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DTR Exam > Nutrition Care > Flashcards

Nutrition Care Flashcards

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1
Q

What is the tricep skin fold

A

An anthropometric measurement that can be used to estimate an individual’s body fat

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2
Q

What does the waist to hip ratio measure

A

It is indicative of the distribution of abdominal fat deposits.
WHR greater than 1.0 in men and 0.8 in women indicates that the individual is at high risk for CVD.

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3
Q

What does body mass index measure

A

A formula that can be used to screen for the prescence of excess adipose tissue which may cause weight related problems.

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4
Q

What is the rationale for the nutritional assessment of populations

A

To gain an understanding of the biological, cultural, and environmental factors that contribute or take away from the nutritional status of communities determined to be at risk.

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5
Q

What does the Nutrition screening initiative (NSI) do

A

Helps elderly individuals in the US at risk for compromised nutritional status by identifying those at risk due to their financial, social, or functional status.

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6
Q

What does the DETERMINE acronym stand for

A

Disease
Eating poorly
Tooth loss or mouth pain
Economic hardship
Reduced social contact
Multiple medicines
Involuntary weight loss/gain
Needs assistance in self-care
Elder years above 80

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7
Q

T/F Native Americans and Alaskan natives have higher rates of alcohol abuse, which can contribute to malabsorption of several nutrients and liver disease

A

True

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8
Q

What are some difficulties in counseling homeless people

A

Language and cultural barriers
Lack of transportation
Storage and proper preparation of food
Public health systems do not communicate across communities
Mental health issues

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9
Q

Why is a diet history important

A

It’s essential in determining the current nutritional habits of a client and developing an ongoing nutritional plan.

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10
Q

What should a diet history include

A

Information about the daily intake, disabilities/conditions, ethnic and cultural influences, religious restrictions, allergies, sense of taste and smell, and appetite.

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11
Q

What recording methods can be useful in obtaining a diet history

A

3-day food record
Food frequency survey
Interviewing the client

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12
Q

What are signs the individual may not be understanding the questions asked

A

Consistent head nodding
Lack of eye contact/focus

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13
Q

What are the two major programs to monitor the health and nutritional status of low income infants, mothers, and children

A

The Pediatric Nutrition Surveillance System (PedNSS)
The Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT)

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14
Q

What is type 1 diabetes

A

An autoimmune condition where the insulin production system is permanently disabled.

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15
Q

What is type 2 diabetes

A

Develops gradually and often results with poor diet, and sedentary lifestyle.
The cells no longer respond to insulin, and the production of insulin begins to fail.

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16
Q

What is the recommended diet for diabetes

A

Carb exchange diet to manage carb intake.

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17
Q

Why should people with diabetes aim for a heart healthy diet.

A

Due to their increased risk for heart disease.

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18
Q

What are the protein needs for diabetic adults and children

A

Adults- 0.8g/kg
Infants/children- 1-2.2g/kg

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19
Q

How much protein should diabetics consume for their total energy intake

A

15-20% kcal.
Minimal research suggests between 12-15% to decrease risk of kidney disease.

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20
Q

To help guard against vascular disease in diabetics what is the recommended amount of fat and total cholesterol they should consume for their total energy intake

A

<30% Fat
Under 300mg/day Cholesterol

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21
Q

How much saturated fat should diabetics consume for their total energy intake

A

<10% lipids

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22
Q

How much carbs should diabetics consume for their total energy intake

A

Ranges from 55-60%
Depends on the patient’s glucose response.

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23
Q

What is the most common dietary changes implemented in individuals with kidney disease.

A

Controlling amount of protein, and limiting phosphorus, sodium and potassium intake.
Monitoring of protein malnutrition.

