Term
| What is the primary source of energy for the body? |
|
Definition
|
|
Term
| What are the simple sugars? |
|
Definition
Monosaccharide (1 unit)and Disaccharides (two saccharide)
Glucose (monosaccharide) primary source of energy for the brain |
|
|
Term
| What is a polysaccharide? |
|
Definition
|
|
Term
| What founds have GOOD carbohydrates in them? |
|
Definition
Whole grains
Vegetables, Fruits
Legumes (peas and beans)
Potatoes
Honey |
|
|
Term
| What are empty calories? Ex? |
|
Definition
Lack essential amino acids, vits & minerals
Sugar
Candy |
|
|
Term
| What are proteins made of? |
|
Definition
| amino acids (contains other minerals-ex: iron, copper) |
|
|
Term
| What do proteins do in the body? |
|
Definition
| Required for growth, maintenance, repair of cells and tissues |
|
|
Term
| What are essential amino acids? |
|
Definition
| can’t be manufactured by the body, must come from food |
|
|
Term
|
Definition
| organic, carbon substance, insoluble in water, fuel body at rest, during light activity, aid in absorption of fat soluble vitamins |
|
|
Term
| What foods contain proteins? |
|
Definition
|
|
Term
| What are the functions of a lipid? |
|
Definition
Supply essential nutrients
Energy source
Flavor and satiety
Insulation, protects organs, thermoregulation, cell metabolism
Cholesterol functions: supports cell body, found in bile which digest fats, & precursor to all steroid hormones |
|
|
Term
| What are the 3 classifications of lipids? |
|
Definition
-Glycerides
-Sterols
-Phospholipids |
|
|
Term
|
Definition
| triglycerides (true fats composed of fatty acid) |
|
|
Term
|
Definition
| lipids, contain carbon, water insoluble, ex: cholesterol |
|
|
Term
|
Definition
| contains a phosphate group, water soluble |
|
|
Term
| What is a phospholipid + a protein? |
|
Definition
|
|
Term
|
Definition
| are transport vehicles for lipids in the bloodstream |
|
|
Term
| What are the 2 kinds of lipoproteins? |
|
Definition
|
|
Term
|
Definition
transport cholesterol to body cells, high saturated fat diet increase LDL’s = CVD
BAD |
|
|
Term
|
Definition
| remove cholesterol from bloodstream, protects against CVD |
|
|
Term
| What are the 2 types of fatty acids? |
|
Definition
| Unsaturated and saturated |
|
|
Term
| What do unsaturated fatty acids do in the body? |
|
Definition
Lowers LDL and Raises HD:
fish, nuts, & seeds |
|
|
Term
| What do saturated fatty acids do in the body? |
|
Definition
Raises LDL:
animal fats; whole milk, butter, cheese, ice cream |
|
|
Term
|
Definition
Saturated fat.
Raises LDL’s: margarines, shortening, fried chips, fast foods, commercial baked goods |
|
|
Term
| What foods are cholesterols found in? |
|
Definition
| animals-meats, egg yolks, dairy, organs meats |
|
|
Term
| What is an essential fatty acid? |
|
Definition
| the body can’t manufacture, an absence creates a deficiency dx |
|
|
Term
| What foods have essential fatty acids? |
|
Definition
Ex: omega 6, found in polyunsaturated vegetable oils, nuts, seeds
and omega 3, in fatty fish: tuna, shellfish 2 X wk
Both protect against heart dx |
|
|
Term
| What do micronutrients do? |
|
Definition
Regulate body functions
They are the vitamins/minerals of the body |
|
|
Term
| What is a mineral? What does it do? |
|
Definition
inorganic, found in nature, absorbed by plants
Fluid regulation, nerve impulse transitions |
|
|
Term
| What is the most common mineral deficiency? |
|
Definition
|
|
Term
|
Definition
| Is a solvent; transport nutrient and O2;maintain body structure; & temperature |
|
|
Term
| What are the fluid compartments of the bodY? |
|
Definition
ICF
ECF - blood/lymph/GI tract |
|
|
Term
| How much water should you drink a day? |
|
Definition
|
|
Term
| What resources are available for nutrition requirements? |
|
Definition
Dietary Reference Intake (DRI charts)
Revised Recommended Daily Allowance (RDA)
For vitamins, minerals, protein, & total kcal
USDA Dietary guidelines
Food guide pyramids (see Fig. 26-1) |
|
|
Term
|
Definition
| Kcal burned to maintain weight |
|
|
Term
| How are Kcals burned measured? |
|
Definition
| BMR-measures energy used at rest, rarely measured directly |
|
|
Term
|
Definition
body composition, growth periods, body temp., environmental temperature, disease, physical exertion (see page 615)
