Nutrition Care

Question 1

What are the macronutrients?

Answer 1

Carbs (into monosaccharides by amylase), proteins (into amino acids by protease) and fat (monoglycerides and fatty acids by lipase and bile)

Question 2

What are the fat soluble vitamins?

Answer 2

A, D, E and K

Question 3

What is vitamin A necessary for?

Answer 3

Vision

Question 4

What is vitamin D necessary for?

Answer 4

Ca absorption

Question 5

What is vitamin K necessary for?

Answer 5

Clotting

Question 6

What is cobalamin and B12 used for?

Answer 6

Binds to IF- intrinsic factor from parietal cells in stomach

Question 7

What is ascorbic acid (Vit C) used for?

Answer 7

Aids iron absorption

Question 8

Where are Ca and iron absorbed?

Answer 8

Stomach

Question 9

Manifestation of thiamine deficiency

Answer 9

Beriberi (peripheral neuropathy and maybe HF)

Wernicke-Korsakoff syndrome (neurologic sequela)

Question 10

Manifestations of B vit deficiency (riboflavin-2, niacin-3 and pyridoxine-6)

Answer 10

Cheilitis, angular stomatitis, glossitis

Question 11

Other manifestations of niacin (B3) deficiency

Answer 11

Pellagra (diarrhea, dermatitis, dementia)

Question 12

Manifestations of folate deficiency

Answer 12

Macrocytic anemia

Question 13

Manifestations of cobalamin (B12) deficiency

Answer 13

Macrocytic anemia and peripheral neuropathy

Atrophic glossitis

Question 14

Manifestations of vit D deficiency

Answer 14

Rickets and osteomalacia

Question 15

Manifestations of Vit A deficiency

Answer 15

Night blindness, bitot spots in eyes, poor wound healing, dry skin

Question 16

Manifestation of zinc deficiency

Answer 16

Hypogeusia (taste disturbance), impaired wound healing

Question 17

Manifestation of iodine deficiency

Answer 17

Goiter and hypothyroidism

Question 18

Manifestation of calcium deficiency

Answer 18

Tetany

Question 19

Manifestation of iron deficiency

Answer 19

Pallor, pale conjunctiva, koilonychia

Question 20

Manifestation of vitamin C and K deficiency

Answer 20

Petechiae and purpura

Question 21

Manifestation of vit E deficiency

Answer 21

Sensory and motor neuropathy

Question 22

What is necessary in pregnancy to prevent neural tube defect?

Answer 22

Folic acid

Question 23

What do exclusively breast fed pts need to receive?

Answer 23

Vit D supplements

Question 24

Nutrition important for adulthood

Answer 24

Well balanced nutrient rich diet focused on healthy food choices, portion control, food prep and meal planning, and mindful eating

Question 25

What is a good method for nutrition?

Answer 25

Myplate method

Question 26

What is important to remember about elderly nutrition?

Answer 26

Changes associated with normal aging increase nutritional risk

Question 27

Diet for elderly

Answer 27

Liberalize diet Incorporate high calorie foods Add oral nutrition supplements as appropriate

Question 28

Why do a nutrition screen

Answer 28

ID individuals at nutritional risk (decreased oral intake and appetite, weight loss, barriers to eating)

Question 29

Components of nutrition assessment

Answer 29

Food and nutrition related history Pt history (conditions with nutritional implications, surgeries and social) Anthropometric measurements (weight pattern etc) Nutrition focused PE (target body weight, muscle wasting, fat stores, vol status, signs of nutrient deficiencies) Laboratory indicators

Question 30

What do these signs suggest? | Edema and ascited

Answer 30

Protein deficiency

Question 31

What do these signs suggest? | Sunken dry appearance of orbital area

Answer 31

Dehydration

Question 32

What do these signs suggest? | Temporal muscle wasting

Answer 32

Protein (calorie) deficiency

Question 33

What do these signs suggest? | Poor wound healing, pressure ulcers

Answer 33

Protein, vit C and A, zinc deficiency

Question 34

What do these signs suggest? | Muscle wasting and decreased strength

Answer 34

Protein calorie deficiency

Question 35

What do these signs suggest? | Confusion

Answer 35

Thiamine deficiency

Question 36

Why are oral nutrition supplements used?

Answer 36

Concentrated source of kcals, protein, vitamin and minerals

Question 37

Types of nutrition support

Answer 37

Enteral (preferred) and parenteral

Question 38

What is enteral nutrition?

Answer 38

Nutrition delivered directly into GI tract bypassing oral cavity *appropriate for ppl with functioning GI tract but can't get requirements by mouth

Question 39

Routes of enteral nutrition

Answer 39

gastric or small bowel

Question 40

Short term enteral nutrition

Answer 40

<4-6 wks | NG, ND or NJ tube (risk of nasal/esophageal erosion)

Question 41

Long term enteral nutrition

Answer 41

>4-6 wks | Gastrostomy (G tube), J tube or G/J tube

Question 42

How to administer enteral nutrition

Answer 42

Bolus feeds via stomach | Continuous feeding via small bowel

Question 43

Complications of enteral nutrition

Answer 43

Mechanical (misplacement, displacement or obstruction) Metabolic abnormalities Intolerance Pulm aspiration

Question 44

What is parenteral nutrition?

Answer 44

Nutrition delivered directly into vein for those with nonfunctioning GI tract or when oral intake and EN is not feasible or C/I

Question 45

Types of parenteral nutrition

Answer 45

``` Peripheral Total (long term > 7 days with central venous catheter or peripherally inserted central catheter) ```

Question 46

What is GERD?

Answer 46

Reflux of gastric contents into esophagus

Question 47

What is gastroparesis?

Answer 47

Delayed gastric empyting

Question 48

What is gastroparesis a complication of?

Answer 48

Diabetes (diabetic autonomic neuropathy)--so glycemic control should be optimized in diabetics

Question 49

What is roux-en-y gastric bypass?

Answer 49

Restrictive/ malabsorptive bariatric surgery procedure

Question 50

What is short bowel syndrome?

Answer 50

Surgical resection or disease of small bowel can disrupt digestive/absorptive surface capacity and contribute to nutrient malabsorption, diarrhea, dehydration and lyte abnormalities

Question 51

Diverticulosis vs diverticulitis

Answer 51

Losis is presence of diverticula (high fiber) Litis is inflammation (clear liquid and NPO) Difference in diet

Question 52

Nutrition goals for diabetes

Answer 52

Aimed to optimize A1c, BP and Cholesterol

Question 53

Renal disease

Answer 53

Poor excretion can lead to sodium and fluid retention, hyperkalemia and hyperphosphatemia

Question 54

Recommendation for vit K and coumadin

Answer 54

Main the consistency of vit K with coumadin

Question 55

Concern with ACE and ARBs

Answer 55

Hyperkalemia

Question 56

Concern with diuretics

Answer 56

Hyponatremia, kalemia or magnesemia

Question 57

Concern with cholestyramine

Answer 57

Fat soluble vitamin deficiency

Question 58

Concern with sulfasalzine and methotrexate

Answer 58

Folic acid deficiency

Question 59

Concern with isoniazid

Answer 59

Vit B6 deficiency

Question 60

Concern with metformin

Answer 60

B12 deficiency

Question 61

Concern with coumadin

Answer 61

Vit K consistency important

Question 62

Concern with statins

Answer 62

Avoid grapefruit juice