Nutrition Flashcards
1
Q
Metabolism
A
Encompasses all chemical and physical processes that are constantly going on in cells
2
Q
Enzymes
A
Act as catalysts to break down the more complex substances in the foods into simple substances
3
Q
Basal metabolic rate (BMR)
A
Energy required by a person to function at the lowest or most basic level of cellular function at rest.
4
Q
Calorie
A
Amount of heat needed to raise the temperature of 1 gram of water 1 degree celsius.
(Kilocalorie -kcal- is amt of heat needed to raise temp of one kilogram of water 1 degree.
5
Q
How do calories basically work?
A
Kilocalories (large calories) are what we count when “counting calories.”
When food is metabolized after eating, energy or heat is freed to allow normal body function.
6
Q
Nutrient
A
Based on the latin word, “nutrire”, meaning to nourish.
And “nutrix”, meaning nurse.
7
Q
Macronutrients (3)
A
Carbohydrates
Proteins
Lipids
8
Q
Micronutrients
A
Vitamins and minerals
9
Q
Seven primary categories of nutrients
A
Fluids, carbohydrates, fiber, proteins, lipids (fats) vitamins minerals
10
Q
What are Carbohydrates made of?
Where are excesses stored?
A
Made up of Carbon, hydrogen and oxygen
Excess carbs are stored in liver and muscle as glycogen
11
Q
Insulin
A
Produced by beta cells of islets of Langerhans in pancreas
Promotes glucose transport into cells through cell membranes, enabling glucose to be used as an energy source.
12
Q
Recommended range of carbohydrates
A
45 to 65% of an adult total caloric intake
13
Q
Fiber recommendations
A
20-38 grams depending on age and gender.
Females lower in the range.
14
Q
Proteins consist of
A
Carbon, hydrogen, oxygen and nitrogen(nitrogen is not in carbs)
15
Q
Amino acids
A
Atoms of Carbon, hydrogen, oxygen, nitrogen form nine essential amino acids
16
Q
Protein’s role
A
Energy
Growth and maintenance
Repair
Maintenance of nitrogen balance
17
Q
One gram of protein equals
A
4 kilocalories
18
Q
Nitrogen balance
A
Nitrogen builds and Repairs tissues
Severe burns, starvation, prolong states of infection or other injuries can cause the body to lose more Nitrogen then it retains resulting in negative nitrogen balance.
19
Q
Recommended levels of protein
A
0.8 g per kilogram of body weight for adults.
Generally 56 g for males per day and 46 g for females
Higher protein diet recommended for people who are critically ill
20
Q
Lipids
A
Composition similar to that of carbohydrates but percentages of carbon, hydrogen and oxygen differ.
21
Q
Weight loss calculation
A
In a single pound of stored body fat there are 3500 calories.
In order to lose a pound a week a person must create a 3500 cal deficit per week. Averages 500 cal per day.
22
Q
Dysphasia
A
Difficulty chewing or swallowing foods
23
Q
Vitamin A Deficiency
A
Vitamin A Maintains visual acuity skin tissue and immune function. Deficiency can result in xerophthalmia a.k.a. night blindness.
In children deficiency can adversely affect development of teeth and bones
too much vitamin A Can cause abnormal fetal development.
24
Q
Vitamin E: what does it do
And what happens in deficiency
A
Synthesizes heme, Builds up red blood cells.
Deficiency can result in increased hemolysis or destruction of red blood cells
25
Vitamin K: what does it do and what happens with deficiency
Forms prothrombin in the blood and aids blood clotting.
Deficiency can contribute to prolonged clotting bleeding times in adults and
hemorrhagic disease in newborns
26
Vitamin C: what does it do and what happens with deficiency
Build strong capillary walls and red blood cells and aids in the metabolism of amino acids and wound healing.
Deficiency can lead to bleeding gums, bruising, scurvy, and wounds that do not heal.
27
Symptoms of scurvy
Caused by vit c deficiency.
| Weakness, anemia, spongy gums, and bleeding from mucous membranes
28
B1 (thiamine)
| What it does and what Happens with deficiency?
Necessary for normal function of nerves, muscles, and heart.
| -In less developed countries deficiency can lead to a condition known as beriberi-Effects cardiac and nervous systems.
29
Vitamin B6 (pyridoxine)
Necessary for healthy blood and nerve cells
| Deficiency in vitamin B6 manifests in anemia, cracks at the corners of the mouth and other skin lesions.
30
Vitamin B12 (cobalamin)
Necessary for red blood cell production.
Deficiency results in pernicious anemia that includes neurological and gastrointestinal symptoms.
Deficiency is seen especially in older adults has gastric secretions which are often reduced, aid in B 12 absorption.
