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Vitamins Flashcards

1
Q

Body needs essential building blocks to grow and maintain itself

A

Carbohydrates
Fats
Proteins
Vitamins and minerals
Enzymes and coenzymes

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2
Q

Vitamins

A

Organic molecules needed in small quantities for normal metabolism and growth or repair of tissue

Attach to enzymes or coenzymes and help them activate anabolic (tissue-building) processes

Natural sources from both plants and animals

Insufficient amounts result in various deficiencies

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3
Q

Water-Soluble Vitamins

dissolved in?

excreted in?

Cannot be _____ by the body over long periods

______ required to prevent deficiencies

A

Vitamin B & C

B-complex group and vitamin C
Can be dissolved in water
Easily excreted in the urine
Cannot be stored by the body over long periods
Daily intake required to prevent deficiencies

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4
Q

Fat-Soluble Vitamins
Stored (Two) and excreted via?

A

Vitamins A, D, E, and K

Present in both plant and animal foods
Stored primarily in the liver
Exhibit slow metabolism or breakdown
Excreted via the feces
Can be toxic when consumed in excess

Stored in the liver and fatty tissues
Deficiencies occur only after prolonged deprivation from an adequate supply or from disorders that prevent their absorption.
Daily intake not required unless one is deficient.

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5
Q

Vitamin A

also known as

sources

A

Also known as: Retinol, retinyl palmitate, and retinyl acetate

Fat soluble

Vitamin A comes from carotenes, which are found in plants (green and yellow vegetables and yellow fruits).

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6
Q

Vitamin A food sources:

A

liver, fish, dairy products, egg yolks, dark green leafy vegetables, and yellow-orange vegetables and fruits

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7
Q

Vitamin A: Functions

A

Required for growth and development of bones and teeth (morphogenesis)

Essential for night and normal vision (rhodopsin)

Necessary for other processes
-Reproduction
-Integrity of mucosal and epithelial surfaces
-Cholesterol and steroid synthesis

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8
Q

Vitamin A: Indications

A

Dietary supplement
-Infants and pregnant and nursing women

Deficiency states
-Hyperkeratosis of the skin
-Night blindness

Used to treat skin conditions
-Acne, psoriasis, keratosis follicularis

Concurrent use of isotretinoin and Vitamin A can result in additive effects and possible toxicity.

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9
Q

Vitamin A: Toxicity

A

Ingestion of excessive amounts causes toxicity.

Irritability, drowsiness, vertigo, delirium, coma, vomiting, diarrhea

Increased intracranial pressure in infants

Generalized peeling of the skin and erythema over several weeks

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10
Q

Vitamin D

A

Fat soluble

“Sunshine vitamin”

Responsible for proper utilization of calcium and phosphorus

Vitamin D2 (ergocalciferol)
-Plant vitamin D
-Obtained through dietary sources

Vitamin D3 (cholecalciferol)
-Produced in the skin by ultraviolet irradiation

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11
Q

Vitamin D2–containing foods:

A

Fish liver oils, saltwater fish
Fortified foods: milk, bread, cereals
Animal livers, tuna fish, eggs, butter

Endogenous synthesis in the skin

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12
Q

Vitamin D: Functions

A

Works with parathyroid hormone to regulate absorption of and use of calcium and phosphorus.

Necessary for normal calcification of bone and teeth

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13
Q

Vitamin D: Indications

A

Dietary supplement

Treatment of vitamin D deficiency

Treatment and correction of conditions related to long-term deficiency: rickets, tetany, osteomalacia

Prevention of osteoporosis

Other uses: treatment of osteodystrophy, hypocalcemia, hypoparathyroidism, pseudohypoparathyroidism, hypophosphatemia

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14
Q

Vitamin D: Toxicity

A

Long-term ingestion of excessive amounts causes toxicity.
Hypertension, dysrhythmias, weakness, fatigue, headache, drowsiness
Anorexia, dry mouth, metallic taste, nausea, vomiting, constipation
Decreased bone growth, bone pain, muscle pain
Polyuria, albuminuria, increased blood urea nitrogen level
Can progress to impairment of renal function and osteoporosis if left untreated.

