Nutrition vit/mineral packets Flashcards
What are the bulk minerals?
sodium
potassium
chloride
calcium
phosphorus
magnesium
describe sodium
cation in body fluids
cell membrane function
describe potassium
cation in cytoplasm
cell membrane function
describe chloride
anion in body fluids
forms HCl
describe calcium
muscle/neuron function
nucleic acids
bone structure
describe phosphorus
cellular function
nucleic acids
bone structure
describe magnesium
enzyme cofactor
cell membrane function
What are the trace minerals
iron
zinc
copper
manganese
cobalt
selenium
chromium
describe iron
Hgb
myoglobin
cytochromes
describe zinc
enzyme cofactor
-carbonic anhydrase (respiration, digestion, pH regulation
Describe copper
cofactor for Hgb synthesis
Describe cobalt
mineral in vit B12
cofactor
Describe selenium
Antioxidant
Describe chromium
cofactor for glucose metabolism
Describe vitA
vision/retina
epithelium
immune system
growth/bone remodeling
Describe vitD
bone growth
intestinal Ca/P absorption
retention of Ca/P at kidneys
Describe vitE
prevents breakdown of vitA and fatty acids
Describe vitK
synthesis of prothrombin/other clotting factors in liver
Describe vit B1
thiamine
coenzyme
cerebral energy utilization
Describe vit B2
riboflavin
metabolic pathways (glycolysis)
Describe vit B3
niacin
coenzyme in many pathways
Describe vit B5
pantothenic acid
coenzyme A (CoA)
many pathways
Describe vit B6
pyridoxine
coenzyme in amino acid/lipid metabolism
Describe vit B7
biotin
coenzyme in many pathways
describe vit B9
folic acid
coenzyme in amino acid/nucleic acid metabolism
Describe vit B12
cobalamin
coenzyme in nucleic acid metabolism
Describe vit C
Coenzyme in many pathways
immune system
What are the risk factors for poor nutrition?
nutrition literacy
disease states
physical limitation
geographic - food deserts
socioeconomic:
-finances
-transportation
-social connection
What should be assessed with nutritional history?
Unintended weight changes
appetite
skin changes
hair loss
GI sx
Risk factors
3-day dietary recall
Five W
What are the Five W of nutritional history
Who
What
Where
When
Why (triggers)
What vital sign assesses metabolic risk
waist circumference
What should be assessed on the skin for PE?
pallor
cyanosis
jaundice
triceps skin-fold thickness
What should be inspected on HEENT?
conjunctive/sclera
changes to oral mucosa with vit deficiencies
How will lymphocyte counts change when malnourished?
low; become slower to mature
What are the red cell findings?
anemia and volume status
-increased volume in concentrated state/ dehydration
What is transferrin
acute-phase reactant
liver produces in response to inflammatory cascade
elevated in IDA
Describe albumin
most abundant protein in human serum
hypoalbuminemia associated with all-cause mortality
surgical risk and post op complications
muscle mass in elderly
about 20 day half life
Describe prealbumin
transport protein for thyroid hormone
shorter half life - 2 days
Describe BUN/Creatinine
renal function
may be elevated with abnormal protein intake/metabolism
Describe lipid panel values
total cholesterol - <200
triglycerides - <150
HDL - 50-60
LDL - 100-130 or less
VLDL - <30
What is fat needed for
tissue growth and hormone production
What is protein needed for
tissue maintenance, function, and growth
Describe amino acids
20 total
9 EEAs - only from diet
What are carbs needed for
increase blood glucose levels to supply energy
simple - mono/di
complex - starches and fiber
How are micronutrients (vitamins and trace minerals) best absorbed?
in whole foods
What is a unique nutritional need for infants (<2) and for elderly?
