X Nutrition (Foundations Chpt 21) Flashcards

1
Q

Patient weight taken mandatory how many times?

A

1/month

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1
Q

Nurse is link between patient and

A

dietician

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1
Q

RDA

A

Recommended Daily Allowance

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1
Q

DRI

A

Dietary Reference Intake (label at back with nutrition info)

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1
Q

Essential Nurtrients

A

nutrients the body can not make on it’s own.

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1
Q

6 classes of essential nutrients

A
Carb
Fat
Protein
Vitamins
Minerals
Water
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1
Q

What can not make Vit C

A

Humans and Guinea Pigs

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1
Q

kcal/h

CARB

A

4cal

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1
Q

kcal/h

FAT

A

9cal

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1
Q

Vit A,D, E, K

Fat/water soluble?

A

Fat

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1
Q

Normal body pH

A

7.34-7.45

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1
Q

Normal cholesterol levels?

See pic

A

Total cholesterol <200mg/dL

HDL >= 60mg/dL

LDL < 100mg/dL

Triglycerides < 150mg/dL

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2
Q

Calories

Fat, Carb, Protein

A

Fat - 9 kcal/g
Carb - 4 kcal/g
Protein - 4 kcal/g
(amount of heat required to raise 1cc of H2O 1degree

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3
Q

Build and repair tissue

A

Protein, Fat, Ca, P and Fe

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4
Q

Anabolism

A

Building up

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5
Q

Catabolism

A

breaking down

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6
Q

Kcal, Calories, Food Calories

A

synonyms

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7
Q

Carbs main function

A

provide energy

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8
Q

Simple Carbs

A

Simple Sugars: monosaccharides, disaccharides

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9
Q

Complex Carbs

A

Polysaccharides
Starch, Glycogen, Dietary Fiber
(not sweet, C6H12O6)

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10
Q

Can we digest Dietary Fiber?

A

NO. it is the one carb we don’t use for energy

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11
Q

Carbs broken down into

A

Glucose to make ATP

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12
Q

The simplest carb is…

A

Glucose

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13
Q

Calories

Fat, Carb, Protein

A
Fat - 9 kcal/g
Carb - 4 kcal/g
Protein - 4 kcal/g
ETOH - 7 kcal/fl oz
(amount of heat required to raise 1cc of H2O 1degree
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14
Q

Can we digest Dietary Fiber?

A

NO. it is the ONLY carb we don’t use for energy. Helps move food through intestines

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15
Q

Carbs broken down into

A

Glucose (fuel) to make ATP (fire)

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16
Q

The simplest carb is…

A

Glucose

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17
Q

Merasmus

A

starvation

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18
Q

All sugars/carbs broken down into

A

Glucose

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19
Q

Fats provide

A

Satiety

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20
Q

Glucose stored where?

A

Liver and Muscles

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21
Q

Extra Glucose stored as?

A

Fat

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22
Q

Insulin allows Glucose into cells to be used for ATP

A

.

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23
Q

Glycogen stored where?

A

Liver, muscles

When full it is converted to fat

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24
Q

If energy needs met, carbs stored as?

A

Glycogen

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25
Q

If glycogen store full, excess carbs converted to ?

A

Fat

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26
Q

Fats and cholesterol are ?

A

Lipids

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27
Q

Adipose functions

A

Cushioning

Insulation

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28
Q

Cholesterol needed for

A
  • Integrity of cells

- Vit D synthesis

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29
Q

Fat provides satiety and adds flavor and aroma to foods

Aka ?

A

Umami

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30
Q

Vege based sat fat (very few)

A

Coconut oil

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31
Q

Unsaturated Fatty Acids

A

One or more bonds of missing H

Monounsaturated (can take 1 more H)
polyunsaturated ( can take a few more H)
Plant sources
Liquid at room temp

Blood cholesterol lowering properties

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32
Q

Monounsaturated (can take 1 more H)

polyunsaturated ( can take a few more H)

A

Mono- thicker oils (avocado, olive)

Poly - thinner ( sesame, walnut, sunflower)

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33
Q

Fats (lipids)

Trans fatty acids

A

Unsaturated fats made into sat fats in lab by adding H. They become solid in room temp.

