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Definition
is a protein that is formed within the liver, it makes about 60% of
total protein, maintains osmotic pressure, transport blood constituents like drugs, hormones, enzymes.
-Indicator of Hepatic function, liver function and health. Used to study nutritional status.
Half life is 21 days - slow in
reflecting status. Indicator of malnutrition in chronic illness.
Normal: 3.5-5.0 g/dl
Mild depletion = 3.0-3.4 g/dl
Moderate depletion = 2.5 -2.9 g/dl
Severe depletion= <2.5 g/dl |
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Basal Energy Expenditure- is used to determine the caloric need in a
24 hour period depending on the level of activity. |
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Basal Metabolic Rate- is the energy needed to maintain life-sustaining
activities like breathing, circulation, HR, Temp @ rest. Factors like age,
body mass, gender, fever, starvation, etc. can affect energy requirements. |
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Definition
Body Mass Index- measures weight corrected for height and serves as an
alternative to trasitional height-weight relationships. Assessment of fat.
Formula is Weight (kg)/height (m)^2= BMI
BMI< 18.5 is underweight
BMI>18.5 and <24.9 is healthy weight
BMI 25 to 29.9 is overweight
BMI 30 to 39.9 is obese
BMI> 40 or greater is extreme obesity |
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Term
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Definition
AKA: kcal
-use to measure a unit of food energy.
-When energy is met = weight stays the same
-When kcal exceed energy demands = gain weight
-When kcal fail to meet demand = weight loss |
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Definition
are the main source of energy, each gram produces 4 kcal and
serves as main source of fuel (glucose) for the brain, skeleton muscle,
during exercise and other activities.
-Obtained from plants foods, except for
lactose.
-Storage: small amounts are stored in the liver and muscle as glycogen.
Excess are stored as fat
Recommended: 40-60% of total calories in complex carbs.
Fiber is a carb. |
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is the breakdown of biochemical substances into simpler
substances and occurs during physiological state of negative nitrogen
balance. ie. starvation, when wasting of body tissue occurs |
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Definition
Fats that are compose of chains of carbon and hydrogen atoms
with an acid group at the end and methyl group at the other. Ex. saturated,
unsaturated, monounsaturated, polyunsaturated. Provide 9 kcal/g of energy |
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Definition
a basic guide for buying food and meal preparations, provides for diet ranging from 1600-2800 kcal/day. Foods are selected from enriched cereals, complex carbs and grains to round out meals and meet energy requirements.
1-2 servings: eggs, fish, poultry
2-4 servings: plant oils
4-8 servings: whole grains
5-13 servings: fruits and vegetables
5-8 (8oz) glasses of water daily |
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Ideal Body Weight.
-provides an estimate of what a person should weigh
% of IBW= Current Weight/Ideal Weight x 100 |
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(Fat) the most calorie dense nutrient, providing 9kcal/g, composed
of triglycerides and fatty acids.
-Triglycerides circulate in the blood and are made up of 3 fatty acids and glycerol.
-The synthesis of fatty acids is called lipogenesis.
Saturated – higher in animal fats
Unsaturated – mono- and poly- are higher in vegetable fats
Trans - formed when vegetable oils are hardened into solids (hydrogenated oil); may be identified as a portion of the saturated fat on food labels
Linoleic acid, an unsaturated fatty acid, is the only essential fatty acid in humans.
Fat is the body’s major form of stored energy. The metabolism of 1 gm of lipid yields more than twice the energy as CHO or PRO.
Recommended that only 30% of kcal are from fat (typically 35-45% of American diet), & that intake of saturated fat and cholesterol is low.
New technology:
Benecol has cholesterol lowering properties; 3 servings/day for 1 year |
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Term
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Definition
Clear Liquid: broth, coffee, tea, carbonated beverages, clear fruit juices, gelatin (jello) & popsicles
Full Liquid: ice cream, custards, cooked cereals, all fruits and vegetable juices |
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Definition
inorganic elements also essential in the body as catalysts in biochemical reactions
Classification:
-macro minerals: daily requirement 100mg or more
-trace elements: daily requirement less than 100mg |
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Definition
| 1 mililiter is the SI unit of measurment and is referred to as mL for measurment tools. cc is the same as cubic centimeter which refers to the volume of the substance occupying the space in the measurement tool. 1 cc is the same as mL. |
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Source for energy; 1 gm PRO = 4 kcal.
Essential for building, repair, & replacement of body tissue; nitrogen balance.
PRO is 16% nitrogen & the body’s only source of nitrogen (essential for growth, maintenance of muscle fiber & vital organs, & in wound healing).
Amino acid (AA) is the simplest form of PRO. Essential AA – body cannot synthesize, must come from diet.
