SM02 Mini2 Flashcards

1
Q

define basal metabolic rate

A

energy required by the body when lying down at complete mental & physical rest, wearing light clothing in a room, comfortably at least 12 hours after a meal

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2
Q

what factors influence BMR?

A
  • thermic effect of food: food ingestion stimulates metabolism
  • proportion of lean body mass: leaner muscle mass has higher BMR
  • abnormal states of starvation & malnutrition: decrease BMR
  • hyperactive thyroid: increases BMR
  • sleep: decreases BMR by 10%
  • fevers: increase BMR 7% per 1ºF
  • pregnancy & lactation increase BMR
  • tropical climate: increases BMR 5-20%
  • physical activity: increases BMR
  • dz that increase cell activity (ex. cancer) increase BMR
  • growth hormone increases BMR
  • cold climates increase BMR to heat body
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3
Q

what are the normal BMR used in calculations for males & females?

A

males= 1 calorie/kg/hour

females= 0.9 calorie/kg/hour

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4
Q

total energy requirement/output

A

=BMR + thermic effect of food intake (TEF) + physical activity

TEF= calories of food x 0.10 approximately 10% used to metabolize

physical activity is BMR x activty level (sedentary 20%; very light 30%; moderate 40%; heavy 50%)

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5
Q

the ntional academy of science recommends that what percentage of daily calories should come from carbohydrates?

A

55-60%

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6
Q

carbohydrate provide how many calories per gram?

A

4cal/gm

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7
Q

what is ketosis?

A

condition in which unusual products of fat breakdown ketone bodesi accumulate in the blood

caused by absence of carbohydrates in the body

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8
Q

why are carbohydrates important to have in the diet?

A
  1. protein-sparing
  2. anti-ketogenic effect (prevents ketosis)
  3. CNS function: brain doesn’t store glucose
  4. fiber source
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9
Q

how much carbohydrates are needed daily to avoid protein breakdown & ketosis?

A

100grams/day on average

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10
Q

why are high fiber diets becoming increasingly important?

A

for treatment of chronic constipation and diverticular dz of colon in diabetes, hypertension, & prevention of colonic cancers

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11
Q

how does a high fiber diet decrease hyperlipidemia?

A
  • dietary fiber lead to increase secretion of bile acids
  • bile acid excretion causes more cholesterol to be converted to bile acids
  • thus decreasing cholesterol serum levels
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12
Q

how does a high fiber diet work to prevent colonic cancer?

A
  • some colonic cancers are caused by carcinogenic secondary products of bile acids
  • consuming fiber increases bile acid excretion & clearance rates
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13
Q

what is the daily recommended fiber intake?

A

20-30 grams/day

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14
Q

what are the essential amino acids for adults?

A

isoleucine

leucine

lysine

methionine

phenylalanine

threonine

tryptophan

valine

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15
Q

how do the essential amino acids vary for children?

A

adult 8 plus

arginine & histidine

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16
Q

what is the US reccomended daily allowance (RDA) for protein?

A

10-15% of total calories

protein yields 4calories/gram

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17
Q

what is the national academy of science’s recommendation for adequate protein intake?

A

0.8g/kg body weight/day

1-1.6g/kg for athletes

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18
Q

define maramus & list its signs and symptoms

A

chronic condition of semi-starvation leading to growth retardation

signs: muscular wasting, lack of subcutaneous fat
causes: failure to breastfeed, use of over diluted formula, or infection from contaminated water supply

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19
Q

define kwashiokor & list its signs and symptoms

A

deficiency dz associated w/diet high in carbohydrates & inadequate in protein (low value when available)

common in 1-4yo age group

signs: hypoalbuminemia, pitting edema, pot belly, enlarged fatty liver, muscle wasting (usually masked by edema)

protein & energy deficiency

“dz of disposed baby when next is born”

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20
Q

how many calories is provided per gram of fat?

A

9

concentrated source of energy

21
Q

what is the amercian heart association reccomendation for daily fat intake?

A

no more than 30% of total calories in those w/no symptoms of heart dz

22
Q

what are triglycerides?

