Nutrition for the Chronically Ill Adult Flashcards
what are the main reasons why nutrition is important?
for the maintenance of health and disease prevention
What are the nutrition assessment ABC’s?
Anthropometric, Biochemical, Clinical, Dietary methods, and Environment
define anthropometry
the measure of physical dimensions and composition of the body
list a few examples of things that can be considered antrhopometric
height, weight, head circumference
what is looked at when assessing the biochemical component of a patients nutrition
Laboratory methods/values - such as serum proteins (albumin and prealbumin, hemoglobin, and lipid profile
what is the purpose of the clinical aspect of nutritional assessment?
to detect signs and symptoms of malnutrition. These can be found during a clinical examination.
give an example of a clinical finding that can be discovered by examination
painful cracks at the corner of the mouth can be a sign of riboflavin or niacin defiency
How do you assess a patients dietary methods?
you survey the PT to measure the quantity of food consumed over a period of time through methods such as a 24-hour dietary recall, a food diary, or food frequency questionnaire
What aspects need to be assessed to make an observation about a PT’s nutritional environment?
you should looks at aspects such as their access to food, income, home environment (clean water, cooking equipment), etc..
Define dysphagia
difficulty swallowing
what are the two different types of dysphagia?
oropharyngeal and esophageal dysphagia
describe esophageal dysphagia
this is when food or liquid stops in the esophagus. solids are often more difficult to swallow that liquids
what can cause esophageal dysphagia?
cancer, esophageal stricture(narrowed esophagus often caused by tumors or scar tissue), muscle disorders of the esophagus
describe oropharyngeal dysphagia
difficulty swallowing food to the back of mouth and initiating swallowing. liquids are often more problematic than solids.
what can cause oropharyngeal dysphagia?
brain or nerve disorders such as Parkinson’s, Alzheimer’s, stroke, cerebral palsy, and cancer
what are the symptoms that can help to identify oropharyngeal dysphagia?
drooling, coughing, choking, pocketing of food, gurgly voice
what methods are commonly used to assess for dysphagia?
bedside evaluations or a modified barium swallow completed by a speech or occupational therapist
what are the four different classification for consistency of a liquid
puddung thick, honey thick, syrup/nectar thick, and thin
how do you thicken up a liquid?
add tasteless powder
how many food levels are there for the dysphagia diet?
5
what are the five levels of a dysphagia diet?
1-pureed, 2-minced, 3-ground, 4-chopped, 5-regular
In what specialty diet are meats ground if not already into a form that is easily chewed and most raw fruits, vegetables, seeds and nuts are restricted?
mechanical soft
what kind of PT’s are restricted to mechanical soft diet?
PT’s with poor dentition or poorly fitting dentures, PT’s with difficulty chewing, dysphagia, or PT’s have undergone neck or head srugery
List and describe foods used for the pureed diet
since this diet requires minimal chewing/swallowing strained foods, soft cooked cereal, cream soups, soft desserts, etc… are used. Food can also be blended to an appropriate consistency or shaped. between meal feeding is suggested
What kind of PT’s should be on a low bacteria diet?
PT’s who are immunosupressed or comprimised such as PT’s who have undergone chemo, radiation, medication (such as antibiotics), or organ transplant
define cirrhosis
it is a result of advanced liver disease. It is characterized by replacement of liver tissue by fibrosis (scar tissue) and regenerative nodules (lumps that occur due to attempted repair of damaged tissue).These changes lead to loss of liver function.
what is a cirrhosis diet designed to do?
to promote liver regeneration, nutritional repletion, and to prevent hepatic encephalopathy
what does the cirrhosis diet consist of?
high calorie, high protein diet (unless there is development of encephalopathy) fat should only be limited if steatorrhea or jaundice develop. sodium and fluid should only be restricted if ascites (fluid in peritoneal cavity) or edema (swelling) present. Alcohol should be avoided in general
define hepatic encephalopathy
it is the occurrence of confusion, altered level of consciousness, and coma as a result of liver failure.
what is a diet for a PT with hepatic encephalopathy designed to do?
to prevent tissue catabolism, ammonia production, and to promote liver regeneration.
what does a diet for a PT with hepatic encephalopathy consist of?
adequate Kcal and protein, sodium and fluid restriction if ascites present, serum potassium levels should be monitored if taking potassium-wasting/sparing diuretics
a fat restricted diet is appropriate for what kind of PT’s?
gallbladder disease and biliary, pancreatic, and intestinal disorders.
why is a fat restricted diet appropriate for a PT with biliary, pancreatic, or intestinal disorder?
maldigetsion, malabsorption, or problems in the transport of fat may occur
describe steatorrhea
it is the presence of excess fat in the stools as a result of malabsorption
if steatorrhea is present the use of what may be indicated for the PT?
medium chain triglycerides (MCT) oil
