Nutrition and Factors that Impact wound healing

Question 1

What is the primary objective of identifying factors impeding wound healing?

Answer 1

To create strategies to mitigate effects of impeding factors.

Question 2

What should be compared and contrasted in nutritional guidelines?

Answer 2

Recommended general nutritional guidelines vs recommended guidelines for patients with wounds.

Question 3

What is the role of the physical therapist in nutritional screening?

Answer 3

To provide information on diet and nutritional issues to patients, clients, and the community.

Question 4

List some interventions the physical therapist may use when working with a patient with nutritional deficiencies.

Answer 4

• Education
• Nutritional strategies
• Assessment

Question 5

According to the House of Delegates (2019), what is within the professional scope of physical therapist practice?

Answer 5

To screen for and provide information on diet and nutritional issues.

Question 6

What are common issues with the Standard American Diet?

Answer 6

• Under-consumption of fruits and vegetables
• Selection of lower quality carbohydrates
• High intake of refined grains and added sugars
• Excessive fast food consumption

Question 7

What macronutrient is essential for wound healing?

Answer 7

Proteins.

Question 8

What is the main source of energy during rest and food deprivation?

Answer 8

Fats.

Question 9

Name two essential functions of vitamins in nutrition.

Answer 9

• Required for inflammatory response
• Needed for immune function and energy metabolism

Question 10

What is the role of water in the body?

Answer 10

• Solvent for vitamins/minerals
• Transports substances to/from cells
• Lubricant for joints and organs
• Helps maintain body temperature

Question 11

What is the recommended daily intake of protein for adults?

Answer 11

0.8-1.0 g/kg body weight.

Question 12

What is malnutrition defined as according to the Academy of Nutrition and Dietetics?

Answer 12

Presence of 2 or more indicators such as insufficient energy intake, weight loss, or loss of muscle mass.

Question 13

What does protein energy malnutrition involve?

Answer 13

Inadequate energy and protein intake to meet bodily demands.

Question 14

What is the BMI threshold for obesity?

Answer 14

BMI > 30.

Question 15

What is the process of nutritional screening?

Answer 15

Identifying characteristics associated with nutritional problems.

Question 16

How often should nutritional status be assessed for those at low risk?

Answer 16

Every 3 months.

Question 17

What is the Canadian Nutrition Screening Tool?

Answer 17

A tool that uses 2 questions to indicate malnutrition risk.

Question 18

What are signs of dehydration?

Answer 18

• Decreased urine output
• Dark-colored urine
• Increased confusion
• Decreased blood pressure

Question 19

List some functional limitations affecting nutrition.

Answer 19

• Chewing and swallowing problems
• Loss of dexterity
• Reduced mobility
• Sensory losses

Question 20

What percentage of people live in food-insecure households?

Answer 20

Approx 12.5% of homes with children.

Question 21

What are the nutritional requirements for wound healing in terms of protein?

Answer 21

1.5-2 g/kg for adults.

Question 22

Fill in the blank: The main source of energy during rest, sleep, and food deprivation is _______.

Answer 22

[Fats]

Question 23

True or False: Vitamins supplements are recommended if a patient’s diet is poor or deficient.

Answer 23

True.

Question 24

What is the significance of arginine in nutrition?

Answer 24

Involved with insulin secretion and protein regeneration.

Question 25

What are the effects of obesity on wound healing?

Answer 25

* Delayed wound healing * Increased risk for surgical site infections

Question 26

What are some critical nutrients considered during nutritional assessment?

Answer 26

* Amino acids * Minerals * Water

Question 27

What are the conditions that increase fluid needs for wound healing?

Answer 27

* Burns * Constipation * Dehydration * Diarrhea * Emesis * Fever * Hemorrhage * Hot/dry environments * Hypotension * Polyuria medications

Question 28

What conditions decrease fluid needs for wound healing?

Answer 28

* Cardiac disease/CHF * Edema * Fluid overload * Renal failure * Significant hypertension * SIADH (syndrome of inappropriate antidiuretic hormone secretion)

Question 29

What is the recommended fluid intake for wound healing?

Answer 29

30 ml/kg of body weight per day

Question 30

What is the role of Vitamin A in wound healing?

Answer 30

Stimulant for onset of wound healing, epithelialization, and fibroblast deposition of collagen

Question 31

What is the function of Vitamin C in wound healing?

Answer 31

Cofactor for collagen synthesis, immunity, fatty acid metabolism

Question 32

How does Vitamin D contribute to wound healing?

Answer 32

Regulates structural integrity of receptor signaling; promotes peptides to improve healing

Question 33

What role does Copper play in wound healing?

Answer 33

Cofactor for connective tissue production, collagen cross-linking, and cytochrome oxidase for energy production

Question 34

What is the significance of Iron in wound healing?

Answer 34

Cofactor in collagen synthesis

Question 35

What is the role of Manganese in wound healing?

Answer 35

Cofactor for collagen and ground substance synthesis

Question 36

What is the function of Selenium in wound healing?

Answer 36

Antioxidant

Question 37

What is the role of Zinc in wound healing?

Answer 37

Cofactor for DNA, RNA, and polymerase for collagen and ground substance synthesis

Question 38

What are the diagnostic markers for malnutrition?

Answer 38

* Albumin: 3.5-5.5 g/dL * Prealbumin: 15-36 mg/dL * Transferrin: 204-360 mg/dL

Question 39

What are the normal ranges for WBC?

Answer 39

4.5-11 x 10^3 mm^3

Question 40

What are the normal hemoglobin levels for males and females?

Answer 40

* Males: 13.5-18 g/dL * Females: 12-15 g/dL

Question 41

What are the normal hematocrit (Hct) values for males and females?

Answer 41

* Males: 37-50% * Females: 36-46%

Question 42

What is the normal platelet count range?

Answer 42

150-400 x 10^3/mm^3

Question 43

What is the normal range for Prothrombin Time (PT)?

Answer 43

12.3-14.2 seconds

Question 44

What is the normal range for Partial Thromboplastin Time (PTT)?

Answer 44

25-34 seconds

Question 45

What is the therapeutic range for INR?

Answer 45

0.9-1.1 (therapeutic range: 2-3; Mechanical valve 2.5-3.5) | higher INR: higher risk of bleeding

Question 46

What are the supplement recommendations for wound healing?

Answer 46

* Ensure calories from a balanced diet * Protein * Fluid * Vitamin A: 10,000-15,000 IU/day * Vitamin C: 500-1000 mg/day * Vitamin D: Consider deficiencies * Arginine: 4.5g/day (with adequate protein) * Zinc: 40-220 mg/day * Selenium * Iron

Question 47

What is enteral nutrition?

Answer 47

Feeding by way of a tube directly into the GI tract

Question 48

What is parenteral nutrition?

Answer 48

Bypasses the GI tract and administers nutrients directly into the venous system

Question 49

What behaviors can impede wound healing?

Answer 49

* Stress * Smoking * Alcohol abuse

Question 50

True or False: Smoking can impair wound healing by causing tissue hypoxia.

Answer 50

True

Question 51

What is the recommended abstention period from smoking before surgery?

Answer 51

At least 4 weeks

Question 52

What are the alcohol consumption thresholds that inhibit healing in males and females?

Answer 52

* Males: >14 drinks/week * Females: >7 drinks/week