nutrition power point Flashcards
malnutrition is
imbalance in the amount of nutrient intake and the body need
Basal metabolic rate
minimum amout of energy required to maintain body functions in resting, awake state
major biochemeical process of metabolism
anabolism
catabolism
anabolism is
use of energy to change simple materials into complex body substances and tissue
catabolism is
breaking down of substances from complex to simple resulting in a energy release
continuous process of metabolism means.
metabolism is dependent on the intake of proper nutrition
nutrients structure
Macronutrients
Micronutrients
Macronutrients are
carbohydrates, fats, proteins, and water
(nutrients that are needed in large amounts)
Micronutrients
minerals and vitamins (needed by the body in smaller amounts)
carbohydrates is either
simple or complex
carbs shoud be __% to __% of daily calories
40-60
fiber is either
soluble or insoluble
soluble fiber
mixes with water and forms a gel-like substance (slower digestion)
insoluble fiber
does not retain water but allows formation of bulk, resulting in accelerated passage of the end products of food through the intestines and a slowing of starch absorption
how much kilocalories are carbs
4 per gram
fats have __ kcal per____
9, gram
fat types
lipids
trigylcerides
saturated fatty acids
monosaturated fatty acids
polysaturated fatty acids
trans fatty acids
unsaturated “essential” fatty acids
lipids are
fats within the body
triglycerides are the
most abundant lipids in food
saturated fatty acids diatery
margarine, shortenings, pastries, crackers, fried food, cheese, ice cream, and other processed foods; raise cholesterol.
Monounsaturated fatty acids are found in
olive and peanut, oil, almonds, avocados, cashews
proteins contain _kcal of energy per _____
4 kcal per gram
amino acids are
bulding block of protien
must be consumed daily
does not produce or store
protien is either
complete or incomplete
complete Protient
contain all essential amino acids (animal based foods, soybeans)
incomplete protiens
lack on or more essential amino acids
incomplete protiens examples
beans, peas, nuts, seeds, fruits, vegetables, bread/ bread products
water is
a component of the body intra and take 2/3 of it
and take 1/3 of extracellular fluid
dehydation is
lack of enough fluid in the body; body cannot transport nutrients and organ system is affected
water intoxication is
too much fluid in the body causes hyponatremia due to dilution, caused by too much water intake or body holding fluid for another reason
fat soluble vitamins are
A
D
E
K
vitamin A does what
Helps fight infection, helps with vision, bones, teeth, skin
vitamin a is found in
Found in liver, milk, egg yolk, and dark, leafy green vegetables, yellow and orange vegetables and fruits
vitamin and the sun
its synthesized in the skin when exposed to sunlight
vitamin D is important for
bone and tissue formation
vitamin D is found in
eggs, fortified food products, liver, fatty fish
vitamin E is an
Antioxidant that protects cells from injury from free radicals (byproducts from when the body changes food to energy)
vitamin E is important for
immune system
vitamin E is found in
nuts, seeds, and soybean, canola, corn, and other vegetable oils
vitamin K promotes
blood clotting
vitamin k is synthisized
by bactiria in the large intestine
vitamin K is found in
dark-green leafy vegetables such as broccoli, spinach, Brussel sprouts, and cabbage
water soluble vitamins are
vitamin C
vitamins B
vitamin C is also called
ascorbic acid
vitamin C benefits
Helps synthesize the protein collagen
Antioxidant that protects against cellular damage from chemicals and pollutants in the environment
Contributes to the development of a strong immune system
Helps produce antibodies that fight Viruses and bacteria
