Domain 2 Flashcards

Question

Considerations for thin, dry hair

Answer 1

vitamin c or protein deficiency

Answer 2

vitamin a, zinc or riboflavin deficiency

Answer 3

riboflavin, pyridoxine or niacin deficiency

Answer 4

iron deficiency

Answer 5

vitamin c deficiency

Answer 6

calcium deficiency, poor intake

Answer 7

iron, folic acid, zinc deficiency

Answer 8

iron or protein deficiency

Answer 9

3.5-5.0 g/dl - levels above normal range likely due to dehydration - low levels associated with edema or surgery

Answer 10

>/= 200 mg/dl - increases with iron deficiency, transports iron to bone marrrow

Answer 11

16-40 mg/dl

Answer 12

3-6 mg/dl - binds and transports retinol

Answer 13

men- 42-52% women- 37-47% pregnant women- 33% newborn- 44-64% - volume of packed cells in whole blood

Answer 14

men- 14-17 g/dl women- 12-15 g/dl pregnant women

Answer 15

men 12-300 ng/ml women 10-150 ng/ml -indicates size of iron storage pool

Answer 16

0.6-1.4 mg/dl -related to muscle mass; measures somatic protein

Answer 17

normal = 80% ratio of creatinine excreted/24 hours to height

Answer 18

10-20 mg/dl - related to protein intake

Answer 19

115+/- 20 ml/minute - measures glomerular filtration, renal function

Answer 20

>2700 cells/cu mm -measures immunocompetency

Answer 21

marker of acute inflammatory stress - when elevated CRP decreases, PAB increases

Answer 22

direct measure of toxic effects of lead on heme synthesis. Increased in lead poisoning. Lead depletes iron leading to anemia

Answer 23

evaluates clotting adequacy; change in vitamin K intake will alter rate (11.0-12.5 seconds)

Answer 24

useful in measuring intake of toxic metals

Answer 25

1.2 1.3 1.5

Answer 26

Men: (10 × weight in kg) + (6.25 × height in cm) - (5 × age in years) + 5 Women: (10 × weight in kg) + (6.25 × height in cm) - (5 × age in years) - 161

Answer 27

appetite stimulant

Answer 28

appetite suppressant, anorexia, nausea, weight loss

Answer 29

decreased fat absorption by binding lipase, vitamin/mineral supp.

Answer 30

appetite stimulant

Answer 31

anorexia,, weight loss, nausea

Answer 32

decreased LDL, TG; increase HDL

Answer 33

malabsorption

Answer 34

decrease absorption of fat, fat soluble vitamins

Answer 35

protein deficits

Answer 36

decrease folate, B6, C

Answer 37

deplete thiamin, potassium, magnesium, calcium, sodium

Answer 38

decrease potassium, magnesium, calcium, sodium

Answer 39

decrease vitamin k

Answer 40

decrease bone growth, CHO intolerance

Answer 41

decrease folate

Answer 42

increased appetite, weight gain; must maintain sodium and caffeine levels

Answer 43

antagonizes vitamin K; avoid Ginkgo biloba extract, garlic, ginger, vitamin A and E

Answer 44

sedative; 1.1 calories/ml, check TG

Answer 45

decreased folic acid, vitamins B12, D, K B6

Answer 46

hyperlipidemia, hyperglycemia, hyperkalemia, hypertension

Answer 47

depletes pyridoxine, peripheral neuropathy, don't take with vitamin D, calcium or phosphorus

Answer 48

sedative effect, weight gain, increased appetite

Answer 49

decreased effectiveness of levodopa which controls symptoms of parkinsons disease. Take in morning with limited protein

Answer 50

binds tetracycline

Answer 51

hypertension if taken with monoamine oxidase inhibitor.