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15
Q

Forms of Vitamin D

A

calcifediol
calcitriol (Rocaltrol®)
dihydrotachysterol
ergocalciferol (Osto-D2®)

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16
Q

Vitamin E

A

Fat soluble

Four biologically active chemical forms: alpha(α)-, beta(β)-, gamma(γ)-, and delta(δ)- tocopherol

The exact biological function of vitamin E is unknown.

Believed to act as an antioxidant

Unproved theory that vitamin E has beneficial effects for patients with cancer, heart disease, Alzheimer’s disease, premenstrual syndrome, and sexual dysfunction

Results from the Heart Outcomes Prevention Evaluation trial showed no benefit of vitamin E supplementation.

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17
Q

Vitamin E food sources

A

Dietary plant sources:
Fruits, grains, fortified cereals, vegetable oils, wheat germ, nuts

Animal sources:
Eggs, chicken, meats, fish

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18
Q

Vitamin E: Indications

Highest risk of deficiency in

A

Dietary supplement
Antioxidant
Treatment of deficiency
Highest risk of deficiency in premature infants

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19
Q

Vitamin E: Adverse Effects

A

Very few acute adverse effects
Gastrointestinal (GI) tract
Central nervous system (CNS) effects

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20
Q

Vitamin K

A

Fat soluble
Three types: phytonadione (vitamin K1), menaquinone (vitamin K2), and menadione (vitamin K3)
Body does not store large amounts of vitamin K.
Vitamin K2 is synthesized by the intestinal flora.

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21
Q

Dietary sources of Vitamin K1:

A

Green leafy vegetables (broccoli, Brussels sprouts, cabbage, spinach, kale), cheese, soybean oils

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22
Q

Vitamin K: Functions

A

Essential for synthesis of blood coagulation factors in the liver

Vitamin K–dependent clotting factors
-Factor II (prothrombin)
-Factor VII (proconvertin)
-Factor IX (Christmas factor)
-Factor X (Stuart-Prower factor)

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23
Q

Vitamin K: main indication

A

Reverses the effects of certain anticoagulants (warfarin)

Patient becomes unresponsive to warfarin for approximately 1 week after vitamin K administration.

Other:

Dietary supplementation
Treatment of deficiency states (rare)
Antibiotic therapy
Newborn malabsorption
Given prophylactically to newborn infants

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24
Q

Forms of Vitamin K

A

Vitamin K1 (phytonadione)
Vitamin K3 (menadione)