vitamin C is found in
fresh yellow and orange fruits, papaya, kiwi, broccoli, and white potatoes
Vitamin B helps
form red blood cells and coenzymes
vitamin b1 is also called and helps with
thiamine: helps with metabolism of protein fat and carbs to help produce energy
vitamin B2 is also called and helps with
riboflavin; assist in the metabolism of protein and the function of other b vitamins, promote vision and healthy skin
vitamin B3 is also called
nican
vitamin B5 is also called
pantothenic acid
vitamin B6 is also called
pyridoxine
Vitamin B7 is also called
biotin
vitamin B9 is also called
folic acid
vitamin b9 is
synthesis of DNA, not found in body naturally
vitamin B12 is also called
cyanobalamin
minerals types
potassium
sodium
chloride
calcium
phosphorus
magnesium
Potassium, sodium, chloride benefits
maintain fluid balance, elp with nerve conduction and muscle contractions
potassium is found in
milk, bananas, legumes, green leafy veggies, orange juice, tomatoes, vegetable juice, avocadoes, and cantaloupe
sodium is found in
table salt, smoked meat, fish, olives, pickled foods
chloride is found in
tomatoes celery seaweed and olives
calicim phosphorus and magnesium is important for
production and maintenance of bone tissue
calicum is found in
milk salmon spinach kale whole wheat bread tofu and orange juice
phosphorus is found in
milk and meat products
magnisum is found in
hailbut, seeds,nuts, tofu, swiss chard, spinach, wheat , yeast, molasses
Antioxidants are
Substances that protect body cells against the effects of free radicals (molecules produced when the body breakdown food or is subjected to environmental exposure to potential toxins and cause cell dysfunction)
Antioxidants slow or prevent
the oxidative process caused by free radicals
antidioxidants are found in
radicalsBeta carotene, lutein, lycopene, selenium, and vitamins A,C, and E
digestion process
Digestion starts with salivary glands as food enters the mouth and chewing takes places food is digested, it travels through the intestines as a semiliquid mass called Chyme Waste products are propelled through the intestines, rectum, and anus by peristalsis
Dietary Guidelines
Combines healthy eating choices from all food groups while noting calorie limits
Emphasizes fruits, veggies, whole grains, and fat-free or low-fat milk and milk products
Includes seafood, lean meats, poultry, beans, eggs, nuts, seeds, and soy products
Low in saturated fats, trans fats, sodium, and added sugars
Based on eating smaller portions and drinking water rather than sugary beverages
calorie intakes depends on
exerices and body size
morphology is
gastric bypass or sleeve, eating disorder
nutrients tat affect musculoskeletal function
Vitamins A & D
Osteocalcin: softening of bone due to low Vitamin D leads to increased risk of weak bones and fractures
Minerals such as calcium, phosphorus, and magnesium affect bone mass density
poor nutrition effect on neurologic function
increased or decreased body fat, slower mental problem solving,decreased alertness, and slower muscle response time
sodium effect of neurologic function
blood pressure, which can increase incidence of stroke
folate deficiency affect of neurologic function
depression, confusion, glossitis, loose stools, decrease in nerve function
Folic acid and B vitamins affect
cognition, memory, and functional ability
altered structure and function cadiopulmonary
Cholesterol and lipids combine with other substances and can attach themselves to walls of arteries, increasing the risk for coronary artery disease.
In atherosclerosis
plaque or a piece of plaque may break off and enter arteries, and can cause heart attack
dysohagia is
difficulty in swallowing due to a physical or pathophysiological reason.