31
Vitamin B9- Folic acid
Aids and maturation of red blood cells.
Deficiency can result in macrocytic anemia. Pregnant women may develop this anemia. Deficiency in pregnant women can also result in neural tube defects in children causing spinal deformities.
32
Vitamin B 3 (niacin)
Synthesizes fat and contributes to the utilization of protein.
A deficiency can result in pellagra a chronic disease characterized by anorexia and generalize weakness.
More severe pellagra can cause neurological and gastrointestinal disorders and severe skin eruptions.
33
Excess vitamin D can cause:
Dangerous increase blood levels of calcium
34
What are common reactions of vitamin excess?
Nausea and vomiting are the most common symptoms of vitamin excess.
35
Calcium: What it does and what happens with deficiencies?
Facilitates nerve impulse transmission, cardiac function, muscle contraction and formation of bones.
Deficiency: tingling sensation around the mouth and of the fingers, muscle cramping and spasms of toes her thumb. Severe hypocalcemia can cause convulsions.
Excess: cardiac irregularities and a state of over relaxation of the skeletal muscles.
36
Magnesium: what it does and deficiencies
Helps body to maintain electrical activity in nerves and muscles, and enables calcium and protein utilization.
Deficiencies: confusion, hallucinations, irritability of nervous system and a failure to grow
37
Potassium
Cardiac impulse transmission and muscle contraction.
- Deficiency: muscle weakness, fatigue, cardiac irregularities including a weak in rapid pulse
- Excess: confusion, abnormally slow pulse, muscle weakness, decreased urinary output
38
Sodium
Maintenance of acid base and fluid Balance.
Deficiency: hypotension, weakness, decreased level of consciousness, muscle twitching, nausea vomiting and abdominal cramps
Excess: Edema, shortness of breath, thirst, a dry tongue, and restlessness
39
Iodine- What it does and what are deficiencies and excess
Regulates thyroid hormones
Deficiency: can result in goiter or swollen thyroid gland. Hypothyroidism
Excess: Hyperthyroidism
40
Iron: what does it do?
Iron Forms hemoglobin and aids in the formation of antibodies. Oxygen is carried to the cells by iron for energy release.
41
Iron deficiency
Iron deficiency is probably the most common mineral deficiency resulting in iron deficiency anemia. Sx: impaired immune, lethargy, fatigue, DOE.
At risk people: breast fed infants, age 6-18 need iron fortified food, adolescent girls w/ menstrual blood loss, fiber may interfere with iron absorption, lack of meat, asa use d/t internal bleeding
42
Zinc: what does it do? Deficiency?
Helps body Maintain connective tissue like skin.
| Deficiency may result in impaired wound healing, skin lesions, and decreased sense of smell and taste.
43
Anemia
Anemia literally means “without blood.”
| The blood suffers from a deficit of iron.
44
What can low numbers of red blood cells mean?
- Nutritional anemia,
| - malnutrition with related deficiencies of folate, B 12 or B6.
45
Red blood cell range- RBC
Varies with altitude and gender.
- Males 4.7- 6.1 million cells perMicroliter.
- Females 4.2- 5.4 million cells per microliter.
46
Hemoglobin :what it does?
| What does low or high level mean?
Hemoglobin is a protein molecule and red blood cells that carries oxygen and gives blood its color.
Low hemoglobin levels can be related to the deficiency anemia or fluid retention. Blood loss.
High hemoglobin levels can be related to dehydration.
47
Normal levels of hemoglobin
Women: 12-16grams per ml
Men: 14-18 grams per ml
48
Hematocrit: what is it?
| What is cause of high or low level?
Volume of red blood cells compared to the volume of the whole blood. It is a measure of cell volume and iron status.
Low hematocrit can indicate excess fluid, some types of anemia, or protein calorie malnutrition (PCM)
High hematocrit may indicate dehydration.
49
Normal hematocrit values
Women: 37–47%
Men: 40 to 54%
50
White blood cell count
AKA total lymphocyte count
Normal ranges
4300 to 10,800 cells per cubic millimeter.
51
Low WBC causes?
Depressed immune system that could be related to In adequate intake of essential nutrients specifically protein.
Malignancies or other depressed immune disorders like aids may exhibit low lymphocyte count
52
Serum albumin:
| What is it and what are normal ranges?
Measures serum protein levels in the blood.
| Normal range is 3.4 to 5.4 g/dL. (Grams per deciliter)
53
Reasons for low levels of serum albumin.
Protein Depletion, and generally of a long-term nature, related to PCM.
General malnutrition and malabsorption syndromes like Crohn’s disease, sprue, and Whipples disease may also cause low levels of albumin
54
Serum transferrin:
what is it ?
and what are the normal levels?