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25
Water-Soluble Vitamins
Vitamin B complex Thiamine (B1) Riboflavin (B2) Niacin (B3) Pantothenic acid (B5) Pyridoxine (B6) Folic acid (B9) Cyanocobalamin (B12) Vitamin C Ascorbic acid
26
Water-Soluble Vitamins Act as
Can dissolve in water Present in plant and animal food sources Excessive amounts excreted in the urine, not stored in the body Toxic reactions very rare Act as coenzymes or oxidation-reduction agents
27
Vitamin B1 (Thiamine) Food sources
Enriched whole grain breads and cereals, liver, beans, yeast
28
2 Vitamin B1 (Thiamine) deficiencies
Beriberi Wernicke’s encephalopathy
29
Beriberi
Brain lesions, polyneuropathy of peripheral nerves, serous effusions, cardiac anatomical changes
30
Wernicke’s encephalopathy
Also known as cerebral beriberi
31
Vitamin B1 (Thiamine) essential for? maintains integrity of three systems?
Essential for: Carbohydrate metabolism Many metabolic pathways, including Krebs cycle Maintains integrity of: Peripheral nervous system Cardiovascular system GI tract
32
Vitamin B1 (Thiamine): Indications
Treatment of thiamine deficiency -Beriberi -Wernicke’s encephalopathy -Peripheral neuritis associated with pellagra -Neuritis of pregnancy (inflammation of peripheral nerves) Metabolic disorders Malabsorption Management of poor appetite, ulcerative colitis, chronic diarrhea, and cerebellar syndrome or ataxia Suggested as oral insect repellent, but studies do not support this.
33
Vitamin B2 (Riboflavin) Food sources:
Food sources: Green, leafy vegetables Eggs, dairy products Nuts, legumes Meats, liver Yeast, enriched whole-grain products
34
Vitamin B2 (Riboflavin): Causes of Deficiency
Alcoholism a major cause Also caused by: Intestinal malabsorption Long-standing infections Liver disease Malignancy Probenecid therapy (gout treatment)
35
Vitamin B2 (Riboflavin): Functions
Converted into two coenzymes essential for tissue respiration Required to activate vitamin B6 (pyridoxine) Converts tryptophan into niacin Maintains erythrocyte integrity
36
Vitamin B2 (Riboflavin): Deficiency
Deficiency results in cutaneous, oral, and corneal changes: -Cheilosis (chapped or fissured lips) -Seborrheic dermatitis -Keratitis
37
Vitamin B2 (Riboflavin): Indications
Dietary supplement Treatment of deficiency Microcytic anemia (helps with erythrocyte integrity) Acne Migraine headaches
38
Vitamin B2 (Riboflavin): Adverse Effects
No adverse or toxic effects Large doses discolour urine yellow orange.
39
Vitamin B3 (Niacin) Food sources:
Beans, turkey, tuna, liver, yeast, peanuts Enriched whole-grain breads and cereals, wheat germ
40
Also synthesized from tryptophan (an essential amino acid obtained from protein digestion)
Vitamin B3 (Niacin)
41
Vitamin B3 (Niacin): Functions
Once ingested, converted to nicotinamide Nicotinamide is converted to two coenzymes. These enzymes are required for: -Glycogenolysis and tissue respiration -Carbohydrate, lipid, protein, and purine metabolism Purine-produces uric acid
42
Vitamin B3 (Niacin): Indications
Prevention and treatment of pellagra Management of dyslipidemia Beneficial effect in peripheral vascular disease
43
Vitamin B3 (Niacin): Deficiency
Pellagra: niacin deficiency Mental: various psychotic symptoms Neurological: neurasthenic syndrome Cutaneous: crusting, erythema, desquamation of skin, scaly dermatitis Inflammation of mucous membranes: oral, vaginal, and urethral lesions; glossitis GI: diarrhea or bloody diarrhea
44
Vitamin B3 (Niacin): Adverse Effects
Adverse effects seen when higher doses are used in the treatment of dyslipidemia: Flushing Pruritus GI distress
45
Vitamin B6 (Pyridoxine) Sources:
Whole grains, wheat germ, yeast, fortified cereals Fish, organ meats, poultry, meats, eggs Peanuts, nuts, vegetables, bananas
46
Vitamin B6 (Pyridoxine) Composed of three compounds
Pyridoxine Pyridoxal Pyridoxamine All three are converted in the erythrocytes to active forms of B6
47
Vitamin B6 (Pyridoxine): Function
