Nutrition

Question 1

Duodenum

Answer 1

• Powerhouse for absorption
• Preferred site for absorption of calcium, magnesium, iron, folate
• 10 inches long

Question 2

Jejunum

Answer 2

• Absorption of 90% of nutrients, calcium, zinc, drugs
• 6-10 feet long

Question 3

Ileum

Answer 3

• Absorption of B12, bile salts
• 10-13 feet long

Question 4

Transverse colon

Answer 4

• Absorbs water, electrolytes

Question 5

Stomach

Answer 5

• Mix/dilute chyme
• Digest protein
• Acidic
• Add intrinsic factor

Question 6

Short bowel syndrome

Answer 6

• Intestinal dysfunction –> malabsorptive
• Small bowel length
• Loss of function of long segments of small bowel

Question 7

Short bowel syndrome characterizations

Answer 7

• Maldigestion
• Malabsorption
• Malnutrition

Question 8

Results of short bowel syndrome

Answer 8

• Inability to maintain nutritional. fluid, electrolyte homeostasis while consuming normal/healthy diet

Question 9

Causes of short bowel syndrome

Answer 9

• Small bowel resection
• Functional (luminal absorption failure)
• Birth defects

Question 10

Short bowel syndrome adaptation

Answer 10

• Compensatory
• Intestinal villi grows in length and thickness

Question 11

S/S of short bowel syndrome (9)

Answer 11

• Severe diarrhea
• Dehydration
• Malnutrition
• Steatorrhea
• Fatigue
• Pain
• Vitamin/mineral deficiencies
• Edema
• Weight loss

Question 12

Electrolyte imbalances in short bowel syndrome

Answer 12

• Hyponatremia
• Hypokalemia
• Hypomagnesemia

Question 13

Iron

Answer 13

Necessary in RBC production, component of Hgb

Question 14

Iron deficiency

Answer 14

• Anemia
• Weakness
• Fatigue

Question 15

Folate

Answer 15

Synthesis of protein and rapidly dividing cells (GI lining/fetus), maintenance of mature RBCs

Question 16

Folate deficiency(4)

Answer 16

• Anemia
• anorexia
• Fatigue
• Diarrhea

Question 17

Calcium

Answer 17

Bone formation, coagulation, nerve/muscle function

Question 18

Calcium deficiency(3)

Answer 18

• Osteoporosis
• Prolonged bleeding
• Muscle spasm

Question 19

Magnesium

Answer 19

Maintains normal nerve/muscle function, bones, protein synthesis

Question 20

Magnesium deficiency (4)

Answer 20

• Dysrythmias
• Muscle cramps
• Fatigue
• Osteoporosis

Question 21

Bile salt

Answer 21

Necessary for digestion and absorption of fats

Question 22

Bile salt deficiency

Answer 22

• Decreased absorption of fat soluble vitamins
• Increased fat in stool
• Decreased level of plasma proteins

Question 23

Fat soluble vitamins

Answer 23

• A
• D
• E
• K

Question 24

Zinc

Answer 24

Important for growth and cell turnover

Question 25

B12

Answer 25

Necessary in production of RBCs, nerve/brain health

Question 26

B12 deficiency (7)

Answer 26

- Anemia - Anorexia - Sore mouth/tongue - Pallor - Weight loss - Nausea - Constipation

Question 27

Pharmacological treatment for short bowel syndrome (8)

Answer 27

- Multivitamins, mineral supplements - Antidiarrheal medications - Bile acid binding resins - Pancreatic enzyme - Medications to reduce GI secretions - Teduglutide - Somatropin - Glutamine

Question 28

Antidiarrheal medications

Answer 28

- Loperamide (Imodium) - Diphenoxylate atropine (lomotil) - Slow intestinal transit

Question 29

Bile acid binding resins

Answer 29

- Cholestyramine (Questran) - Manage diarrhea from malabsorbed bile salts

Question 30

Pancreatic enzyme

Answer 30

Help with digestion

Question 31

Teduglutide

Answer 31

Increases surface area

Question 32

Somatropin

Answer 32

Enhances intestinal adaption

Question 33

Glutamine

Answer 33

Improves absoprtion

Question 34

Equipment needed for TPN

Answer 34

- CVC - PICC - IV pump - Micron filter

Question 35

TPN contains

Answer 35

- Proteins - Carbs - Fats - Vitamins - Minerals

Question 36

Pancreatitis - Grey Turner Sign

Answer 36

Gray, blue discoloration of flanks

Question 37

Cullen's sign

Answer 37

Ecchymosis of umbilical area

Question 38

Pancreatitis labs

Answer 38

- Increased amylase - Increased lipase - Increased bilirubin - Increased alkaline phosphatase - Decreased calcium/magnesium - Increased WBCs, BUN, triglycerides, glucose - Thrombocytopenia - Decreased albumin