X Nutrition (Foundations Chpt 21) Flashcards
1
Q
Patient weight taken mandatory how many times?
A
1/month
1
Q
Nurse is link between patient and
A
dietician
1
Q
RDA
A
Recommended Daily Allowance
1
Q
DRI
A
Dietary Reference Intake (label at back with nutrition info)
1
Q
Essential Nurtrients
A
nutrients the body can not make on it’s own.
1
Q
6 classes of essential nutrients
A
Carb Fat Protein Vitamins Minerals Water
1
Q
What can not make Vit C
A
Humans and Guinea Pigs
1
Q
kcal/h
CARB
A
4cal
1
Q
kcal/h
FAT
A
9cal
1
Q
Vit A,D, E, K
Fat/water soluble?
A
Fat
1
Q
Normal body pH
A
7.34-7.45
1
Q
Normal cholesterol levels?
See pic
A
Total cholesterol <200mg/dL
HDL >= 60mg/dL
LDL < 100mg/dL
Triglycerides < 150mg/dL
2
Q
Calories
Fat, Carb, Protein
A
Fat - 9 kcal/g
Carb - 4 kcal/g
Protein - 4 kcal/g
(amount of heat required to raise 1cc of H2O 1degree
3
Q
Build and repair tissue
A
Protein, Fat, Ca, P and Fe
4
Q
Anabolism
A
Building up
5
Q
Catabolism
A
breaking down
6
Q
Kcal, Calories, Food Calories
A
synonyms
7
Q
Carbs main function
A
provide energy
8
Q
Simple Carbs
A
Simple Sugars: monosaccharides, disaccharides
9
Q
Complex Carbs
A
Polysaccharides
Starch, Glycogen, Dietary Fiber
(not sweet, C6H12O6)
10
Q
Can we digest Dietary Fiber?
A
NO. it is the one carb we don’t use for energy
11
Q
Carbs broken down into
A
Glucose to make ATP
12
Q
The simplest carb is…
A
Glucose
13
Q
Calories
Fat, Carb, Protein
A
Fat - 9 kcal/g Carb - 4 kcal/g Protein - 4 kcal/g ETOH - 7 kcal/fl oz (amount of heat required to raise 1cc of H2O 1degree
14
Can we digest Dietary Fiber?
NO. it is the ONLY carb we don't use for energy. Helps move food through intestines
15
Carbs broken down into
Glucose (fuel) to make ATP (fire)
16
The simplest carb is...
Glucose
17
Merasmus
starvation
18
All sugars/carbs broken down into
Glucose
19
Fats provide
Satiety
20
Glucose stored where?
Liver and Muscles
21
Extra Glucose stored as?
Fat
22
Insulin allows Glucose into cells to be used for ATP
.
23
Glycogen stored where?
Liver, muscles
| When full it is converted to fat
24
If energy needs met, carbs stored as?
Glycogen
25
If glycogen store full, excess carbs converted to ?
Fat
26
Fats and cholesterol are ?
Lipids
27
Adipose functions
Cushioning
| Insulation
28
Cholesterol needed for
- Integrity of cells
| - Vit D synthesis
29
Fat provides satiety and adds flavor and aroma to foods
Aka ?
Umami
30
Vege based sat fat (very few)
Coconut oil
31
Unsaturated Fatty Acids
One or more bonds of missing H
Monounsaturated (can take 1 more H)
polyunsaturated ( can take a few more H)
Plant sources
Liquid at room temp
Blood cholesterol lowering properties
32
Monounsaturated (can take 1 more H)
| polyunsaturated ( can take a few more H)
Mono- thicker oils (avocado, olive)
| Poly - thinner ( sesame, walnut, sunflower)
33
Fats (lipids)
| Trans fatty acids
Unsaturated fats made into sat fats in lab by adding H. They become solid in room temp.
34
Cholesterol
```
Provides no energy
Synthesized in liver
Foods of animal origin
Highest in shrimp/lobster
No more than 300mg per day
```
35
Bile doesn't break down fats, it .....
Emulsifies
37
Fatty stool, float or sink?
Floats
also in people without a gall bladder. bile is not deposited into duodenum to start emulsification so most fat is excreted with stool.
38
Lipoproteins (LDL, HDL) facilitate transport of ?what to ?where
lipids to bloodstream
39
Where is Lipase made and what does it do?
made in pancreas
| breaks down lipids
40
HDL, LDL
| difference? Which is good/bad?
