Nutrition And Respiratory Diseases Flashcards
Parts of the respiratory system
Trachea
Primary bronchi
Secondary bronchi
Tertiary bronchi
Bronichioles
Terminal bronchioles
Respiratory bronchioles
Alveolar ducts
Alveoli
Site of gas exchange with the blood
Alveoli
This is closely related to capillaries
Alveoli
What makes up the respiratory membrane?
Wall of alveolus + wall of capillary
Gas exchange occurs by
Diffusion
Medical history
Dyspnea
Chest pain
Respiratory rate
Breathing pattern
Patient history
Occupation
Genetics
Smoking
Laboratory test
Arterial blood gas analysis
Pulmonary function
Diagnostic criteria for blood gas analysis
PCO2 = 35-45 mmHg
PO2 = 80-100 mmHg
HCO3 = 22-26 mEQ/L
O2 saturation = > 95%
pH = 7.35 to 7.45
Anthropometrics
Body weight
True or false. The underlying cause of asthma is still unclear.
True.
Nutritional factors associated with asthma
Maternal diet during pregnancy
Infant and toddlerhood diet
Adult obesity
Asthma is an interplay of complex factors, such as
Genes
Immune system
Environment
Describe the pathophysiology of asthma
Genetic factors + Immunologic factors (T lymphocytes release cytokines —> inflammation) + Environmental factors (IgE is released —> airway edema)
Will lead to
Airway inflammation
Intermittent airway obstruction
Bronchial hyper responsiveness
Manifestations
Persistent mouth breathing
Paroxysmal dyspnea secondary to airway obstruction
Wheezing
Decreased breathing sounds
Objectives of drug and nutritional management
1) Allergic type: identify and control allergens im the environment
2) Promote adequate hydration
3) Promote improved resistance against diseases
4) Ease out difficulty of breathing
5) Encourage a health-maintenance and asthma management program
Rationale: provide balanced, small, nutrient-dense meals (Asthma)
To reduce risk of infections and poor state of health; to aid in breathing
Strategy: What vitamins are needed to prevent oxidative stress in tissues? (Asthma)
Vitamins A, C, B6, Zn
R: Increase fluid intake (2-3 L) (Asthma)
To liquefy secretions
R: Include sources of n-3 and n-6 fatty acids (Asthma)
Reduce bronchial inflammation
R: Mg (Asthma)
Smooth muscle relaxant and anti-inflammatory agent
S: Bronchodilator (Asthma)
Methylxanthines (caffeine and theobromine in cocoa)
S: to prevent asthma attacks
Remove allergens
R: Na restriction for patients with pulmonary edema
Avoid water retention
Acute inflammation of the airway structures
Bronchitis
Bronchitis may be serious in ________ patient and those with _______ _________ _______ disease.
Debilitated; chronic lung heart
This is a critical complication of bronchitis.
Pneumonia
Differentiate acute infections vs acute irritative
Acute infections bronchitis
- Mycoplasmic pneumoniae
- Chlamydia
- Exposure to air pollutant
Acute irritative
- mineral and vegetable dusts
- fumes from strong acids
- tobacco or other smoke
- volatile organic solvents
Pathophysiology of bronchitis
Hyperemia of mucous membranes —> edema, leukocytic infiltration, mucus production —> cough (affected by disturbance of cilia and bacterial invasion of the bronchi) —> airway obstruction and spasm of bronchial muscles
Manifestations of bronchitis
Cough: initially dry and nonproductive
Fever: 38.3-38.8 C (3-5 days)
Dyspnea: secondary to airway obstruction
MNT goals for bronchitis
Prevent dehydration
Allow ample rest before and after feedings
Relieve discomfort
Replenish nutrients
Avoid further infections
Normalize body temp
Bronchitis: Diet should be
High calorie (40-55% CHO, 15-20% CHON, 30-40% Fat)
Bronchitis: Milk intake is limited because
It thickens mucus
Vitamin C should be adequate because
Prevents oxidative stress
Bronchitis: This is given to replenish GI bacteria lost because of antibiotics
Probiotics
Bronchitis: Potassium is provided to
Maintain fluid balance
