meals
Dietary inadequacies (include iron and calcium)
May experiment with alcohol or drugs, which can have detrimental effects on nutrients
Common problems in adolescence
Anorexia nervosa Bulimia nervosa Obesity Poor bone growth Anemia
What is a good source of iron?
Raisins
Special nutrient consideratoins for early/middle adulthood
Need nutrient dense foods (dark green leafy vegetables)
Calcium vitamin D
Drink caffiene
What happens during early/middle adulthood?
Caloric requirements decrease
Muscle and bone mass start declining
Proportion of fat increases
Types of nutrient modification diets
Carbohydrate-controlled (for diabetics)
Lactose-restriced diets
HIgh and low fat diets
Protein controlled diets (high and restricted)
Gluten restricted diets
Controlled mineral and electrolyte diets (sodium, calcium, phosphrous, potassium)
What can caffeine cause in children?
Hyperactive behavior
What should you limit intake of caffeine to?
300mg/day
Why are elderly at rsik of nutritional problems?
Physiologic, economic, and psychosocial changes
What are some changes as we age?
related to nutrition
Decreased ability to absorb nutrients
Difficulty swallowing
Nursing consideratons with the elderly
Constipation
Decreased thirst
Weight management
What are some nutritional concernse for adults in LTC?
Malnutrition is common
Residents should be offered familiar foods that taste good
Fluids should be offered frequently
Nurses must understand the value of mealtime as a pleasant, social experience
What are some drug interactions with nutrients?
Drugs can alter appetite or ability to eat
Can affect absorption, metabolism, and excretion of certain nutrients
Food intake and vitamin/mineral supplementatoin may affect the absorption, distribution, metabolism, and action of some medications
Pregancy nutrition needs
Caloric needs increase (increase 300 calories daily in 2nd and 3rd trimesters)
Should select food from all food groups
Increase milk, yogurt, and cheese group to 3-4 servings daily
Increase calcium intake before last half of pregancy
Maintain folic acid (recomended 400-600)
Fiber is important
Increase fluid intake
Definition of Pica
Abnormal craving for nonfood item during pregnancy
What are concerns during pregnancy?
Weight gain (normal is 25-30lbs) Pregnancy induced hypertension Gestational diabetes Anemia Alcohol consumption Caffeine consumption Smoking Lactation Additonal 500 kcal/day is recommended Fluid needs increase Adequate nutritional intake is vital
Red meat, fish, poultry, and beans are all high in:
Iron
Citrus fruits & vitamin c supplements enhance the absorption of:
Iron
The DASH Eating Plan focuses on:
Limiting intake of cholesterol
Increasing intake of nutrients known to lower BP
increasing intake of potassium, magnesium, and calcium
3 essential amino acids & what foods they’re found in:
Lysine
Histidine
Tryptophan
Milk, eggs, cheeses, and whole-grain cereals and breads
Delivery of tube feedings via the GI tract
Usually replaces all oral intake
Enteral nutrition
Nutrients administered directly into blood stream via a central venous catheter, bypassing the GI tract
Parenteral nutrition
Glycosolated Hemoglobin Test
Measure the amount if glucose present in the blood over a period of 2-3 months, giving a better overall picture of glycemic control
H2 Blockers are sometimes known to interfere with absorption of which nutrients?
Vitamin B 12
Iron
Folate
Purpose of the blue pigtail of a double lumen NG tube is to:
Serve as an air vent
Prevent tube from adhering to the stomach wall during decompression
Mealtime preparation considerations?
Odors Environment Toileting Client comfort Client positioning (high fowlers) Client cleanliness
What are the types of consistency modifications?
Bland Liquid (clear, full, mechanical soft, pureed)
What is a clear liquid diet?
Liquids that are see-through
tea, coffee, clear broths, etc
What is a full liquid diet?
Foods that are liquid at room temperature
What is a mechanical soft diet?
