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nutrition > unit 9- supplemental nutrition > Flashcards

unit 9- supplemental nutrition Flashcards

1
Q

who do vitamin supplements benefit

A

1) those who routinely fail to obtain recommended amounts of vits and mins from diet (i.e. chronic dieter)
2) those with special needs (pregnancy, elderly)

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2
Q

true or false: research in the area of vit/min is conflicting

A

true

some same there is benefit, others say too little evidence

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3
Q

in Canada how many take vits, mins, herbals, homeopathic meds, ect

A

71%

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4
Q

what are these known as and what are they regulated by

A

natural health products

  • under natural health product regulations (jan 1 2004)
  • these regulations were designed to increase safety and efficacy of NHPs
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5
Q

what were the natural health products regulations a result of?

A

-a consultation process with canadian consumers, academics, hcps, and industry stakeholders

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6
Q

what do the regulations include

A
  • provisions on product licensing, site licensing, good manufacturing practices, adverse reaction reporting, clinical trials, and labeling
  • also included is a mandatory, pre-market review of all NHPs to ensure that what is on the label is in the bottle
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7
Q

NHP examples

A
  • vits and mins
  • herbal remedies
  • homeopathic meds
  • chinese traditional meds
  • probitocs
  • aa and essential fa’s
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8
Q

what do approved NHPs have on their bottle

A

-either:
> NPN
>DIN - homeopathic medicine (DIN- HM)

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9
Q

what does an NPN or DIN-HM let the consume know?

A

that the product has undergone and passed a review of its formulation, labelling, and instructions for use, so it is safe product to choose
-health canada has list of approved products on their website

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10
Q

what about NHPs from other countries/over internet

A
  • if they are available in other countries, they do not have to meet these regulations
  • not same assurance of safety
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11
Q

what is the best practice when it comes to supplements

A

-make changes to diet to improve nutrition content and only take supplements as needed
(greater risk of toxicity, expensive, and van give false sense of security about healthfulness of diet)

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12
Q

what can NHPs interact with

A
  • meds, foods and other supplements

- ie grapefruit juice

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13
Q

sometimes, due to illness or medical condition, regular food intake is not able to meet patients needs. What does this result in?

A

need for alternative nutrition support, including enteral or parenteral

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14
Q

enteral nutrition

A

-involves giving nutrients using GI tract either orally or via feeding tubes

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15
Q

parenteral nutrition

A

-giving nutrients IV

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16
Q

what can be used if individual is having difficulty maintaining an adequate food intake

A

-use nutritional supplements
ie Boost, Ensure, and other store brands (life brand, equate, PC ultra shake)
-nutrition content very comparable among brands
-can be in shake form, but also fortified puddings or fruit beverages
-ususally have different shakes (high protein, extra calories, reduced carbs, high fibre)
-all have diff flavours

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17
Q

when is tube feeding useful

A
  • if indie is unable to meet their nutrient needs orally provided that GI tract is functioning
  • not all patients are candidates (i.e. may have severe swallowing disorder, Gi obstructions, intestinal surgeries, etc)
  • it can supplement oral intake or provide all nutrients
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18
Q

tube feeding routes

A
  • nasogastric
  • nasointestinal
  • nasoduodenal
  • nasojejunal
  • patient is frequently awake during transversal
  • these are chosen if less than 4 weeks
  • orogastric (mouth to intestine- infants)
  • if over 4 weeks or cannot access through nose, create direct route through enterostomy (gastrostomy or jejunostomy)
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19
Q

what are the main types of enteral formulas available

A

1) standard- polymeric formulas (for ppl who can absorb nutrients w/o difficulty- have protein isolates, cornstarch or glucose, and sugars)
2) elemental- hydrolyezed, chemically defined or monomeric formulas (for those w compromised digestive or absorptive fxn- contains proteins and carbs that are partially or fully broken down, low in fat)
3) specialized- disease specific
4) modular- created from individual macronutrient preps called modules

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20
Q

formula selection is based on

A

-patints medical condition, digestive/absorptive capabilities, nutrient status, and individual tolerance

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21
Q

what types of systems can formulas be fed thrgouh

A

open or closed

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22
Q

before feedings begin, it is important that:

A

-tube is correctly placed and is securely attached

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23
Q

how can enteral formulas be admined

A

-continuous, intermittent, and bolus feedings, and they each have advantages and disadvantages

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24
Q

open feeding system

A

-formula delivery system that requires the formula to be transferred from its original packaging to a feeding container before being administer through feeding tube

