Week 2: Impact of Nutrition (Ch 9) Flashcards Preview

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Flashcards in Week 2: Impact of Nutrition (Ch 9) Deck (80):
1

Which nutrient is vital to wound healing?

Water

2

What is dehydration?

1% decrease in body weight due to fluid loss

3

How much water is required daily?

30-35 mL of water / kg BW daily

4

What is the average water intake per day?

2.7-3.7 L/day

5

How much water do patients on air-fluidized beds require?

40-60 mL of water/Kg BW daily

6

What is protein required for when it comes to wound healing?

- Collagen synthesis
- Granulation tissue formation
- Angiogenesis
- Remodeling
- Immune function

7

Protein deficiency alters ________.

osmotic pressure, leading to edema formation

8

Protein is _____% nitrogen. Why does this matter?

16%
Positive nitrogen balance is needed to enhance wound healing

9

Patients lose significant protein through _____.

Wound drainage

10

How much protein is required daily?

1.25-1.5 g / kg BW

11

What do carbohydrates do for wound healing?

Provide energy for tissue repair and regeneration
Protein-sparing effect

12

What form are carbohydrates typically in?

glucose

13

How many carbohydrates are required daily?

30-35 kcal/kg BW daily

14

What is the importance of free fatty acids?

- Vital components of cell membranes
- Required for synthesis of new cells

15

What do fats do with respect to wound healing?

- energy source
- thermoregulation
- carry fat-soluble vitamins

16

Which vitamins are fat-soluble?

ADEK

17

Which vitamins are water-soluble?

C, B-complex

18

Which vitamins must you be careful with supplementation? why?

Fat-soluble- they can accumulate in the body and become toxic

19

Which vitamin maintains health skin and epithelial integrity, is required for collagen synthesis, promotes granulation tissue formation, facilitate epithelialization, may reverse the inhibitory effects of corticosteroids, may increase wound tensile strength, and has topical and systemic supplementation?

Vitamin A

20

Which vitamin builds and maintains tissues, helps the body absorb iron, may help control infections and limit damaging effects of free radicals, may enhance wound healing in malnourished patients and patients with pressure ulcers, and has a common subclinical deficiency?

Vitamin C (ascorbic acid)

21

Which vitamin is essential for blood clotting (limit if on anticoagulant), and with a deficiency may lengthen the inflammators stage?

Vitamin K

22

Pretreatment of irradiated skin with ______ may limit skin damage?

Vitamin C

23

Which vitamin is essential for function and formation, is required for normal immune function and energy metabolism, aids in white blood cell function, antibody formation, and resistance to infection, facilitates fibroblast function, facilitates collagen synthesis, and has important co-enzymes?

Vitamin B

24

Which vitamin helps prevent free-radical-related cellular damage, decreases inflammatory phase of wound healing, enhances immune function, and decreases platelet adhesion?

Vitamin E

25

How many vitamins are included in the B-Complex?

8

26

Which minerals are microminerals?

iron, zinc, copper, and magnesium

27

Which minerals are macrominerals?

calcium, phosphorous, selenium

28

Skin contains _____% of the body's zinc stores.

20%

29

Which mineral is an antioxidant and is vital to collagen and protein synthesis, cell proliferation, epithelialization, and normal immune function?

Zinc

30

Which mineral is a component of hemoglobin, is required for antibody production and normal immune function, is a cofactor in many enzyme systems, is required for collagen and DNA synthesis

Iron

31

Whats iron anemia lead to?

tissue hypoxia, decreased immune function, decreased cell replication, and decreased wound tensile strength

32

Which mineral is required for hemoglobin synthesis and iron absorption/transport, increases strength of collagen cross links... and with deficiency may lead to poor wound healing and decreased immune function?

Copper

33

Which mineral is a cofactor in over 300 enzyme systems, is important for bone/protein synthesis?

Magnesium

34

Magnesium deficiency may lead to _______ and ______. Where is deficiency often found?

hypertension and vasoconstriction
patients with diabetes, alcoholism, chronic diarrhea, or dehydration

35

Which vitamin is important for bone formation, remodeling, muscle contraction, fibrin synthesis, blood clotting, and is a neurotransmitter?

Calcium

36

Which mineral is important for bone formation, is an essential component of many enzyme systems, and needed for normal metabolism?

Phosphorous

37

Which mineral assists with normal immune function and is required to make up to 30 proteins?

Selenium

38

What are the important markers for nutritional assessment/changes in body weight?

