remainder Flashcards
1
Q
fatty foods and alcohol
A
decrease LES pressure
2
Q
gastric ulcers develop even with low acid output
A
false
3
Q
duodenal ulcers develop with high gastric acid secretions
A
4
Q
H2 Blocking agents
A
decrease gastric acid
5
Q
lack of if cause macrocytic anemia
A
6
Q
low residue diet is fiber
A
les than 20 grams of insoluble fiber
7
Q
in a illeal resection
A
inssuficient bile salts to emulsify the lipids
8
Q
diverticulosis is treated with
A
high fiber diet
9
Q
normal amount of fat excreted n diter
A
2-6 grams
10
Q
ascites fluid resctriction
A
if they are on low sodium with hypnatremia
11
Q
amino acids that decrease
A
BCAA v l i
valine leucine isoleucine
12
Q
spider nevi
A
portal pressure
13
Q
hepatic encephalopathy meds
A
lactulose rifaximin
14
Q
minerals malabsorbed in steatorrhea
A
ca mg zn
15
Q
POST lver trasnplant 6 onths foward
A
mod pro intake
wt mntc
mod fat 30%
16
Q
pancreatitis 2 main causes
A
low albumin and soap formation by ca and fatty acids
17
Q
severe acute pancatitis
A
not using GI tract worsen symptoms use jejunal lower feeding to minimize pancreatic stimulations
18
Q
this lab indicated impaired liver funtion
A
ammonia
19
Q
chonric alcoohol abuse can beneifit from supplementation of
A
thiamine
20
Q
encelophathy encourage veggie proteins
A
true
21
Q
post liver transplant should follow
A
moderate protein low fat
22
Q
bile salts and low fat are MNT for
A
gallstone
23
Q
pancretitis patients should limiti
A
fatty foods and alcolhol
24
Q
this kind of nutrition suppport maybe needed for acute severe pancreatitis patients
A
tpn
25
check which lab before starin TPN in hepatic patients
tg
26
ranks severity of pancreatitis
ranson
27
ebb phase
hypovelemic shock
28
hrmone response in metabolic stress
cortisol mobilizes amino acids from skeleton muscles
29
glucose levels metabolic stress
140-180
30
burns
replace fluids and elecyrolyctes
31
first step in controling fat malabsoprtion
enzymes
32
CF pulmonary
Na , salt losses sweat losses
33
post operative metabolic and pulmonary tpm can be given if
pt cant oral 5-7 days or moere
34
albumin can be low
negatve acute phase protein and multiple fluid
35
tisseu hypozia with COPD causes
anorexia, bloating and early satiety, constipation
36
weight loss in COPD is common bc
work of breatign and low energy intake
37
overhydration vs deydration in pulmonary pts
we will see more =overhydration in these pts
| lab data expected to see decreased electrolys low protein - diluted effec
38
rq is respiratory quotient and is highest wen
a lot of cals are consumed
39
if rq is 2 or 3
we are feeding too much
40
if rq >1
decrease total caloric intake
adjust cho to lipid rato
decrease especially cho
41
if rq is < .8
increase calories
42
** IN CF WE RECOMMEND
LOW SALT DIET, PANCRATIC ENZYMES, WATER SOLUBLE VITAMINS
43
SEVERELY MALNOURISHED PTS IN MET/PULM STRESS
TPN
WANT TO DO A CLEAR LIQUID DIET - JUICE OR JELLO
IF OPTION DO TUBE FEEDING NG EVEN IF WELL NOURISHED
44
FUEL SOURCE FOR ENTEROCYTES N CRITICAL ILLNESS
GLUTAMINE
45
.261
46
MNT for oxalate kidney stones includes
High Ca diet and low oxalate foods
47
Bacterial hydrolysis of blood from bleeding varices can lead to
Increased NH3
48
NutraHep TF product is
high in BCAA
49
Rapid ingestion/digestion of simple CHO causing increased insulin secretion is
Dumping syndrome
50
Guaiac and Melena are medical terms for
Blood in stool
51
The Hippocratic writings encourage physicians to recognize when medicine has reached its limit of usefulness. So it is ethically defensibe to ... hydration and nutrition support for some patients who
have advanced dementia
are in a persistent vegetative state
are terminally ill
ALLLLLLL THE ANSWERS ARE CORRRECT!!!!