Daily energy requirements= # of kcal needed to replace those used for basic metabolism & physical activity |
|
|
Term
| What is the body composition analysis? |
|
Definition
|
|
Term
| What is important when considering infant nutrition? |
|
Definition
Calories and Protein
Vitamins & minerals: Iron, calcium, vit C &D
Fluids (breast milk or formula):
1.5 to 2 oz /lb of body wt /day |
|
|
Term
| What can infants NOT have? |
|
Definition
NO regular cow’s milk (GI bleed, Kidney strain)
NO honey or corn syrup (fatal botulism toxin) |
|
|
Term
| What is important when considering toddler nutrition? |
|
Definition
Toddlers 900-1800 kcal and 1250ml flds/ day
3 meals/day |
|
|
Term
| What deficiency problems are apparent in toddlers? |
|
Definition
| Fat and meat; Iron, calcium, vit A & C |
|
|
Term
| What steps should you take to avoid toddler choking? |
|
Definition
cut food into small pieces
Be aware of chipmunk food
Avoid eating in car seat or bouncy seat |
|
|
Term
| What is important when considering preschoolers nutrition? |
|
Definition
Picky: may avoid green veggies, or drink less milk, casseroles, sauces
Require between meal snacks
Begin to develop life long habits
Do not use food to punish or reward |
|
|
Term
| What is important when considering school-age children nutrition? |
|
Definition
Need 2400 kcal & 1750 mL fluid/day
Adequate vits and minerals are critical
Advertising affects choices
May use lunch money to buy junk food
Encourage Breakfast to fuel mind and activities |
|
|
Term
| What are the percentages of overweight and obese school age children? |
|
Definition
| 32% overweight, 16% obese, 11% extremely obese |
|
|
Term
| What is important when considering adolescent nutrition? |
|
Definition
Growth & development of reproductive sys.
Need protein, calcium, iron, vit B and D
Active lifestyle, snack often, eat on the go foods with little nutritional value
Keep healthy food in the home: cheese, fruit veggies |
|
|
Term
| What is important with adolescent boys? |
|
Definition
| increase in muscle & bone length and density; eat constantly |
|
|
Term
| What is important with adolescent girls? |
|
Definition
| fat deposition and menstruation, caution dieting |
|
|
Term
| What is important when considering adult nutrition? |
|
Definition
Need adequate amt. protein, vits & minerals
Calcium, vit D, folic acid, and Iron are critical (especially in women for reproductive health)
BMR of middle adults decreases= wt. gain
Diabetes, HTN, obesity, hyperlipidemia as a result of poor choices and sedentary lifestyle |
|
|
Term
| What happens to the older adult body in regards to nutrition? |
|
Definition
Decreased lean body mass, physical activity, and BMR
Need fewer kcal but high levels of nutrients: more milk, yogurt, cheese, water & fiber ; less breads and cereal groups;
May lose interest in eating and thirst sensation
Chronic dx= diet with low NA, simple sugars, & fat
Taste and smell diminish
Limited vision, hearing, & mobility= difficulty with purchasing and preparing food
Tooth loss and gum dx limit chewing
Arthritic hands, inability to drive limits options and preparation
Gastroesophageal reflux, decreased gastric secretions & peristalsis, decreased glucose intolerance
Need supplements of calcium, vit D and B12 |
|
|
Term
| What considerations should be made with pregnant/lactating women? |
|
Definition
Increased nutritional requirements 300kcal/day in 2nd and 3rd trimester
Folic Acid supplement in 1st trimester
Adequate protein, calcium and iron supplements
Lactating need 500 kcal/day extra
Increased fluid, calcium and protein |
|
|
Term
| What affects nutritional status? |
|
Definition
-DIetary patterns
-Cooking methods
-Oral contraceptives
-Using food to cope
-Tobacco smoking
-Alcohol
-Caffine |
|
|
Term
| What foods increase your risk for disease? |
|
Definition
| Foods high in simple sugars increase risk for dx: saturated and trans fats, sodium |
|
|
Term
| What vitamins are lost in cooking? |
|
Definition
|
|
Term
| What do oral contraceptives do to vitamin levels? |
|
Definition
|
|
Term
| How do people use food to cope? |
|
Definition
| Stressing and skipping meals, binge eating, too much snack food |
|
|
Term
| What people use vitamin C faster? |
|
Definition
|
|
Term
