Nutrition Flashcards by Shelby Campbell

What is nutrition?

“the science of food, the nutrients and the substances therein, their action, interaction, and balance in relation to health and disease, and the process by which the organism ingests, absorbs, transport, utilizes, and excretes food substances” The Council on Food and Nutrition of the American Medical Association

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What are essential nutrients?

Essential Nutrients are either not synthesized in the body naturally or are made in insufficient amounts.- these must be provided in the diet or through the use of supplements

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Essential nutrients must: (3)

Have at least one specific biological function of the nutrient in the body must be identified.
Omission of the nutrient from the diet must lead to a decline in certain biological functions, such as production of blood cells.
Replacing the omitted nutrient in the diet before permanent damage occurs, will restore those normal biological functions

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The six classes of nutrients, and what they do

Nutrients that supply energy
Carbohydrates
Lipids
Proteins

Nutrients that regulate body processes
Vitamins
Minerals
Water

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Poor diet and sedentary lifestyle are risk factors for:

chronic diseases:
Disease of the heart (29% of all deaths)
Cancer (22%)
Cerebrovascular disease (~7%)
Diabetes (3%)
Accounts for ~2/3 of all deaths

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Describe carbohydrates

Sugars and starches
Organic compounds composed of carbon, hydrogen, and oxygen
Most abundant and least expensive source of calories in the world
Classified as simple or complex sugars
Energy yielding (~4 kcal /gm)
90% of carbohydrate intake is ingested
Converted to glucose for transport through the blood
50 to 100 g of carbohydrates are needed daily to prevent ketosis

USDA and DHHS recommend 45-65% of total calories come from complex carbohydrates.

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Describe proteins

Composed of carbon, hydrogen, oxygen, nitrogen
Structural material
Required for the formation of all body structures
Labeled complete (high quality) or incomplete (low quality), based on amino acid composition
Animal proteins are complete; plant proteins are incomplete
Needed for tissue growth
Added needs during illness

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T or F:

Red meat is an incomplete protein.

False. It is a complete protein.

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Describe lipids

Insoluble in water and blood
Composed of carbon, hydrogen, and oxygen
95% of lipids in diet are triglycerides
Contain mixtures of saturated 
 (raise cholesterol levels) and 
 unsaturated (lower cholesterol levels) 
 fatty acids
-Most animal fats are saturated
-Most vegetable fats are unsaturated
Digestion occurs largely in the small intestine
Most concentrated source of energy in the diet
RDA not established, should be no more than 20% to 35% total calorie intake

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describe trans fats/ Hydrogenation of fatty acids

A partially hydrogenated oil

Makes oil solid

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Describe vitamins

Composed of various elements and are needed by the body in small amounts. Enable chemical reactions

Fat soluble
Water soluble

Yield no energy

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Fat soluble vitamins

A D E K

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Water soluble vitamins

C some B

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Describe minerals

Inorganic substances
Function in cellular processes, nervous system, water balance, structural systems
During cooking / soaking can cause a loss of minerals
Trace minerals
Major minerals
Electrolytes
Yield no energy

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Describe Water

Accounts for between 50% and 60% of adult’s total weight
Two-thirds of body water is contained within the cells (ICF)
Remainder of body water is ECF, body fluids (plasma, interstitial fluid)
Provides fluid medium necessary for all chemical reactions in body
Acts as a solvent and aids digestion, absorption, circulation, and excretion

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Describe phytocemicals

A chemical found in plants

Not considered essential nutrients
Provide significant health benefits
Found in fruits and vegetables

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The food guide pyramid

Translates science into practical terms
Helps people meet nutritional needs
For carbohydrate, protein, fat, vitamins, & minerals
Suggests a pattern of food choices
Incorporates foundations of healthy diet:
Variety, balance, moderation

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Using the pyramid

Choose low-fat/non-fat options
Include plant proteins several times a week
Include dark green vegetable every day
Include vitamin C-rich food every day
Choose whole-grain products
Include plant oils daily
Eat fish at least twice a week

