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822: Integumentary > The Impact of Nutrition With Wound Recovery > Flashcards

The Impact of Nutrition With Wound Recovery Flashcards

1
Q

Sufficient amounts of what 6 nutrients are required for homeostasis, repair, and regeneration?

A
  • Water
  • Protein
  • Carbohydrates
  • Fats
  • Vitamins
  • Minerals
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2
Q

Clinical dehydration is defined as a _% decrease in body weight due to fluid loss

A

1

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3
Q

Healthy individuals without open would should consume __-__ mL of water per kg of body weight daily

A

30-35

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4
Q

Patients on air-fluidized beds, specialty beds for patients with severe pressure ulcers, required up to __-__ mL of water per kg of body weight daily

A

40-60

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5
Q

What 5 functions are affected if there is protein deficiency?

A
  • Collagen synthesis
  • Granulation tissue formation
  • Angiogenesis
  • Remodeling
  • Immune function (phagocytosis)
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6
Q

Protein deficiency alters osmotic pressure allowing fluid to move from within the vasculature to the interstitium which impairs healing in 2 ways, what are they?

A

1) edema decreases oxygen’s ability to diffuse into the affected area
2) the pressure created by the edema can restrict blood flow within the affected area, further decreasing the availability of oxygen and allowing the accumulation of metabolic waste products

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7
Q

True or False

Patients with heavily draining wounds and those with large surface area wounds can lose a significant amount of protein through drainage

A

True

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8
Q

The balance of what element is essential in determining whether or not a wound patient is protein deficient?

A

nitrogen

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9
Q

It is suggested that a wound patient ingests __-__ grams of protein per kg of body weight daily

A

1.25-1.5

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10
Q

Carbohydrates in what form provide the energy needed to power the repair and regeneration process?

A

glucose

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11
Q

Carbohydrates have a protein-sparing affect, what does that mean?

A

If sufficient energy is not attained from a patient’s diet the body with convert fat and protein to energy - which can lead to protein deficiency.

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12
Q

It is suggested that a wound patient ingests __-__ kcal per kg of body weight daily

A

30-35

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13
Q

What is the most important role fat plays in wound healing?

A

It provides needed energy source to fuel cellular processes when carbohydrate sources have been depleted

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14
Q

Fat is also required to carry fat-soluble vitamins (A, E, and K) that help with what?

A

thermoregulation by providing insulation

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15
Q

Fats in the form of free fatty acids are vital components of what?

A

cell membranes and are required for the synthesis of new cells

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16
Q

In what 3 ways does vitamin A (retinol) enhance the healing process?

A
  • collagen synthesis
  • granulation tissue formation
  • facilitates epithelialization
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17
Q

What affect does the supplementation of vitamin A have on patients taking corticosteroids?

A

It may reverse the inhibitory effects of long-term corticosteroid therapy, including decreased collagen synthesis, granulation tissue formation, and wound contraction

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18
Q

Vitamin A supplementation may also ____ wound tensile strength and _____ the risk of wound dehiscence

A

increase

decrease

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19
Q

What type of vitamin A supplementation is recommended?

A

topical

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20
Q

What role does vitamin C (ascorbic acid) have on wound healing?

A

It is needed to build and maintain tissues. It also helps the body absorb iron and is required for collagen synthesis

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21
Q

What 3 things does vitamin C deficiencies result in?

A
  • altered capillary integrity
  • decreased wound tensile strength
  • increased risk of wound dehiscence
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22
Q

How does vitamin C help control infection?

A

By activating WBCs and enhancing their ability to migrate into the wound region

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23
Q

Vitamin C is also an antioxidant which results in what?

A

A limitation in the damaging effects of free radicals

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24
Q

True or False

Pretreatment of irradiated skin with Vitamin C may limit skin damage associated with radiation

A

True

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25
Q

What role does vitamin K play on wound healing?

A

It is essential for blood clotting, so deficiencies may lengthen the inflammatory phase

26
Q

What role do B-complex vitamins play in wound healing?

A
  • WBC function
  • antibody formation
  • resistence to infection
  • facilitate normal fibroblast function and collagen synthesis which improves wound tensile strength
27
Q

Vitamin E is a fat-soluble antioxidant which helps to prevent what?

A

free radical–related cellular damage

28
Q

What are 3 roles vitamin E plays in wound healing?

A
  • Decreases inflammatory phase of wound healing
  • Enhances immune function
  • Decreases platelet adhesion
29
Q

What are 4 microminerals and 2 macrominerals that are important for the would healing process?

A
  • zinc
  • iron
  • copper
  • magnesium
  • calcium
  • phosphorus
30
Q

What are some patient characteristics suggestive of malnutrition?