Nonessential AA – body can synthesize.
Complete PRO (AKA high-biological value PRO) – contains the entire essential AA in sufficient quantity to support growth & maintain nitrogen balance.
Meat, fish, poultry, milk, & eggs
Incomplete PRO + Incomplete PRO (contains missing AA or increases the amount of AA) = supplies essential AA to support growth and nitrogen balance.
Cereals, legumes (beans, peas), and vegetables
Incomplete PRO can also be made complete with supplement of synthetic amino acids |
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Recommended Dietary Allowance
- average indicator, the amount necessary for all healthy people |
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Definition
Clear Liquid: broth, coffee, tea, carbonated beverages, clear fruit juices, gelatin (jello), & popsicles
Full Liquid: ice cream, custards, cooked cereals, all fruit & vegetable juices
Puree: scrambled eggs, pureed meats fruit & vegetables, mashed potatoes & gravy
Mechanical Soft: diced meats, cottage cheese, cheese, rice, soups, & peanut butter
Soft or Low Residue: pastas, cooked fruits & vegetables, cakes & cookies
High Fiber: fresh fruits & vegetables, oatmeal, bran, dried fruits
Low Sodium: no added salt to severe sodium restriction (500mg Na diet) that requires selective food purchases.
Low Cholesterol: 300 mg/day
Diabetic: recommended 1800 calories. Balanced intake of carbohydrates, fats, and proteins.
Regular: no restrictions, unless specified |
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Definition
| No restrictions, unless specified |
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Diet consists predominantly of plant foods; can be nutritionally adequate if planned carefully.
-Lactoovovegetarian – eats eggs and milk
-Lactovegetarians – drinks milk, avoids eggs
-Vegans – only plant foods
-Vegan, Zen macrobiotic (only brown rice & herb tea) and fruitarian (only fruits, nuts, honey, and olive oil) are nutrient poor and may result in malnutrition. |
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Definition
Organic substances, essential for normal metabolism; act as catalysts in biochemical reactions. Body can not synthesize required amounts, must be supplemented.
Vitamin content highest in fresh foods, used quickly with minimal exposure to heat, air, water.
Water-soluble vitamins – vitamin C and B-complex. Cannot be stored in the body, must be provided each day through diet.
Fat-soluble vitamins – A, D, E, & K; can be stored in the body. Toxicity may result from mega doses of synthetic vitamins. |
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Term
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Definition
Water is 60-70% of total body weight. Muscle contains more water than any tissue except blood (so, lean people have higher % than the obese).
Cell function depends on a fluid environment; acts as a solvent for nutrients.
Fluid needs met through intake of fluids, foods high in water content, & by water produced through the oxidation of food.
Normally I = O. Average 2200-2700;
Oral Intake 1100-1400,
Solids 800-1000 |
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Term
| Describe key components of basic nutrition |
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Definition
carbohydrates
proteins
fats
water
vitamins
minerals. |
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| Identify individual factors that commonly influence basic nutrition |
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Definition
a. Age
b. Diet life style
c. Financial status
d. Influences |
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Term
| List essential nutrients and food sources required for adult nutritional balance. |
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Definition
-Grains
.Whole grain cereals, rice, pasta
-Vegetables
.Broccoli, spinach, dark leafy greens
-Fruits
.Fresh, frozen, canned, or dried fruit.
-Milk
.Milk, yogurt, milk products
-Meat & beans
.Lean meats and poultry |
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Term
Describe the food guide pyramid and discuss its value in planning
meals for adult clients. |
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Definition
1-2 servings: eggs, fish, poultry
2-4 servings: plant oils
4-8 servings: whole grains
5-13 servings: fruits and vegetables
5-8 (8oz) glasses of water daily
-Adults exercise 30min 5x week to maintain weight
-60-90 minutes to prevent weight gain
-most should take a multi-vitamin
In planning diets for adults, depending on their
condition(s), a balance diet will be needed to tend to their disease
processes or nutrient needs. Based off the 2000k/cal a day,
certain food may need to be replaced with other groups due to,
personal preference or allergies. E.g protein from meats can also be
found in certain vegetables. (self-written based of RDA allowances
and food guidelines) |
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| Describe the major methods of nutritional assessment |
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Definition
1. Screening: part of the initial assessment in identifying malnutrition or risk of malnutrition.
2. Anthropometry: is the measurement system of the size and makeup of the
body.