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34
Q

Cholesterol

A
Provides no energy
Synthesized in liver
Foods of animal origin
Highest in shrimp/lobster
No more than 300mg per day
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35
Q

Bile doesn’t break down fats, it …..

A

Emulsifies

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37
Q

Fatty stool, float or sink?

A

Floats

also in people without a gall bladder. bile is not deposited into duodenum to start emulsification so most fat is excreted with stool.

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38
Q

Lipoproteins (LDL, HDL) facilitate transport of ?what to ?where

A

lipids to bloodstream

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39
Q

Where is Lipase made and what does it do?

A

made in pancreas

breaks down lipids

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40
Q

HDL, LDL

difference? Which is good/bad?

A

HDL, tighter membrane

LDL, loose wall. WBS eat and die. They become so full and become foam cells, stick to wall. Atherosclerosis

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41
Q

Saturated fatty acids

A

Chem bonds completely filled w H
Generally or ANIMAL origin
Solid at room temp
Raise cholesterol levels and risk for atherosclerosis

Lard, margarine, suit

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42
Q

Protein made up of ….

A

amino acids

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43
Q

How many Amino acids? How many considered essential?

A

22, 9 essential

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44
Q

Essential Amino Acids

A

Not produced by the body. Must be obtained from diet

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45
Q

Complete Proteins

A

contains all 9 essential amino acids, of animal origin (meat, poultry, fish, milk, cheese, eggs

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46
Q

Incomplete Proteins

A

lacking one or more essential amino acids, of plant origin (grains, legumes, nuts, seeds)

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47
Q

Soy is the highest non-meat source of protein

A

contains PhytoEstrogen

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48
Q

Lactovegetarian

A

vegetarian plus dairy products

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49
Q

Lacto-ovo-vegetarian

A

vegetarian plus dairy and eggs

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55
Q

Create complete proteins by eating things together…

A

mac and cheese
peanut butter and jelly
rice and beans

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56
Q

Kwashiorkor malnutrition

A

severe protein deficiency. kids mainly. only eat rice and wheat, no protein. Causes edema. Solutes attract H2O out into intersticial. starving kids with big bellies. Change in hair color. body no longer produces melanin.

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57
Q

Marasmus

A

extreme malnutrition and emaciation. starvation.

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62
Q

Vitamins can be destroyed by

A

Heat, light. Air

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62
Q

Antioxidant function

A

Delay or prevent breakdown of cell membrane in presence of O

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62
Q

Pre vitamin form of Beta Carotene

Antioxidants

A

Vitamin E and C

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62
Q

Antioxidants: Oil?

A

Usually.

Oils prevent rust in iron

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62
Q

Water soluble vitamins

A

B, C (wound healing)

Not stored in body, excess excreted in urine

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62
Q

Fat soluble vitamins

A

A, D, E, K

Over consumption leads to toxicity
Stored in liver and fat

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62
Q

Bothe vitamins and minerals can be lost in food by…

A

Cooking in water

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62
Q

Minerals can be destroyed by..

A

Nothing.

They are single elements, not compounds

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71
Q

Vit C for?

Deficiency?

A
  • wound healing, immune function
  • deficiency: Scurvy
  • Symptoms: petichea, gum disease, lose teeth and hair
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72
Q

Vit D for?

Deficiency?

A

Found in milk, dairy
Body can make it w exposure to sun

Deficiency: Rickets (osteopenia, osteomalaysia

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73
Q

Vit K for?

Deficiency?

A
  • role in blood clotting
  • Hemorage due to lack of Vit K
  • found in leafy greens
  • avoid when on Cumadin
  • use on infants before circumcision
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74
Q

Rescue Drug for Cumadin

A

Vit K

75
Q

where is Vit K made?

A

In gut

76
Q

Folate for?

Deficiency?

A
  • neural tube health in women of child bearing age

- Spinabifida

77
Q

Congenital Disease

A

during gestation

78
Q

B12 for?

Deficiency?

A
  • making RBCs
  • animal origin

Deficiency: Pernicious Anemia

79
Q

What is made in stomach for absorption of B12?

