vitamins and minerals (Q) Flashcards
vitamins
organic molecules from natural sources needed in small quantities for normal metabolism / biochemical functions
EX: tissue growth / repair
*insufficiencies result in deficiencies
fat-soluble vitamins
vitamins that can be dissolved in fat; stored in the liver and fatty tissues
INCLUDE: A, D, E, K
daily intake is not required because they are stored longer and not readily excreted in urine, but deficiency can occur with prolonged deprivation from supply OR a disorder preventing its absorption
fat-soluble vitamin characteristics
1.) present in both plant and animal foods.
2.) stored primarily in the liver.
3.) exhibit slow metabolism or breakdown.
4.) excreted in the feces.
5) can reach toxic levels (hypervitaminosis) if excessive amounts are consumed.
possible issues with vitamins (4)
1.) nutrient mega dosing: consuming vitamins or supplements in doses significantly larger than recommended daily intake
2.) toxic hypervitaminosis: an excess amount of vitamins in the body, leading to adverse health effects
3.) recommended daily allowances
4.) dietary reference intakes
vitamin a
FAT-SOLUBLE,
also known as RETINOL
sources: liver, fish, dairy products, DARK GREEN leafy vegetables, YELLOW-ORANGE vegetables + fruits
* comes from CAROTENES, found in GREEN + YELLOW vegetables and YELLOW fruits
* may cause orange tint to skin / urine
vitamin a function
1.) morphogenesis: development of the physical shape of the body
2.) rhodopsin: a major retinal pigment that aids in night + normal vision
3.) growth and development of bones
OTHER:
reproduction, integrity of mucosal / epithelial surfaces, cholesterol + steroid synthesis
vitamin a indications
SUPPLEMENT:
infants, pregnant / nursing women
DEFICIENCY STATE:
hyperkeratosis of skin, night blindness, many conditions r/t EYE
ISOTRETINOIN:
a vitamin-a related compound used to treat acne, psoriasis, keratosis follicularis
vitamin a contraindications
drug product allergy
known state of hypervitaminosis
excessive supplementation beyond recommended guidelines, especially during pregnancy / oral malabsorption syndromes
signs of vitamin a toxicity
irritability, drowsiness, vertigo, delirium, vomiting, generalized peeling of skin / erythema
INFANTS:
increased cranial pressure
vitamin d
FAT-SOLUBLE
1.) vitamin D2 (ergocalciferol): obtained through dietary sources
EX: fish liver oils, saltwater fish, milk, OJ, cereal, animal liver, eggs, dairy products
2.) vitamin v3 (cholecalciferol): produced in the sun by UV irradiation
vitamin d function
responsible for the regulation and use of calcium and phosphorus by working with PTH
* necessary for normal calcification of bone + teeth
vitamin d indications
SUPPLEMENT:
tx for vitamin d deficiency and long-term deficiency conditions (rickets, tetany, osteomalacia)
PREVENTION:
prevents osteoporosis
OTHER:
tx of bone, calcium, thyroid, and phosphorus diseases
EX: osteodystrophy, hypocalcemia, hypoparathyroidism, hypophosphatemia, etc.
signs of vitamin d toxicity
for LONG-TERM, EXCESSIVE ingestion:
hypertension, weakness, fatigue, headache, anorexia, dry mouth, metallic tase, NV, abdominal cramps, ataxia, bone pain
PROGRESSION:
can lead to impaired renal function and osteoporosis if untreated
vitamin k
FAT-SOLUBLE
*the body does not store large amounts
1.) vitamin K1 (phytonadione): dietary sources
EX: green leafy vegetables (broccoli, cabbbage, spinach, kale), cheese, soybean oils
2.) vitamin K2 (menaquinone): synthesized by intestinal flora
3.) vitamin K3 (menadione)
vitamin k function
essential for BLOOD COAGULATION factors
INCLUDES:
factor II (prothrombin)
factor VII (proconvertin)
factor IX (Christmas factor)
factor X (Stuart-Prower factor)
vitamin k indications
SUPPLEMENT:
rarely occurs, but can be used to tx vitamin k deficiency r/t antibiotic therapy and malabsorption
USED:
prophylactically for newborn infants
reverse the effects of certain anticoagulants (warfarin); pt becomes unresponsive to warfarin 1 week after vitamin k administration
vitamin k contradiction
drug allergy
water-soluble vitamins
vitamins that can be dissolved in water
INCLUDE:
B-complex group and vitamin c
these are not stored in the body in large amounts because they are readily excreted in urine; this results in the need for daily intake
water-soluble vitamin characteristics
1.) present in both animal and plant sources
2.) excessive amounts are typically secreted in urine
3.) toxic reactions are rare
4.) act as coenzymes / oxidase-reduction agents
vitamin b1 (thiamine)
WATER-SOLUBLE
food sources: whole grain breads, cereal, liver, beans, yeast
causes of thiamine deficiency
poor diet
extended fever
hyperthyroidism
liver disease, alcoholism,
malabsorption
pregnancy + breast feeding
thiamine function
ESSENTIAL FOR:
carbohydrate metabolism + metabolic pathways (Kreb’s Cycle)
INTEGRITY OF:
peripheral nervous system, cardiovascular system, GI tract
thiamine indications
TX OF DEFICIENCY
deficiencies: beriberi, Wernicke’s encephalopathy (cerebral beriberi), peripheral neuritis associated with pellagra, neuritis of pregnancy
metabolic disorders
malabsorption
management of poor appetite, UC, chronic diarrhea, cerebellar syndrome or ataxia
oral insect repellent
vitamin b2 (riboflavin)
