Nutrition & Vitamins Flashcards
What are the fat soluble vitamins?
A
D
E
K
Fat soluble vitamins are stored whereas water soluble vitamins are excreted. True or false?
True
Vitamins and minerals have key roles in processes such as?
Metabolism, cell production, tissue repair
What affects absorption of minerals?
Presence of other minerals/vitamins, components found in the blood, amount of mineral already in blood
Which groups of people are at higher risk of vitamin D deficiency?
Those with limited sun exposure and those with dark skin
What is fortification?
Addition of nutrients to appropriate food vehicles
What are some problems with supplements?
Toxicity & accumulation, expensive, cause complacency, legal status means there’s practically no control, interactions
Which 2 vitamins can be made by the body from non-dietary sources?
D & K
Where are fat soluble vitamins absorbed?
Absorbed by bile in large intestine
Where are water soluble vitamins absorbed?
Upper SI - Duodenum
Where is vitamin B12 absorbed?
Absorbed by intrinsic factor in ileum
Vitamins are sources of energy. True or false?
False
Vitamins have an antioxidant role. True or false?
True
What does deficiency in vitamin A result in?
Poor night vision
What does deficiency in vitamin B1 result in?
Wernicke’s encephalopathy
What does deficiency in vitamin B7 result in?
Hair loss and anaemia
What does deficiency in vitamin B12 lead to?
Megaloblastic anaemia - neural tube defects
What does vitamin D deficiency lead to?
Rickets and osteoporosis
What does vitamin C deficiency lead to?
Scurvy
What does vitamin K deficiency lead to?
Abnormal clotting
In pregnancy, why is vitamin B9 (folic acid) supplemented?
To prevent neural tube defects including spina bifida
Trace elements are required in small quantities whereas minerals are required in large amounts. True or false?
True
What can a deficiency in magnesium and potassium lead to?
cardiac arrhythmias
What can a deficiency in calcium and magnesium lead to?
Osteoporosis, muscle cramps and tetany
What can a deficiency in zinc lead to?
Hair loss and poor wound healing
A deficiency in which trace element can lead to Wilson’s disease?
Copper
Methotrexate can interact with which vitamin?
Vitamin B9 (folic acid)
What is meant by enteral nutrition?
Nutrition administered via the GI tract
Who needs enteral nutrition?
Patients with eating and swallowing difficulties - e.g. facial injury or surgery, Severe intestinal malabsorption - Crohn’s disease, Eating disorders, Self-neglect - intentional or non-intentional
What are the different routes of administration for enteral nutrition?
Naso-gastric tubes (NG), NJ, PEG tubes, PEJ tubes
What are some problems that can occur as a result of enteral nutrition?
Diarrhoea, regurgitation, dislocation of tube, especially NG
What are some drugs that interact with enteral feeds?
Ciprofloxacin, Theophylline, Phenytoin
When should total parenteral nutrition be used?
Only when EN is not an option
when patient cannot take anything by mouth or via GIT. In “gut failure” - patient unable to digest and absorb food. If GIT is non-functional, inaccessible, or perforated
How can short-term TPN be given?
Via Venflon
How can long-term TPN be given?
peripherally inserted catheter - Hickman line
Via central line - intrajugular, subclavian, femoral
How is re-feeding syndrome characterised?
Abnormalities in fluid balance, glucose metabolism, vitamin deficiency, hypokalaemia
What are some consequences of malnutrition?
weakness and loss of muscle mass, apathy and depression, reduced immune response, poor wound healing, increased morbidity and mortality
When should artificial nutritional support be given?
When patients can’t meet their requirements by eating and drinking normally
What types of nutritional support is available?
normal diet, softened diet, IV fluids, oral nutrition support (fortified food, additional snacks, sip feeds), enteral tube feeding, total parenteral nutrition
What are some benefits of enteral nutrition?
less risk of infection, closely mimics normal feeding, maintains GIT, cheaper, easier for home patients, calorie control
What advise would you give regarding the administration of drugs via enteral feeding tubes?
Use liquid preps if possible, give each drug separately, flush with >20ml of water before and after each drug, crushed tablets may block tube, don’t give modified release or cytotoxic drugs
What are some complications of TPN?
Air embolism/insertion problems, catheter blockage, line infections, metabolic problems, bone disease, re-feeding syndrome
What monitoring should be done for those on TPN?
clinical history, fluid balance, weight, nutritional intake, GI function, temperature. Bloods: U&Es, renal function, glucose, LFTs, FBC, magnesium, phosphate calcium, selenium, zinc, other vitamin levels