A
  • Intrinsic Factor

- without IF, B12 is not absorbed and can lead to pernicious anemia

80
Q

Major minerals, amount needed

A
  • needed in amounts >100mg/pday

- Ca, P, Mg, S, Na, K, Cl

81
Q

Trace minerals, amount needed

A
  • needed in smaller amounts

- Fe, Z, I, Se, Cu, Fl, Ch, Molybdenum

81
Q

Pernicious Anemia symptoms

A
  • Feeling tired and weak
  • Tingling and numbness in hands and feet
  • A bright red, smooth tongue
82
Q

Ca for?

Deficiency?

A
  • protection against osteoporosis, clotting, muscle contractions, and HTN
  • 1000-1200mg/p day
83
Q

Na for?

Deficiency?

A

Electrolyte

<2400mg / pday

84
Q

Low residue diet

A

Clear liquid
Chicken no skin
High protein, not complex carbs that can break down into fiber

85
Q

K for?

Deficiency?

A
  • electrolyte
  • protect against HTN
  • 2000mg/day
  • ESRD must be careful for HyperKalemia
86
Q

Fe for?

Deficiency?

A
  • part of hemoglobin (part of RBC that carries oxygen to cells)
  • 8-15mg/pday (30mg for pregnant)
  • iron rusts because of oxidation.
87
Q

Water %of body

A

60%, adult
80%, infant
Provides form, structure, solvent for chem processes, transport, lubrication, body temp regulation

88
Q

Teens usually deficient in….

A

Ca, Fe

89
Q

Soy has

A

All essential amino acids. No fat. Water soluble vits

90
Q

Normal pregnancy weight gain

A

25-35lbs

91
Q

PIH (pregnancy induced hypertension)

A

Goes into fetus

O, antibodies, glucose, dissolved substances

92
Q

Required for RBCs

A

Folate, B12, Fe

93
Q

Deficiency Disease of

Folate, B12, Iron

A

Folate: microcytic anemia
B12: pernicious anemia
Fe: anemia, hemoglobin

94
Q

Diabetes Melitus

A

Occurs during pregnancy

Mom hi blood sugar, baby hi, large and fat

95
Q

If mom suffers from diabetes Melitus, what is she at risk for later?

A

Type II Diabetes

96
Q

First milk

A

Colostrum

97
Q

Nicotine/caffeine

A

Vasoconstrictor

98
Q

FAS

A

Fetal Alcohol Syndrome

Midline, low ears, wide nose, thin upper lip, genital problems

99
Q

First year food

A

Rice cereal

100
Q

Solid food starts how old?

A

4-6mos

101
Q

Common dietary inadequacies

A

Iron and Calcium

102
Q

Common problem in nursing homes?

A

Malnutrition

103
Q

Limit caffeine intake to….

A

Less than 300mg/day

105
Q

Low residue diet

A

Clear liquid
chicken
over cooked watery veges

106
Q

Caffeine affects

A

-central nervous system stimulant, diuretic
nervousness, irritability, anxiety, insomnia, heart arrhythmia’s, palpitations, BP, circulation, gastric acid secretion
-less than 300mg p/day
- People w GERD should avoid caffeine

107
Q

Clear Liquids

A

bouillon, broth, gelatin, tea, coffee no milk, ginger ale, water, clear juice

108
Q

Full liquid

A

strained cereals, soups no chunks, ice cream, pudding, milk, milkshakes, fruit juices

109
Q

clear liquid - full liquid - solid

A

types of diets

110
Q

mechanical soft diet

A

puree/chopped

111
Q

High Kcal

A

surgery trauma, HIV AIDS, Burns

112
Q

Cachectic

A

Cancer patients

113
Q

Anorexia vs Anorexia Nervosa

A

lack or appetite vs self inflicted starvation

114
Q

Diabetes I vs II

A

I: No Insulin II: Insulin resistant

115
Q

Optimal Blood Glucose level

A

80 - 120mg/dL

116
Q

Fasting BLood Sugar

A

blood drawn first thing in AM after fasting all night.

normal 70-80mg/dL

117
Q

Exchange List

A

Diabetes patients. Exchange carbs for other smilar valued carbs. Every carb = glucose

(if you want a banana carb, you must remove toast)

118
Q

Dumping Syndrome

A

occurs post sugery to stomach.
food passes throught too rapidly. body reacts by sending water into intstinal tract to wash through, reducing blood pressure.
treatment: many small meals

119
Q

Bile stored and produced where?