Answer 52

may reduce inflammation, antioxidant

Answer 53

survey categorizing a POPULATION's general health status

Answer 54

infant deaths under 1 year of age, expressed as the number of deaths per 1000 live births

Answer 55

incidence: (number of NEW cases of a disease over a period of time/total number of people at risk) x 100,000 Prevalence: (total number of people with a disease during a period of time/average number of people) x 100,000

Answer 56

continuous collection of data

Answer 57

Promote nutrition and improve nutritional care for the elderly to identify nutritional problems early. Level 1: screen identifies those who need more comprehensive assessments Level 2: screen provides more specific diagnostic info on nutritional status

Answer 58

includes all data collection and analysis activities of the federal government attitudes about diet and health (jointly run by USDHHS and USDA

Answer 59

run by USDHHS -low income, high risk children, birth-17 yo. (emphasis on birth-5 yo) - height, weight, birth-weight, hematocrit, hemoglobin, cholesterol, breast feeding - monitors growth and nutritional status, infant feeding practices

Answer 60

run by USDHHS -low income, high risk pregnant women - maternal weight gain, anemia, pregnancy behavioral risk factors (smoking, alcohol) birth weight, countrs # of women who breast feed -identify and reduce pregnancy-related health risks

Answer 61

-ongoing repeated survey - evaluates clinical, chemical (hemoglobin, hematocrit, cholesterol), anthropometric, nutritional data - NHANES III- oversampling of adults >/=65 - WWEIA (what we eat in america)- two days of 24 hour recall data. conducted by usda for adults >/=60 african americans and hispanics

Answer 62

-evaluates 7 nutrients: protein, calcium, iron, thiamin, riboflavin, vitamin C, A. - diets are good if intake equals or is above RDA; rated poor if less than 2/3 of RDA for 1 or more nutrients

Answer 63

run by USDHHS - adults 18 yo and older residing in households with telephones - telephone interviews collect info on height, weight, smoking, alcohol, food frequency for fat, fruits and vegetables, preventable health problems, diabetes

Answer 64

run by USDHHS - Grades 9-12. smoking, alcohol use, weight control, exercise, eating habits - prevalence of health risk behaviors among young people

Answer 65

run by FDA and USDHHS - telephone survey of randomly selected adults - tracks self-perception of relative nutrient intake levels, use of food labels, knowledge of fats and cholesterol, prevalence of supplement use and awareness of diet and disease

Answer 66

- states determine the eligibility and benefits and services provided

Answer 67

-provides food to help meet nutritional needs of children and adults and strengthens agricultural market for products produced by American farmers -food given to school lunch, elderly feeding, supplemental food programs

Answer 68

- administered by state health agencies - monthly commodity canned or packaged foods - low income women (pregnant, breast feeding, post partum), infants, children up to 6 years old and some elderly at nutritional risk

Answer 69

- quarterly distributions for commodity foods by local public or private non profit agencies, food banks, soup kitchens, homeless shelters -supplements diets of low income households

Answer 70

-run by USDA - cash grants/food donations; dollars reimburse schools on basis of numbers of meals served - lunch must provide on average over a school week: 1/3 recommended protein, vitamin A and C, iron and calcium - grades 9-12: 2 oz meat serving; nuts must be combined and only used for half the requirement - graham flour is considered whole grain - K-5: 3/4 cup vegetables is one serving - 100% full strength fruit juice may be used as 1/2 of weekly servings of fruit

Answer 71

-run by USDA - entitlement program, meals must meet dietary guidelines - breakfast must provide on average over each school week: 1/4 daily recommended levels for protein, calcium, iron, vitamin A and C

Answer 72

-run by USDA - provides healthy snacks - cash subsides for each snack served. same eligibility as NSLP

Answer 73

- run by USDA - purpose is to encourage milk consumption in children

Answer 74

- run by USDA - school lunch - administered by FNS, state educational agencies, public or private nonprofit residential summer camps

Answer 75

- run by USDA - reimburses operators for meal costs, provides commodity food and nutrition education materials - meals must meet guidelines; must offer free or reduced price to eligible

Answer 76

- run by USDA - introduces children to fresh fruits and vegetables - free to children nationwide in selected schools

Answer 77

- run by USDA -for pregnant women, postpartum, breast-feeding, infants and children up to 5 yo. - provides food for low income mothers at nutritional risk - for infants at risk with weight, height, head circumference in infants, hemoglobin, hematocrit. - provides food, nutrition education and referrals - health exam is REQUIRED - foods provided include: iron-fortified formula, cereal, milk, cheese, fruit juice - Not an entitlement program: cap on amount of federal dollars allocated

Answer 78

- run by USDA - provides grants to universities that assist in community development - trains nutrition aides to educate the public - improves food practices of low income homemakers with young children - works with small groups and teaches skills to obtain a health diet

Answer 79

- run by USDHHS - under Title V of social security act - provides training, consultation, funding - women of child-bearing age, infants, children; state eligibility requirements