52
General energy requirements for cancer pts
30-35 kcal /kg
53
Cancer cachexia
Progressive wt loss anorexia wasting weakened increased lipolysis
Cytokines produced by tumor . Causes proteolysis - amino acids. n excretion
Lipid mobilizing factor
Inhibits lipase no fat stores
Therefore bold goes back to liver and they are broken down into TG
54
Medication for cancer cachexia
Magestrol/ megaCe
Used for anorexia cachexia and unplanned wt loss
Make sure pt doesn’t have a hx of clotting or on blood thinning
55
When calcium level is high in cancer
We don’t put them on low calcium
We treat with hydration
Make sure they are not getting calcium supllmentestion and Vit d
56
MNT for chemotherapy side effects
| Diarrhea
MAINTAIN HYDRATION STATUS
replace electrolytes
Low fat low fiber possibly low
Bulking agents BRAT diet
57
FOOD AND DEUG INTERACTION cancer Tx
Alimta
| Requires b12 and folic acid to avoid anemia
58
MNT FOR CHEMOTHERAPY SIDE EFFECT ORAL CHANGES
Hydration tart foods
Bitterness in meat
Meat aversions
59
MNT for chemotherapy for oral mucositis
Soft diet and liquids
60
Tamoxifen and a astrodome side effects
Hormonal
| Hot flashes
61
Radiation induced enteritis
Supplement b 12 fat soluble and calcium to prevent deficiency
62
CANCER pancreatic surgery , Whipple procedure MNT
Enzyme replacement, small frequent low fat meals and snacks, avoid simples CHO
Enzymes allow them to eat
63
Resection of terminal ileum
| MNT
Bile salts losses steatorrhea
B12 malabsorption
Diet low in fat osmolality lactose and oxalates
64
When can you start using the GI tract cancer
if diarrhea ia less than 500 ml/day
65
Minimal amount of fluid needed to eliminate daily fixed solute load of around 600 mOsm
500 mL
66
Osteodystrophy in kidney disease
High serum phosphorus stimulates PTH o help with resorption of calcium from the blood - a way to help the blood calcium normal
67
GFR calculator kidney disease, uses
serum creatinine, age, race, gender
68
Lab tests renal disease
high BUN
excessice body protein catabolism
GI bleeding
high BUN doesn't always mean renal
69
Biggest risk factor for kidney stone
not drinking enough water
70
nephritic syndrome MNT
restrict sodium to control BP
71
Edema in nephrotic syndrome causes
`Proteinuria- GI permeability lower albumin in blood more oncotic pressure more edema
Glomerular injury leads to decrease in GFR then kidney kicks in rening angio tensin - retention of water and sodium
72
Nephrotic syndrome nutrition
.8 PRO
35KCAL/KG/DAY
3G SODIUM
low sodium low protein helps control edema
73
high biological value protein
contains all essencial amino acids
74
juice used to treat bacterial infection in kidney - pyelonephritis
cranberry and blueberry
75
Acute kidney disease oliguria amount
< 500 mL per day
76
Kidney transplant medication can cause increase in serum
potassium
77
name of kidney transplant medications
cyclosporine tacrolimus
| causes high potassium htn hlp
78
dialysis diet
low K, low sodium, postassium exchanges
79
veggies ad fruites broken broken down in - renal diet
potassium content
80
****MNT for constipation
Adequate mix of soluble and insoluble fiber
Adequate fluid intake
Exercise
81
Soluble fiber
fruits veggies oats
forms a gel and slows down digestion
o good for watery diarrhea
82
insoluble fiber
bran wheat brans
| absorbs water increases stool wegiht so speeds up time in small intestine - stumlats bowel mocement
83
****EXUDATIVE DIARRHEA characteristics
Mucosal damage - outpouring, mucous, fluid, blood
84
****EXUDATIVE DIARRHEA associated with
chrons disease
Ulcerative colitis
radiation enteritis
85
*****osmotic diarrhea related to*
solute that cant be absorbed
dumping syndrome
lactose intoleracne
releived by fasting
86
***secretory diarrhea
from bacterial exotoxin
c diff
viruses
increases intestinal hormone secrestions
87
***malabsorptive diarrhea
steatorrhea - excess fat
inflammatory bowel disease or bowel resection
not enough bile and pancreatic enzymes to digest
not getting the breakdown needed
88
***steatorrhea*
excess fat n stool
| 60 g normal is 2-6 g
89
steatorrhea related to*****
lver disease
disease involvng distal ileum
BLIND LOOP SYNDROME
90
MNT for steatorrhea*****
MCT - synthetic fats
| products absorbed witout bile salts
91
*****MNT for diarrhea
manage fluid and electrolyte - be careufl with dehydration
92
****minimal residue diet
insoluble fiber >20 g
93
*****MNT for diarrhea in chldren
replace Na and K losses
94
*** celiac disease gluten
specific peptide fraction of proteins - resistant to complete digestion by GI enzymes
95
Inflammatory bowel disease - CRONS DISEASE vs UC
Crons can eba naywhere along the GI TRACT
| uc limited to large intestine and rectum
96
**** inflamatory bowel disease etiology
inappropriate inflammatory response and ablity to suppress it
damage to the cells of the small / large intestine
malabsorption, ulceration, stricture
97
*****Energy requirements for IBD
energy requirements are constant unless weight gain desired
1.3-1.5 protein
bc of steroid use and protein losses from mucosa
98
divertculitis
bowel rest
99
short bowel syndrome - resection
b12 - intrinsic factor
100
*****!!! see nutrition for short bowel syndrome CHO FAT AND OXALATE
101
*** SMALL INTESTINE BACTERIAL OVERGROWTH SIVBO OR BLIND LOOP SYNDROME
overgrowth of bacteria
102
*** SMALL INTESTINE BACTERIAL OVERGROWTH SIVBO OR BLIND LOOP SYNDROME
consequences
B12 DEFICIENCY
