Nutrition Flashcards
Exam 4/Final
Nutrients
Specific biochemical substances used by the body for growth, development, activity, reproduction, lactation, health maintenance, and recovery from illness or injury
Three types of nutrients
Essential
Macro
Micro
Essential nutrients
Essential—not synthesized in the body or are made in insufficient amounts; must be provided in the diet or through supplements
Macro nutrients
Macro—supply energy and build tissue; i.e., carbohydrates, fats, and proteins
Micro nutrients
Micro—regulate and control body processes; i.e., vitamins and minerals
Six classes of nutrients
Carbohydrates
Protein
Lipids (fats)
Vitamins
Minerals
Water
Nutrients that supply ENERGY
Carbohydrates
Protein
Lipids (fats)
Nutrients that REGULATE BODY PROCESSES
Vitamins
Minerals
Water
Energy Balance: Where is energy derived from?
Energy is derived or obtained from foods consumed
How is energy measured?
Measured in kilocalories (often called calories)
What provides calories?
Only carbs, protein, and fat provide calories
Total daily energy expenditure
all of the calories used to perform physical activity, maintain metabolism, and digest, absorb, and metabolize food
Total daily energy intake
total calories for each food item eaten
Daily intake and expenditure differences determine what?
Daily intake and expenditure differences determine stable weight, weight loss, or weight gain
Basal Metabolic Rate (BMR)
BMR is energy (number of calories) required to fuel the involuntary activities of the body at rest after 12 hours; energy needed to sustain metabolic activities of cells and tissues
Who has a higher BMR males or females
Males have a higher BMR due to larger muscle mass
Factors that increase BMR:
Growth,
infections,
fever,
emotional tension,
extreme environmental temperatures, elevated levels of certain hormones
Factors that decrease BMR
Aging,
prolonged fasting, and
sleep
Body Mass Index
Ratio of weight in kilograms to height in meters squared
What does BMI provide an estimate for?
Provides an estimate for body fat
Provides an estimation of relative risk for diseases that can occur with more body fat: heart disease, type 2 diabetes, hypertension, and certain cancers
Diseases that can occur because of more body fat?
heart disease,
type 2 diabetes,
hypertension, and certain cancers
What can BMI be used for?
Can be used as an initial assessment of nutritional status
What is wrong with BMI
May be inaccurate for certain groups of people
How is overweight and obesity defined compared to adults?
Overweight and obesity defined differently for children and teens
What is thought to be an important and reliable indicator of disease risk
Location of where body fat is deposited is thought to be an important and reliable indicator of disease risk
What kind of obesity poses a greater risk/
Central and abdominal obesity poses a greater risk
What is a good indicator of abdominal fat?
Waist circumference is a good indicator of abdominal fat
Relationship between waist measurement and risk of obesity for men
Risk increases with a waist measurement of 40 inches or more for men and 35 inches or more for women
Relationship between waist measurement and risk of obesity for women
Risk increases with a waist measurement of 40 inches or more for men and 35 inches or more for women
Example of carbohydrates
Sugars and starches;
organic compounds composed of carbon, hydrogen, and oxygen
What does carbohydrates serve as a structural framework for?
Serve as the structural framework of plants; lactose is only animal source (sugar present in mild)
Most abundant and least expensive source of calories in the world
Carbohydrates
Intake of carbohydrates is correlated to what?
Intake often correlated to income: as income increases, carbohydrate intake decreases
How are carbs classified?
Classified as simple or complex sugars
What is the primary function of carbohydrates?
Primary function is to supply energy
What is the recommended total carb calories for adults?
Recommended as 45% to 60% of total calories for adults
How does carbs differ from proteins and fats?
Carbs more easily and quickly digested than protein and fat
What percent of carbs is ingested?
90% of carbohydrate intake is ingested
What are carbs converted to? for what?
Converted to glucose for transport through the blood
What tissues rely of carbs almost exclusively for energy?
Efficient fuel that certain tissues rely on almost exclusively for energy (i.e., nervous system)
How are carbs transported?
Transported from the GI tract, through the portal vein, to the liver
What does liver do to glucose?
Liver stores glucose and regulates entry into the blood
What do cells do to glucose?
Cells oxidize glucose to provide energy, carbon dioxide, and water
What is required for the formation of all body structure?
Proteins
How many different proteins exist in the body?
More than 1,000 different proteins are made in the body by combining various of the 22 amino acids
What do complete proteins contain?
Complete proteins contain sufficient essential amino acids to support growth
Incomplete proteins
Incomplete proteins are deficient in one or more essential amino acids
Example of complete protein?
Animal proteins are complete;
plant proteins are incomplete (except that soy and quinoa are complete)
Examples of incomplete proteins?
Plant proteins are incomplete (except that soy and quinoa are complete)
How can vegetarians get complete protein/
Vegetarians, who do not eat animal protein, can combine different plant proteins to supply a complete protein
How are dietary proteins broken down?
Dietary protein is broken down into amino acids by pancreatic enzymes in the small intestine which are absorbed and transported to the liver
What happens to amino acids in the liver?
In the liver, amino acids are recombined into new proteins or are released for use by tissues and cells
Protein tissues are in a constant state of flux, what does this mean?
Protein tissues are in a constant state of flux. Tissues are continuously being broken down (catabolism) and replaced (anabolism)
Recommended Daily Allowance of Protein for adults?
RDA for adults is 0.8 g/kg of body weight, 10% to 35% total calorie intake
Fats- how are they soluble and what are they composed of?
Insoluble in water and blood; composed of carbon, hydrogen, and oxygen
What percent of lipids in the diet are triglycerides?