| How does alcohol contribute to obesity and malnutrition? |
|
Definition
adds unnecessary cal., slows fat metabolism
Interferes with adequate nutrition
Replacing food, depressing appetite, decreases absorption |
|
|
Term
| How does caffeine affect nutritional status? |
|
Definition
High doses= upset stomach, anxiety
Can enhance mood, mental and physical performance
Aids in burning fat for fuel instead of carbs
Lowers risk of Parkinson’s dx, type II DM, stroke, and dementia |
|
|
Term
|
Definition
Exclude red meat and poultry
Many different types |
|
|
Term
| What should vegetarians eat to enhance nutrition? |
|
Definition
| Soy beans, soy milk, tofu, processed protein products |
|
|
Term
| Why do people become vegetarians? |
|
Definition
Ethical and religious reasons
Health reasons (limiting fat intake) |
|
|
Term
| What supplements may vegetarians need? |
|
Definition
| B12, Vit D, Calcium, Iron, zinc, protein |
|
|
Term
| What kind of diets lead to an imbalance in nutrition? |
|
Definition
Fad diets
Fail to create lifestyle changes |
|
|
Term
| What do good diets for weight loss do? |
|
Definition
focus on food selection & preparation tips
Promote variety and balance nutrition
Includes Physical activity
Self-monitoring and behavior modifications |
|
|
Term
| What diet is recommended for HTN and AHA? |
|
Definition
|
|
Term
| What are some barriers to following prescribed diets? |
|
Definition
Language: use visual aids
Ethnic/cultural food choices: usually what is plentiful in their particular environment/region
Religious fasting/abstaining from meat |
|
|
Term
| What is childhood obesity big in? |
|
Definition
| Mexican americans and african americans |
|
|
Term
| How are some foods preserved? |
|
Definition
-Salted meats
-Dried fruit
-Spices |
|
|
Term
| Does culture always match HCP's idea of health? |
|
Definition
|
|
Term
| How does chronic disease effect nutrient intake/digestion/absorption/use/excretion? |
|
Definition
Dx increase metabolic demands (esp. fever)
Increases need for protein, water, kcal’s
Burns: need protein, vit C for wound & tissue healing
Cancer: Protein-calorie malnutrition
Wt loss & muscle and fat wasting |
|
|
Term
| How does appetite effect nutrition? |
|
Definition
| Poor appetite = decreased nutrient intake |
|
|
Term
| What medicines cause N/V or decreased appetite? |
|
Definition
| Aspirin, antibiotics, anticonvulsants, antidepressants, anti-inflammatory agents, antineoplastic agents, asthma meds (theophylline), fluoride, opioids, potassium chloride, vit & mineral supplements |
|
|
Term
| What medicines DIRECTLY decrease appetite? |
|
Definition
| amphetamine, dextroamphetamine (Adderal), ASA, benadryl, lithium carbonate |
|
|
Term
| How does cognitive functioning effect nutrition? |
|
Definition
| Developmental delay, mental illness, confusion, memory loss |
|
|
Term
| How does the inability to obtain food effect nutrition? |
|
Definition
Unable to shop for food
Limited income: sacrifice food over meds/utilities
Homeless |
|
|
Term
| How does inability to chew effect nutrition? |
|
Definition
| Missing teeth or dentures |
|
|
Term
| How does swallowing effect nutrition? |
|
Definition
| Pharyngitis or esophageal cancer= avoid foods |
|
|
Term
| How does stomach function effect nutrition? |
|
Definition
| Heartburn, stomach disorders= bland diet to avoid pain |
|
|
Term
| How does peristalsis effect nutrition? |
|
Definition
Diverticuli or cancer may increase peristalsis
Leads to decreased absorption
Stress
Gastroparesis= early satiety, N/V affecting intake |
|
|
Term
| How does intestinal surface area effect nutrition? |
|
Definition
| Decreased r/t surgery=decreased absorption |
|
|
Term
| How do enzyme secretions effect nutrition? |
|
Definition
Problems with liver, gallbladder, pancreas affect secretion of enzymes for food metabolism
May lack the enzyme Lactase needed to digest milk
Lactose intolerant |
|
|
Term
| How do medications effect nutrition? |
|
Definition
Chemotherapy/radiation
Cause oral ulcers, intestinal bleeding, diarrhea and interfere with absorption |
|
|
Term
| How does ASA affect folate levels? |
|
Definition
| ASA decreases folate levels and increases excretion of vit C |
|
|
Term
| How do laxatives effect calcium and potassium? |
|
Definition
| may cause depletion of calcium & potassium |