HDL, tighter membrane
| LDL, loose wall. WBS eat and die. They become so full and become foam cells, stick to wall. Atherosclerosis
41
Saturated fatty acids
Chem bonds completely filled w H
Generally or ANIMAL origin
Solid at room temp
Raise cholesterol levels and risk for atherosclerosis
Lard, margarine, suit
42
Protein made up of ....
amino acids
43
How many Amino acids? How many considered essential?
22, 9 essential
44
Essential Amino Acids
Not produced by the body. Must be obtained from diet
45
Complete Proteins
contains all 9 essential amino acids, of animal origin (meat, poultry, fish, milk, cheese, eggs
46
Incomplete Proteins
lacking one or more essential amino acids, of plant origin (grains, legumes, nuts, seeds)
47
Soy is the highest non-meat source of protein
contains PhytoEstrogen
48
Lactovegetarian
vegetarian plus dairy products
49
Lacto-ovo-vegetarian
vegetarian plus dairy and eggs
55
Create complete proteins by eating things together...
mac and cheese
peanut butter and jelly
rice and beans
56
Kwashiorkor malnutrition
severe protein deficiency. kids mainly. only eat rice and wheat, no protein. Causes edema. Solutes attract H2O out into intersticial. starving kids with big bellies. Change in hair color. body no longer produces melanin.
57
Marasmus
extreme malnutrition and emaciation. starvation.
62
Vitamins can be destroyed by
Heat, light. Air
62
Antioxidant function
Delay or prevent breakdown of cell membrane in presence of O
62
Pre vitamin form of Beta Carotene
| Antioxidants
Vitamin E and C
62
Antioxidants: Oil?
Usually.
Oils prevent rust in iron
62
Water soluble vitamins
B, C (wound healing)
Not stored in body, excess excreted in urine
62
Fat soluble vitamins
A, D, E, K
Over consumption leads to toxicity
Stored in liver and fat
62
Bothe vitamins and minerals can be lost in food by...
Cooking in water
62
Minerals can be destroyed by..
Nothing.
They are single elements, not compounds
71
Vit C for?
| Deficiency?
- wound healing, immune function
- deficiency: Scurvy
- Symptoms: petichea, gum disease, lose teeth and hair
72
Vit D for?
| Deficiency?
Found in milk, dairy
Body can make it w exposure to sun
Deficiency: Rickets (osteopenia, osteomalaysia
73
Vit K for?
| Deficiency?
- role in blood clotting
- Hemorage due to lack of Vit K
- found in leafy greens
- avoid when on Cumadin
- use on infants before circumcision
74
Rescue Drug for Cumadin
Vit K
75
where is Vit K made?
In gut
76
Folate for?
| Deficiency?
- neural tube health in women of child bearing age
| - Spinabifida
77
Congenital Disease
during gestation
78
B12 for?
| Deficiency?
- making RBCs
- animal origin
Deficiency: Pernicious Anemia
79
What is made in stomach for absorption of B12?
- Intrinsic Factor
| - without IF, B12 is not absorbed and can lead to pernicious anemia
80
Major minerals, amount needed
- needed in amounts >100mg/pday
| - Ca, P, Mg, S, Na, K, Cl
81
Trace minerals, amount needed
- needed in smaller amounts
| - Fe, Z, I, Se, Cu, Fl, Ch, Molybdenum
81
Pernicious Anemia symptoms
- Feeling tired and weak
- Tingling and numbness in hands and feet
- A bright red, smooth tongue
82
Ca for?
| Deficiency?
- protection against osteoporosis, clotting, muscle contractions, and HTN
- 1000-1200mg/p day
83
Na for?
| Deficiency?
Electrolyte
| <2400mg / pday
84
Low residue diet
Clear liquid
Chicken no skin
High protein, not complex carbs that can break down into fiber
85
K for?
| Deficiency?
- electrolyte
- protect against HTN
- 2000mg/day
- ESRD must be careful for HyperKalemia
86
Fe for?
| Deficiency?
- part of hemoglobin (part of RBC that carries oxygen to cells)
- 8-15mg/pday (30mg for pregnant)
- iron rusts because of oxidation.
87
Water %of body
60%, adult
80%, infant
Provides form, structure, solvent for chem processes, transport, lubrication, body temp regulation
88
Teens usually deficient in....
Ca, Fe
89
Soy has
All essential amino acids. No fat. Water soluble vits
90
Normal pregnancy weight gain
25-35lbs
91
PIH (pregnancy induced hypertension)
Goes into fetus
| O, antibodies, glucose, dissolved substances
92
Required for RBCs
Folate, B12, Fe
93
Deficiency Disease of
Folate, B12, Iron
Folate: microcytic anemia
B12: pernicious anemia
Fe: anemia, hemoglobin
94
Diabetes Melitus
Occurs during pregnancy
Mom hi blood sugar, baby hi, large and fat
95
If mom suffers from diabetes Melitus, what is she at risk for later?