A process characterized by the presence of emphysema or chronic bronchitis, or both, leading to airway obstruction
Chronic obstructive pulmonary disease
Two types of COPD
Type 1 - emphysema
Type 2 - chronic bronchitis
Differentiate type 1 COPD from type 2
Emphysema
- weakened and collapsed air sacs with excess mucus
- “pink puffer”
- (1) thin and older (2) dyspnea (3) mild hypoxemia but normal hematocrit values (4) late cor pulmonale
Chronic bronchitis
- chronic productive cough with inflammation of one or more bronchi and secondary changes in the lung tissue
- also called the chronic mucus hypersecretion syndrome
- “blue bloater”
- (1) normal or overweight (2) hypoxemia is prominent (3) increased hematocrit values (4) early cor pulmonale
Etiology of COPD
Tobacco smoking
Air pollution
Genetic susceptibility (a-1 antitrypsin deficiency)
Pathophysiology of COPD
a-1 antitrypsin deficiency —> neutrophils release cytotoxic proteinase —> lung elastin production and mucosal hypersecretion —> airway obstruction —> decline in lung function
Manifestations of COPD
Chronic or recurring cough
Mucus production
Presence of hypoxemia and hypercapnia
Dyspnea
MNT goals for COPD
Correct malnutrition
Overcome anorexia
Prevent or correct dehydration
Improve ventilation before meals
Alleviate swallowing or chewing difficulties
Avoid constipation
COPD: Diet should be
High kcal and protein (45% CHO, 15% CHON, 40% Fat)
COPD: Why is carbohydrate reduced?
To balance the need for O2 and elimination of CO2
Should soft diets be recommended for COPD patients? Why or why not?
Yes. They have chewing or swallowing difficulties.
COPD: small frequent feedings
To lessen fatigue
COPD: needed for tissue healing
Vitamin A and C
COPD: B complex is needed for
Energy metabolism
COPD: fluid intake should be
1 ml/kcal
True or false. Potassium and sodium should be increased for COPD patients
False. Potassium is increased, sodium is restricted
COPD: Fiber is increased gradually because
To avoid constipation.
Indicate infection and inflammation of the lung tissue
Pneumonia
Any lung condition in which the alveoli becomes filled with fluid or blood
Pneumonia
Classifications of pneumonia
Whole lungs
Lobular
Bronchopneumonia
Interstitial
Pathophysiology of pneumonia (bacteria)
Pneumococci —> upper respiratory tract —> lodge in bronchioles —> inflammation in alveolar spaces —> congestion
Pathophysiology of pneumonia (virus)
Virus —> invade bronchiolar epithelial —> bronchiolitis —> infection extends to pulmonary interstitium and alveoli
Manifestations of pneumonia
Impaired pulmonary ventilation and diffusion
Increased pulse rate and respirations
Cyanosis on lips and nail beds
Cough
Elevated leukocytes
MNT goals for pneumonia
Prevent or correct dehydration
Prevent weight loss due to hypermetabolic state
Avoid additional infections
Relieve breathing difficulties
Avoid constipation
P: Progress as tolerated to a
High calorie/soft diet
How many liters of fluid is recommended for patients with pneumonia?
3-3.5 L
Should supplements and fiber be included in the diets of patients with pneumonia?
Yes.
PTB is caused by what bacteria
Tubercle bacillus
Chronic, recurrent infection most common in the lungs
PTB
PTB is associated with the formation of _____ in the lung tissue.
Granuloma
True or false. PTB cannot be acquired through air.
False.
Manifestations of PTB
Chest pain
Cough
Dyspnea
Hemoptysis
MNT goals of PTB
Maintain or prevent weight loss
Normalize Ca serum levels
Replace nutrient losses from lung hemorrhage
Promote healing of the cavity
Stimulate appetite
Prevent dehydration
Prevent pleurisy and complications
PTB: protein and kcal
Liberal CHON and adequate kcal
PTB: Ca, Vit. D, and adequate fluids are provided because
To counteract INH therapy
PTB: B-complex is needed for
Hgb formation and wound healing
Isoniazid:
Rifampicin:
Bacteriacidal
Inhibits RNA synthesis of the bacteria