-Ht/wt and IBW% on admission
-Assessment of body weight: (current wt/usual wt) x 100
-Compare to reference data or previous usual body weight
-Try to weigh at same time/on same scale/in same clothes
-Body Mass Index (BMI)
-Assessment of body fat
-Weight (lbs) times 705/Height (inches)/Height (inches)
BMI < 18.5 is underweight
BMI >18.5 and < 24.9 is healthy weight
BMI 25 to 29.9 is overweight
BMI 30 to 39.9 is obese
BMI 40 or greater is extreme obesity
-Ratio of Ht: Wrist Circumference
-Estimate of body frame: Ht (cm)/ Wrist (cm); >10.1 - small, 10.1-11 - medium, < 11 - large
-Mid-upper arm circumference (MAC) estimates skeletal muscle mass
-Triceps skin fold (TSF) is used to est. fat content of SQ tissue
-Mid-upper arm muscle circumference (MAMC) measure skeletal muscle mass
-Compare findings to standard
-Changes over time are more significant than isolated measurements.
3. Lab & Biochemical tests
-No single lab test is diagnostic for
malnutrition. Factors that influence test results are fluid balance, liver functions, kidney function, and presence of disease. Ex of test to study malnutrition are plasma proteins
like albumin, transfferin, prealbumin, retinol binding proteins, Total iron-binding and hemoglibin.
*Albumin is a better indicator for chronic illnesses
4. Diet History/Health History
• Focuses on the patient’s habitual intake of food and fluids
• Also looks at preferences, allergies, problems, ability to obtain food
• Activity level to determine energy needs
5. History/Physical exam: most important. observe for malnutrition
6. Dysphagia: refers to the difficulty of swallowing, indicators of neurogenic,
myogenic and obstructive problems. Can cause aspiration pneumonia,dehydration, decrease nutritonal state and weight loss. Leads to disability or decrease functional status, increase length stay and cost of care
-Signs are: cough during eating, change in voice tone, or quality after swallowing,
*Abnormal signs of the mouth, tongue, or lips. Delay swallowing, “silent
aspiration”.
* Often leads to inadequate food intake which can lead to malnutrition. |
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Term
Identify nursing diagnoses for clients with actual or risk for
nutritional problems. |
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Definition
• Risk for aspiration
• Constipation
• Diarrhea
• Health-seeking behaviors (nutrition)
• Deficient knowledge (nutrition)
• Imbalanced nutrition: less than body requirements
• Imbalanced nutrition: more than body requirements
• Readiness for enhanced nutrition
• Feeding self-care deficit |
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| Describe dietary modifications for older adults |
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Definition
Dietary modifications:
1. Diets typically low in PRO foods and high in breads, cakes, cereals
2. Provide PRO with cheese (calcium), eggs, & peanut butter, beans, peas
3. Encourage whole grain cereals & breads
4. Encourage cream soups & meat-based vegetable soups
-Decreased need for calories: decreased metabolic rate.
-Factors influencing nutritional status:
.Income – fixed income, spend less on food.
.Health – therapeutic diets; difficulty eating due to lack of teeth or dentures, or ill-fitting dentures; at risk for food-drug interactions.
.Physical disability – makes preparation difficult.
.Lack of transportation – males shopping difficult.
.Living alone – decreases interest and pleasure of meals.
Physiological changes:
1. Decreased taste acuity
2. Decreased gastric secretions (less efficient digestion)
3. Decreased thirst sensation (inadequate fluid intake)
4. Decreased GI motility |
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| Discuss dietary guidelines for promotion of nutritional health in adult clients |
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Definition
1. Dietary Reference Intakes - DRIs (1997)-- Presents a range for acceptable intake of protein, vitamins & minerals in place of absolute values.
Generic term encompassing 4 values:
A.) Estimated Average Requirement (EAR)
-minimum indicator
-risk of ingesting too few nutrients is 50%
B.) Recommended Dietary Allowance (RDA)
-average indicator, the amount necessary for all healthy people
C.) Adequate Intake (AI)
-followed when RDA is not known
-derived from expert judgment, not scientifically proven
D.) Tolerable Upper Intake Level (UL)
-the maximum level of daily nutrient intake the is evidenced as unlikely to cause toxicity
2. Food Guide Pyramid (USDA, 2003)--Models a daily diet for between 1600-1800 kcal/day. Specifies food choices for the total diet by recommending a diet adequate in protein, vitamins, minerals, & fiber, without excessive amounts of calories, fat, saturated fat, cholesterol, sodium, added sugars, & alcohol.
3. Daily Reference Values (DRVs)--
Developed by the Nutritional Labeling and Education Act (NLEA) in 1990 to provide a more understandable format for the general public. DRVs are listed for CHO, PRO, FAT (total and saturated), fiber, cholesterol, sodium, and potassium. NLEA also set standards for terms like lite, diet, and low calorie. |
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| Describe the role of the Rn in relationship to other members of the health care team when caring for clients with nutritional problems |
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Definition
| multidisciplinary approach-- coordinating plan of care with healthcare provider, dietitian, etc. |
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