Nutrition Lecture

Question 1

malnutrition is associated with what

Answer 1

1) increased morbidity and mortality
2) increased cost and length of stay in hospitals
3) decreased wound healing
4) decreased immune function

Question 2

to classify someone with severe malnutrition

Answer 2

acute
less than 50% for greaterthan or equal to 5 days
2,5,7.5 for 1 week 1 month and 3 month weight loss
fat loss, muscle loss, fluid accumulation mod or greater
grip streth, measurably reduced

chronic
less than 75% for greater than ewual 1 month
weight loss 5, 7.6, 10 (1,3,6 months)
severe fat loss, muscle loss, fluid accumulation, and grip strength measurably reduced

Question 3

what are the other malnutrition codes for protein-calories malnutrition

Answer 3

1) Albumin 7% pre-illness or usual wt.
3) Wt. <75% standard wt.
4) Poor intake for 3 or more days
5) BMI 16.1-18.4

Question 4

malnutrition of mild degree

Answer 4

1) wt. 75% to 90%of standard wt.
2) wt. loss of 5-10% pre-illness or usual wt.
3) Albumin 3.5-5gm/dl

Question 5

unspecified protein calorie malnutrition

Answer 5

Albumin <3.5gm/dl
7 days of poor intake, NPO or clear lqd.
Delay wound healing
Stress factors: injury, infection or surgery

Question 6

cachexia

Answer 6

Wt loss of >5% in 1 month; >7.5% in 3 months; >10% in 6 months
Depletion of serum protein
Depletion of fat tissue and muscle mass
Related to chronic diseases: Cystic Fibrosis, CP, Cancer, AIDS, CHF, end stage organ failure
#1, #2 & #3 must be present

Question 7

albumin should not be used as the SOLE indicator for visceral protein status when

Answer 7

pt has liver dis. infection, postop, fluid imbalance and nephrotic syndrome

Question 8

how much cholesterol should you have

Answer 8

200 mg/day

Question 9

saturated fat

Answer 9

increases LDL and cholesterol

Question 10

lowers LDL, HDL and cholesterol

Answer 10

polyunsaturated fat

Question 11

lowers cholesterol and LDL, increases HDL

Answer 11

monounsaturated fat

Question 12

trans fat

Answer 12

increases cholesterol and LDL, decreases HDL

Question 13

helps lower triglycerides and decreases inflammation

Answer 13

omega 3 fatty acids

Question 14

helps decrease cholesterol

Answer 14

soluble fiber

Question 15

roughage for regularity

Answer 15

insoluble fiber

Question 16

how much sodium should be consumed for DASH diet

Answer 16

1500 mg

Question 17

CHF diet

Answer 17

low sodium  (2,000)
fluid restriction (6-8 cups/day)

Question 18

if a patient with pancreatitis is unable to tolerate oral foods then

Answer 18

Enteral nutrition is preferred OVER TPN

Question 19

what should a diet for pancreatitis

Answer 19

clear liquids and low fat

Question 20

enteral nutrition

Answer 20

place feeding tube beyond the ligament of treitz, reduces pancreatic secretions, low fat tube feeding formula

Question 21

TPN

Answer 21

last resort, can cause pancreatic pseudocyst, fistula, abscess, no pancreatic secretion

Question 22

what should be the diet of kidney disease

Answer 22

high calorie 30cals/kg
low protein sodium and potassium (.8,2.2)
fluid restriction of 500-1000ml+urine output

Question 23

hemodialysis

Answer 23

High calorie (30 cals/kg) 
High protein (1.2 - 1.5  g/kg)
Low sodium (2 g/day) & potassium (2 g/day)
Fluid restriction (500-1000 ml + urine output)

Question 24

peritoneal dialysis

Answer 24

High calorie (30 cals/kg) 
High protein (1.2 – 1.5 g/kg)
Non restrictive

Question 25

continuous renal replacement therapy

Answer 25

High calorie (30 cals/kg) 
Very high protein (2 – 2.5 g/kg)

Question 26

when is low protein appropriate

Answer 26

hepatic encephalopathy

Question 27

liver failure diet

Answer 27

Dietary protein does not cause alterations in mental status. Most patients can tolerate .8 – 1 g/kg and up to 1.2 – 1.5 g/kg

Question 28

cancer patients diet

Answer 28

Increases calorie and protein needs

30 – 40 cals/kg; protein is 1.2 – 2 g/kg

Question 29

diverticulitis

Answer 29

low fiber

Question 30

diverticulosis

Answer 30

high fiber (25g or more)

Question 31

IBS diet

Answer 31

high fiber
low fat
soft
bland foods

Question 32

chron’s diet

Answer 32

low fiber
no alcohol/caffeine
bland foods

Question 33

ulcerative colitis

Answer 33

low fiber
no alcohol/caffeine
bland foods

Question 34

illeostomy

Answer 34

high risk for malabsorption, B12 deficiency

Question 35

colostomy

Answer 35

Lower risk for malabsorption
High fiber foods may cause obstruction
To decrease odor: cranberry juice, butter milk, yogurt, parsley
To decrease diarrhea: bananas, applesauce, peanut butter, rice

Question 36

what are the three objectives of nutrition support

Answer 36

preserve lean body mass
maintain immune function
avert metabolic complications

Question 37

Nutritional modulation of the stress response to critical illness includes:

Answer 37

Early enteral nutrition
Appropriate macronutrient and micronutrient delivery
Meticulous glycemic control

Question 38

refeeding syndrome

Answer 38

metabolic consequences of depletion and repletion of nutrients. shift of stored fat to carb as primary fuel source increases insulin and causes decrease of magnesium, potassium, phosphorous and glucose

Question 39

branched chain amino acids are reserved for

Answer 39

hepatic encephalopathy

Question 40

indications of parental nutrition

Answer 40

nonfunctioning gut
can’t gain access to gut
continued interolance to enterlal nutrition
duration to be more than 5 days, need access PICC,

Question 41

use caution with St. Johns wart because

Answer 41

it increases sensitivity to sunlight

Question 42

cholesterol lowering drugs use caution with

Answer 42

red yeast rice
echinacea
astragalus
licorice
alfalfa

Question 43

breast cancer use caution with

Answer 43

black cohosh, soy, ginsing

Question 44

nilk and calcium juices may do what to antibiotics

Answer 44

decrease

Question 45

grafruit juice, pomegranate, cranberry do what to some statins

Answer 45

increase

Question 46

chocolate ansd tyramine foods do what to antidepressants

Answer 46

increase

Question 47

blood thiners affected by

Answer 47

leafy greens (decreased drug effect)

Question 48

american academy of pediatrics has stated that

Answer 48

children should not consume energy drinks

Question 49

qualifications of gastric bypass

Answer 49

BMI-greater than 40 or BMI 35-40 with comorbidities