Necessary for many metabolic functions -Protein, lipid, and carbohydrate utilization -Conversion of tryptophan to niacin Necessary for integrity of peripheral nerves, skin, mucous membranes, hematopoietic system
48
Vitamin B6 (Pyridoxine): Deficiency Signs and symptoms
Sideroblastic anemia Neurological disturbances Seborrheic dermatitis Cheilosis (chapped, fissured lips) Xanthurenic aciduria
49
Vitamin B6 (Pyridoxine): Causes of Deficiency
Inadequate intake Poor absorption Uremia, alcoholism, cirrhosis, hyperthyroidism, malabsorption, heart failure Drug-induced -Isoniazid for tuberculosis -Hydralazine for hypertension
50
Vitamin B6 (Pyridoxine): Indications
Vitamin B6 deficiency Seizures that are unresponsive to usual therapy Morning sickness during pregnancy Patients with various metabolic disorders may respond to pyridoxine therapy.
51
Vitamin B6 (Pyridoxine): Toxicity
Toxic effects occur with large doses, especially neurotoxicity.
52
Vitamin B12 (Cyanocobalamin) Food sources:
Liver, kidney, fish, shellfish, poultry, milk Eggs, blue cheese, fortified cereals
53
Vitamin B12 (Cyanocobalamin)
Water soluble Synthesized by microorganisms present in the body
54
Vitamin B12 (Cyanocobalamin): Function
Present as two different coenzymes Required for many metabolic pathways -Fat and carbohydrate metabolism -Protein synthesis -Growth, cell replication -Hematopoiesis -Nucleoprotein and myelin synthesis
55
Vitamin B12 (Cyanocobalamin): Deficiency
The most common manifestation of untreated cyanocobalamin deficiency is pernicious anemia. Deficiency leads to: -Neurological damage -Megaloblastic anemia Deficiency states are caused by: -Malabsorption -Poor dietary intake of animal-origin foods (as in vegetarians)
56
Vitamin B12 (Cyanocobalamin): Oral absorption of vitamin B12 requires presence of the which is _____ secreted from
Oral absorption of vitamin B12 (extrinsic factor) requires presence of the intrinsic factor. The intrinsic factor is a glycoprotein secreted from the gastric parietal cells.
57
Vitamin C (Ascorbic Acid) Natural sources:
Citrus fruits, strawberries Tomatoes, potatoes Broccoli, spinach, Brussels sprouts Cabbage, green peppers Liver
58
Vitamin C (Ascorbic Acid)
Water soluble Acts in oxidation-reduction reactions Required for several metabolic activities: -Collagen synthesis -Maintenance of connective tissue -Tissue repair -Maintenance of bone, teeth, and capillaries -Folic acid metabolism -Erythropoiesis Enhances absorption of iron Required for the synthesis of: -Lipids -Proteins -Steroids Aids in cellular respiration Aids in resistance to infections
59
Vitamin C (Ascorbic Acid): Deficiency results in? what are the signs and symptoms?
Prolonged deficiency results in scurvy -Weakness -Gingivitis and bleeding gums -Loss of teeth -Anemia -Subcutaneous hemorrhage -Bone lesions -Delayed healing of soft tissues and bones -Hardening of leg muscles
60
Vitamin C (Ascorbic Acid): Indications
Dietary supplement Prevention and treatment of scurvy Urinary acidifier Most large controlled studies have shown that ascorbic acid has little or no value as a prophylactic for the common cold.
61
Vitamin C (Ascorbic Acid): Megadoses
Megadoses may cause: Nausea, vomiting, headache, and abdominal cramps Acidified urine, with possible stone formation Discontinuing megadoses may result in scurvylike symptoms.
62
Minerals
Essential nutrients Inorganic compounds Bind with enzymes or other organic molecules Help to regulate many bodily functions -Muscle contraction -Nerve transmission -Production of hemoglobin Building blocks for many body structures Required for intracellular and extracellular body fluid electrolytes Macrominerals Microminerals, or trace elements
63
Calcium
Most abundant mineral element in the body Accounts for 2% of body weight Highest concentration in bones and teeth Efficient absorption requires adequate amounts of vitamin D.
64
Calcium requirements high for:
Growing children Women who are pregnant or breastfeeding
65
Calcium: Food Sources
Especially milk and dairy products Fortified cereals Calcium-fortified orange juice Sardines, salmon
66
Calcium: Function