A
  • emaciation
  • petechiae
  • transparent skin
  • pallor
  • dull or thinning hair
  • pale eye membranes
  • missing or poor dentition
  • redness or swelling of the mouth
  • swollen gums that bleed easily
  • mouth sores
31
Q

Classify what underweight, normal weight, overweight, and class 1, 2, and 3 obesity are according to BMI

A 
Underweight: less than 18.5
Normal Weight: 18.5-24.9
Overweight: 25-29.9
Class 1 Obese: 30-34.9
Class 2 Obese: 35-39.9
Class 3 Obese: greater than 40
32
Q

Significant weight loss is defined as a decrease of _% body weight per week, _% per month, _% in 3 months, or __% in 6 months

A

1

5

7.5

10

33
Q

Describe some patient characteristics of someone who may be dehydrated

A
  • dry skin, hair, and mucus membranes
  • poor skin turgor
  • increased HR and RR
  • orthostatic hypotension
  • confusion
  • sunken eyeballs
34
Q

Describe some patient characteristics of someone who may have a protein deficiency

A
  • dull, dry hair
  • pallor
  • peripheral edema
  • pressure ulcers
35
Q

Describe some patient characteristics of someone who may have a carbohydrate deficiency

A
  • decline in body weight
  • pallor
  • extremely poor dentition
36
Q

Describe some patient characteristics of someone who may have a fat deficiency

A
  • emaciated
  • epidermal flaking
  • fissuring of the skin
  • large flakes of dandruff
37
Q

Describe some patient characteristics of someone who may have a vitamin A deficiency

A
  • night blindness
  • difficulty adapting to changes in light intensity
  • scleral changes and dry eyes
  • gingivitis
  • pigment changes
  • dry skin
38
Q

Describe some patient characteristics of someone who may have a vitamin C deficiency

A
  • swollen gums that bleed readily
  • transparent skin quality
  • weakness
  • delayed wound healing
39
Q

Describe some patient characteristics of someone who may have a vitamin K deficiency

A
  • petechiae

- wound bleeds readily

40
Q

Describe some patient characteristics of someone who may have a vitamin B complex deficiency

A
  • pallor
  • pale eye membranes
  • hyperpigmentation
  • redness or swelling of the mouth
  • mouth sores
  • purple discoloration of the tongue
  • swollen gyms
  • confusion
  • muscle cramps
  • anemia
41
Q

Describe some patient characteristics of someone who may have a zinc deficiency

A
  • decreased sense of taste
  • dull, dry, or thinning hair
  • seborrhea-like dryness and redness of the face
42
Q

Describe some patient characteristics of someone who may have a iron deficiency

A
  • pallor
  • yellow discoloration of the skin
  • soft, spoon-shaped nails
  • easily fatigued
  • dyspnea
  • anemia (purple eye bags)
43
Q

What are the 6 most commonly performed diagnostic tests to determine the presence of malnutrition?

A
  • creatine
  • serum albumin
  • prealbumin
  • serum trasnferrin
  • blood urea nitrogen
  • total lymphocyte count
44
Q

Creatine is a mesure of kidney function and protein status, __-__ mg/dL is considered a normal creatine level

45
Q

Normal serum albumin levels are at least __ mg/dL. Levels lower than this correlate with what?

A

3.5

pressure ulcer severity

46
Q

Normal prealbumin levels are between __-__ mg/dL and the risk of mortality increases as levels drop

47
Q

Serum transferrin levels less than ___ mg/dL indicate malnutrition

48
Q

Normal levels of blood urea nitrogen are between _-__ mg/dL. Elevated levels are associated with what?

A

5-25

decreased wound healing

49
Q

Total lymphocyte count should be greater than ___/mm3. What is associated with lower than normal levels?

A

1800

delayed wound healing and increased mortality

50
Q

Normal blood glucose is between __-___ mg/dL

51
Q

What are increased levels of blood glucose associated with?

A

risk of ulceration and impaired wound healing

52
Q

Does blood glucose increase or decrease with exercise?

53
Q

What are the 3 main causes of malnutrition?

A
  • lack of knowledge
  • poverty
  • associated health problems
54
Q

It is suggested that a person consumes __-__ calories and __-__ grams of protein per kg of body weight

A

30-35

1.25-1.5

55
Q

The formation of what type of wound is directly related to protein-calorie deficiency?

A

pressure ulcer

56
Q

What type of ulcerations are more prevalent in patients with poor glycemic control?

A

Neuropathic

57
Q

Do extensive burns increase or decrease metabolic rate?

58
Q

Patients with burn injuries covering more than __% of total body surface area and patients who require prolonged ventilator support may require supplemental external feeding

59
Q

______ implies a one-way interaction in which the clinician directs the patient, whereas _______ implies that the patient freely chooses to follow suggested guidelines

A

Compliance

Adherence

60
Q

What may result in patients being nonadherent?

A

poor relationship with their clinicians

822: Integumentary (16 decks)

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