|
|
Term
| How do thiazide diuretics effect B12? |
|
Definition
| Thiazide diuretics decrease absorption of vit B12 |
|
|
Term
| What are some special diets? |
|
Definition
Regular
NPO
Calorie restrictions
Sodium Restriction
Fat restrictions
ADA- diabetic (look up examples in class)
Renal Diet (look up and know)
Gluten free- celiac disease (look up)
Calorie-protein push: wound healing, increase wt., promote growth |
|
|
Term
| What is the subjective data related to nutritional assessment? |
|
Definition
Basic eating habits
Food preferences
Cultural factors
Dietary supplements
Food diary |
|
|
Term
| What is included in a food diary? |
|
Definition
24 hr recall- may not be accurate
Food frequency questionnaire provides a global image of intake
Food record- most accurate, client keeps a 3 day record, requires high level cognitive function & commitment |
|
|
Term
| What is involved in a nutritional screening? |
|
Definition
Ht, wt., BMI, and dietary history
Especially assess elderly for nutrition deficit |
|
|
Term
| What is an anthropometric measurement? |
|
Definition
Skinfold measurement with a caliper
Circumference- waist hip ratio (WHR=w/h)
Abdominal fat= risk for HTN, DM, hyperlipidemia, CVD
BMI |
|
|
Term
| How do you calculate BMI? |
|
Definition
BMI= weight in kilograms/(height in meters)²
So convert weight in lbs to kilograms by dividing by 2.2
Then convert height in inches to meters by 39.37 |
|
|
Term
| What are the ranges for BMI? |
|
Definition
Below 18.5 Underweight
18.5 – 24.9 Normal
25.0 – 29.9 Overweight
30.0 and Above Obese |
|
|
Term
| What are the imaging techniques? |
|
Definition
DEXA scan is used to assess bone mineral content and density
CT scan measures volume, quantity of adipose tissue
MRI excellent assessment of body composition but too costly |
|
|
Term
| What are is hypoglycemia? |
|
Definition
|
|
Term
| What are the causes of hypoglycemia? |
|
Definition
| insufficient food intake, physical exertion, hypoglycemic medications |
|
|
Term
|
Definition
BG greater than 109 fasting or 126 mg/dL random
INDICATOR OF DIABETES |
|
|
Term
| What are the causes of hyperglycemia? |
|
Definition
Excess amount of carbohydrates
Stressors- emotional or physical |
|
|
Term
| What is a low albumin level? What does this indicate? |
|
Definition
| malnutrition (3.5 dL or less) |
|
|
Term
| What causes low albumin levels? |
|
Definition
| malabsorption, liver dx, loss of protein through burns, or wounds |
|
|
Term
| How do fluid levels effect albumin? |
|
Definition
| Well Hydrated pt will have false low |
|
|
Term
| Why is pre albumin a better indicator of albumin levels? |
|
Definition
Pre albumin levels tells you 3 days before the test.
albumin is 3 weeks |
|
|
Term
|
Definition
| A protein that binds with iron. |
|
|
Term
| How is transferrin measured? |
|
Definition
| Total-iron-binding capacity |
|
|
Term
|
Definition
| an end product of protein metabolism, formed in liver and excreted in kidneys |
|
|
Term
|
Definition
| Measured by blood urea nitrogen (BUN) |
|
|
Term
| What is BUN an indicator of? |
|
Definition
| of liver an kidney function |
|
|
Term
|
Definition
| Elevated with impaired kidney function, dehydration, excessive protein breakdown (DM, hyperthyroidism, starvation) |
|
|
Term
|
Definition
| Low with impaired liver function, fluid overload, low protein intake |
|
|
Term
|
Definition
|
|
Term
|
Definition
| end product of skeletal muscle metabolism |
|
|
Term
| What is creatinine an indicator of? |
|
Definition
| Excreted via kidneys, indicator of renal function |
|
|
Term
| What is an increased level of creatinine mean? |
|
Definition
| Increased level indicate impaired renal function or loss of muscle mass |
|
|
Term
| What is leukopenia found in? |
|
Definition
| malnutrition, protein deficiency, alcoholism, bone marrow depression, anemia |
|
|
Term
|
Definition
| composed of iron (heme)and serum protein (globulin) |
|
|
Term
| What does low hemoglobin mean? |
|
Definition
inadequate iron intake or chronic blood loss
OR
decrease in globulin= insufficient protein intake or excessive protein loss |
|
|
Term
| Who should take vitamins and minerals? |
|
Definition
| Appropriate for clients when diet does not provide recommended intake of vit & minerals |
|