Foods easily chewed and digested (usually low in fiber and fat)
Two types of textured modification diets
High fiber diets
Low-residue diet
What is a high calorie diet for?
People who are underweight
Persons with prolonged illnesses
What is a low calorie diet for?
To promote obesity related weight loss
Types of nutreitn modification diets
Carbohydrate-controlled (for diabetics)
Lactose-restriced diets
HIgh and low fat diets
Protein controlled diets (high and restricted)
Gluten restricted diets
Controlled mineral and electrolyte diets (sodium, calcium, phosphrous, potassium)
What is a soft diet?
Soft foods, generally low in fiber, includes foods from all give food groups nutritionally adequate except fiber
What is a low residue diet?
Similiar to soft, but also restricts milk because it leaves more residue in the colon
What is a high fiber diet?
Variation of the regular diet that doubles the intake of fiber
Meal frequency modifications
6-8 small meals or snacks
Decreases workload on the GI tract and CV system
Lactose intolerance
Occurs as a result of a lack of the digestive enzyme lactase
The GI system cannot break down lactose
Diet excludes milk and milk products; food with milk added may need to be avoided as well
S&S of lactose intolerance
Occurs after ingestion of milk products
N/D
Cramps
Bloating
Flatulence
What does a fat controlled diet limit?
Total fat, saturated fat, and trans-fatty acids
***Rather than totally limiting intake, moderatoin is key
Why might someone be on a fat controlled diet?
Prevent/treat atherosclerosis, heart disease, hyperlipidemia
Why might someone be on a low fat diet?
For a disease that involves malabsorption of fat
Why might someone be on a potassium restricted diet?
Renal failure
Cirrhosis of the liver
Why might someone be on a sodium restricted diet?
Hypertension
Water retention
CHF
Edema
Why might someone be on a potassium MODIFIED diet?
Increased- BP control
Restriction- end stage renal/kidney disease
Why might someone be on a fluid modified diet?
End stage renal disease Edema CHF Directly after MI Hepatic coma Ascites
Nursing considerations for a fluid modified diet
May expereince excessive thirst
Rinse mouth with mouth wash Lemon in cold water Freezing fluids Cold fruits and veggies Breath mints Hard candies Brush teeth
Why might someone be on a kcal modification diet?
Treatment of obesity
Vegetarian diet
Made up of mainly plant foods, some may include dairy products or eggs as well
Vegan diet
Excludes ALL animal products
Lactovegetarian diet
Includes fruits, vegetables, grains, and milk and dairy products
(NO EGGS)
Ovo-vegetarian diet
Plant foods, eggs, NO DAIRY PRODUCTS
Lacto-ovo-vegetarian diet
Includes eggs and dairy products
When is nutritonal support instituted?
When a person is unable to meet nutritional needs orally.
Can be short or long term
What does nutritional support include?
Tube feedings
TPN
IV fluids
Tube feedings
Means of providing liquid nourishment through a tube into the GI tract
(AKA enteral feeding)
When is a tube feeding indicated
When a client is unable to chew or swallow, has no appetite, or refuses to eat
Used only when all or at least part of the GI tract is functioning
Are tube feedings continuous or intermittent
BOTH
Types of tubes
NG PEG Endoscopic G tube J tube Button feeding device
NG tube feeding
Check for placement before feeding or administering meds (tube may be in the lung or esophagus) or (NI may be in stomach when it should be in the small bowel)
How do you check if a tube is in place?
Chest x-ray
Test pH of aspirated fluid
Use auscultory method
What is another term for parenteral nutrition?
Hyperalimentation
What is TPN?
Total parenteral nutrition
Administered through a large central VEIN
Parenteral support is composed of?
Glucose, amino acids, vitamins, minerals, electrolytes,
Fats also given as supplementation to the main formula
When is parenteral support indicated?