Answer 80

- run by USDHHS - reduces infant mortality and improves health of low income women, infants, children and families

Answer 81

-administration on aging - developed services to foster independent living; cash and commodities to state agencies - OOA older americans act run by USDHHS - one hot meal each day, 5 days/week, provide 1/3 recommended intake - eligibility: all aged 60 and older plus spouse, regardless of income

Answer 82

- run by USDA - largest food assistance program: entitlement - assist low income with monthly benefits; net income must be at or below certain % of poverty level; income limits vary by household size and are adjusted to cost of living - designed to increase their purchasing power -no non food items

Answer 83

-run by USDHHS - Medicare: health insurance program for people over 65 yo; of any age with stage renal disease. includes annual wellness visit provided by affordable care act (RD included) - Medicaid: payment for medical care for all eligible needy: all ages, blind, disabled, dependent children

Answer 84

- under social security act, partnership between federal and state governments - expands health coverage to uninsured children whose families earn too much income to quality for medicaid but too little to afford private coverage.

Answer 85

- run by USDHHS - helps low income children (3-5 yo) - introduces new foods, teaches good food habits

Answer 86

- run buy USDA since 1977 - amendment to school lunch act - provides nutrition education training to teachers and school foodservice employees

Answer 87

- run by USDA - grants to states to provide low income seniors with coupons to be exchanged for eligible foods at farmer's markets, roadside stands, community supported agriculture programs. - may be limited to specific and locally grown food - nutrition education and information is provided (how to select, store, prepare)

Answer 88

receive both federal and private funds - american red cross - national research council- food and nutrition board (developed RDA)

Answer 89

-voluntary health agencies- private, non profit, chartered and licensed by a government agency, funded by contributions from citizens or organizations (e.g. american heart association) - professional organizations- academy of nutrition and dietetics - foundations, business, industry

Answer 90

FAO- food and agricultural organization- increasing levels of nutrition globally by increasing efficiency of production /distribution of foods

Answer 91

clinical, intake and behavioral-enironment

Answer 92

nutritional findings/problems that relate to medical/physical condition - functional balance: physical or mechanical change that interferes/prevents desired nutritional results; swallowing difficulty, altered GI function - biochemical balance: change in capacity to metabolize nutrients due to medications, surgery or indicated lab values - weight balance: chronic or changed weight status when compared with UBW: underweight, involuntary weight loss, overweight

Answer 93

actual problems related to intake - caloric energy imbalance - oral or nutrition support intake - fluid intake imbalance - bioactive substances (supplements, alcohol, functional foods) - nutrient balance

Answer 94

problems related to knowledge, access to food and food safety - knowledge and beliefs - physical activity balance and faction - food safety and access

Answer 95

problem (diagnostic label) etiology (cause/contributing factor) signs/symptoms (objective data/changes)

Answer 96

NC 1.4- looks at problems inside the GI tract NC 2.1- looks at problems with the metabolism of nutrients once they have entered the circulatory system

Answer 97

1. food delivery 2. education 3. counseling 4. coordination of care with other providers

Answer 98

reduced exposure to a promoter of disease. health promotion

Answer 99

recruiting those with elevated risk factors into treatment programs. risk reduction

Answer 100

as disease progresses, intervention to reduce severity, manage complications. rehabilitation efforts

Answer 101

used to evaluate information credibility (authors credentials) accuracy (info is correct and factual) reasonableness (info is fair, balanced and consistent) support (has supporting citations)

Answer 102

-eroded mucosal lesion - treatment: antacids, antibiotics -diet: as tolerated, well-balanced, avoid late night snacks -omit: cayenne and black pepper, large amounts of chili powder, avoid excess caffeine and alcohol

Answer 103

-protrusion of a portion of the stomach above the diaphragm into the chest - small, bland feedings; avoid late night snacks, caffeine, chili powder, black pepper

Answer 104

follows a gastrectomy (billroth 1 and 2) - cramps, rapid pulse, weakness, perspiration, dizziness - when rapidly hydrolyzed carbohydrates enter the jejunum, wanter is drawn in to achieve osmotic balance. this causes a rapid decrease in vascular fluid compartment and decrease in peripheral vascular resistance. Blood pressure drops. two hours later, carbs are digested and absorbed rapidly, blood sugar rises, stimulating an overproduction of insulin, causing a drop in blood sugar below fasting. - can lead to anemia (B12 or folate deficiency) - diet: frequent small meals, fluids before or after to slow passage. 50-60% complex carbs and protein at meals with limited fat