1% decrease in a week
5% decrease in a month
7.5% decrease in 3 months
10% decrease in 6 months

39

What is the BMI Scale/Interpretation?

40

- Dry skin, hair, and mucous membranes
- Poor skin turgor
- Increased heart rate and respirations
- Orthostatic hypothension
- Confusion
- Sunken eyeballs

Water deficiency

41

- Dull, dry hair
- Pallor
- Peripheral edema
- Pressure, ulcers, especially multiple or repeat ulcerations

Protein deficiency

42

- Decline in body weight
- Pallor
- Extremely poor dentition

Carbohydrate deficiency

43

- Emaciated
- Epidermal flaking
- Fissuring of the skin
- Large flakes of dandruff

Fat deficiency

44

- Night blindness
- Difficulty adapting to changes in light intensity
- Seleral changes and dry eyes
- Gingivitis
- Pigment changes
- Dry skin

Vitamin A deficiency

45

- Swollen gums that bleed readily
- Transparent skin quality
- Weakness
- Delayed wound healing

Vitamin C deficiency

46

- Petechiae
- Wound bleeds readily

Vitamin K

47

- Pallor
- Pale eye membranes
- Hyperpigmentation
- Redness or swelling of the mouth
- Mouth sores
- Purple discoloration of the tongue with loss of villi
- Swollen gums that bleed readily
- Confusion
- Muscle cramps
- Anemia

B-Complex Vitamin deficiency

48

- Decreased sense of taste
- Dully, dry, or thinning hair
- Seborrhea-like dryness and redness of the face

Zinc deficiency

49

- Pallor
- Yellow discoloration of the skin
- Soft, spoon-shaped nails
- Easily fatigued
- Dypnea
- Anemia

Iron deficiency

50

- Thinning of hair
- May have pigmentation changes

Copper deficiency

51

- Dehydration
- Neuromulscular hyperexcitability
- Confusion

Magnesium deficiency

52

- Acute: neuromuscular hyperexcitability, dysrhythmias
- Skeletal deformities such as kyphoscoliosis
- Idiopathic and compression fractures
- Bone pain
- Dry scaling skin and hair
- Brittle nails

Calcium deficiency

53

- Skeletal deformities
- Idiopathic fractures
- Bone pain

Phosphorous deficiency

54

- Decreased ability to fight infection
- Muscle pain
- Muscle wasting

Selenium deficiency

55

What is a measure of kidney function and protein status?

Creatine

56

What is a normal creatine level?

0.8-1.5 mg/dL

57

What decreases creatine level?

malnutrition

58

What is a plasma protein produced by the liver?

serum albumin

59

What is a normal serum albumin level?

at least 3.5 mg/dL

60

What decreases and increases serum albumin levels? what do they lead to?

dehydration increases levels
low levels lead to edema and correlate with pressure ulcer severity

61

What is a major transport protein that has a short half life?

Prealbumin

62

What is a normal prealbumin level?

16-40 mg/dL

63

What happens are prealbumin levels drop?

mortality risk increases

64

What is a sensitive indicator of protein status?

Serum transferase

65

What is a normal serum transferin?

less than 170 mg/dL

66

What is a byproduct of protein metabolism and is ecreted by the kidneys and is an indicator of renal function?

Blood Urea Nitrogen (BUN)

67

What is a normal BUN level?

5-25 mg/dL

68

What are elevated levels of BUN associated with?

decreased wound healing

69

What is an indirect measure of nutritional status and immune function?

Total Lymphocyte Count (TLC)

70

What is a normal TLC level?

>1800 / mm3

71

What is decreased TLC associated with?

delayed wound healing and increased mortality

72

What is a normal level of blood glucose?

70-110 mg/dL

73

Increased blood glucose levels are associated with what?

risk of ulceration and impaired wound healing

74

What happens to blood glucose with exercise?

decreases

75

What are the main causes of malnutrition?

Lack of knowledge, poverty, health problems

76

What is proper calorie intake?

30-35 cal / ks BW

77

What are dietary guidelines for someone with extensive burns?

high calorie, protein, and carbohydrate... low fat diet
multivitamin (A and C), and zinc supplementation
Tube feedings or TPN may be needed

78

What is compliance?

a one-way interaction in which the clinician directs the patient

79

What is adherence?

the patient freely chooses to follow suggested guidelines

80

What are some causes of nonadherence?

unintentional, due to misunderstanding, due to forgetfulness, or intentional