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24
Q

Why should people with kidney disease avoid multivitamins

A

The body has a difficult time breaking down some vitamins and minerals

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25
What are side effects of cancer that may affect a patients nutritional status
Fatigue, altered sense of taste and smell, nausea, vomiting, diarrhea, constipation, dry/sore mouth.
26
What foods should cancer patients avoid and why
Raw, undercooked, and unpasteurized foods. Due to their weakened immune system which makes them more susceptible to bacteria.
27
What are the typical nutritional recommendations for cancer patients
High calorie diet rich in vitamins and minerals Add additional sweeteners, sugars, nut butters, etc to foods to enhance flavors.
28
What are the recommendations for a low sodium diet for heart disease
<2300mg Na/day
29
What are the recommendations for a low cholesterol diet for heart disease
<300 mg/day
30
Why is vitamin D increased during pregnancy
Essential in skeletal formation in the fetus and for metabolism of calcium.
31
T/F calcium metabolism increases during pregnancy
True
32
What is the RDA for vitamin D during pregnancy
5-10mcg/day
33
Why is folate important during pregnancy
Plays a role in the synthesis of nucleic acids
34
What is the RDA for folate in females
400mcg/day ideally should be consumed before conception for women of child-bearing age
35
What is the RDA for iron during pregnancy
30mg/day Iron stores should be built up before conception
36
How many more calories is needed during pregnancy
200-400 more kcal.
37
How is the amount of calories determined for pregnant women
Depends on pre-pregnancy weight.
38
What are common foods pregnant women should avoid
Alcohol, seafood with high mercury levels, and caffeine should be limited.
39
What are common things that can affect nutrition status in elderly
Medication interactions Senses of taste, sight, and smell diminish Tooth decay/mouth problems (dentures) Li exhibits decreased motility (constipation) Dementia/depression Lack of access
40
What are common symptoms of dehydration
Decreased urination Sunken eyes, cheeks, or abdomen Fatigue, dizzyness, Irritability
41
What is the recommended amount of fluids
30ml/kg of body weight
42
What is the best nutrition intervention for iron deficiency
Increasing iron rich foods Consuming vitamin C rich foods to enhance absorption of non-heme iron
43
What are common heme iron sources
Clams, oysters, shrimp Organ meats, beef
44
What are common non-heme iron sources
Fortified cereals Soybeans Tomato products Prune juice Various beans
45
What are common reasons people would experience iron deficiency
Rapid growth, pregnant women Menstruation Large amounts of blood loss due to blood donation/accidents.
46
Why do pressure ulcers occur
When pressure is placed on one part of the body for too long Layers of the dermis break down from unrelenting pressure and cause open wounds that vary in severity.
47
What might pressure ulcers be a sign of
Malnourishment
48
What is the nutrition intervention for pressure ulcers
Increased calorie and protein needs
49
What is celiac disease
A disease that attacks the Si and creates sensitivity to gluten
50
What is the nutrition intervention for those with celiac disease
Avoidance of gluten containing products
51
What are some common gluten substitutes for celiac disease
Soy, rice, potato Nuts, legumes, corn, flaxseed, and buckwheat
52
T/F some vitamins, supplements, and pharmaceuticals can contain gluten
True
53
How are gastric ulcers caused
Caused by factors leading to impairment of the mucosal barrier allowing stomach acid to enter the gastric tissue where erosion and eventual ulceration can occur. Due to malfunction of pyloric sphincter Taking NSAID drugs and infection with H. pylori bacteria
54
What is the nutrition intervention of gastric ulcers
Avoidance of alcohol in high amounts, spicy foods, and pepper. Other foods can be consumed as tolerated. Focuses on patient comfort, neutralization of stomach acids, and maintenance of healthy gastric mucosa.
55
What is dumping syndrome and how is it caused
It is a response to the presence of excess amounts of undigested foods in the jejunum Commonly caused when large amounts of stomach and intestine is surgically removed.
56
This condition impacts the small intestine and is not cureable. It may be managed through resection of the intestine.
Chron's disease
57
This condition can be treated with Li removal.
Ulcerative Colitis
58
Food and drug interactions of Aspirin
Can cause GI bleeding Decreased uptake of abscorbic acid
59
Diuretics food and drug interactions
Can cause increased excretion of potassium Can also increase calcium absorption.
60
Corticosteroids food and drug interactions
Increase protein breakdown, decrease calcium absorption, decrease protein synthesis
61
T/ F diarrhea is a symptom of a disease process rather than a disease itself
True
62
How many grams of fat should be present in regular stools
2-5g fat
63
How many grams of fat is in steatorrhea stools
Up to 60g fat
64
What is a nutrition method to combat patients who lose weight due to fat loss.
Increase energy intake mainly through carbs and protein Supplement as needed to achieve good vitamin and mineral status
65
Following a large resection of the small intestine, what nutrition support is recommended (SBO) and when should TF and oral intake resume
TPN only for the first several weeks after surgery Gradually TF may be administered Months after oral intake may resume as tolerated. Small, more frequent meals are recommended
66
How is liver failure defined
Defined as the function of the liver being reduced to 30% or less
67
How much should fat be reduced in liver disease
To 25% of caloric intake
68
Why does alcohol consumption decrease the ability in organs to absorb vitamin c
It causes inflammation
69
What may be an indicator of fat soluble supplementation in those with liver disease
Fat in stool
70