Client has a nonfunctioning or dysfunctional GI tract
Common diagnositc tests to evaluate nutritional status
Creatinine BUN Lipid profile Blood glucose CBC Albumin (protein/blood)
What comprises a lipid profile?
Trglycerides (Normal 40-160, critical >400)
Cholesterol (HDL 35-60, LDL 80-110)
Lipoproteins
What comprises a CBC
RBC
Hemoglobin/Hematocrit
WBCs
How can the nurse promote good nutrition?
Help the client understand the importance of the diet and encouraging dietary compliance
Serve meal trays to clients prompt and positively
Assist some clientswith eating
Take and records clients weight
Record clientsintake
Observe S&S of poor nutrition and report them
Serve as a communication link
Educate clients on food pyramid (myplate) and reading labels
Feeding the patient
Weakness, paralysis, cast, and other physical limitations may make self-feeding impossible (these clients are fed)
Provide relaxed mood
Demonstrate caring and respect
Ask client about order in which to offer food and fluids
Use spoon
For visually impaired cleints, identify foods and fluids and their location on the tray (like a clock)
What is the pH of stomach content?
1-4
Macronutrients
Carbs
Fats
Proteins
Water
Adult loss of water = _____
2.5 quarts / 2.37 Liters
Protein is made up of what 4 things?
Carbon
Hydrogen
Oxygen
Nitrogen
Protein produces ____ and ____
Energy, Heat
In the absence of dietary protein, the body uses _____ from _______, ______, and ______.
Proteins
Bloodstream, muscles, organs
Complete Proteins contain all 9 ______ ________.
Amino acids
Complete proteins are found in what foods and what ONE plant?
Meat Poultry Fish Eggs Cheese SOY
Incomplete proteins come from what plants?
Grains
Legumes
Nuts
Seeds
Marasmus
Disease of wasting (extreme form of malnutrition)
Not enough intake of food to maintain body weight
Kwashiorkor
Protein deficiency of young children
Classic pot belly with thin legs
Changes in pigment of skin (spots)
Major function of fats
Provide energy
What essential nutrient helps maintain function and integrity of capillaries and cell membranes?
Fats (lipids)
Saturated Fatty Acids
- Animal fats
- Chemical bonds are completely filled with hydrogen
- Solid at room temperature
Food sources of saturated fatty acids:
Lard Butter Whole milk Cream Egg yolks Fat in meat Poultry Fish Coconut Palm Palm kernel oils
Unsaturated Fatty Acids
Can be mono or poly saturated fats
Usually liquid at room temperature
Unsaturated Fatty Acids
Poultry
Fresh water fish
All plant oils (except coconut, palm, and palm kernel)
Olive, canola, peanut and sunflower oils = mono
Safflower, sunflower, soybean, and corn oils = poly (more processed)
Trans-Fatty Acids
Produced during hydrogenation
Tend to increase cholesterol, but not as much as saturated fats
Found in foods containing partially hydrogenated vegetable oils
Cholesterol
Does not provide energy Manufactured in liver Found in foods of animal origin Highest in organ meats and egg yolks Intake should average no more than 300 mg/day
Fats must be emulsified by ____ to be digested
Bile
____________ facilitate the transport of lipids into the bloodstream.
Lipoproteins
Body stores fat in the form of:
Triglycerides
Carbs are made up of what 3 things?
Carbon
Hydrogen
Oxygen
Major function of carbs
Provide energy
Simple or Complex Carbs are based on the # of _____ _________.
Sugar molecules
_______ is the body’s major source of energy.
Glucose
2 examples of simple carbs:
Monosaccharides
Disaccharides
Polysaccharides are ______ _____
Complex carbs
Starch, dextrin, glycogen, and dietary fiber are all what?
Complex carbs
Complex carbs are (insoluble/soluble) in water.
Insoluble
All carbs (except fiber) are broken down in the GI tract into _________.
