Week 10-12 Flashcards

1
Q

History of Canada’s Food Guide

A
  • Started in 1940s
  • Values set to fatten up soldiers
  • Develop from testing on Indigenous children
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2
Q

Proper Portions

A
  • 1/2 plate fruits/veg
  • 1/4 plate protein
  • 1/4 plate carbs
  • Make water drink of choice
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3
Q

Food Deserts

A
  • Access barriers
  • Connivence stores become primary option - expensive
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4
Q

High Fibre

A
  • Lower LDL cholesterol
  • Lower blood sugar
  • Decrease cancer risk
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5
Q

High Protein

A
  • Delays carb absorption & hunger
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6
Q

Potassium

A
  • Maintain normal fluid levels within cells
  • Muscle contraction
  • Normal blood pressure
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7
Q

Sodium

A
  • Maintain normal fluid levels outside of cells
  • Hypertension risk - stroke/heart attack
  • Nerve impulse conduction
  • Muscle contraction/relaxation
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8
Q

Trans Fats

A
  • Artificially created HDLs & LDLs
  • Raise bad cholesterol
  • Lower good cholesterol
  • Risk of CV diseases
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9
Q

Saturated Fats

A
  • Occur naturally in diary, meat
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10
Q

Unsaturated Fats

A
  • Vegetable - corn oil
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11
Q

Polyunsaturated Fats

A
  • Beneficial - olive oil
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12
Q

Sugar Considerations

A
  • Reduced intake of free sugars throughout course of life (less than 10%)
  • Limit intake of free sugars to less than 10% of total calorie intake
  • 50g of free sugars consumed per day in a 2000 calorie diet
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13
Q

Alcohol

A
  • 0 drinks per week ‘safe amount’
  • Only carcinogen without warning labels
  • Leading cause of preventable death
  • Occurrence of malignant tumours (oral, pharynx, larynx, esophagus, liver)
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14
Q

Water

A
  • Drink according to thirst
  • 8 glasses of day is a myth
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15
Q

Albumin

A
  • protein levels
  • Malnutrition sign - low
  • Liver/kidney disease - low
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16
Q

Nitrogen

A
  • Blood urea nitrogen test (BUN)
  • Poor kidney function - high
  • Dehydration - high
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17
Q

Transferrin

A
  • Amount of iron in body
  • Predictor of protein status
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18
Q

Lymphocytes

A
  • Nutritional deficiencies may impact immune system
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19
Q

Hemoglobin

A
  • Composed of protein & iron
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20
Q

Cholesterol

A
  • HDL, good
  • LDL, bad
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21
Q

Oral Health

A
  • High sugar
  • Tobacco
  • Alcohol
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22
Q

Dysphagia

A
  • Difficulty swallowing
  • Change in voice tone/quality, altered gage, pocketing food, coughing
  • Caused by stork, dementia/confusion, motor function
  • Aspiration risk
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23
Q

Dysphagia Interventions

A
  • Changes to diet - SLP consult
  • NPO
  • IV - dehydration
  • TPN - hard on liver/veins (NPO for multiple days)
  • Enteral feeds - dehydration
  • Nasal gastric tube NGT
  • Gastrostomy G Tube
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24
Q

