Nutrition Flashcards
Duodenum
- Powerhouse for absorption
- Preferred site for absorption of calcium, magnesium, iron, folate
- 10 inches long
Jejunum
- Absorption of 90% of nutrients, calcium, zinc, drugs
- 6-10 feet long
Ileum
- Absorption of B12, bile salts
- 10-13 feet long
Transverse colon
- Absorbs water, electrolytes
Stomach
- Mix/dilute chyme
- Digest protein
- Acidic
- Add intrinsic factor
Short bowel syndrome
- Intestinal dysfunction –> malabsorptive
- Small bowel length
- Loss of function of long segments of small bowel
Short bowel syndrome characterizations
- Maldigestion
- Malabsorption
- Malnutrition
Results of short bowel syndrome
- Inability to maintain nutritional. fluid, electrolyte homeostasis while consuming normal/healthy diet
Causes of short bowel syndrome
- Small bowel resection
- Functional (luminal absorption failure)
- Birth defects
Short bowel syndrome adaptation
- Compensatory
- Intestinal villi grows in length and thickness
S/S of short bowel syndrome (9)
- Severe diarrhea
- Dehydration
- Malnutrition
- Steatorrhea
- Fatigue
- Pain
- Vitamin/mineral deficiencies
- Edema
- Weight loss
Electrolyte imbalances in short bowel syndrome
- Hyponatremia
- Hypokalemia
- Hypomagnesemia
Iron
Necessary in RBC production, component of Hgb
Iron deficiency
- Anemia
- Weakness
- Fatigue
Folate
Synthesis of protein and rapidly dividing cells (GI lining/fetus), maintenance of mature RBCs
Folate deficiency(4)
- Anemia
- anorexia
- Fatigue
- Diarrhea
Calcium
Bone formation, coagulation, nerve/muscle function
Calcium deficiency(3)
- Osteoporosis
- Prolonged bleeding
- Muscle spasm
Magnesium
Maintains normal nerve/muscle function, bones, protein synthesis
Magnesium deficiency (4)
- Dysrythmias
- Muscle cramps
- Fatigue
- Osteoporosis
Bile salt
Necessary for digestion and absorption of fats
Bile salt deficiency
- Decreased absorption of fat soluble vitamins
- Increased fat in stool
- Decreased level of plasma proteins
Fat soluble vitamins
- A
- D
- E
- K
Zinc
Important for growth and cell turnover
B12
Necessary in production of RBCs, nerve/brain health
B12 deficiency (7)
- Anemia
- Anorexia
- Sore mouth/tongue
- Pallor
- Weight loss
- Nausea
- Constipation
Pharmacological treatment for short bowel syndrome (8)
- Multivitamins, mineral supplements
- Antidiarrheal medications
- Bile acid binding resins
- Pancreatic enzyme
- Medications to reduce GI secretions
- Teduglutide
- Somatropin
- Glutamine
Antidiarrheal medications
- Loperamide (Imodium)
- Diphenoxylate atropine (lomotil)
- Slow intestinal transit
Bile acid binding resins
- Cholestyramine (Questran)
- Manage diarrhea from malabsorbed bile salts
Pancreatic enzyme
Help with digestion
Teduglutide
Increases surface area
Somatropin
Enhances intestinal adaption
Glutamine
Improves absoprtion
Equipment needed for TPN
- CVC
- PICC
- IV pump
- Micron filter
TPN contains
- Proteins
- Carbs
- Fats
- Vitamins
- Minerals
Pancreatitis - Grey Turner Sign
Gray, blue discoloration of flanks
Cullen’s sign
Ecchymosis of umbilical area
Pancreatitis labs
- Increased amylase
- Increased lipase
- Increased bilirubin
- Increased alkaline phosphatase
- Decreased calcium/magnesium
- Increased WBCs, BUN, triglycerides, glucose
- Thrombocytopenia
- Decreased albumin
