chapter 33 nutrition Flashcards
(193 cards)
1
Q
good nutritional status can
A
maintain health
promote normal growth and development
protect against disease
2
Q
plays a role in healing, recovery, and reducing complications
A
nutrition
3
Q
People at an increased risk for HCA, postop complications, and increased pressure ulcer risk are
A
malnourished people
4
Q
required for energy, cellular metabolism, and organ function
A
food
5
Q
No single one can provide all the nutrients needed by the body
A
food
6
Q
nutrients NOT produced in the body or not produced in enough amounts
A
essential nutrients
7
Q
water
macronutrients: carbs, fats/lipids, protein
micronutrients: vitamins and minerals
A
essential nutrients
8
Q
energy is measured in
A
kilocalories
9
Q
energy producing nutrients
A
macronutrients: carbs, proteins, fats/lipids
10
Q
most abundant essential nutrients
A
carbs
11
Q
individuals who are poor have a diet consisting mainly of
A
carbs
12
Q
abundant
inexpensive
body’s main source of energy
A
carbs
13
Q
easily stored
quickly and effectively broken down by body
A
carbs
14
Q
only has 1 or 2 sugars
no nutritional value
A
simple carbohydrates
gummi bears
15
Q
contains many sugars
more nutrients
A
complex carbohydrates
16
Q
apples pasta beans broccoli whole wheat bread
A
complex carbs
17
Q
decrease serum cholesterol
decrease glucose absorption in SI
decreases constipation
decreases free radicals in GI tract
A
functions of fiber
18
Q
dissolves in water and forms gel
A
soluble fiber
fruit, legumes
19
Q
roughage
not digested
increased constipation and free radicals
A
insoluble fiber
apple peel, bran
20
Q
recommended 5-10 grams/day but prefer 10-25 grams/day
A
fiber intake
21
Q
to increase fiber to diet:
A
Add beans to salads
choose cereal high in fiber
eat fruit instead of drinking juice
fiber supplements
22
Q
increase fiber ____________ to prevent ___________
A
slowly to prevent bloating and problems. have adequate intake of fluids
23
Q
functions in WOUND healing, energy source when insufficient carbs or fat, regulates fluid balance, regulates acid base balance, necessary component of insulin, antibodies, and other enzymes/hormones
A
protein
24
Q
essential for wound healing
A
protein
25
ONLY NUTRIENT THAT CONTAINS NITROGEN
PROTEIN
26
sufficient amount of essential amino acids
complete proteins
27
eggs, dairy products, meats
complete proteins
28
deficient in essential amino acids
incomplete proteins
29
plant proteins except SOY PROTEIN
incomplete proteins
30
mix 2 incomplete proteins to make one complete protein
complimentary proteins
31
black beans and rice
complimentary protein
32
body is taking in more protein than it is excreting
positive nitrogen balance
33
A pregnant woman or a child in a rapid growth spurt would have a positive/negative nitrogen balance
positive
34
patient taking in some protein, but excreting more than taking in
negative nitrogen balance
35
person on starvation diet or very malnourished
negative nitrogen balance
36
most common form of malnutrition in U.S.
protein energy malnutrition
37
treatment of protein energy malnutrition:
```
increase intake of protein by:
supplements
provide protein at each meal
patient teaching
consider economics, abilities, culture, etc.
```
38
insoluble in water/blood
fats/lipids
39
```
concentrated source of energy
high satiety value
improve palatability of diet
absorption fat-soluble vitamins
protect/insulate vital organs
```
lipid function
40
95% of fat in the body is
triglycerides
41
triglycerides are divided into three groups:
saturated fat, unsaturated fat, and transfat
42
types of fat in body:
triglycerides
phospholipids
sterols/cholesterol
43
solid at room temperature
most originate from animal sources- whole milk, beef, butter, but also coconut and palm oils
linked to CV disease and obesity
saturated fats
44
originates from whole milk, beef, butter, coconut oil, palm oil
Saturated fats
45
remain soft/liquid at room temp
unsaturated fats
46
olive oil, canola oil, peanut oil
monounsaturated fats
47
positive effect
decrease risk of CV disease and inflammatory diseases
omega 6 and omega 3
polyunsaturated fats
48
monounsaturated and polyunsaturated
unsaturated fats
49
manufactured
partially hydrogenated liquid oils
added to foods to make more solid or stable
transfat
50
doughnuts, French fries
transfat
51
contributes to CV disease
| increases free radicals-cancer
transfat
52
component of bile salts that assist in fat digestion
cholesterol
53
necessary of brain and nerve cell function and steroid production
cholesterol
54
increased levels increase atherosclerosis
cholesterol
55
intake should be limited
keep intake less than 200 mg a day
desirable serum level less than 200 mg/dl
cholesterol
56
good cholesterol
HDL or high density lipoprotein
57
bad cholesterol
LDL or low density lipoprotein
58
circulates from liver to tissues to get caught in veins, etc.
