Nutrition

Question 1

What are the eat well guidelines?

Answer 1

• 5 portions of fruit and vegetables daily
• Base meals on potatoes, bread, rice, pasta or other starchy carbohydrates
• Have some dairy or dairy alternatives
• Choose lower fat and lower sugar options
• Eat some beans, pulses, fish, eggs, meat and other proteins
• Choose unsaturated oils and spreads
• Drink 6-8 cups/glasses of fluid a day

Question 2

What factors influence dietary choices?

Answer 2

age, illness, social circumstances, culture, advertising/marketing, knowledge, skills

Question 3

Why is adequate nutrition important in hospital?

Answer 3

To improve chances of recovery

Question 4

What are the 2 main strategies used when patients cannot feed themselves?

Answer 4

Enteral feeding: Delivery of a nutritious fluid past the upper GI tract and into the stomach/small intestine.

Pareneteral feeding: Bypassing the GI tract altogether via delivery of nutrients into the blood.

Question 5

Compare the route of delivery for enteral and parenteral nutrition

Answer 5

enteral - A tube is placed into GI tract to deliver liquid food.

parenteral - administered through blood via venous catheter

Question 6

What kind of patient is enteral and parenteral used for?

Answer 6

enteral - upper GI problem, trauma, dysphagia so cannot chew

parenteral - dysfunction of GI tract so cannot absorb or excrete

Question 7

Complications of enteral and parenteral

Answer 7

enteral - nausea, vomiting aspiration

parenteral - blood clots, infection, liver failure

Question 8

Which one of enteral and parenteral require special training?

Answer 8

parenteral

Question 9

What is the effect of enteral and parenteral on the GI tract?

Answer 9

enteral - maintains GI structure

parenteral - atrophy of GI if underuse

Question 10

Compare costs of enteral and parenteral

Answer 10

enteral - cheaper

Question 11

What is short bowel sydrome?

Answer 11

Significant removal of the bowel which leaves the patient with less than 100 cm of functional intestinal tract. This is usually necessary because of problems such as Crohn’s disease, cancer, ischaemia, ulcerative colitis, irradiation.

Question 12

Symptoms of short bowel syndrome?

Answer 12

malnutrition, dehydration, malabsorption

Question 13

Consequences of short bowel syndrome?

Answer 13

• Reduction in absorptive surface area
• Loss of small intestine tissue interrupts the usually efficient control of gut function via hormones and the enteric nervous system
• Loss of large intestine tissue is associated with increased risk of infection

Question 14

Management of short bowel syndrome (aims)

Answer 14

• To provide adequate nutrition for patients
• To ensure adequate water and electrolytes to maintain homeostasis
• Correction and prevention of acid base imbalance

Question 15

How can the reliance on parenteral nutrition be reduced surgically?

Answer 15

Anastamosis of the small intestine to the colon

Question 16

What affects the metabolism of alcohol?

Answer 16

diet, gender, body-habitus, racial and genetic influences

Question 17

What are the physical effects of alcohol?

Answer 17

CNS – Wernickes encephalopathy, Cerebral atrophy, Cerebellar syndrome, Optic Atrophy, Peripheral neuropathy

CVS – Hypertension, Alcoholic cardiomyopathy, Stroke

GIT – Oesophagitis, Gastritis, Oesophageal and Gastric cancer, Pancreatitis, Pancreatic cancer, Alcoholic Hepatitis, Cirrhosis, Liver Cancer

GUT – Glomerulonephritis, Renal failure

Endocrine & Reproduction – Pseudocushings, Impotence, Subfertility, Breast Cancer, Fetal Alcohol Syndrome