Answer 105

gastroduodenostomy -attaches the remaining stomach to the duodenum

Answer 106

gastrojejunostomy - attaches stomach to jejunum (secretion of secretin and pancreozymin is reduced- due to bypassing duodenum- these hormones stimulate the pancreas so there is little pancreatic secretion and calcium and iron absorption are affected)

Answer 107

- delayed gastric emptying: surgery, diabetes, viral infections, obstructions - moderate to severe hyperglycemia: detrimental effects on gastric nerves - prokinetics (erythromycin, metoclopramide) increase stomach contractility - small, frequent meals; pureed foods, avoid high fiber, avoid high fat (liquid fat may be better tolerated) - bezoar formations may be due to digested food or medications; treatment includes enzyme or endoscopic therapy

Answer 108

-bacterial, viral, parasitic infection - chronic GI disease, intestinal lesions, may also affect stomach - diarrhea, malnutrition, deficiencies of B12 and folate due to decreased HCL and intrinsic factor - antibiotics, high calories, high protein, B1 and folate supplements

Answer 109

-celiac disease, gluten-induced enteropathy - reaction to gliadin (affects ileum and jejunum- proximal intestine) - malabsorption, macrocytic anemia, weight loss, diarrhea, steatorrhea, iron deficiency anemia - need gluten free restricted diet (no wheat, rye, oats, barley, bran, graham, malt, couscous, durum, orzo, thickening agents)

Answer 110

- sometimes due to an atonic colon (weakened muscles) - diet: high fluid, high fiber diet, exercise

Answer 111

-presence of diverticula- small mucosal sacs that protrude through the intestinal wall due to structural weakness. Related to constipation and lifelong intra-colonic pressures -diet: high fiber, increase volume and weight of residue, provides rapid transit

Answer 112

-when diverticula become inflamed as a result of food and residue accumulation and bacterial action - diet: clear liquids, low-residue, gradual return to high fiber

Answer 113

-provides indigestible bulk, promotes intestinal function - dietary fiber: non-digestible carbs and lignin, binds water, increases fecal bulk - soluble fiber decreases serum cholesterol by binding bile acids converting more cholesterol into bile - soluble fibers (pectins, gums) delay gastric emptying, absorb water, form soft gel in the small intestine; slows passage and delays or inhibits absorption of glucose and cholesterol - high fiber diet may increase need for Ca, Mg, P, Cu, Se, Zn, Fe

Answer 114

-inflammation of stomach - diet: clear liquids, avoid gastric irritants

Answer 115

Crohn's disease (regional enteritis) - affects terminal ileum - B12 and iron deficiency Chronic ulcerative colitis - begins in the rectum - chronic bloody diarrhea, weight loss, electrolyte disturbance (Na,K), dehydration, anemia, negative nitrogen balance Treatment: - maintain fluid/electrolyte balance - bowel rest, PN or minimal residue for CD, possibly elemental diet for UC. - when IBD is under control/in remission, high fiber to stimulate peristalsis

Answer 116

-chronic abdominal discomfort, altered intestinal motility, bloating -goals: adequate nutrition intake, avoid large meals, excess caffeine, alcohol or sugars

Answer 117

- normally lactase splits lactose into glucose and galactose. Without lactase, there is high hyperosmolar pressure and water is drawn into the intestine to dilute the load. This causes distention, craps ,etc. Bacteria then ferment the undigested lactose, releasing CO2 gas. - detected by breath hydrogen test. hydrogen is produced by colonic bacteria on lactose, absorbed into bloodstream and exhaled 60-90 min later. - lactose tolerance test- oral dose of lactose (up to 50g) after a fast. if intolerant of lactose, blood glucose will rise <25 mg/ml above fasting. of tolerant, glucose will rise >25 mg/ml. -diet: no animal milk or milk products, no whey. - calcium and riboflavin supplements are recommended

Answer 118

- acute- aggressive and immediate rehydration (glucose electrolyte solution). reintroduce oral intake within 24 hours - chronic- consider fat to CHO ratio, and volume of ingested liquids. Give 40% calories as fat, balanced with limited fluids. do not give fruits juices with high osmolar loads