increases CV disease, plaques in arteries
LDL
59
energy value of carbohydrates
4 cal/gm
60
energy value of protein
4 cal/gm
61
energy value of fat
9 cal/gm
62
most concentrated source of energy
fat
63
What are the fat soluble vitamins:
A, D, E, K
64
What is necessary for the absorption of fat soluble vitamins:
fats
65
What are some functions/common sources of Vitamin A?
carrots, sweet potatoes,
| eyes, skin, hair
66
What are some functions/sources of Vitamin D?
calcium absorption, healthy bones
| eggs, milk, yogurt
67
What are some functions/common sources of Vitamin E?
corn, nuts, olives
| antioxidant, heart health
68
what are some functions/sources of vitamin K?
green leafy vegetables, broccoli, squash, tomatoes, peppers, parsley, kale, olive oil
functions in clotting
69
Limit which vitamin if taking Coumadin
vitamin K
70
water soluble vitamins
| these are not stored
B & C
71
which type of vitamins are more likely to build up and cause toxicity
fat soluble
72
which vitamins are stored
fat soluble
73
Show signs of deficiency early with which type of vitamins:
water soluble
74
sources of vitamin C
limes, kiwi, tomatoes
75
B1
thiamine
76
B vitamin that is decreased in alcoholics
B1/thiamine
77
B2
riboflavin
78
B3
niacin
79
B vitamin often used for hypercholesteremia
B3/niacin
80
B6
pyridoxine
81
b12
cobalamin
82
gastrectomy patients have to take which B supplement
b12
83
requires intrinsic factor and HCl acid for absorption
B12
84
deficiency of B12 leads to
pernicious anemia
neuritis
sore mouth or tongue
nerve damage
85
sources of B12
animal products
| liver or lean meat
86
A vegan would have which B deficiency
B12
87
Needed for RBC development, energy and oxygen transport
iron
88
food sources of iron
organ meats, red meat, and raisins
89
side effects of iron supplements
black or dark green stools
gastric upset
can discolor tooth enamel
90
do not crush, chew, or break oral tablets
iron
91
if liquid supplement, use a straw
iron
92
vitamin C will increase absorption of
iron
93
DO NOT ADMINISTER WITH DAIRY PRODUCTS, CAFFEINE, CHOCOLATE, EGGS, ANTACIDS, OR PROTON PUMP INHIBITORS; it will cause a decrease in the absorption
IRON
94
required for survival
infants/geriatrics most vulnerable to deprivation
50-60% total body weight in adult
2/3 in intracellular fluid
water- essential nutrient
95
weight at regular-daily intervals
most accurate
1 liter of fluid = 1 kg of weight
get adequate I&O
assessment of water loss
96
amount of nutrients needed to prevent disease
Recommended Daily Allowances (RDA)
97
amount of nutrient necessary to promote/optimize health
Dietary reference intake (DRI)
98
No meat, eggs, or dairy
vegan-total vegetarian pyramid
99
vegan plus eggs diet
Ovo-vegetarian
100
vegan plus dairy diet
Lacto-vegetarian
101
vegan plus dairy, eggs, and fish
presco-vegetarian
102
vitamins very important in vegans
B12, iron, and protein
103
promote awareness of nutrients found in food
| comparison of nutritional values for products
product labels
104
foodborne disease from improperly home-canned foods, smoked and salted fish, ham, sausage, shellfish
botulism
| caused by clostridium botulinum
105
symptoms vary from mild discomfort to death in 24 hours, initially nausea and dizziness, progressing to motor (respiratory)paralysis
botulism
106
disease from undercooked meat (ground beef)
E. coli
| caused by Escheririchia
107
severe cramps, nausea, vomiting, diarrhea (may be bloody), renal failure; appears 1-8 days after eating, lasts 1-7 days
E. Coli
108
disease from soft cheese, meat (hot dogs, pate, lunch meats), unpasteurized milk, poultry, seafood
listeriosis
| caused by Listeria
109
severe diarrhea, fever, headache, pneumonia, meningitis, endocarditis, appears 3-21 days after infection
listeriosis
110
disease from cooked meats, meat dishes held at room or warm temperature
Perfringens enteritis
| caused by Clostridium