Essential for normal maintenance and function of: -Nervous, muscular, and skeletal systems. -Cell membrane and capillary permeability. Catalyst in many enzymatic reactions Essential in many physiologic processes -Transmission of nerve impulses -Contraction of cardiac, smooth, and skeletal muscles -Renal function, respiration, and blood coagulation
67
Calcium deficiency (hypocalcemia)
Infantile rickets Adult osteomalacia Osteoporosis Many other conditions associated with calcium deficiency
68
Calcium: Causes of Deficiency
Inadequate intake of calcium or vitamin D Hypoparathyroidism Malabsorption syndrome
69
Calcium: Indications
Achlorhydria Alkalosis Chronic diarrhea Hyperphosphatemia Hypoparathyroidism Menopause Pancreatitis Pregnancy and lactation Premenstrual syndrome Renal failure Sprue Steatorrhea Vitamin D deficiency Adult osteomalacia Hypoparathyroidism Infantile rickets or tetany Muscle cramps Osteoporosis Kidney insufficiency
70
Calcium: Toxicity
Hypercalcemia may occur with therapy. Anorexia Nausea Vomiting Constipation Severe hypercalcemia can cause: Heart irregularities Delirium Coma
71
Calcium: Two Drug Interactions
Chelation: -Calcium salts will bind (chelate) with tetracyclines to produce an insoluble complex. -If hypercalcemia is present in patients taking digoxin, serious cardiac dysrhythmias can occur.
72
Magnesium
One of the principal cations of intracellular fluid Essential for enzyme systems associated with energy metabolism Required for: -Nerve function -Muscle contraction
73
Magnesium Dietary sources:
Green leafy vegetables Meats, seafood, milk, cheese, yogurt Bran cereal, nuts Required in higher amounts for those with diets high in protein-rich foods, calcium, and phosphorus
74
Magnesium: Causes of Deficiency
Hypomagnesemia -Malabsorption -Alcoholism -Long-term intravenous feedings -Diuretics -Metabolic disorders (hyperthyroidism, diabetic ketoacidosis)
75
Magnesium: Indications
Nutritional supplement Magnesium deficiency -Anticonvulsant in magnesium deficiency -Pre-eclampsia and eclampsia -Tocolytic drug for inhibition of uterine contractions in premature labour -Pediatric acute nephropathy -Cardiac dysrhythmias -Constipation (short-term treatment)
76
Magnesium: Adverse Effects
Adverse effects that are caused by hypermagnesemia: -Tendon reflex loss -Difficult bowel movements -CNS depression -Respiratory distress -Heart block -Hypothermia
77
Phosphorus sources
Widely distributed in foods -Milk, yogourt, cheese -Peas, meats, fish, eggs Dietary deficiency is rare.
78
Phosphorus Deficiency Causes
Deficiency that is caused by nondietary causes: Malabsorption Extensive diarrhea or vomiting Hyperthyroidism Long-term use of aluminum or calcium antacids Liver disease
79
Phosphorus: Functions
Required precursor for the synthesis of essential body chemicals Building block for body structures Required for the synthesis of: -Nucleic acid -Adenosine diphosphate -Adenosine monophosphate -Adenosine triphosphate
80
Phosphorus: Functions
Responsible for cellular energy transfer Necessary for the development and maintenance of the skeletal system and teeth
81
Phosphorus: Indications
Treatment of deficiency states Dietary supplement in several multivitamin formulations
82
Phosphorus: Adverse Effects
Diarrhea Nausea and vomiting Other GI disturbances Confusion Weakness Breathing difficulties
83
Zinc
Trace element Essential in metabolic reactions of proteins and carbohydrates Important for normal tissue growth and repair, especially wound repair
84
Zinc sources
Red meats, liver, oysters, milk products, eggs, beans, nuts, whole grains, fortified cereals, certain seafoods
85
Nursing Implications
Assess nutritional status. Assess baseline lab values (hemoglobin, hematocrit, white blood cell count, red blood cell count, protein, albumin levels). Assess history and medication history. Assess for contraindications. Follow specific guidelines for administration, especially if parenteral. Provide nutritional counselling about necessary foods to include in the diet.

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