Nutrition and Factors that Impact wound healing Flashcards
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What is the primary objective of identifying factors impeding wound healing?
To create strategies to mitigate effects of impeding factors.
What should be compared and contrasted in nutritional guidelines?
Recommended general nutritional guidelines vs recommended guidelines for patients with wounds.
What is the role of the physical therapist in nutritional screening?
To provide information on diet and nutritional issues to patients, clients, and the community.
List some interventions the physical therapist may use when working with a patient with nutritional deficiencies.
- Education
- Nutritional strategies
- Assessment
According to the House of Delegates (2019), what is within the professional scope of physical therapist practice?
To screen for and provide information on diet and nutritional issues.
What are common issues with the Standard American Diet?
- Under-consumption of fruits and vegetables
- Selection of lower quality carbohydrates
- High intake of refined grains and added sugars
- Excessive fast food consumption
What macronutrient is essential for wound healing?
Proteins.
What is the main source of energy during rest and food deprivation?
Fats.
Name two essential functions of vitamins in nutrition.
- Required for inflammatory response
- Needed for immune function and energy metabolism
What is the role of water in the body?
- Solvent for vitamins/minerals
- Transports substances to/from cells
- Lubricant for joints and organs
- Helps maintain body temperature
What is the recommended daily intake of protein for adults?
0.8-1.0 g/kg body weight.
What is malnutrition defined as according to the Academy of Nutrition and Dietetics?
Presence of 2 or more indicators such as insufficient energy intake, weight loss, or loss of muscle mass.
What does protein energy malnutrition involve?
Inadequate energy and protein intake to meet bodily demands.
What is the BMI threshold for obesity?
BMI > 30.
What is the process of nutritional screening?
Identifying characteristics associated with nutritional problems.
How often should nutritional status be assessed for those at low risk?
Every 3 months.
What is the Canadian Nutrition Screening Tool?
A tool that uses 2 questions to indicate malnutrition risk.
What are signs of dehydration?
- Decreased urine output
- Dark-colored urine
- Increased confusion
- Decreased blood pressure
List some functional limitations affecting nutrition.
- Chewing and swallowing problems
- Loss of dexterity
- Reduced mobility
- Sensory losses
What percentage of people live in food-insecure households?
Approx 12.5% of homes with children.
What are the nutritional requirements for wound healing in terms of protein?
1.5-2 g/kg for adults.
Fill in the blank: The main source of energy during rest, sleep, and food deprivation is _______.
[Fats]
True or False: Vitamins supplements are recommended if a patient’s diet is poor or deficient.
True.
What is the significance of arginine in nutrition?
Involved with insulin secretion and protein regeneration.
What are the effects of obesity on wound healing?
- Delayed wound healing
- Increased risk for surgical site infections
What are some critical nutrients considered during nutritional assessment?
- Amino acids
- Minerals
- Water
What are the conditions that increase fluid needs for wound healing?
- Burns
- Constipation
- Dehydration
- Diarrhea
- Emesis
- Fever
- Hemorrhage
- Hot/dry environments
- Hypotension
- Polyuria medications
What conditions decrease fluid needs for wound healing?
- Cardiac disease/CHF
- Edema
- Fluid overload
- Renal failure
- Significant hypertension
- SIADH (syndrome of inappropriate antidiuretic hormone secretion)
What is the recommended fluid intake for wound healing?
30 ml/kg of body weight per day
What is the role of Vitamin A in wound healing?
Stimulant for onset of wound healing, epithelialization, and fibroblast deposition of collagen
What is the function of Vitamin C in wound healing?
Cofactor for collagen synthesis, immunity, fatty acid metabolism
How does Vitamin D contribute to wound healing?
Regulates structural integrity of receptor signaling; promotes peptides to improve healing
What role does Copper play in wound healing?
Cofactor for connective tissue production, collagen cross-linking, and cytochrome oxidase for energy production
What is the significance of Iron in wound healing?
Cofactor in collagen synthesis
What is the role of Manganese in wound healing?
Cofactor for collagen and ground substance synthesis
What is the function of Selenium in wound healing?
Antioxidant
What is the role of Zinc in wound healing?
Cofactor for DNA, RNA, and polymerase for collagen and ground substance synthesis
What are the diagnostic markers for malnutrition?
- Albumin: 3.5-5.5 g/dL
- Prealbumin: 15-36 mg/dL
- Transferrin: 204-360 mg/dL
What are the normal ranges for WBC?
4.5-11 x 10^3 mm^3
What are the normal hemoglobin levels for males and females?
- Males: 13.5-18 g/dL
- Females: 12-15 g/dL
What are the normal hematocrit (Hct) values for males and females?
- Males: 37-50%
- Females: 36-46%
What is the normal platelet count range?
150-400 x 10^3/mm^3
What is the normal range for Prothrombin Time (PT)?
12.3-14.2 seconds
What is the normal range for Partial Thromboplastin Time (PTT)?
25-34 seconds
What is the therapeutic range for INR?
0.9-1.1 (therapeutic range: 2-3; Mechanical valve 2.5-3.5)
What are the supplement recommendations for wound healing?
- Ensure calories from a balanced diet
- Protein
- Fluid
- Vitamin A: 10,000-15,000 IU/day
- Vitamin C: 500-1000 mg/day
- Vitamin D: Consider deficiencies
- Arginine: 4.5g/day (with adequate protein)
- Zinc: 40-220 mg/day
- Selenium
- Iron
What is enteral nutrition?
Feeding by way of a tube directly into the GI tract
What is parenteral nutrition?
Bypasses the GI tract and administers nutrients directly into the venous system
What behaviors can impede wound healing?
- Stress
- Smoking
- Alcohol abuse
True or False: Smoking can impair wound healing by causing tissue hypoxia.
True
What is the recommended abstention period from smoking before surgery?
At least 4 weeks
What are the alcohol consumption thresholds that inhibit healing in males and females?
- Males: >14 drinks/week
- Females: >7 drinks/week