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25
closed feeding system
-formulas delivery system in which the formula comes prepackaged in a container that can be attached directly to the feeding tube for admin
26
intermittent feedings
-relatively large amounts several times per day
27
continuous feeding
-smaller amounts continuously
28
bolus feeding
rapid delivery of a large volume of formula into the stomach (over 5-15 mins)
29
what should be monitored throughout tube feeding
-patient tolerance, including nutrition and metabolic parameters (such as weight and labs)
30
true or false: many complications can arise during tube feeding
true -ie aspiration of formula, clogged feeding tube, constipation, diarrhea, fluid and electrolyte imbalances, and n/v/cramps
31
if Gi function is impaired how may nutrients be given
IV | -there are many conditions where parenteral nutrition is indicated
32
what are contraindications for parenteral nutrition
- GI tract functioning and accessible - only short term treatment anticipated (in patients w/o severe malnutrition)- usually less than 7 days - risks outweigh benefits - palliative care/ terminal - patient not stable - inability to obtain venous access
33
where can parenteral nutrition be administered
-through peripheral or central veins
34
peripheral parenteral nutrtion
- usually short (7-14 days) | - solutions must be less concentrated to prevent damage to the peripheral veins, and therefore higher volumes needed
35
central parenteral nutrition
= total parenteral nutrition bc a person's entire nutrition needs can reliably be provided (larger veins, blood volume greater and nutrient concentrations donned to be limited) - used when parenteral nutrition is required longer term - solutions more concentrated therefore volume required is lower
36
who works together to determine appropriate parenteral solution that the patient requires
-multi-disciplinary team of doctors, nurses, pharmacists, and dieticians
37
prescriptions for parenteral solutions
- very individualized | - can change on daily basis if condition is unstable
38
parenteral solution ratio
-either 2-in-1 or 3-in-1 (also called total nutrient admixture)
39
what does a 2-in-1 contain
-dextrose and aa, and the lipid emulsion would be administered seperately
40
what does a 2-in-2 contain
-dextrose, aa, and lipids
41
how can parenterals be administered
-either continuously (over 24 hour time period) or cyclic (over 8-16 hour period)
42
why must parenteral nutrition be continually monitored
- many potential complications i. e. refeeding syndrome is of particular concern and can occur when feedings are overly aggressive for severely malnourished individuals
43
symptoms of referring syndrome
-fluid and electrolye imbalances, as well as hyperglycemia
44
what are some catheter related complications
-air embolism, blood clotting at catheter tip, clogging, infection, phlebitis, ect
45
what are some metabolic complications
-electrolyte imbalances, gallbladder disease, liver disease, hyperglycaemia, nutrient deficiencies, and refeeding syndrome
46
dysphagia
- difficulty in swallowing | - affects food and beverage intake, mouth care, medication use, ect
47
what does management of dysphagia require
-multidisciplinary team, including speech language pathologist, dietician, OT, nurse, pharmacist, dental specialists and dr
48
symptoms of dysphagia
- drooling - choking or coughing during or after meals - pocketing food - absent gag reflex - inability to suck from straw - chronic uper resp infection - weight loss/ anorexia - gurgly voice
49
health conditions associated with oropharyngeal dysphagia
- advanced alzheimers - cerebral palsy - MS - Parkinsons - stroke
50
health conditions associated with esophageal dysphagia
-esophageal cancer, spasm, or compression; strictures, scleroderma
51
complications of dysphagia
- aspiration, deydration, loss of enjoyment for eating, and weight loss - often leads to malnutrition du e to inadequate intake
52
goal of nutrition intervaentions for dysphagia
-ensure diet remains nutritionally adequate and palatable in consistencey safely tolerated by pt
53
common management strategies
-altering food texture, and altering the viscosity of fluids
54
why are the textures of foods modified
- to make them easier to swallow | - may be minced, pureed, blederized to make easier to swallow
55
what types of foods are easier to swallow
- foods that are naturally soft and form cohesive blous (i.e. mac casseroles, egg dishes, meat loaf) are typically easier to swallow than dry foods - adding sauces and gravies to foods may make them easier to swallow and can add additional calories
56
mixed texture foods
-ie cereal and milk -these can be difficult to manage, therefore are blended to single consistency (this can make it less appealing, but try to improve if possible
57
thin fluids
-require most coordination and control to consume, and are therefore easily aspirated into the lungs
58
thickened liquids
-easier to swallow nectar thick: i.e. soups can be sipped through straw (drip off spoon) honey thick fluids: i.e. tomato sauce hold shape on spoon and are too thick to sip
59
what is a concern when thickened fluids are used
-hydration
60
what are other alts for patients with dysphagia
- learn alt feeding tech, such as exercise to strengthen tongue, new methods of swallowing, or changing position - often speech lang pathologist or OT involved
61
how to improve acceptance of mech altered foods
- prepare favourites - sub brightly coloured veggies for white ones (use contrast) - shape the pure so they resemble traditional dish - try layer ingredients (looks like fancy casserole) - use attractive plates, silverware

nutrition (5 decks)

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