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Med/Surg II Wound Care Unit > Nutrition > Flashcards

Nutrition Flashcards

1
Q

What are some possible causes of malnutrition? (7)

A

Decreased appetite, GI problems, difficulty swallowing/chewing, lack of knowledge, financial status, impaired mobility, or other health problems

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2
Q

What are some parts of nutritional assessment?

A

Pt. medical hx and sx hx, overall nutrition status, IBW, hydration status, nutritional deficits, route of intake, unintentional weight loss, eating patterns, social factors, financial factors

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3
Q

IBW is one nutritional measure. What is considered a red flag? What loss is considered significant?

A
  • loss of >5% over 4 weeks is considered significant

- unintentional weight loss is always a red flag

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4
Q

What has weight loss to below IBW been linked to?

A

impaired immune function, weakness, susceptibility to infection, death

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5
Q

What does malnutrition look like?

A

NOT JUST SKINNY PEOPLE! serum albumin 15%

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6
Q

What is the significance of losing 1g/dL of albumin?

A

3x increase in the odds of developing a pressure ulcer

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7
Q

What is the half life for albumin?

A

20 days

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8
Q

What can albumin levels be used to show, and what ranges indicate normal, mild depletion, moderate depletion, and severe depletion?

A 
Albumin reflects prolonged protein depletion, and increases slowing with good referring.
Normal= greater than 3.5g/100ml
Mild depletion= 2.8-3.4
Moderate depletion= 2.1-2.7
Severe depletion= less than 2.1
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9
Q

What is the half life of pre albumin?

A

48 hours

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10
Q

What is prealbumin sensitive to, and what can cause it to be elevated?

A
  • Sensitive to acute deprivation and protein deficiency (responds quickly to refeeding)
  • May be elevated in use of corticosteroids or renal disease
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11
Q

What values represent normal, mild, moderate, and severe depletion of prealbumin levels?

A

normal= 16-30 mg/100ml
mild depletion= 10-15
moderate depletion= 5-9
severe depletion= less than 5

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12
Q

Lymphocytes fight infection, and protein calorie malnutrition reduces the number of WBCs. What is the formula for total lymphocyte count?

A

TLC= WBC x %lymphocytes

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13
Q

What TLC values represent standard value, mild, moderate, and severe depletion?

A

standard= 2500mm3

mild depletion= <800

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14
Q

Hemoglobin is responsible for oxygen transport. What does a value <12 mean? What importance does it have to wound management?

A

<12= anemia

important for debridement

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15
Q

What represents “severe” percentages for IBW and weight loss?

A

IBW 25%

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16
Q

What do you need to know in order to assess caloric needs?

A

activity level, injury factors, surgery, infection, degree of stress, chronic disease

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17
Q

Should you put an obese patient with a wound on a calorie-restricted diet? Why or why not?

A

NO! That would cause the patient to go into starvation mode and doesn’t provide the wound with the nutrients needed.

18
Q

What are the components of a good wound healing diet?

A

protein (low fat meats and proteins), carbohydrates for energy, fluids to replenish losses via exudate and for skin integrity and turgor, vitamins

19
Q

What vitamins are essential for a wound care diet?

A

multivitamin, vitamin C, vitamin A, vitamin E

20
Q

How much vitamin C do you need?

A

500 mg/day (smokers need more)

21
Q

How much vitamin A do you need in a day?

A

1600-2000 mg/day needed for immune-compromised patients to facilitate macrophage action

22
Q

How much vitamin E do you need?

A

400-800 iu per day

23
Q

What is the function of vit A and what may cause a deficiency?

A

function- collagen synthesis

deficiency- corticosteroid use

24
Q

What is the function of vit C and what may happen with a deficiency?

A

function- collagen synthesis, membrane integrity, immune system support
deficiency- delayed healing, capillary fragility

25
Q

What is the function of vit E and what may happen with a deficiency?

A

function- fat metabolism, collagen synthesis, membrane stabilization
deficiency- delayed healing, tissue fragility

26
Q

What vitamin should you watch closely if the patient is on coumadin? What is present with a deficit?

A

vit K, petechiae present when deficient

27
Q

What are some minerals necessary in your diet?

A

calcium, magnesium, iron, zinc, copper, manganese

28
Q

What are important values of calcium and what is it important for?

A

800-1500 mg/day- bone health and protein synthesis

29
Q

What are important values of magnesium and what is it important for?

A

320-420 mg/day- muscle and nerve function, steady heart rhythm, immune function, controls blood sugars and BP, protein synthesis, energy

30
Q

What are important values of iron and what is it important for?

A

8mg/day- regulation of cell growth and differentiation, immune function, energy, oxygen delivery

31
Q

What are important values of zinc and what is it important for?

A

60mg/day- needed for protein and collagen synthesis

32
Q

What are important values of copper and what is it important for?

A

1-3 mg/day- needed for collagen production and cross-linking

33
Q

What are important values of manganese and what is it important for?

A

5-11 mg/day- needed for collagen and ground substance

34
Q

What are good food sources of protein?

A

dairy, meat, meat substitutes, nuts and seeds

35
Q

What are good food sources of vit C?

A

fruits and vegetables

36
Q

What are good food sources of zinc?

A

beef, liver and crab, smaller amounts in sunflower seeds, almonds, peanut butter, black-eyed peas, whole grain products, eggs and milk

37
Q

What is arginine?

A

an essential amino acid needed for collagen synthesis and increases the number of total lymphocytes

38
Q

What can be used as meal supplements?

A

Ensure, Carnation Instant Breakfast

39
Q

What can be used as appetite stimulants?

A

Megace oral suspension, Marinol

40
Q

What anabolic steroids are used as medical interventions?

A

Testosterone, Oxandrolone

41
Q

What are some helpful interventions to be aware of to help patients get the nutrition they need?

A

aide for assistance with eating, financial aid, meals on wheels, adaptive devices, education for patient and family/caregiver, constant reassessment

42
Q

What are some elements of a nutritional plan of care?

A

review patient’s dietary intake, consult MD if CHF or renal patient, educate on wound healing diet, educate on vitamin supplements, assess need for nutritional support or supplements, consider dietary consult if no healing

Med/Surg II Wound Care Unit (11 decks)

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