A

dietary fats & oils

23
Q

what are the functions of omega 3 fatty acids?

A
  • reduce risk of heart dz & stroke
  • lower bp & hr
  • guard against plaque build-up & clot formation in arteries
  • aid brain development
24
Q

what are trans fatty acids?

A

formed when hydrogen is added to vegetable oil in order to change a liquid to a solid at room temperature

aka hydrogenation

makes unsaturated fatty acids in to saturated fats

25
what is the recommended daily allowance for cholesterol?
300 milligrams/day
26
why is vegetarianism increasing in the US?
1. health 2. religion 3. Fad 4. ecological reasons 5. cost
27
what are the benefits to vegetarianism?
1. more closely resembles guidelines of "my plate" * high complex carbohydrates, high fiber, low fat, low sugar, low sodium 2. usually follow moderate lifestyle pattern * less alcohol, no smoking, regular exercise 3. higer intake of vitamins A & C * antioxidants decrease risk of cancers & heart dz 4. reduced incidence of obesity, diabetes, HTN, hypercholesterolemia, gallstomnes, & colon cancers 1.
28
causes of folate deficiency
* inadequate intake: poverty, mental illness, alcoholism, chronic illness, kwasiorkor * malabsorption: cealic dz, jejunal resection, tropic sprue * increase requirement: pregnancy, lactation, prematurity, hemolytic dz (sickle cell, thalessemia, leukemia) * chronic inflammatory dz: RA, TB, malaria
29
what is the reccomended daily allowance for folate?
400ugs/day for adults 600ugs/day for pregnant women 500ug/day for lactating women
30
what is the daily reccomended intake for calcium?
9-18yo: 1300mg/day 19-50yo: 1000mg/day \>51yo: 1200mg/day
31
risk factors for osteoporosis
* low calcium diet throughout life * lack of adequate physical activity * excessive alcohol intake * family hx of osteoporosis * premature menopause * short stature * cigarette smoking
32
nutritional considerations for alcoholics
* alcohol= 7cal/g of empty calories * may decrease appetite * alcohol can damage muscosal lining affecting absorption * usually thiamine deficient leading to lactic acid acidosis * decreases production of intrinsic factor→ B12 deficiency * increased plasma methyl THF levels * decreased myelin formation→ neuropathy, myleopathy, & axomal degeneration * impared folate absorption
33
what is root cause analysis?
method of determining underlying factors causing negative outcome or series of incidents brings together individuals of different training levels & departments to review an incident purpose of change to prevent future similar incidents
34
what is quality gap?
difference between expected care per researched optimal care and actual care given
35
how does a hospital receive "top performer" status?
given by the Joint Commission for 1 of 9 "core measure sets" * heat attack * heart failure * pneumonia * sx * children's asthma * inpatient psychiatric services * stroke * immunization
36
measure
act or process of ascertaining extent, dimension, or quantity of something must be chosen w/understanding of level of system to which it relates include where data are generated, who is responsible for collecting data, specific units
37
what are the challenges to measurement?
* time consuming data collection * collecting appropriate data * results match reality? * unexpected answers & their consequences
38
what are the benefits of measurement?
* sets stage for improvement * shows progress or change * "sell" ideas to management * common frame of reference * away from anecdotes & opinions
39
process measure
captures basic performance of process should be performed on variety of processes w/in system evalulates actions that influences results
40
outcome measure
measure end result of process success of system
41
what tool is used to assist in choosing the proper measures?
value compass
42
what are the faces of performace measurement?
research, judgement, improvement not mutually exclusive
43
how can the faces of performance measurement be differentiated?
research: use of p-value, for hypothesis testing judgement: for comparison (clinics, treatments, etc.) improvement: assessing change over time
44
causes of variation
* living things being "non-standard" * human factor * environment * data collection & recording * margin of error
45
what is a run?
one or more points on a side of the median data points on the median do not count
46
on a point diagram, what would indicate a special cause variation?
at least 25 data points w/8-17 runs
47
what is a shift?
7+ consecutive data points on one side of the median points on the median do not count
48
what is a trend?
7+ consecutive data points constanly going in one direction consecutive data point of the same value do not ruin the trend