Answer 119

- remove the cause: bowel rest, replace lost fluids/electrolytes (Na/K) - once diarrhea stops, start with low fiber food, followed by protein foods - avoid lactose at first - foods or supplements that contain prebiotic components (pectin, fructose, oats, banana flakes) - probiotics- sources of bacteria to reestablish gut flora

Answer 120

- consequence of malabsorption - normal stool fat 2-5 g; >7g indicative of malabsorption - dietL high protein, high complex carb, fat as tolerated, vitamins especially fat soluble, minerals, MCT rapidly hydrolyzed in GI tract

Answer 121

- loss of ileum (especially distal 1/3), loss of ileocecal valve, loss of colon are off concern - most digestion takes place in the first 100 cm of intestine (duodenum and 1/2 of jejunum) what remains- small amounts of sugars, starches, fibers, lipids - nutrition care: - PN initially to restore and maintain nutrient status - enteral - start early to stimulate growth (may take weeks or months to transition to food) - for ileum resection: use MCT, limit fat, supplement fat soluble vitamins, Ca, Mg, Zn, B12 - for jejunal resection: normal balance of carbs, proteins, fats. avoid lactose, oxalates and large numbers of concentrated sweets

Answer 122

- ileum can adapt and take over jejunal functions

Answer 123

- distal: absorption of B12, intrinsic factor, bile salts - ileum normally absorbs major portion of fluid in GI tract (patients with ostomy bags should be drinking +1 L in addition to baseline) - if ileum cannot recycle bile salts. lipids are not emulsified, leads to malabsorption of fat soluble vitamins, Ca, Zn and Mg. Colonic absorption of oxalate increases- renal oxalate stones. Increased fluid and electrolyte secretion; increased colonic motility.

Answer 124

water and electrolyte loss, loss of salvage absorption of carbs and other nutrients

Answer 125

stores and releases blood, filters toxic elements, metabolizes and stores nutrients, regulates fluid and electrolyte balance

Answer 126

ALP - alkaline phosphatase (30-120 U/L) elevated (liver/bone disease) low (scurvy or malnutrition) LDH - lactic acid hehydrogenase elevated (hepatitis, myocardial infarction, muscle malignancies) AST - aspartate amino transferace elevated (hepatitis) low (uncontrolled DM with acidosis) ALT - alanine aminotransferance elevated (liver disease)

Answer 127

- inflammation, necrosis, jaundice, anorexia, nausea, fatigue - jaundice occurs when bile ducts are blocked - treatment: increase fluids, 50-55% carbs to replenish liver glycogen and spare protein, 1-1.2 g/kg protein for cell regeneration, provide lipotropic agents to convert fat into lipoproteins for removal from liver, supplement with B vitamins, C, K and zinc

Answer 128

A: fecal-oral transmission B: sexually transmitted C: blood to blood contact

Answer 129

-damaged liver tissue is replaced by bands of connective tissue which divides the liver into clumps and reroutes many of the veins and capillaries. - protein deficiencies lead to ascites, fatty liver, impaired blood clotting

Answer 130

abdominal/esophageal/collateral veins to portal vein to liver to vena cava

Answer 131

-occur when blood can't enter the liver - connective tissue overgrowth causes resistance to blood entering from portal vein. due to portal hypertension

Answer 132

- high protein (0.8g/kg); in stress (1.5 g/kg) - high calorie (BEE x 1.2-1.5) or 25-35 cals/kg - moderate to low fat - low fiber if varices are present; low sodium if edema or ascites - with hyponatremia, fluid restriction of 1-1.5 L/day and moderate sodium levels - add B vitamins, C, K, Zn, Mg (maybe A and D)

Answer 133

- hepatic steatosis, alcoholic hepatitis, cirrhosis - alcohol is converted into acetaldehyde and excess hydrogen which disrupts liver metabolism. 1. hydrogen replaces fat as fuel in the krebs cycle so fat accumulates in liver leading to fatty liver and high TG in blood. - malnutrition: alcohol replaces food, inflammation of GI tract interferes with absorption of thiamin, B12, vit C and folic acid, folate and protein deficiencies, thiamine deficiencies.