111
disease caused my milk, custards, egg dishes, salad dressings, sandwich fillings, polluted shellfish
salmonellosis
| caused by salmonella
112
mild to severe diarrhea, cramps, vomiting; appear 12-24 hours after ingestion, last 1 -7 days
salmonellosis
113
disease caused by milk, milk products, seafood, salads
shigellosis
| caused by shigella
114
mild diarrhea to fatal dysentery; appear 7-36 hours after ingestion; lasts 3-14 days
shigellosis
115
caused by custards, cream fillings, processed meats, ham, cheese, ice cream, potato salad, sauces, casseroles
staphylococcus
| caused by staph aureus
116
severe abdominal cramps, pain, vomiting, diarrhea, perspiration, headache, fever, prostration; appear 1-6 hours after ingestion, lasts 1-2 days
Staphylococcus
117
who is at risk for malnutrition
burn patients, chemo patients
118
involuntary loss/gain of greater than 10% usual body weight within 6 months
or
greater than 5% usual body weight in 1 month
20% over/under ideal body weight
chronic disease
altered diets/diet schedules
inadequate nutrient intake for greater than 7 days
People at risk for malnutrition
119
```
disease
eating poorly
tooth loss/mouth pain
economic hardship
reduced social contact
multiple medications
involuntary weight loss
needs assistance in self-care
any disease that makes it hard to swallow or digest
elder above age 80
```
risk factors for malnutrition
120
has a positive effect on appetite
socialization
121
```
difficulty chewing-dentures
decreased economic status
decreased ability to cook, shop
decreased hand function hand/eye coordination
decreased senses of taste/smell
social isolation/loneliness
function of the GI tract
polypharmacy
```
problems affecting nutrition of older adult patients
122
The need for calories decreases/increases with aging adults.
decreases
123
height, weight, waist to hip ratio, skin fold measurements, mid arm muscle circumference
anthropometric measurements
124
measures fat stores in body
skin fold measurements
125
very important
| measures amount of lean body mass
mid-arm muscle circumference
126
most widely used measure of nutritional status
weight
127
poor indicator of nutritional status when edema or ascites present
weight
128
desire waist to hip ratio for men and women
female 0.8 or less
| male 1 or less
129
is pear or apple shaped healthier
pear shaped
130
ratio of height to weight
BMI formula
131
normal BMI is
19
132
BMI of 40 indicates
obesity
133
BMI of less than 18.5 indicates
underweight
134
BMI of 25-29.9 indicates
overweight
135
normal BMI range is
18.5-24.9
136
BMI of 30-39.9 indicates
obesity
137
BMI of greater than 40 indicates
EXTREME obesity
138
walking at a vigorous pace on level ground
moderate activity level
139
seated and standing activities
sedentary activity level
140
walking at a comfortable pace on level ground
light activity level
141
walking uphill, manual labor
heavy activity level
142
no coffee, tea, or alcohol in this culture's diet
Mormons
143
No beef! Cows are sacred in this culture
Hindus
144
Pork is restricted in this culture
Islamic or Muslim
145
Pork is restricted in this culture also
Jewish/Kosher
146
long term nutritional status is indicated by this test
albumin
147
not a good indicator of individuals response to nutritional support
takes around 3 wks for significant changes to be reflected in lab work
albumin
148
3.5-5.0 g/dL normal range
albumin
149
this lab value increases in dehydration and decreases in malnutrition, overhydration, or trauma
albumin
150
Lab tests to check nutritional status:
Albumin, pre-albumin, transferrin, TLC, BUN/creatinine, UA
151
reflects short term nutritional status
| 1/2 life of 2 days
pre-albumin
152
20-40 mg/dL normal range
pre-albumin
153
expensive test
increases with nutritional intake, renal failure
decreases with poor diet intake
levels drop rapidly with sudden demands for protein synthesis