Measure of iron transport.
can also indicate insufficient dietary protein intake when low. May be a better indicator of protein calorie depletion then serum albumin.
Normal 60- 170 Micrograms per deciliter (mcg/dL)
55
Serum transferrin:
| Reasons for low or high levels
Abnormally low serum transferrin and levels can also reflect iron deficiency anemia related to an inadequate dietary iron or poor absorption of iron. pregnancy can cause low values.
High levels May be related to nutritional deficiencies of vitamin B 12 and vitamin B 6.
56
Triglyceride levels- should be less than 150. What causes high or low levels?
High triglyceride values may be due to a diet low in protein and high in carbohydrates or poorly controlled diabetes.
Very low triglyceride Levels may relate to malabsorption syndrome or a very low fat diet.
57
Blood urea nitrogen BUN
| What does it indicate If too high or too low? And what is a normal range?
Low BUN levels can indicate insufficient protein intake malnutrition or overhydration.
High BUN can indicate that too much protein has been ingested.
Normal range for BUN is 7 to 20 mg/dL.
58
Blood urea nitrogen BUN
| WHAT IS IT?
Urea, formed as a result of the metabolism of amino acids, circulates through the blood and is excreted in urine after traveling through the kidneys.
Too much protein adversely affect kidney function and can contribute to kidney diseases and even kidney failure.
59
Urinary creatinine excretion normal ranges
measured in a 24 hour urine collection.
Related to skeletal muscle mass that atrophies or shrinks if a patient is severely malnourished which results in decreased excretion of creatinine.
Normal lab values can range from 500 to 2000 mg per day
60
Enteral nutrition
Includes any form of nutrition in which nutrients are directly digested and absorbed through the G.I. tract
61
PEG tube
Percutaneous endoscopic gastrostomy tube.
| Into stomach.
62
PEJ tube
Percutaneous endoscopic jejunostomy tube.
| Into jejunum
63
Bolus feeding through the tube.
Toomey syringe.
| Bolus is usually followed by 30 to 60 mL of water to clear the feeding tube.
64
Nasogastric tube placement measurement:
Measure length of tube from the tip of the nose, to the ear lobe, and to the xiphoid process at the tip of the sternum. Mark the tube with tape prior to insertion.
65
After measuring nasogastric tube what are the next steps for placement?
-Use water based lubricant.
-High Fowler’s (90 degree)
-Patient hyperextend neck
advance tube through nose and back toward the ear into the nasopharynx
66
Aspirating gastric contents
General rule:
If more than 100 mL residual, feeding may be held
Always re-insert any undigested tube feeding back into stomach to maintain electrolyte balance.
67
Guidelines for ensuring tube feeding placement.
Ensure x-rays taken to visualize a newly inserted to prior to the administration of any tube feeding solution medication.
Marked feeding tubes.
68
Dumping syndrome
| Causes and symptoms
Can occur with jejunostomies.
Sudden movement of body fluids from circulatory system across intestinal cell membranes in attempt To compensate for the sudden dumping of highly Concentrated solution into the jejunum.
Diaphoresis, n/v, pallor, palpitations, tachy, diarrhea, sometimes fainting immediately following tube feeding.
69
TPN
| Total Parenteral Nutrition
- IV nutrition
- Hypertonic
- AKA- hyperalimentation
- Used when gi tract should be bypassed
- Glucose provides greatest percentage of nutrients.
70
Conditions that may indicate need for TPN
Crohn’s
Severe ulcerative colitis
Severe malnutrition
Severe trauma or burns
71
TPN infusion: how is it infused?
Indwelling Venous catheter or a central venous catheter that feeds into the superior vena cava.
Large veins to accommodate highly concentrated solution.
72
Lipid emulsions
| Fat emulsion
Another form of parenteral nutrition. Can be given in addition to TPN through separate IV line or using Y connector tubing.
Need for extra calories and supplemental fatty acids.
73
Total Nutrient admixture
| Three-in-one
Type of TPN solution.
| Combines amino acids, dextrose, IV fat emulsions and other nutrients into a single admixture.
74
Signs of fluid overload-
| Related to IV solution at too rapid of a flow rate.
```
Confusion
SOB
Pitting edema
Decreased urinary output
Weak pulse
Tachycardia
Hypo or hypertension
Adventitious breath sounds (crackles)
Can cause pulmonary edema or CHF
```
75
Nursing actions for fluid overload
To prevent: monitoring and maintaining flow rate and monitor central venous pressure (CVP).