A

Produced in Liver, stored in Gall Bladder

120
Q

Steatorrhea

A

fluffy fatty stool

121
Q

Protein restricted diet for

A

very rare

people w ESRD or Hepatic Cirrhosis (kidney, liver)

122
Q

Asterixis

Liver takes Amino acid from gut to…

A

make protein. If diseased liver cant’ metabolize as much protein, not metabolizing N. Becomes toxic and produces NH3. crosses brain

123
Q

NAS

A

no added salt

124
Q

Potassium modified diet

ESRD patietns

A

3Ds: diarrhea, diuresis, diaphoresis. Losing K. HypoKalemia.
or
If not urinating, not losing K, HyperKalemia
Electrical impulse of heart

oranges, bannana

125
Q

Day/Eve/Night

A

0700-1500/etc . 8hrs each shift

126
Q

ESRD Fluid restriction to 1L/day

A

.

127
Q

duration of Nasogastric Tube

A

only up to 7 days

128
Q

PEG restrictions (in stomach)

A
  1. meticulous mouth care, LO salivary production. PAROTIDITIS
  2. continuous feed. head of bed always 30* or UP
  3. check residual periodically (continuous) or BA feeding (intermittent). aspirate stomach contents. >75cc
  4. replace residual acid from stomach
  5. check placement of tube. aspirate sm amount of stomach contents to check pH.
129
Q

PPN

A

Partial Parenteral Nutrition.

can be administered into peripheral vein

130
Q

TPN

A

Total Parenteral Nutrition (Hypertonic solution)

  • Glucose + Amino Acid, vit, min, electrolytes (digested carb/protein)
    1. into MAIN line (IVC or SVC venacava)
    2. can’t be allergic to egggs. lipid complete
    3. Sterile care of main line (bacteria would thrive in TPN mixture so avoid it)
    4. Test for glucose. as UP glucose, Pancreas not getting message to release insulin on it’s own since not going through the stomach, but only intravenously.
131
Q

Change TPN line how often?

A

every 24hr

normal: every 3 days

132
Q

proteins used for?

A

structure

133
Q

Glucagon

A

changes glycogen into glucose

134
Q

Glycogen store where?

A

muscle and liver

135
Q

High Protein Diet

A

wound healing, kids, pregnant women

136
Q

IRON should be taken with?

A

CITRUS

Dairy (Ca) will inhibit absorbtion

137
Q

*** Schillings Test

A

test for pernicious anemia. radioactive B12 tracer injected. If we can’t absorb B12, that indicates we LACK intrinsic factor. RBC w start dyng if no B12. ~128days

TREAT give Cyanocobalumin (B12 IM monthly)

138
Q

Ca dose

A

1000 - 1200 mg/d

139
Q

K in

A

banana, citrus, tomatoes, peanuts

140
Q

Iron

A

Hemoglobin part thatl atches onto Oxygen.

Take w Citrus, straw to prevent staining. Z-track to prevent staining skin

141
Q

Pre-Eclampsia

A
PIH, pregnancy induced HTN
damage to glomeruli (spring leak i glomeruli and H20 adn protein escape.  PROTEINUREA
symptoms: mom has seizures
treatment: Mg (risk for DOWN Resp Rate)
rescue drug: Calcium Gloconate
142
Q

Make vitamin D out of ?