Type II Diabetes
96
First milk
Colostrum
97
Nicotine/caffeine
Vasoconstrictor
98
FAS
Fetal Alcohol Syndrome
Midline, low ears, wide nose, thin upper lip, genital problems
99
First year food
Rice cereal
100
Solid food starts how old?
4-6mos
101
Common dietary inadequacies
Iron and Calcium
102
Common problem in nursing homes?
Malnutrition
103
Limit caffeine intake to....
Less than 300mg/day
105
Low residue diet
Clear liquid
chicken
over cooked watery veges
106
Caffeine affects
-central nervous system stimulant, diuretic
nervousness, irritability, anxiety, insomnia, heart arrhythmia's, palpitations, BP, circulation, gastric acid secretion
-less than 300mg p/day
- People w GERD should avoid caffeine
107
Clear Liquids
bouillon, broth, gelatin, tea, coffee no milk, ginger ale, water, clear juice
108
Full liquid
strained cereals, soups no chunks, ice cream, pudding, milk, milkshakes, fruit juices
109
clear liquid - full liquid - solid
types of diets
110
mechanical soft diet
puree/chopped
111
High Kcal
surgery trauma, HIV AIDS, Burns
112
Cachectic
Cancer patients
113
Anorexia vs Anorexia Nervosa
lack or appetite vs self inflicted starvation
114
Diabetes I vs II
I: No Insulin II: Insulin resistant
115
Optimal Blood Glucose level
80 - 120mg/dL
116
Fasting BLood Sugar
blood drawn first thing in AM after fasting all night.
| normal 70-80mg/dL
117
Exchange List
Diabetes patients. Exchange carbs for other smilar valued carbs. Every carb = glucose
(if you want a banana carb, you must remove toast)
118
Dumping Syndrome
occurs post sugery to stomach.
food passes throught too rapidly. body reacts by sending water into intstinal tract to wash through, reducing blood pressure.
treatment: many small meals
119
Bile stored and produced where?
Produced in Liver, stored in Gall Bladder
120
Steatorrhea
fluffy fatty stool
121
Protein restricted diet for
very rare
| people w ESRD or Hepatic Cirrhosis (kidney, liver)
122
Asterixis
| Liver takes Amino acid from gut to...
make protein. If diseased liver cant' metabolize as much protein, not metabolizing N. Becomes toxic and produces NH3. crosses brain
123
NAS
no added salt
124
Potassium modified diet
| ESRD patietns
3Ds: diarrhea, diuresis, diaphoresis. Losing K. HypoKalemia.
or
If not urinating, not losing K, HyperKalemia
Electrical impulse of heart
oranges, bannana
125
Day/Eve/Night
0700-1500/etc . 8hrs each shift
126
ESRD Fluid restriction to 1L/day
.
127
duration of Nasogastric Tube
only up to 7 days
128
PEG restrictions (in stomach)
1. meticulous mouth care, LO salivary production. PAROTIDITIS
2. continuous feed. head of bed always 30* or UP
3. check residual periodically (continuous) or BA feeding (intermittent). aspirate stomach contents. >75cc
4. replace residual acid from stomach
5. check placement of tube. aspirate sm amount of stomach contents to check pH.
129
PPN
Partial Parenteral Nutrition.
| can be administered into peripheral vein
130
TPN
Total Parenteral Nutrition (Hypertonic solution)
- Glucose + Amino Acid, vit, min, electrolytes (digested carb/protein)
1. into MAIN line (IVC or SVC venacava)
2. can't be allergic to egggs. lipid complete
3. Sterile care of main line (bacteria would thrive in TPN mixture so avoid it)
4. Test for glucose. as UP glucose, Pancreas not getting message to release insulin on it's own since not going through the stomach, but only intravenously.
131
Change TPN line how often?
every 24hr
| normal: every 3 days
132
proteins used for?
structure
133
Glucagon
changes glycogen into glucose
134
Glycogen store where?
muscle and liver
135
High Protein Diet
wound healing, kids, pregnant women
136
IRON should be taken with?
CITRUS
| Dairy (Ca) will inhibit absorbtion
137
*** Schillings Test
test for pernicious anemia. radioactive B12 tracer injected. If we can't absorb B12, that indicates we LACK intrinsic factor. RBC w start dyng if no B12. ~128days
TREAT give Cyanocobalumin (B12 IM monthly)
138
Ca dose
1000 - 1200 mg/d
139
K in
banana, citrus, tomatoes, peanuts
140
Iron
Hemoglobin part thatl atches onto Oxygen.