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Factors affecting BMR

Males have a higher BMR due to larger muscle mass
BMR is about 1 cal/kg of body weight per hour for men
BMR is about 0.9 cal/kg of body weight per hour for women

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

Age, sleep, infections, fasting, trauma, burns

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On the average- (after age 20) BMR decreases ___ per decade…

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Factors affecting food habits

Physiologic and physical factors
Stage of development, state of health, medications

Physical, sociocultural, and psychosocial factors influencing food choices
Economics, culture, religion, tradition, education, politics, social status, food ideology

Developmental considerations

growth, activity, age-related changes, nutritional needs

Growth

infancy, adolescence, pregnancy, and lactation increase nutritional needs

Activity

increase nutritional needs

Age related changes

in metabolism and body composition

nutritional needs

level off in adulthood | Fewer calories required in adulthood because of decrease in BMR

Risk factors for poor nutritional status

``` Developmental factors Gender State of health Alcohol abuse Medications Megadoses of nutrient supplements ```

Components of nutritional assessment

``` History taking Dietary, medical, socioeconomic data Physical assessments Anthropometric and clinical data Laboratory data Protein status, body vitamin, mineral, and trace element status ```

What would you look for in lab data specifically?

albumin: low-poor nutrition Prealbumin: more reliable than albumin looks at short term changes faster

BMI

``` Underweight = BMI < 18.5 Healthy weight = BMI 18.5-24.9 Overweight = BMI 25-29.9 Obese = BMI 30-39.9 Severely obese = BMI >40 *A high BMI may not reflect overweight or fatness. Extra muscle tissue can result in a BMI greater than 25. ```

Describe types of Dietary data

24-hour recall method Food diaries/calorie counts Food frequency record Diet history

Factors to Assess for Nutritional Status

``` Usual dietary intake Food allergies or intolerance Food preparation and storage Dietary practices Eating disorder patterns ```

T or F: According to the MyPyramid Food Guide, the average person should consume 2½ cups of vegetables daily.

True | According to the MyPyramid Food Guide, the average person should consume 2½ cups of vegetables daily.

Dietary nursing interventions

Screening patients at home for nutritional risk Observing intake and appetite Evaluating the patient’s tolerance Assisting the patient with eating Administering enteral and parenteral feedings Consulting with the dietitian and physician Addressing potential for drug–nutrient reactions Obtaining more food or snacks for the patient if appropriate Monitoring food brought in by visitors Participating in nutrition education efforts

Enteral

GI tract

Parenteral

Usually IV

Monitoring nutritional status

Stimulating the appetite Assisting with eating Providing nutrition in special situations

Describe Liquid diets

Clear- foods that are clear at room temperature (water, tea, broth, clear juices, gelatin)

Describe full liquids diet

contain additional items such as milk drinks, pasteurized eggs, vegetable juices… *Commonly used with patients with dysphagia

Describe soft diets

(AKA bland/low fiber) low in fiber- lightly seasoned

Descrive mechanical soft diet

diet that this modified texture and allows minimal chewing before swallowing

Describe vegan diets

range from avoidance of red meat to complete elimination of animal products.

NPO

Nothing by mouth

Describe enteral nutrition

(tube feeding) less than 4 week duration -Levine, Salem Sump, Dobhoff (stylet)

Describe Peg

(Percutaneous endoscopic gastrostomy), Low profile Pegs

Describe parental nutrition

nutrition support via IV route. Can be given through a - CVC or TPN - Peripherally –PPN through a short term IV access device (less concentrated).

PICC

Peripherally interted centeral catheter Length ranges from 40 to 65 cm Chest x-ray to determine placement (tip rests in the SVC)

Complications of TPN

``` Insertion problems Infection and sepsis Metabolic alterations (hyperglycemia) Fluid, electrolyte, and acid–base imbalances Phlebitis Hyperlipidemia ```

PICC

Peripherally inserted central catheter Length ranges from 40 to 65 cm Chest x-ray to determine placement (tip rests in the SVC)

CVC

central venous catheter