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Inamn domain 2 topic B
Nutrition diagnosis
96
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Post-Graduate
06/15/2018

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Term
Nutrition diagnosis
Definition
identification of an occurrence, risk of, or potential for developing a nutrition problem we are expected to treat independently.
Term
a functional nutrition diagnosis would relate to problems like
Definition
swallowing difficulty, altered GI function
Term
a biochemical nutrition diagnosis would relate to problems like
Definition
change in capacity to metabolize nutrients d/t medications, surgery, or lab values
Term
Bioactive substances
Definition
supplements, alcohol, functional foods
Term
Behavioral-environmental nutrition diagnoses would relate to problems like
Definition
food knowledge, access, safety, physical activity
Term
The s/s of the PES (s) need to be able to indicate, through continued monitoring, that
Definition
the problem is resolved or not
Term
Altered GI fx vs Impaired nutrient utilization
Definition
Altered GI fx: changes in digestion, absorption, and/or elimination - N/V/D, malabsorption, constipation. Impaired nutrient utilization: problems with the metabolism of nutrients AFTER they have been absorbed - renal/liver failure, inborn errors of metabolism
Term
Impaired nutrient utilization:
Definition
problems with the metabolism of nutrients AFTER they have been absorbed - renal/liver failure, inborn errors of metabolism
Term
Altered GI fx:
Definition
changes in digestion, absorption, and/or elimination - N/V/D, malabsorption, constipation.
Term
If you will not be able to resolve the underlying nutrition problem, the goal of the PES should be to
Definition
minimize sx
Term
Major nutrient reabsorption occurs where in the kidney?
Definition
proximal convoluted tubule
Term
the unit of the kidney
Definition
nephron
Term
What part of the kidney deals with water and Na balance?
Definition
Loop of Henle
Term
What part of the kidney deals with acid-base balance?
Definition
distal tubule
Term
kidney fx
Definition
blood filtration, absorption, excretion, secretion, acid base balance, blood pressure
Term
What are the only 2 things not filtered through the kidney tubules?
Definition
blood cells, protein
Term
vasopressin (ADH - antidiuretic hormone)
Definition
Increases water reabsorption by kidneys, elevating blood pressure (is a pressor)
Term
SIADH
Definition
Syndrome of inappropriate antiduiretic hormone (Causes hyponatremia, tx w/ FR)
Term
renin
Definition
vasoconstrictor secreted by kidney when blood volume decreases. renin stimulates aldosterone to increase Na absorption and return blood pressure to normal
Term
EPO - erythropoietin
Definition
produced by kidney to stimulate bone marrow to produce RBC
Term
Increased BUN, BUN:CR, means
Definition
kidney dx
Term
Renal solute load is the
Definition
Solutes excreted in 1 L of urine
Term
1 Manifestation of renal disease
Definition
anemia d/t decreased production of EPO
Term
Causes of AKI
Definition
Burns, accident, obstruction, severe dehydration
Term
AKI sx
Definition
oliguria, azotemia
Term
Azotemia
Definition
abnormally high levels of nitrogen-containing compounds (such as urea, creatinine, various body waste compounds, and other nitrogen-rich compounds) in the blood
Term
abnormally high levels of nitrogen-containing compounds (such as urea, creatinine, various body waste compounds, and other nitrogen-rich compounds) in the blood
Definition
Azotemia
Term
Initial AKI MNT
Definition
PN
Term
AKI pro if dialysis is not necessary
Definition
0.6-0.75g
Term
AKI pro if dialysis is not necessary and non catabolic
Definition
1.2g
Term
AKI pro if dialysis is not necessary AND catabolic
Definition
1.2-1.5g
Term
AKI kcals
Definition
25-35kcals
Term
Low Na in AKI when
Definition
edematous
Term
fluid needs AKI
Definition
Replace losses from previous day +500mL
Term
phos needs AKI
Definition
8-15mg/kg
Term
K needs AKI
Definition
2-3g/d based on o/p, serum K, dialysis
Term
nephrosis is also called
Definition
nephrotic syndrome
Term
Nephrosis is
Definition
protein escaping through the tubules when it should NOT be
Term
Nephrosis causes
Definition
albuminuria, edema, malnutrition, hyperlipidemia
Term
Nephrosis protein needs
Definition
mod resctrition, 0.8-1g, HBV
Term
nephrosis fat needs
Definition
<30% fat, <12mg/kgd chol (<200mg total)
Term
Nephrosis phos needs
Definition
<12mg/kg/d
Term
Nephrosis Ca needs
Definition
1-1.5g/d
Term
Nephrosis fluid needs
Definition
may need fluid restriction w/ edema
Term
Nephrosis has abnormalities in what nutrients r/t protein loss?