Enteral Feeds

A
  • Patients at high risk of aspiration
  • Provides essential nutrition
  • QOL impacts
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25
Clinically Signifiant Malnutrition
- Serum albumin below 3.5mg/100mL - Total lymphocyte count below 1800/mm3 - Body weight decreased more than 15%
26
Fluid Volume Deficit
- Decrease BP - Pulse tachycardic, weak, thready - Slowed cap refill - Flat neck veins - Lethargy - Less than 30mL output/hr - oliguria
27
Fluid Volume Overload
- Increase body weight - Lower leg edema - Increase BP - Excess output - polyuria - Neck vein distension - Lung crackles - Confusion
28
Fluid Volume Interventions
- Daily weigh ins - Client education - Secure access to safe water
29
Fluid Management
- Encourage oral - Enteral (water flushes) - IV
30
Antibiotic History
- Penicillin discovery in 1928 - Used for infections in WWII soldiers
31
Antibiotic Resistance
- Overuse - Inappropriate prescribing - Extensive agriculture use - injected to humans when food is consumed - Few new antibiotics - no longer an economical investment
32
Lymphocyte Levels
- Elevated with inflammatory response
33
Monocyte Level
- Increased protozoal - TB
34
Eosinophils
- Increased parasitic
35
Basophils
- Normal with infection
36
Neutrophils
- Increased suppurative (pus) infection - Decreased overwhelming infection
37
Infection Response
- Remove offending body - Monitor vitals - Antibiotics - Wound care vs DB&C - Nutrition - Rest
38
Ulcer Prevention
- Sensory perception - Moisture - Activity - Mobility - ability to change position - Nutrition - Friction & shear
39
Inflammatory Phase
- Reaction to injury
40
Proliferative Phase
- Filling wound with granulation tissue, contraction, resurfacing
41
Remodelling Phase
- Scar formation
42
Dehiscence
- Splitting/bursting open of wound
43
VAC
- Decrease air pressure around wound to promote healing
44
Common Vaccines
- Flu - Pneumococcal >65 - Shingles >65 - Covid - Ebola
45
Colon
- Water absorption
46
Age
- Decreased peristalsis - Loss of pelvic floor strength
47
Cystocele
- Dropping of bladder into vagina due to muscle loss
48
Rectocele
- Dropping of rectum into vagina
49
Constipation causing Medications - CAIAO
- Calcium - Antibiotics - Iron - dark/black - Aspirin/NSAIDS - Opioids
50
Norovirus
- GI causing nausea/vomit - Common in LTC
51
Clostridium Difficile (C-diff)
- Gram positive - 65+ - 3 unformed stools in 24hrs
52
C-Diff Treatment
- PPE - Abx stewardship - stop causing, start treatment - Fidaxomicin, flagyl, vancomycin - c-diff target - Specimen collection - sample in orange container - Fecal microbiota transplant
53
Bowel Routine
- Timing, amount of time - Diet & exercise - Stimulants/cathartics - laxatives - Digital stimulation
54
Colorectal Risk Factors
- Nutrition (red meat, fibre, milk, vit D) - Alcohol - Smoking - Body fat - Medications
55
Non-Modifable Colorectal Risk Factors
- Family history - IBD - Height - tall people
56
Stoma Care
- Stool consistency - more removed = more mushy stool - Frequency of wearing pouch - all the time - Surgeon attempts to position midline - Emptied every 4-6hrs - Pouch lasts 5-7 days
57
Anuria
- Absence of urine production - Scant - less than 50mL in 24hrs
58
Polyuria
- Abnormally large volume of urine - Diabetes
59
Dysuria
- Pain/burning/stinging/itching associated with urination - UTI
60
Nocturia
- Need to get up at night to urinate - on regular basis
61
Pyuria
- High levels of WBC in urine
62
Oliguria
- Abnormally small amount of urine production
63
Ketouria
- High levels of ketone in urine - Diabetes
64
Skin Assesment
- Hydration indicator - Incontinence leads to breakdown
65
Kidney Assessment
- Size - Shape, ultrasound - Flank pain
66
Bladder Assessment
- Palpable when full
67
Transplant for Kidney Disease
- Best option - Immunosuppressant meds
68
Hemodialysis
- 3x per week - blood out, blood clean, blood home - Fistula/graft needed
69
Peritoneal Dialysis
- Performed daily, overnight
70
Incontinence Considerations
- Timing - Fluid intake - Medications/caffeine - Pelvic floor muscle exercises
71
Urinalysis
- pH 4-6 - Protein - Glucose - diabetes - Ketones - Blood - Specific gravity - fluid balance/dehydration test
72
Catheter Types
- Indwelling/foley - Condom - In & out - CBI - continuous bladder irrigation - Suprapubic
73
Catheter Removal Barriers
- Data hard to find, not accurate, not available - Not a priority - Confusion about who has authority to remove - Lack of agreement on standard protocol - Communication barriers among clinicians
74
Urinary Diversions
- Divert flow to abdominal surface - Ileal conduit - Cancer, trauma, radiation, fistulas - Temporary/permanent - Changes to urine - Body image/self esteem