malabsorption is and causes
problematic or inadequate absorption of nutrients in the GI tract- may causeweight loss, fatigue, GI upset, and vitamin/ mineral deficiencies
vitamin d deficiency causes
rickets
vitamin c deficincy causes
scruvy
Phenylketonuria (PKU) is
inborn error of metabolism when an infant cannot metabolize the amino acid phenylalanine, can cause impaired brain development and cognitive delays
Metabolic Alterations: Diabetes
Pancreas produces insulin, thus controlling excessive amounts of circulating glucose in the body
Not enough insulin =
accumulation of glucose in the circulatory system and decreased entry into the cells
Type 1 Diabetes:
auto-immune, pancreas makes no insulin; patient is insulin dependent
Type 2 Diabetes
not enough insulin or problem with insulin absorption; controlled with diet, exercise, oral hypoglycemic agents
Food allergies are
response of the body’s immune system to and ingredient or food product
can be deadliy
Most common food allergens
peanuts, fish, shellfish, treenuts, and wheat
Food intolerances
trigger a digestive system response resulting in irritation of the digestive tract
causes discomfort
most common food intolerance is
lactose intolerance
metabolic alterations weight clasification BMI
Overweight: body mass index (BMI) of 25-29.9
Obesity: BMI of 30 or higher
Morbid obesity: BMI of 40 or higher
BMI can help determine
the extent of obesity and potential health complications; as BMIrises, so does the risk for hypertension, hyperlipidemia, and diabetes
Malnutrition May result from
absorption or digestive problems, illness, or an inadequate or imbalanced intake of calories
Distribution or access to food frequently causes
malnutrition
Psychological Alterations: Anorexia Nervosa is
Altered mental state which causes improper nutritional intake
Anorexia Nervosa is frequently seen in
adolescents and young adults
anorexia nervosa causes
distortion of body image with an intense fear of gaining weight
anorexia nervosa causes
limited caloric intake, omission of healthy foods, excessive exercise, obsessive behaviors
bulimia nervosa is
Involves an obsession with bingeing (the intake of excessive amounts of food) followed by purging (vomiting)
May also be excessive exercise or abuse of laxatives
complications of bulimia nervosa
tooth decay, gi complications, and many systemic issue
treatment of eating disorders
involve the adolescents in their care
competency Can usually be treated outpatient, but may require inpatient treatment (needs to be before BMI is less than 13)
Collaboration among the physician, nurse, counselor, spiritual advisor, parents, and child required to make treatment plan
Treatment decision must be considered within the legal context of the country and/or state in which the child resides
Assessment: Nutrition History
Dietary intake, changes in weight or appetite
24 hour diet recall
journal of food intake(3-5days)
4Take culture and ethnicity into consideration and how they may influence nutrition.
May need a referral to a registered dietician, who will perform additional assessments
Altered nutrition states may include a variety of problems associated with physiologic, psychological, socioeconomic, cultural, and religious factors, among other health-related issues
All patients should be asked about their typical dietary intake, food preferences, and allergies
Assessment: Malnutrition in Older Adults
Consideration must be given to the decrease in sense organ function related to aging (smell, taste, chew, digesting)
increased fat stores, limited activity, decreased bone mass, decreased kidney function, and a decline in the immune system
Age-related changes place the older person at risk for obesity, poor tolerance of activity, fractures, renal failure, and increased susceptibility to infection
Screening for malnutrition: DETERMINE acronym (disease, eating poorly, tooth loss, economic hardship, reduced social contact, multiple medications, involuntary weight loss/gain, needs assistance in self-care, and elderly years above age 80)
during physical assessment you should check
Height and weight measurements, BMI, laboratory values, signs of malnourishment (poor dentition, poor skin turgor, thinning hair), noting physical and psychological illnesses
Waist circumference, vital signs, past medical history, current medications, and activity level is important for identifying potential risk for cardiac disease
determining BMI can help
establish presence of obesity, malnutrition, or cachexia
malnutrition may be due to
eating disorders, dysphagia, irritable bowel syndrome, chronic alcoholism, celiac disease, and intestinal damage from radiation therapy
Malnutrition may also be caused by
unmet increased metabolic needs in patients with infection, sepsis, burns, or cancer
Anthropometry is
the study of measurements of the human body
Infants and children: anthropometry
height, weight, length, and head circumference
adults anthropometry
height, weight, BMI, waist-to-hip ratio; distribution of fat is significant in determining health risk potential
skin fold measurements
measure the amount of sub q adipose tissue and establishes body fat stores and nutritional status for the person’s age and gender
hair assesment
poor nutrition causes thinning hair that has adry, stiff texture and lack of shine; in severe cases may lose color
Lips assesment
may have a deep red appearance with open lesions and deep cracks in the corners of the mouth, oral mucosa may be darker red and may have oral lesions
skin assesment
dry, rough appearance, pallor, changes in pigmentation; may bruise easily or have pinpoint hemorrhages; poor wound healing; skin tenting
aging effect of dentition
Loss of tooth integrity, decreased enamel, shrinkage of gum tissue
causes diminished ability to cut and chew food effectively
loss of teeth affects
nutrient consumtion
edentulous means
no teeth
edentulous people may have lower
BMI values or malnutrition due to being unable to chew
Prealbumin is
measure of the amount of protein contained in the internal organs; valuable for determining recent nutritional status; normal is 16-30; below 11 = malnutrition
Albumin is
level of protein found in plasma; indicates supply of protein over an extended period; normal is 3.5-5
Transferrin is
transports iron in the body, sensitive to a decrease in protein and iron stores (inverse relationship); normal is 200-400
hemoglobin and hematocrit determine what
identify the number and percantage of circulating erythrocytes, thier ability to provide oxygen to the cells and the body iron store status
Good or poor nutrition can have a drastic effect on
bowel elemination
constipation results from
results from slow progression of digested food through GI tract; caused by lack of fluids or fiber
diarrhea is
excessive bowel elimination; caused by high fat intake, artificial sweeteners, excessive intake of insoluble fiber, fluid / electrolyte imbalances, or overuse of laxatives.