Stop infusion if symptoms appear, notify physician and treat symptoms
76
Complications related to hypertonic solutions (TPN)
Hyperglycemia
Or hypoglycemia if sudden discontinuation because the solution can cause the pancreas to secrete more insulin.
77
Treatment of hyperglycemia
r/t hypertonic solution because of high glucose concentration
and s/sx of hyperglycemia
Sx: nausea, headache, weakness, dehydration
Usually TPN is infused slow- 1 liter per 24 hours
Check cbg q6 hrs
Administer insulin if ordered.
78
Hypoglycemia can occur with sudden discontinuation of TPN.
| What is s/sx of and treatment of hypoglycemia?
S/sx: cold and clammy skin, lightheaded, dizziness, numbness and tingling, occipital headache, confusion, tachycardia.
Do not stop TPN suddenly. Check equipment every hour. Monitor glucose level.
79
Hyperosmotic reactions (TPN)
Osmotic diuresis,Dehydration and even Death can occur with too rapid infusion and electrolyte balances.
Monitor for dehydration- (tenting skin, dry sticky mouth, thirst)
Assessment hourly, notify MD if signs of dehydration, be prepared to administer fluids as ordered.
80
Air embolism from IV air into bloodstream and lungs.
| S/sx:
S/sx: sudden onset of rapid respirations (tachypnea) and possibly chest pain
Follow protocol for resp emergency
Prevent air from getting into IV lines
81
Complications related to lipid or fat emulsions are similar to hypertonic reactions with respect to hyper/ hypoglycemia.
Another complication is Emulsion Reaction. What are s/sx?
```
Sudden onset of of sx.
Allergic reactions(swelling or sob)
Back or chest pain
Cyanosis
Dyspnea
Dizziness, headache, pressure over eyes
N/V
```
Immediately turn off flow and notify MD
82
Warfarin is protein bound. If another protein bound drug is given, what might be expected with dosages?
The dosages of both meds may be decreased
83
Drugs that are enzyme inhibitors:
Decrease metabolism, promoting increase in plasma drug concentration.
84
Effects of smoking on the drug theophylline.
Smoking increases hepatic enzyme activity, increasing the the clearance of theophylline. Smokers may need increase in dose of theophylline.
85
Additive effect of drugs
Two drugs with similar actions are administered together.
86
2 different types of drugs are given. One increases the effect of the other. What type of action is this?
Synergistic effect
87
Symptoms of excess vitamin A
Hair loss and skin peeling
88
Foods high in vitamin B
Whole grain cereal and bread
89
Folic acid deficiency during first trimester may cause:
Spinal cord dysfunctions in fetus
90
Why are large doses of iron contraindicated in in first trimester?
Possible teratogenic effects on fetus
91
What foods are rich in zinc?
Meat and eggs
92
Which mineral may assist in controlling blood sugars in DM 2?
Chromium
93
S/sx hyperglycemia
```
Increased urine output
Dry mucous membranes
Lethargy
Glycosuria
Thirst
```
94
Good source of vitamin a
Pumpkin, sweet potato, carrots, cantaloupe,
| Spinach, kale, collard greens
95
Low residue diet
Limits high fiber foods.
White breads, cooked cereals
Eggs, meat
well cooked veggies
96
What would presence of ketosis in a healthy adult represent?
Inadequate intake of carbohydrates.
| Body will break down fats. Ketones are produced with oxidation of fatty acids.
97
School age children’s diets should be monitored for:
Adequate protein and vit A and C
98
After xray confirmation, the best ways to confirm tube placement:
PH of contents
| And observing the appearance of aspirate.
99
Infant doubles birthweight by which month of age?
| Triples at what month?
Doubles at 4-5 months
| Triples at 12 months
100
Sequence newborns best tolerate new foods:
```
Cereal
Fruits
Yellow veggies
Green veggies
Meats
```
101
Low calorie foods are considered:
To have less than 40 calories per serving
102
Some Protein roles in body:
Stimulates tissue growth and repair
Helps regulate fluid balance through oncotic pressure
Detox harmful substances
Forms antibodies
103
S/sx niacin deficiency
Pellagra, dermatitis
104
What are some significant assessment findings that point to malnutrition?
Loss of appetite
Consuming less than 25% of meals
Dry,brittle hair
105
What is high nutrient density foods?
Fruits and vegetables- foods that provide high number of nutrients in relationship to kcals.
106
Foods high in calcium
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Dairy
Sardines
Spinach
Collard greens
Rhubarb
Tofu
```
107
Foods high in potassium
"POTASSIUM"
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Potatoes, pork
Oranges
Tomatoes
Avocados
Strawberries
Spinach
FIsh (fish with capital i
mUshrooms
Melon
```
Also- carrots, raisins and bananas