infants - high percentage milk fat for healthy brain development
elderly - higher protein intake
Describe Vit B1 deficiency (beriberi)
Thiamine - beriberi
Dry:
-neurologic abnormalities (weakness, paresthesia, gait ataxia)
Wet:
-same as dry + cardiac involvement and fluid overload (cardiomyopathy, cardiomegaly, peripheral edema, tachycardia)
Describe WE/KS
thiamine/B1 deficiency (severe)
WE triad:
1. encephalopathy
2. oculomotor dysfunction
3. gait ataxia
KS -
late manifestation
retro/anterograde amnesia
How to treat WE/KS
parenteral thiamine - banana bag
What is the RDA of thiamine
1-2 mg in adults
What are the symptoms of a B2 deficiency
riboflavin
sore throat/pharyngitis
cheilitis/stomatitis
glossitis
edema of mucous membranes
seborrheic dermatitis
normocytic/normochromic anemia
What is the B2 RDA
riboflavin
1-2 mg/day
Describe vit B3 deficiency
niacin
tryptophan to nicotinomide in the liver
photosensitivity, diarrhea, dementia/encephalopathy
Pellagra
causes:
alcohol abuse
bariatric surgery post op
anorexia nervosa
malabsorptive states
What is the RDA for vit B3
niacin
children: 6-12 mg/day
adult males: 16 mg/day
adult females: 14 mg/day
Describe vit B6
pyridoxine
over deficiency rare
can be used to treat nausea in pregnancy
oral changes
neuropathy
psychiatric
What is the RDA for vit B5
pyridoxine
children: 0.5-1mg/day
young men/women: 1.3mg/day
men > 50: 1.5 mg/day
women > 50: 1.7 mg/day
Symptoms and treatment of vit B12 deficiency
glossitis
fatigue
neuro/psych changes
injections once weekly x 4 weeks then once monthly
oral dose 1000mcg daily (keep absorption issues in mind)
check for resolution of anemia
Difference between B12 and folate deficiency?
folate lacks spinal cord symptoms
Treatment of folate deficiency
oral replacement 1-5mg/day
ensure resolution of anemia
Symptoms of vit C (ascorbic acid) deficiency
impaired collagen synthesis
disordered connective tissue
hyperkeratosis
perifollicular hemorrhage
petechiae/coiled hairs
ecchymoses
gingivitis
Sjogren’s syndrome
edema
anemia
impaired wound healing
limp due to hemorrhage into muscle/periosteum
Symptoms of vit A deficiency
rare
xerophthalmia
night blindness
poor bone growth
decreased immune function
hyperkeratosis
What is the treatment and RDA for vit A
oral replacement, in resource-poor countries universal periodic distribution programs
RDA:
male - 3000 IU
female - 2300 IU
Symptoms/diagnosis of vit D deficiency
mild - asymptomatic
severe:
-osteomalacia/rickets
-secondary hyperparathyroidism
dx: Vitamin-D-25-hydroxy
In what case is vit E deficiency usually seen
fat-malabsorptive states
-pancreatic insufficiency
-cholestatic liver disease
-disease of small intestine
What are the symptoms, diagnosis, and tx for vit E deficiency
neuromuscular disease, hemolysis
serum alpha-tocopherol
oral replacement depending on severity/cause, may be 50-500mg/day
What are the symptoms, Dx, and tx, of vit K deficiency
impaired coagulation
PT/INR elevated (warfarin is vitK antagonist)
10mg dose vit K
-oral vs IV depending on stability
Describe protein-energy malnutrition
energy deficit due to deficiency of all macronutrients
often accompanied by micronutrient deficiency
multiorgan system impairment
What is marasmus? PE findings?
wasting, depletion of fat/muscle stores
-inadequate intake of all nutrients, esp total calories
PE:
-emaciated, weak
-irritable, fretful
-bradycardia, hypotension, hypothermia
-thin, then dry skin
-shrunken areas due to loss of sub Q fat
-thin, sparse hair
What is Kwashiorkor? PE?
edematous malnutrition
-protein deficiency
-muscle wasting with NORMAL fat stores
PE:
-apathy/listless
-rounded prominence of cheeks
-pursed mouth
-thin, dry, peeling skin
-dry, dull, hypopigmented hair/falls out
-hepatomegaly
-distended abd, dialted intestinal loops
-brady, hypotension, hypothermia