95% of lipids in diet are triglycerides
Fats contain MIXTURES of what?
Contain mixtures of saturated (raise cholesterol levels) and unsaturated (lower cholesterol levels) fatty acids
Saturated fats
Saturated (raise cholesterol levels)
Unsaturated fats
unsaturated (lower cholesterol levels) fatty acids
Animal fats are what kind of fats?
saturated
Most vegetable fats are what kind of fats?
Unsaturated
Where does digestion of fats mainly occur?
Digestion occurs largely in the small intestine
How are fats broken down?
Bile which is secreted by the liver and stored in the gallbladder, emulsifies fat so that pancreatic enzymes can break it down for digestion
How are fats absorbed and transported
Fats are absorbed into the lymphatic circulation and transported to the liver
What is the most concentrated source of energy in the diet?
Fats
Recommended intake of fats”
Recommended intake: limit saturated fats to less than 10% of daily calories and intake of trans fats to as low as possible
Vitamins
Organic compounds needed by the body in small amounts; do not provide calories
What are vitamins needed for?
Needed for metabolism of carbohydrates, protein, and fat
What kinds of foods have higher levels of vitamins
Fresh foods are higher in vitamins than processed
Types of vitamins:
Water soluble
Fat soluble
Example of water soluble vitamins
Water soluble: C, B-complex vitamins; not stored in body
Example of fat soluble vitamins
Fat soluble: A, D, E, K
How are vitamins absorbed?
Absorbed through the intestinal wall directly into bloodstream
Where are minerals found?
Organic elements found in all body fluids and tissues
What do minerals do?
Some function to provide structure in the body, others help regulate body processes
Examples of macrominerals
Macrominerals include calcium, phosphorus (phosphates), sulfur (sulfate), sodium, chloride, potassium, and magnesium
Examples of microminerals
Microminerals include iron, zinc, manganese, chromium, copper, molybdenum, selenium, fluoride, and iodine
Water accounts for what percent of adults total weight?
Accounts for between 50% and 60% of adult’s total weight
How much body water in cells?
Two thirds of body water is contained within the cells (intracellular fluid [ICF])
How much body water in ECF?
The remainder of body water is extracellular fluid (ECF), body fluids (plasma, interstitial fluid)
What does water provide for the body?
Provides fluid medium necessary for all chemical reactions in the body
What does water act as in the body?
Acts as a solvent and aids digestion, absorption, circulation, and excretion
Physiological and physical factors affecting nutrition:
stage of development,
state of health,
medications
Social determinants of health and cultural
economic stability,
health care access and quality,
social and community context,
education access and quality, neighborhood and
built environments
Culture, religion, food ideology, and learned aversions
Developmental Considerations of nutrition: Growth
Growth: infancy, adolescence, pregnancy, and lactation increase nutritional needs
Developmental Considerations of nutrition: Activity
Activity increases nutritional needs
Developmental Considerations of nutrition: Age
Age-related changes in metabolism and body composition
Developmental Considerations of nutrition: nutritional needs
Nutritional needs level off in adulthood
Why are fewer calories needed in adulthood?
Fewer calories required in adulthood because of decrease in BMR
Components of Nutritional Assessment
History taking
Physical assessments
Biochemical data
Components of Nutritional Assessment: History taking
Dietary, medical, socioeconomic data
Components of Nutritional Assessment: Physical assessments
Anthropometric and clinical data
Components of Nutritional Assessment: Biochemical data
Protein status, body vitamin, mineral, and trace element status
Dietary data includes
24-hour recall method
Food diaries/calorie counts
Food frequency record
Diet history
Nursing Interventions
Teaching nutritional information
Monitoring nutritional status
Stimulating appetite
Assisting with eating
Providing oral nutrition
Providing long-term nutritional support
Two types of diets
- Therapeutic diets
- Modified consistency diets
Therapeutic diets
Consistent carbohydrate
Fat or sodium restricted
High or low fiber
Renal
Modified consistency diets
Clear liquid
Pureed
Mechanically altered
Short term Nutritional Support
Using the nasogastric or nasointestinal route
How to confirm the NGT placement
Radiographic examination
Assessment of aspirate pH
Measurement of tube length and tube marking
Carbon dioxide monitoring
Confirming nasointestinal tube placement
Long-Term Nutritional Support
Enterostomal tube
Gastrostomy
PEG
Enterstomal tube
An enterostomal tube may be placed through an opening created into the stomach (gastrostomy) or into the jejunum (jejunostomy)
Gastronomy
A gastrostomy is the preferred route to deliver enteral nutrition in the patient who is comatose
Who puts in stomach tubes and how?
Placement of a tube into the stomach can be accomplished by a surgeon or gastroenterologist via a percutaneous endoscopic gastrostomy (PEG) or a surgically (open or laparoscopically) placed gastrostomy tube
Enteral Feeding
Feeding schedule and formulas, and pumps
Monitor for tolerance
Promote patient safety
Monitor for complications
Provide comfort measures
Provide education
How to monitor for tolerance of enteral feeding?
Gastric Residual Volume (GRV)
Parental Nutrition (PN) contains what?
Contains the three primary components necessary to maintain nutrition: amino acids, carbohydrates, and lipids
How is the Parental nutrition nutrients?
Highly concentrated, hypertonic nutrient solution
How is PN administered?
Given intravenously through a central venous access device
What do you monitor for while using PN?
Monitor for and prevent complications
Complications of TPN?
Insertion problems
Infection and sepsis
Metabolic alterations
Fluid, electrolyte and acid-base imbalances
Phlebitis
Hyperlipidemia
Liver and gallbladder disease