Definition
Cu, Fe, Zn, Ca
Term
Nephrosis kcals
Definition
35kcals, complex CHO
Term
Nephrosis Na needs
Definition
mod Na restriction, 2-3g/d, depends on HTN, edema
Term
Edema Na nees
Definition
no added salt or 2-3g
Term
CKD gets anemia why?
Definition
deficient production of erythropoietin by kidneys
Term
stage 4-5 CKD kcals
Definition
35
Term
stage 1-3 CKD kcals
Definition
per kg on bmi
Term
CKD protein restricted when?
Definition
WHEN GFR FALLS
Term
CKD 1-3 pro
Definition
0.8
Term
CKD 4,5 Pro
Definition
0.6
Term
CKD Ca
Definition
1200-1500mg
Term
CKD Phos stages 1-2
Definition
800-1000mg/d
Term
stage 3,4,5 CKD phos
Definition
8-12 mg/kg/d
Term
CKD fluid
Definition
generally unrestricted
Term
When would you use giovanetti diet
Definition
ESRD
Term
giovanetti diet
Definition
20g HBV protein, increased kcal, control edema, prevent def
Term
chronic renal failure HD pro
Definition
1.2
Term
chronic renal failure HD kcals
Definition
30-35
Term
chronic renal failure HD fluid
Definition
if low o/p, restrict Na and fluid
Term
chronic renal failure HD K
Definition
40mg/kg ibw (2-3g/d)
Term
chronic renal failure HD Ca
Definition
1-1.8g/d
Term
chronic renal failure HD Phos
Definition
0.8-1g Or <17mg/kg/ibw
Term
chronic renal failure HD supplements
Definition
VC, B6, folate, B12, VE
Term
chronic renal failure HD Zn
Definition
15mg/d
Term
Peritoneal dialysis pro
Definition
1.2-1.3g
Term
Peritoneal dialysis kcals
Definition
<60 y/o 35kcals including dialysate
<60 y/o 30-35
Term
Peritoneal dialysis Na
Definition
2-4g
Term
Peritoneal dialysis K
Definition
generally unrestricted
Term
Peritoneal dialysis Ca
Definition
<2g including binders
Term
Peritoneal dialysis Phos
Definition
0.8-1.0g
Term
Peritoneal dialysis fluid
Definition
1-3L
Term
Peritoneal dialysis V/M
Definition
As for HD but may need extra thiamin
Term
type 1 DM
Definition
needs exogenous insulin
Term
type 2 DM
Definition
insulin resistance with relative def (may need insulin for max control)
Term
A1c directly measures
Definition
% hgb w/ glucose attached
Term
normal a1c
Definition
<5.7%
Term
normal a1c >65y
Definition
<7%
Term
a1c goal for diabetics
Definition
<7%
Term
a1c measures BG control over
Definition
past 60-90 days
Term
MNT for DMT1
Definition
W/ fixed daily insulin, consistent CHO! Monitor BG and adjust insulin. Reduce insulin for planned exercise
Term
DM goals
Definition
Achieve glucose, lipid, and BP goals
Term
DMT2 MNT
Definition
Weight loss if necessary, improve food choices, space meals, exercise
Term
DM sat fat
Definition
<7% kcals
Term
DM fiber
Definition
encourage
Term
Screen for gestational diabetes when?
Definition
24-28 weeks gestation
Term
DRI for CHO during gestational DM is
Definition
<175g/d
Term
How many CHO at breakfast for gestational DM
Definition
15-30, they are less well-tolerated
Term
Gestational DM increases fetal risk for
Definition
macrosomia (LGA) and hypoglycemia at birth
Term
Do you ever restrict weight gain in pregnant women?
Definition
If DM + overwt obese, mod calorie restriction to slow weight gain
Term
Foods with a lower glycemic index produce greater feelings of
Definition
satiety
Term
Some low GI foods
Definition
legumes, milk, nuts, pasta, ice cream, yogurt
Term
Glycemic load:
Definition
weighted avg of all the glycemic indexes of all foods eaten.
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