Aside from fat soluble vitamins, what are other minerals and vitamins to look out for in those with liver disease
Folate, thiamin, Vit B12
71
Why do patients with liver disease become at an increased risk of hepatic encephalopathy?
Due to the unbalanced ratio of aromatic amino acids and branched chain amino acids.
72
What are medicines they may administer to help lower blood ammonia for someone with liver disease
Neomycin Lactulose
73
What does neomycin do?
It destroys the flora in the gut
74
What is a consequence of lactulose
It induces osmotic diarrhea
75
If neomycin and lactulose don't help to lower a patients blood ammonia what might be another option?
Supplement protein intake with BCAA
76
Why is it important that the blood ammonia doesn't get too high in patients with liver disease
To decrease their risk of developing hepatic encephalopathy
77
If someone with liver disease develops ascites what might be a nutrition intervention to help with that.
Decrease sodium to 500-2000mg/day Use of diuretics
78
What vitamins and minerals does bile help absorb
Fat soluble vitamins, calcium, and iron
79
After a gallbladder surgery what is the recommended nutrition support plan.
Enteral feedings until normal bowel movements resume. Typically within a few days. Low fat diet recommended for the first month after surgery
80
Conor is suffering from acute, severe pancreatitis. What dietary recommendations should he follow
Stop all oral intake, hydration should be given through IV. Within 48 hours after the absence of severe symptoms slowly start oral intake with clear liquids as tolerated.
81
Conor's pancreatitis symptoms cleared up. He was told to try a clear liquid diet as tolerated. He is unable to tolerate that liquid diet. What should the next step be in the nutrition care plan
Parenteral nutrition should be prescribed
82
What should be avoided in chronic pancreatitis
Large meals, high fat foods, and alcohol.
83
What are the calorie recommendations for someone with cystic fibrosis
120-150% of the RDA
84
How is hypertension characterized by
Defined as a blood pressure of 140/90 or greater
85
What is the standard pharmacological approach for hypertension
Diuretics and antihypertensive medications
86
What is the standard conservative approach for HTN
Weight loss Low sodium diet <1500mg/day Exercise Alcohol reduction
87
What is Congestive Heart Failure?
The result of a long process of deterioration in which the heart loses its ability to function
88
Why might edema make it hard to identify if someone has CHF
By making typical anthropometric measures inaccurate.
89
What are appropriate tools to identify if someone has CHF
Dietary history Mid upper arm circumference
90
Conor has been diagnosed with CHF. As the RD what diet would you recommend he follows.
Low sodium diet with fluid restriction. Increase in potassium if on diuretics.
91
What time should mothers be screened for gestational diabetes
24 weeks gestation
92
What is gout
A disease in which abnormal metabolism of purines results in excessive levels of uric acid in the blood. Results in formation of sodium crystals which can increase risk of kidney stones
93
T/F low purine diets are not effective in treating gout
True. May be effective in acute attacks to reduce the severity
94
What is the recommended diet for gout
Low fat, moderate in protein from sources low in purines. Liberal intake of water to dilute the uric acid in the urine.
95
What is galactosemia
A metabolic syndrome that makes the body unable to convert galactose into glucose
96
What is the nutrition management for galactosemia
Lifelong galactose elimination (all dairy products, dates, bell peppers) Monitor ammonia levels in blood Long term management may restrict protein from 1-2g/day
97
What is a goiter
Enlargement of the thyroid gland
98
What causes an enlarged goiter
If the thyroid gland does not produce enough T3 or T4 hormones
99
When would endemic goiter be common
In regions where iodine is absent from the diet
100
What are common food sources of iodine
Seafood, eggs, milk Iodized salt may also be added to foods
101
What is the RDA of iodine
150mcg/day
102
What foods can block the absorption of iodine
Turnips, peanuts, and soybeans
103
Anti convulsant drugs increase _______ and decrease the absorption of _______
Vitamin D; Calcium
104
When should phenobarbital be taken
Between meals, as it is absorbed poorly with meals
105
What diet may be effective for managing seizures as a last resort to medicine
Ketogenic Diet
106
Why is compliance low with the keto diet for controlling seizures?
It can cause nausea and irritability. Unpalatable It must be strictly adhered to. Not easy for children to do.
107
T/F the efficacy of the keto diet in treating seizures wears off within a few years
True
108
What are common food allergies
Milk Peanuts Eggs Fish Shellfish Wheat Soy Treenuts
109
Extensive burns can increase basal energy expenditure by _______
100% or more
110
What macro and micro nutrients should be increased when someone is burned
Protein, fluids Vitamin C Magnesium Zinc
111
When should nutrition support begin for those in serious accidents
As soon as the patient is stable.
112
What is the standard calorie needs for trauma patients
35-45kcal/kg
113
How many calories should come from lipids in trauma patients
~30%
114
What is the standard protein needs for trauma patients
1-2g/kg
115
What BMI classifies someone as obese
30 or greater
116
What BMI classifies someone as overweight
25-29.9
117
Conor has a BMI >40. What diet should he follow for adequate weight loss.
A diet that is 500kcal less than required. Should lose ~1lb/week
118
What are nutrition related side effects of chemotherapy
Nausea, vomiting, diarrhea, mouth sores, and inflammation of the esophagus.
119
Conor has meat aversion due to chemotherapy. What sources of protein would be recommended?
Foods with low odors such as cottage cheese, cold foods, supplemental protein drinks.
120
T/F edema can mask weight loss
True

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