Take w Citrus, straw to prevent staining. Z-track to prevent staining skin
141
Pre-Eclampsia
```
PIH, pregnancy induced HTN
damage to glomeruli (spring leak i glomeruli and H20 adn protein escape. PROTEINUREA
symptoms: mom has seizures
treatment: Mg (risk for DOWN Resp Rate)
rescue drug: Calcium Gloconate
```
142
Make vitamin D out of ?
Cholesterol
143
GERD
6/8 small meals
bed head elevated
don't eat right before bed
don't lie flat right after eating
144
Acidosis
1) Diabetic Ketoacidosis; symptoms Kussmaul Resp, Blow off CO2
2) Loss if bicarbonate from excessive diarrhea
145
Metabolic Alkalosis
loss of gastric acid (vomit, gastric suction, too many antacids)
146
Respiratory Acidosis
Hypoventilation (CO2 + H2O = H2CO3)
COPD, stroke, asthma, pheumonia, opiates
147
Respiratory Alkalosis
blow off CO2, crying baby, mom labor, anxiety
LOW CO2 +H2O = LOW H2CO3
**Kidney retains bicarbonate to neutralize acid
148
Gluconeogenesis
making new glucose
take glocose off of TriGlyc to leave the 3 FAs to create an acidic environment
149
Type 1 Diabetes
Pancrease produces NO INSULIN
150
Insulin
lowers blood sugar by pushing glucose into cells
151
Glucogon
peptide hormone, produced by alpha cells of the pancreas, that raises the concentration of glucose in the bloodstream. Its effect is opposite that of insulin, which lowers the glucose concentration. Wikipedia
152
HgA1C test
to monitor blood sugar compliance
should be
153
DRI (no RDA)
Daily recommended Intake.
No RDA
153
DRI
Daily recommended Intake.
No RDA
154
Ulcers caused from lack of ?
Protein
155
Protein purpose
Wound healing
| Muscle building
156
Parenteral
IV, IM
157
Enteral
```
Through gut
Ostomy
NG tube (Naso gastric)
PO (per os)
PEG tube
```
158
TPN
Total parental nutrition
159
Diverticulosis diet (condition of )
High fiber diet, to move food through intestines
160
Diverticulitis diet
Low residue, clear fluid, high protein, non fatty
161
What aids in absorption of iron
Hinders?
Citrus
Ca inhibits
162
Hiatal Hernia diet
6-8 small meals
Don't lie down after eating
Raise head of bed
163
What allergy w prevent patient from receiving TPN?
Eggs
164
Why monitor ? during TPN administration?
Glucose levels because pancreas doesn't get message from stomach to release insulin.
165
Cholesterol , plant or animal based?
Animal
166
Liver and Renal patient diet
Low protein
No soy
No meat
No nuts
167
B12
| Plant or animal
Animal
169
Schillings Test
Detecting Pernicious Anemia
(Using radioactive B12. If absorbed, NO pernicious anemia). If absorbed it means gut IS producing intrinsic factor to aid in absorption of B12.
If absorbed , you DO have PA
TREATMENT. IM of cyanocobalamin (B12)
170
BMR
Basal Metabolic Rate
| how many calories burned in 24hrs at rest
171
Vit A Deficiency
Night Blindness
172
Central Line
Large Flow Vein
| -jugular, subclaian, Superior vena cava, Inferior vena cava
173
ABG
Arterial Blood Gas
An arterial blood gas (ABG) test measures the acidity (pH) and the levels of oxygen and carbon dioxide in the blood from an artery. This test is used to check how well your lungs are able to move oxygen into the blood and remove carbon dioxide from the blood.
174
Allen's Test
squeeze on Radial and Ulnar veins. Release radial to ensure there is blood flow back to hand, in case you give the Ulnar vein a clot when performing ABG test.
175
otomoy
temporary hole
176
ostomy
surgically created long lasting hole
177
phlebotomy
drawing blood from hole
178
Normal Saline
0.9% NaCl
179
Dextrose, 5% in normal saline
D5NS
180
Dextrose 5% in 1/2 normal saline
D51/2NS
181
half normal saline
0.45%NaCl
182
Macro Drip tubing
10gtt = 1ml
use if IV drip rate is 81ml or UP
183
Micro Drip tubing
60gtt = 1ml
use if IV drip rate is 80ml/hour or slower
184
Blood tubing
15 gtt/1ml