A

Cholesterol

143
Q

GERD

A

6/8 small meals
bed head elevated
don’t eat right before bed
don’t lie flat right after eating

144
Q

Acidosis

A

1) Diabetic Ketoacidosis; symptoms Kussmaul Resp, Blow off CO2
2) Loss if bicarbonate from excessive diarrhea

145
Q

Metabolic Alkalosis

A

loss of gastric acid (vomit, gastric suction, too many antacids)

146
Q

Respiratory Acidosis

A

Hypoventilation (CO2 + H2O = H2CO3)

COPD, stroke, asthma, pheumonia, opiates

147
Q

Respiratory Alkalosis

A

blow off CO2, crying baby, mom labor, anxiety

LOW CO2 +H2O = LOW H2CO3

**Kidney retains bicarbonate to neutralize acid

148
Q

Gluconeogenesis

A

making new glucose

take glocose off of TriGlyc to leave the 3 FAs to create an acidic environment

149
Q

Type 1 Diabetes

A

Pancrease produces NO INSULIN

150
Q

Insulin

A

lowers blood sugar by pushing glucose into cells

151
Q

Glucogon

A

peptide hormone, produced by alpha cells of the pancreas, that raises the concentration of glucose in the bloodstream. Its effect is opposite that of insulin, which lowers the glucose concentration. Wikipedia

152
Q

HgA1C test

A

to monitor blood sugar compliance

should be

153
Q

DRI (no RDA)

A

Daily recommended Intake.

No RDA

153
Q

DRI

A

Daily recommended Intake.

No RDA

154
Q

Ulcers caused from lack of ?

A

Protein

155
Q

Protein purpose

A

Wound healing

Muscle building

156
Q

Parenteral

A

IV, IM

157
Q

Enteral

A
Through gut
Ostomy
NG tube (Naso gastric)
PO (per os)
PEG tube
158
Q

TPN

A

Total parental nutrition

159
Q

Diverticulosis diet (condition of )

A

High fiber diet, to move food through intestines

160
Q

Diverticulitis diet

A

Low residue, clear fluid, high protein, non fatty

161
Q

What aids in absorption of iron

Hinders?

A

Citrus

Ca inhibits

162
Q

Hiatal Hernia diet

A

6-8 small meals
Don’t lie down after eating
Raise head of bed

163
Q

What allergy w prevent patient from receiving TPN?

A

Eggs

164
Q

Why monitor ? during TPN administration?

A

Glucose levels because pancreas doesn’t get message from stomach to release insulin.

165
Q

Cholesterol , plant or animal based?

A

Animal

166
Q

Liver and Renal patient diet

A

Low protein
No soy
No meat
No nuts

167
Q

B12

Plant or animal

A

Animal

169
Q

Schillings Test

A

Detecting Pernicious Anemia

(Using radioactive B12. If absorbed, NO pernicious anemia). If absorbed it means gut IS producing intrinsic factor to aid in absorption of B12.

If absorbed , you DO have PA

TREATMENT. IM of cyanocobalamin (B12)

170
Q

BMR

A

Basal Metabolic Rate

how many calories burned in 24hrs at rest

171
Q

Vit A Deficiency

A

Night Blindness

172
Q

Central Line

A

Large Flow Vein

-jugular, subclaian, Superior vena cava, Inferior vena cava

173
Q

ABG

A

Arterial Blood Gas
An arterial blood gas (ABG) test measures the acidity (pH) and the levels of oxygen and carbon dioxide in the blood from an artery. This test is used to check how well your lungs are able to move oxygen into the blood and remove carbon dioxide from the blood.

174
Q

Allen’s Test

A

squeeze on Radial and Ulnar veins. Release radial to ensure there is blood flow back to hand, in case you give the Ulnar vein a clot when performing ABG test.

175
Q

otomoy

A

temporary hole

176
Q

ostomy

A

surgically created long lasting hole

177
Q

phlebotomy

A

drawing blood from hole

178
Q

Normal Saline

A

0.9% NaCl

179
Q

Dextrose, 5% in normal saline

A

D5NS

180
Q

Dextrose 5% in 1/2 normal saline

A

D51/2NS

181
Q

half normal saline

A

0.45%NaCl

182
Q

Macro Drip tubing

A

10gtt = 1ml

use if IV drip rate is 81ml or UP

183
Q

Micro Drip tubing

A

60gtt = 1ml

use if IV drip rate is 80ml/hour or slower

184
Q

Blood tubing

A

15 gtt/1ml