WATER-SOLUBLE
sources: green leafy vegetables, eggs, dairy products, nuts / legumes, meats, liver, yeast, whole grain products
* not many adverse effects, but large doses may cause yellow-orange tint to urine
cause and results of riboflavin deficiency
ALCOHOLISM
also can be caused by intestinal malabsorption, long-term infections, liver disease, malignancy, probenecid therapy
RESULTS IN:
cutaneous, oral, and corneal changes
EX: cheilosis (chapped lips), seborrheic dermatitis, keratitis
function of riboflavin
converted into enzymes essential for tissue repair
required to activate vitamin B6 (pyridoxine)
converts tryptophan into niacin
maintains erythrocyte integrity
needed for normal respiratory function
riboflavin indications
dietary supplement
tx of deficiency
microcytic anemia
acne
migraine headaches
vitamin b3 (niacin)
WATER-SOLUBLE
sources: beans, turkey, tuna, liver, yeast, whole-grain breads, cereals, wheat germ
* can also be synthesized from tryptophan
* adverse effects include flushing, pruritis, and GI stress during high dosage for tx of hyperlipidemia
function of niacin
converted to nicotinamide, which is then converted to two coenzymes: nicotinamide adenosine dinucleotide (NAD), nicotinamide adenosine dinucleotide phosphate (NADP)
RESPONSIBLE FOR:
1.) glycogenolysis (tissue respiration)
2.) lipid, protein, and purine metabolism
niacin indications
prevention and tx of pellagra
antihyperlipidemic drug: lowers serum cholesterol + triglyceride by reducing low-density lipoprotein synthesis
niacin deficiency
known as PELLAGRA
MENTAL: psychotic symptoms
NEURO: neurasthenic syndrome
CUTANEOUS: crusting, erythema
MUCUS MEMBRANES: inflammation, oral + vaginal + urethral lesions, glossitis
GI: (bloody) diarrhea
vitamin b6 (pyridoxine)
WATER-SOLUBLE
sources: whole grains, wheat germ, yeast, fish, organ meats, poultry, meats, eggs, peanuts, nuts, vegetables, bananas
* TOXIC EFFECTS (neurotoxicity) occur with large doses
pyridoxine function
METABOLIC FUNCTIONS:
protein, lipid, and carb utilization
INTEGRITY OF:
peripheral nerves, skin, mucous membranes, hematopoietic system
pyridoxine deficiency
sideroblastic anemia, neurological disturbances, cheilosis, glossitis, stomatitis, epileptiform convulsions, hypochromic microcytic anemia
CAUSES:
inadequate intake, malabsorption, uremia, alcoholism, cirrhosis, hyperthyroidism, heart failure, drug induced (isoniazid, hydralazine)
pyridoxine indications
prevent + tx vitamin b6 deficiency
seizures unresponsive to usual therapy
morning sickness (pregnancy)
patients with various metabolic disorders
vitamin b12 (cyanocobalamin)
WATER-SOLUBLE
sources: liver, kidney, fish, shellfish, poultry, milk, eggs, blue cheese, fortified cereals
synthesized by microorganisms present in the body
contained in minimal amounts in plants
function of cyanocobalamin
presents as two different coenzymes
required for many metabolic pathways: fat + carb metabolism, protein synthesis, growth, cell replication, hematopoiesis, nucleoprotein, myelin synthesis
cyanocobalamin deficiency
MOST COMMON MANIFESTATION: pernicious anemia
deficiency can lead to: neurologic damage, megaloblastic anemia
CAUSED BY:
malabsorption
poor dietary intake (vegetarians)
what is required for oral absorption of cyanocobalamin?
INTRINSIC FACTOR
secreted by gastric parietal cells
vitamin b12 is considered the extrinsic factor
minerals
inorganic elements or salts that bind with enzymes or other organic molecules to help regulate bodily functions
ESSENTIAL FOR:
building blocks for body structures
required for ICF and ECF electrolytes
macrominerals / microminerals (trace elements)
* when mineral compounds are dissolved in water, they separate into positively charged metallic cations or negatively charged nonmetallic anions
magnesium
one of the principal cations of ICF
essential for enzyme systems associated with energy metabolism
sources: green leafy vegetables, meats, seafood, yogurt, cheese, milk, bran cereal, nuts
REQUIRED FOR:
nerve physiology, muscle contraction
* needed in higher amounts for those with diets high in protein-rich foods, calcium, and phosphorus
deficiency of magnesium
HYPOMAGNESEMIA
caused by:
malabsorption
alcoholism
long-term IV feedings
diuretics, PPIs
metabolic disorders (hyperthyroidism, DKA)
indications for magnesium
nutritional supplement
tx of magnesium deficiency
anticonvulsant
preeclampsia + eclampsia
tocolytic drug to inhibit uterine contractions in premature labor
pediatric acute neuropathy
cardiac dysrhythmias
short term tx of constipation
adverse effects of magnesium
HYPERMAGNESEMIA
tendon reflex loss
difficult BM
CNS depression
respiratory distress
heart block
hypothermia
zinc
TRACE ELEMENT
essential in metabolic reactions of proteins and carbs
important for normal tissue growth + repair (wounds)
source: red meats, liver, oysters, milk products, eggs, beans, nuts, whole grains, fortified cereals, certain seafoods
LABS to look at for vitamins and minerals
H&H
WBC
RBC
total protein
serum albumin
nursing implications
assess nutritional status
assess hx, medical hx, contraindications
follow SPECIFIC GUIDELINES for administration (especially parenteral)
provide nutritional counseling about necessary foods to include in the diet