special diets: clear liquids are
Limited nutrients, used only for a short period of time
Clear juices that don’t contain pulp
example of clear liquid diet
Apple or cranberry juice, gelatin, popsicles, clear broths, black coffee
clear liquid diet is used for which patients
patients with GI problems
before surgery
after surgery
before diagnostic test
full liquid diet is
consists of food that are or may become liquid at room or body temperature
ful liquid examples
Juices with and without pulp, milk and milk products, yogurt, cream soups, and liquid dietary supplements
who need full liquid diets
GI disturbances, dental work, or who cannot tolerate solid food
pureed diet is
food that is placed into a blender and made into a pulplike mixture
foods that should not be included in pureed diets
raw eggs, nuts and seeds
who need a pureed diet
for invidiuals who can chew or swallow solid food
mechanical soft diet
food consistencies that have be modified
mechanical soft diet include
ground meat or soft cooked food
mechanical soft diets is for
used for only people who have difficulty chewing
thickened liquid diet is used for
Used for patients who have difficulty swallowing and are at risk for aspiration
liquids can be thickened by
adding thickening agent
diabetic diet
control carbs intake
high glycemic index and rapidly raise bg foods should be avoided
diabetic diet food include
avoided High-fiber complex carbs (fruits and vegetables) are preferred over simple carbs, sugars, and starchy foods (like bread or pie)
cardiac diet
Control the dietary intake of foods that contribute to cardiovascular disease
Minimize the intake of animal products, processed foods, and foods high in sodium
cardiac diet is used for patients with
HTN, HLD, atherosclerosis
renal diet restricts
potassium, sodium, protein, and phosphorus
renal diets include
Fresh fruits (except bananas) and vegetables
who needs assistance with feeding
Patients with limited mobility, poor activity tolerance, or poor cognitive or physical state
If patients are confined to bed
HOB must be elevated to prevent aspiration and help with dysphagia
when feeding asses for
signs of dysphagia, including coughing, poor tongue control, excessive chewing, gagging, pocketing, or refusing to eat
Enteral Feeding Tubes Provide
short term nutrition for patients who have a functioning GI tract but cannot swallow, refuse to eat, or need additional nutrients to meet the body’s needs
NG tube
feeding tube placed in one of the nares down to thestomach
PEG tube
percutaneous endoscopic gastrostomy- tube placed through LUQ into the stomach; for long-term nutritional replacement
medication and feeding tubes
Medications can be given through enteral feeding tube, but should not be added to a tube feeding. They should be crushed (if able) and administered after flush of water, then flush of water after Aswell
tpn is
Nutrition given through PICC or CVC
who needs a tpn
For patients who do not have a functioning GI tract or trauma
tpn assesment includes
Assessment includes weight, CBC, BMP, and BUN
TPN complications
Complications include site infections, air embolism, catheter-related infections, dislodgment or occlusion of tubing, glucose abnormalities, adverse reactions to lipid formula, liver dysfunction, and other metabolic abnormalities
TPN tubing should be changed every
24
TPN dressing should be changed every
48 hours