Monosaccharides (simple sugar units)
Carb Sources
Plant food (except oils) Honey Sugar Molasses Milk Breads/cereals Legumes/dried beans Fruits Vegetables
Vitamins extract energy from:
Carbs
Fats
Protein
Where do fat-soluble vitamins love to be stored?
Liver
Vitamin A is also known as:
Retinal A
Vitamin A sources:
Orange, yellow & dark green sources:
Carrots
Oranges
Sweet potato
Which vitamin helps with skin and vision?
Vitamin A
Deficiency in vitamin A can cause:
Night blindness
Toxicity of Vitamin A can cause:
Double vision
N/V/D
Vitamin D Sources
Sunlight
Milk
Dairy products
Deficiency of Vitamin D can cause:
Osteoporosis
Softening of bones
Dwarfed growth
Toxicity of Vitamin D can cause:
Kidney stones
Rickets (bones don’t harden and tend to bend - bowlegged)
Vitamin E Sources
Salmon Wheat germ Seeds Nuts Dark, green leafy vegetables Butter
Which vitamin is the “reproductive vitamin” and protects cell membranes?
Vitamin E
Deficiency in Vitamin E
Very rare
Cystic fibrosis
Toxicity of Vitamin E:
Is hard to reach
Vitamin K Sources
Spinach Cabbage Egg yolk Dark, green leafy vegetables Liver
Which vitamin helps with clotting & prothrombin?
Vitamin K
Deficiency of Vitamin K can cause:
Bleeding
Water-soluble vitamins are absorbed directly into the:
Bloodstream from GI tract
Can water-soluble vitamins be stored?
No.
Must be consumed daily
8 types of B-complex vitamins
Riboflavin: B2 Thiamine: B1 Niacin: B3 Folate/Folic acid: B9 Cobalamin: B12 Pyridoxine: B6 Biotin Pantothenic Acid
Deficiency of Thiamine: B1 can cause:
Beriberi (disease of nervous system)
Lose hair
Alcoholics need what supplement?
Thiamine: B1
Sources of Thiamine: B1
Pork
Dry yeast
Organ meats
Niacin: B3 causes:
Flushing
Vasodilation (lowers BP)
Folate/Folic Acid is supplemented during pregnancy to reduce:
Neuro tube defects
Chances of spinal bifida
Vitamin C is also known as:
Ascorbic Acid
Which vitamin helps with wound healing?
Vitamin C
Sources of Vitamin C
Strawberries Sunlight Citrus fruits Broccoli Cauliflower
Which vitamin do you need to absorb Iron?
Vitamin C
Deficiency of Vitamin C can cause;
Scurvy (teeth fall out, gums become unhealthy)
Alcoholic likely to have this deficiency
Which 2 vitamins are sources of antioxidants?
Vitamins E and C
Function of Antioxidants:
Delay or prevent the destruction/breakdown of cell membranes in presence of O2
Minerals are vital for building:
Bones and teeth
Minerals cannot be destroyed because:
They are single elements rather than compounds
Electrolytes are minerals in forms of:
Salts Acids and bases Sodium Potassium Chloride Magnesium
Sodium is found in:
Extra cellular fluids
Potassium is found in
Intercellular fluids
Magnesium helps with
Bone mineralization
Muscle contraction/relaxation
Energy metabolism
Calcium helps with:
Balancing body fluids
Blood clotting
Regulating heart and other muscle activity
Phosphorus is contained in:
Every body cell
Major Minerals present in amounts greater than:
5 grams
Major Minerals:
Calcium Phosphorus Sodium Potassium Magnesium
Trace minerals are needed by body in _____ amounts
Small
Trace minerals present in amounts of _______ or less.
5 grams
Trace Minerals:
Iron Iodine Zinc Chromium Fluoride Copper Selenium
Iodine is needed for production of
Hormone thyroxin (found in salt)
Chromium has a role in:
Function of insulin
Zinc is important in producing:
Hormones and RNA