|
Term
| Who needs vitamin K injections? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Who needs foods rich in b12? |
|
Definition
|
|
Term
| Who needs calcium with vitamin d? |
|
Definition
|
|
Term
| What causes impaired swallowing? |
|
Definition
| R/t mechanical obstruction (tumor), neuromuscular impairment (paralysis), stroke, cerebral palsy, etc. |
|
|
Term
| What changes should be made when dealing with impaired swallowing? |
|
Definition
Avoid drinking straws
Use chin tuck position
Place food at back of mouth on unaffected side
Check for pocketing of food after eating
Monitor body wt, hydration: I&O, skin turgor, mucus membranes
Take aspiration precautions |
|
|
Term
| What are the aspiration precautions? |
|
Definition
Monitor LOC, cough reflex, gag reflex, swallowing ability
Position 90° upright if possible
Available suction
Feed small amounts
Use a thickening agent for liquids
Keep HOB elevated for at least 30 minutes after feedings |
|
|
Term
| What should you do for NPO patients? |
|
Definition
Provide comfort, oral hygiene
IV fluids
Ice chips, hard candy, chewing gum, rinsing mouth
Avoid eating in front of NPO client
Provide activities at meal time
Parenteral nutrition after 3 days to prevent malnutrition |
|
|
Term
| What interventions should be made with nauseas patients? |
|
Definition
Can cause vomiting and loss of appetite
Assess for cause
Provide comfort and prevention measures
Rinse mouth
Calm environment
Loose clothing
Avoid perfumes
Remove unwanted food
Oral hygiene
Upright position after meals
Cool soda drinks, no ice
Consult dietitian, consider supplements (may cause N/V)
Assess dehydration, administer fluids as needed
Alternative measures
Antiemetics as ordered |
|
|
Term
| What are nutritional problems in older adulthood related to? |
|
Definition
| self-care deficit, loss of appetite, loss taste and smell, decreased income, nutritional deficiencies, gastroesophageal reflux, dry mouth, glucose intolerance, decreased intestinal peristalsis, dementia, NPO |
|
|
Term
| How should you assess a client's meals? |
|
Definition
Assess for deficits
Monitor intake, may need liquid supplements for calories and protein
Work with OT and PT
Provide protein and energy enriched foods
Mid-afternoon snack
Implement prescribed diet
Assist with meals prn, may delegate
Refer to Home Health |
|
|
Term
| How should you intervene with LESS than imbalanced nutrition? |
|
Definition
Assess cause of wt loss (pain, fatigue, illness)
Offer high-calorie and high-protein foods
Consult dietitian, swallowing therapy
Weight regularly under same conditions
Offer high-protein supplements between meals
Community resources: meals on wheels
Counseling for eating disorders (Box 26-5)
Fluid and Electrolyte management
Control pain, provide comfortable environment
Tube feeding (Enteral nutrition) |
|
|
Term
| How should you intervene with MORE than imbalanced nutrition? |
|
Definition
Weigh weekly under same conditions
Keep a food diary
Educate about balanced diet
Encourage fresh fruits and veggies, fewer fatty foods and sugar-sweetened beverages
Discuss fat substitutes to improve flavor
Encourage regular exercise |
|
|
Term
| When is parenteral feeding used? |
|
Definition
Used when client cannot be fed through GI tract or in addition to oral feeding to meet nutritional needs
Used in clients with burns, trauma, required GI rest |
|
|
Term
| What does parenteral food contain? |
|
Definition
| Contains 10-70% dextrose in water, amino acids, vitamins and minerals, lipids may be added |
|
|
Term
| How do you avoid complications in parenteral feedings? |
|
Definition
Confirm central line catheter tip is in superior vena cava via chest x-ray
Place patient in supine position
Id patient with 2 identifiers & verify by a 2nd nurse
Compare bag with original order and check bag for cloudiness, particles, or leaks
If lipids added, avoid a brown layer or oil droplets , should not be cold, complete w/in 20 hrs.
Maintain Sterile technique when appropriate and aseptic (clean) technique
Use a FILTER
New bag must have new primed administration set
Clamp catheter and old set when changing tubing
Valsalva maneuver when connecting new tubing
Check VS q 10 minutes for 30 with lipids |
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