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Clin 1 > Respiratory Diseases + Dysphagia + Intuitive Eating > Flashcards

Respiratory Diseases + Dysphagia + Intuitive Eating Flashcards

1
Q

What is COPD?

A

respiratory disease caused by smoking, air pollutants or genetic
inflammation of walls, floppy alveoli and thick mucus

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2
Q

What are the tests done to diagnose COPD?

A 
FEV1 (spirometry)
partial O2 pressure
partial CO2 pressure
HCO3-
O2 saturation
pH
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3
Q

What are the types of COPD?

A
  • chronic bronchitis
  • asma + COPD
  • emphysema
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4
Q

What are the physical signs of COPD?

A 
- blue blotter (bronchitis):
ascites (water retention in abdomen)
rounded nails
coughing often with mucus
blue lips/skin from low O supply (cyanosis)
neck veins distended (RHF) 
- pink puffer (emphysema)
pink skin
low subcutaneous fat
pink skin tint
SOB
cough (can have mucus)
enlarged airspace of alveoli
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5
Q

What is dyspnea?

A

labored breathing = SOB

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6
Q

What is dyspnea on exertion (DOE)?

A

SOBE

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7
Q

What is exacerbation?

A

worsening of symptoms

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8
Q

What is hypercapnia?

A

excess CO2 in the blood

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9
Q

What are the nutrition concerns for patients with COPD?

A
  • weight loss => high protein (1.0-1.5)
  • nutrient-dense food
  • small meals
  • not overfeeding bc exacerbation
    • kcal
  • restrict sodium (2,000 mg) or fluids (1-2 L) for fluid retention
  • oral supp (Medpass or sip sup)
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10
Q

What are the medications for COPD?

A

-bronchodilators
- corticosteroids (Prednisone)
careful for muscle wasting, osteoporosis
short term = hyperlipidemia, hyperglycemia, HTN, increased weight and appetite, edema

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11
Q

what is cystic fibrosis?

A

a genetic disease characterized by Na, Cl channels of exocrine or endocrine organs (GI tract, pancreas) = creates a thick mucus susceptible to infections

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12
Q

What are the classes of mutations of CF?

A 
I = no production of protein
II = protein synthesized but doesn't reach the membrane
III = channel is blocked
IV = channel working but not properly
V = not enough channels produced
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13
Q

What are the symptoms of CF?

A 
cough
growth difficulties
salty skin
bloated stomach
clubbing fingernails
abdominal pain
pancreatic insufficiencies => malnutrition
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14
Q

What is the median survival age for CF?

A

52 yo

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15
Q

What are the complications associated with CF?

A 
liver disease
kidney disease
CF diabetes
oesophageal reflux
DIOS
osteoporosis (treated with steroids)
infections
deficiencies
inflammatory bowel disease
heart problems
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16
Q

What is DIOS?

A

distal intestinal obstruction syndrome
blockage of the intestine by thickened stool
similar to constipation but stools higher in GI tract
may require surgery if severe

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17
Q

What are the symptoms of DIOS?

A

inability to pass gas or stools
abdominal pain
nausea
vomiting

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18
Q

What are the two different treatment approaches for DIOS?

A

incomplete DIOS = oral rehydration + laxatives

complete = IV rehydration + laxatives

19
Q

What are the nutritional preoccupations for patients with CF?

A
  • malnutrition
  • weight loss
  • meal plan = increase E + pro
20
Q

What are the four phases of swallowing?

A
  1. oral preparatory
  2. oral transit
  3. pharyngeal
  4. esophageal
21
Q

what are the cranial nerves involved in swallowing?

A 
V : trigeminal
VII : facial nerve
IX : glossopharyngeal
X : vagus
XII : hypoglossal
22
Q

What is GERD?

A

Gastroesophageal reflux disease = = reflux into esophagus usually because the pressure in esophagus is lower than stomach = opens LES

23
Q

what can trigger GERD?

A
  • hypersecretion of estrogen, progesterone, gastrin
  • medical conditions
  • smoking
  • medications
  • foods
24
Q

What is Barrett’s esophagus?

A

it is the excess production of H+ ions in the esophagus despite medications
the squamous cells become columnar precancerous cells

25
Q

What are the 3 treatment steps to treat GERD?

A
  1. Increasing LES competence
  2. decreasing gastric acidity
  3. increasing clearance of esophagus
26
Q

What are the medications to treat GERD?

A
  • antiacids
  • foaming agents
  • H2 antagonists
  • proton pump inhibitors
  • prokinetics (strengthen pyloric sphincter)
27
Q

What are some lifestyle changes that can be made to help with GERD?

A
  • avoid eating before sleep
  • eat upright
  • stop smoking
  • weight loss
28
Q

what are possible surgeries to treat GERD?

A
  • Laparoscopic Nissen Fundoplication = fundus of stomach wrapped around esophagus = helps LES strength
  • radiofrequency
29
Q

What is the nutrition care to apply to treat GERD?

A
  • B12, Ca and Fe absorption impaired = supp
  • small frequent meals
  • low fat
  • avoid alcohol, mint, chocolate, coffee, fermented beverages
30
Q

What are the two types of dysphagia?

A

0ral, pharyngeal, esophageal

transient (cerebral palsy, GERD, cancer, intubation, chronic anemia) or permanent

31
Q

What is aspiration?

A

inhalation of fluids or particles into lungs

32
Q

what is aspiration pneumonia?

A

inflammation in lungs

33
Q

How can aspiration be prevented?

A
  • seating upright
  • chin down when swallowing
  • small quantities
  • dry swallowing
34
Q

How can dysphagia be diagnosed?

A
  • bedside swallow
  • observations while eating
  • modified barium swallow
  • fiberoptic endoscopic evaluation of swallowing (FEES)
35
Q

What can cause dysphagia?

A
  • physical barriers
  • cancer
  • neurological (stroke, cerebral palsy, Alzheimer, MS, ALS)
  • injury
36
Q

What are the foods allowed and not allowed for tender menu?

A 
no raw fruits or veg
no nuts, seeds or dry fruits 
no hard meat
no biscotti or bagel
no popcorn, nachos, pretzel
37
Q

What are the foods allowed and not allowed for soft menu?

A 
no tough meat
no whole wheat large pasta
no wild rice
no grape
no bean sprouts, snow peas, lettuce, sauteed mushrooms
no fibrous fruits with peel
no though pastries
38
Q

What are the foods allowed and not allowed for minced menu?

A

minced meat
sauce obligatory
no bread, peanut butter, cake

39
Q

What are the foods allowed and not allowed for pureed menu?

A

everything smooth

no oatmeal

40
Q

What are the risk causes for DIOS?

A

severe genotype, history of DIOS, fat malabsorption, pancreas insufficiency, dehydration, organ transplantation

41
Q

What signs can help diagnose CFRD?

A

the decline of breathing and inability to gain weight (or weight loss)
1 hr post-reading of oral glucose tolerance test may help

42
Q

What is the E requirement for CF?

A

110-200% of E of healthy individuals of the same age and sex

43
Q

What are the predictors for non-compliance of CF medication?

A
  • long-term
  • no symptoms
  • complex

Clin 1 (4 decks)

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