pre-albumin
154
loss of muscle mass related to aging and strength
sarcopenia
| this is a normal finding
155
severe muscle wasting
involuntary
not related to aging
related usually to malnourishment
cachexia
156
this finding indicates iron deficiency
spoon shaped nails (koilonychia)
157
beefy red tongue indicates
a decrease in b12 vitamin
158
neurological symptoms indicate
decrease in thiamine or b12
159
ecchymoses indicates
decrease in Vitamin K
160
dry rough skin is an indicator of
decrease in Vitamin A
161
bone abnormalities indicate a deficiency of
vitamin D or calcium
162
if assisting patient in feeding him/herself
use pattern of clock
163
medication to stimulate appetite
Megestrol acetate or Megace
164
NPO should/should not be ordered for extended periods of time
should not
165
regular therapeutic diet is how many calories
2000
166
diet for dysphagia patients
mechanical soft with thickened liquids
167
decreased fried foods and red meat
low fat and low cholesterol diet
168
carbs counted, number of calories usually specified
diabetic diet
169
decreased fiber diet
low residue/soft diet
| for patients with gastric distress
170
blenderized liquid-used with oral/facial surgery or chewing and swallowing disorders
pureed diet
171
bland diet
BRAT- bananas rice applesauce toast
172
high in fruits and vegs. high fiber, low sodium
DASH diet
173
use of certain foods to control/treat illness or disease
MNT- medical nutritional therapy
174
food liquid at room temp
| tea, chicken broth, jello, lemon-lime soda, coffee
clear liquid diet
| often for postop patients
175
has substance, no solids
liquid at room temp
pudding, ice cream and all included on clear
full liquid diet
176
patient is ready to advance diet if:
absence of nausea
no pain or abdominal distention
patient feels hungry
patient can consume 1/2 to 3/4 of meal tray
177
no added salt: whatever occurs naturally in food, nothing added in cooking or at table
no added salt/sodium restricted diet
178
sources of sodium in our diet
deli meats/processed foods
1/4 tsp of salt=500 mg
canned goods
179
foods high in sodium
soy sauce, Wendy's grilled chicken Caesar salad, V-8 juice, beef salami, marinara sauce, raisin brain cereal, cottage cheese
180
study used to diagnose problem with aspiration
barium swallow
181
easiest thing to aspirate is
water/thin fluids
182
to prevent aspiration:
teach chin tuck method when swallowing
| thicken liquids
183
nutrients necessary for wound healing
protein
fat
carbs/sufficient calories
vitamin C and zinc
184
what is the preferred method of feeding:
oral
185
stimulates and maintains the normal activity of the GI tract
oral feeding
186
feeding through a tube- NG, NJ, PEG
| GI tract must be functioning
enteral feeding
187
intravenous route
GI system may/may not be intact
through a central IV line
Parenteral: TPN (total parenteral nutrition)
188
for long term nutritional support
| Patient doesn't have to have general anesthesia
PEG tube
189
Care for patient on enteral feeding:
```
Check abd distention/discomfort/nausea
monitor BMs
Daily weight
monitor edema
monitor I&O
monitor residual tube feeding
monitor serum electrolytes
monitor for aspiration
```
190
provides calories, lipids, fluids, vitamins, electrolytes, minerals, and trace elements
highly concentrated- hypertonic
use central venous device to infuse
risk for infection is very high
risk for hypoglycemic reaction if stopped suddenly- hang concentrated glucose
TPN
191
High osmolality
always through a central line
bag must be changed every 24 hours
TPN
192
care of patient receiving TPN
use surgical aseptic technique
monitor dressing and change per policy
use infusion pump
solution should hang no longer than 24 hours
monitor blood sugar and serum electrolytes
daily weight
193
not as concentrated as TPN
| can be infused into peripheral line
PPN (peripheral parenteral nutrtion)