Answer 134

- liver function decreased to 25% or less - liver cannot convert ammonia (NH2) into urea- ammonia accumulates - portal systemic encephalopathy - asterix (flapping, involuntary jerking movements- signs of a impending coma) - Treatment: moderate to high levels of protein (1-1.5 g/kg), 30-35 kcal/kg, 30-35% calories as fat with MCT, add lactulose- hyper osmotic laxative that removes nitrogen- and neomycin- an antibiotic that destroys bacterial flora that produce ammonia *decreased BCAA and increased aromatic amino acids AAA because damaged liver cannot clear them. adding BCAA is used when stard therapy does not work and patient does not tolerate protein

Answer 135

- inflammation of gallbladder - an infection causes excess water to be absorbed causing cholesterol to precipitate out leading to gallstones- cholelithiasis - treatment: - low fat diet - 30--45 g, or 25-30% of calories - cholecystectomy- surgical removal of gall bladder; bile now secreted from liver directly into intestine

Answer 136

- inflammation with edema, cellular exudate and fat necrosis - may be due to blockage or reflux of the ductal system; premature activation of enzymes within pancreas, leads to autodigestion

Answer 137

- put pancreas at rest, withhold all feeding, maintain hydration (IV) - progress as tolerated to easily digested foods with low fat - elemental (pre digested) EN into jejunum may be tolerated

Answer 138

- recurrent attacks of epigastric pain of long duration - take PERT (pancreatic enzymes orally with meals and snacks to minimize fat malabsorption from lack of pancreatic lipase. - pancreatic bicarbonate secretion may be defective; may need antacids so PERT therapy will work - in severe cases, PN may be needed

Answer 139

- sticky mucus that blocks ducts in the pancreas and prevents enzymes from reaching the small intestine to digest food -disease of exocrine gland- secretion of thick mucus that obstructs glands and ducts; chronic pulmonary disease, pancreatic enzyme deficiency, high perspiration, electrolyte levels, malabsorption - treatment: - PERT pancreatic enzyme replacement therapy with meals and snacks - high protein, high calorie, unrestricted fat, liberal in salt

Answer 140

- systolic >140, or diastolic >90 or both - systolic: contraction, greatest pressure - diastolic: relaxation, least pressure - may be primary (essential) or secondary due to another disease - optimal blood pressure <120/80 mm Hg - thiazide diuretics may induce hypokalemia - primary causes: overweight, high salt intake, alcohol consumption, physical in activity - salt restriction <2400 mg - DASH diet or Mediterranean diet

Answer 141

- accumulation of lipids; structural and compositional changes in the intimal layer of the large arteries

Answer 142

- hard, narrow arteries from plaque buildup

Answer 143

deficiency of blood due to obstruction

Answer 144

loss of elasticity of blood vessel walls

Answer 145

reduction of coronary flow to myocardium due to blood clot blocking a narrowed coronary artery - angina pectoris - heparin (blood clots)

Answer 146

- high triglycerides and low HDL

Answer 147

- transports dietary triglycerides from gut to adipose cells; synthesized in intestine from dietary fat; lowest density due to smallest amount of protein

Answer 148

-pre beta - transports endogenous triglyceride from liver to adipose cells

Answer 149

- beta - transports cholesterol from diet and liver to all cells

Answer 150

-alpha - reverse cholesterol transport; moves cholesterol from cells to liver and excretion

Answer 151

- pre beta to beta - LDL precursor; found in circulation secondary to catabolism of other lipoproteins

Answer 152

- 3 or more of the following risk factors are linked to insulin resistance which often increase risk for coronary events: - elevated blood pressure >/= 135 systolic and or >/= 85 diastolic - elevated TG >/= 150 mg/dl - fasting serum glucose >/= 100 mg/dl - waist measurements >/= 102 cm (40 in) in men and >/= 88 cm (25 in) in women - low HDL <40 mg/dl in men and <50 mg/dl in women

Answer 153

- weakened heart fails to maintain adequate output, resulting in diminished blood flow so fluid is held in tissues (Edema) ; dyspnea (shortness of breath) - reduced blood flow to kidneys causes secretion of hormones that hold in sodium and fluid leading to weight gain - digitalis increases strength of heart contraction - diuretics- nutrient loss, glucose intolerance, increased serum uric acid - diet: low sodium, DASH diet, low fluid - evaluate thiamin status (loss with loop diuretics)- without thiamin, pyruvate cannot be converted into acetyl coA for energy so heart muscle is deprived

Answer 154

-unintended weight loss, blood backs up into liver and intestines causing nausea and decreased appetite. arginine and glutamine may help. low saturated fat, low cholesterol, low trans fat, sodium restriction