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Practice topics Exam 2 > Nutrition and Wound Healing > Flashcards

Nutrition and Wound Healing Flashcards

1
Q

Malnutrition

A

the cellular imbalance between supply of nutrients and energy and the body’s demand for them to ensure growth, maintenance, and specific functions

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2
Q

Nitrogen balance

A

The difference between the amount of nitrogen taken in by the body and that excreted
Most nitrogen is in the form of protein
Proteins metabolism results in nitrogen exertion

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3
Q

Essential amino acids

A

Need to supplement

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4
Q

Non-essential amino acids

A

Produced by the body

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5
Q

Conditional or semi essential amino acids

A

May require supplements at various times (growth spurts)

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6
Q

Fat soluble vitamin

A

Primarily stored in adipose tissue and liver, not easily removed from the body, stays stored until used, can develop toxicity

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7
Q

Water soluble vitamin

A

Easily removed from body, little to no storage by the body

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8
Q

Nutrition goals - wound healing

A 
Provide energy for wound healing
Maintain appropriate nitrogen balance
Maintain optimal hydration for adequate tissue perfusion
Maintain glycemic control
Monitor nutritional status
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9
Q

Nutritional risk factors

A 
Weight loss 5% in 30 days, 10% in 180 days
BMI less than 21 (with weight loss)
Hypoalbuminemia
Lymphopenia 
Diminished ability to intake food
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10
Q

Loss of 10% lean body mass
Complications
Mortality

A

Impaired immunity, increased infection

10%

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11
Q

20% loss of lean body mass
Complications
Mortality

A

Decreased healing, weakness, infection

20%

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12
Q

30% loss of lean body mass
Complications
Mortality

A

Too weak to sit, pressure ulcers develop, pneumonia, no healing
50%

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13
Q

40% loss of lean body mass
Complications
Mortality

A

Death, usually from pneumonia

100%

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14
Q

Calories - goal

A

Basic energy needs

Prevent weight loss

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15
Q

Calories - normal

A

25-35 kcal/kg body weight

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16
Q

Calories - intermediate

A

35-40 kcal/kg body weight

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17
Q

Calories - hypermetabolic

A

40-60 kcal/kg body weight

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18
Q

Calories needed for healing - injury factor: post op with no complications

A

1-1.05

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19
Q

Calories needed for healing - injury factor: wound healing

A

1.2-1.6

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20
Q

Calories needed for healing - injury factor: 40% BSA burn

A

1.5-1.85

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21
Q

Calories needed for healing - injury factor: severe infection

A

1.3-1.55

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22
Q

Calories needed for healing - injury factor: more than 40% BSA burn

A

1.85-2.05

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23
Q

Albumin - risk level and normal

A

Risk level = less than 3.5 with normal hydration

Normal = 3.5-5

24
Q

Prealbumin - risk level and normal

A

Risk level = less than 16

Normal = 15-36

25
Q

Hemoglobin - risk level and normal

A

Less than 12 = risk

Normal = 12-16

26
Q

Hematocrit - risk level and normal

A

Risk level = less than 33%

Norm = 36-49%

27
Q

Cholesterol - risk level and normal

A 
Risk = less than 160
Normal = less than 200
28
Q

Total lymphocyte count - risk level and normal

A 
Risk = less than 1800
Normal = 3000-3500
29
Q

Serum osmalality measures what? Risk level? Norm?

A

Measure of hydration
Risk - more than 295
Norm - 280 - 303

30
Q

Water

A

Oxygen perfusion
Wound hydration
Solvent for a variety of components to allow cell diffusion
Aids in maintaining body temperature

31
Q

Hydration - osmalality - normal and dehydration

A 
Normal = 280-303
Dehydration = more than 303
32
Q

Hydration - serum sodium - normal and dehydration and overhydration

A 
Normal = 135-145
De = more than 145
Over = less than 130
33
Q

Hydration - BUN - normal and dehydration and overhydration

A 
Normal = 7-20
De = over 35
Over = less than 7
34
Q

Hydration - Urine specific gravity - normal, dehydration, overhydration

A 
Normal = 1.002-1.008
De = more than 1.028
Over = less than 1.002
35
Q

Hydration - normal adult requriement is

A

30-40 mL/kg
Minimum of 1.5L
Usually need to replace electrolytes along with fluid

36
Q

Hydration - inc risk patients

A

Air fluidized beds increased need for hydration
CHF and renal failure - need to be careful because do not want to overtax the heart with fluids, but need them to be hydrated

37
Q

Proteins

A 
Major source of energy
collagen synthesis
epithelial cell production
immune response (WBC production)
Angiogenesis
38
Q

Proteins - daily protein requirement

A

Pt weight divided by 2

39
Q

Protein - albumin

A

Protein within the vascular spaces which also controls osmotic equilibrium (think edema)
Late indicator of malnutrition

40
Q

Protein - prealbumin

A

More sensitive indicator of malnutrition

Transport protein and NOT a precursor of albumin

41
Q

Serum albumin - half life

A

Abundant, 20 day half life

Carrier for variety of diff substrates

42
Q

Serum albumin - synthesized where

A

Synthesized in the liver

43
Q

Serum albumin - if dec

A

Dec in amino acids will lead to dec in albumin

Will lead to decrease of lean body mass as shift in energy metabolism occurs

44
Q

Serum pre-albumin - half life

A

2 to 3 days

Carrier for variety of diff substrates

45
Q

Serum pre-albumin - eliminated by

A

kidney
Kidney issues may impact levels!
Renal failure = increase in pre albumin

46
Q

Fatty acids

A

Collagen production/strength
Cell membrane integrity
Role is controversial
Polysaturated fatty acids (omega 3) may slow wound healing
Cholesterol - bile and hormone production, cell membrane fornation

47
Q

Vit A

A

fat soluble

inflammation and epithelialization

48
Q

Vit B

A

water soluble

collagen cross links

49
Q

Vit C

A

water soluble

leukocyte activation, blood vessel stability via cell membrane integrity

50
Q

Vit E

A

fat soluble

people tend to have too much - liver toxicity

51
Q

Vit K

A

fat soluble

coagulation

52
Q

Minerals

A

Ca, Mg, Phosphorus

skeletal system integrity

53
Q

Zinc

A

collagen formation
protein synthesis
WBC function
Fibroblast function

54
Q

Copper

A

Collagen crosslinks

Involved in angiogenesis

55
Q

Arginine

A 
Amino acid
Improves nitrogen balance
Precursor needed for collagen production
Improved immune system responses
Primarily surgical/traumatic wound healing
Effects are still being debated
56
Q

Glutamine

A

Amino acid
Nitrogen transfer function
Oxidizes and becomes fuel for macrophage, lymphocyte and fibroblast activation
Minimizes muscle wasting

Practice topics Exam 2 (15 decks)

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