Shared Flashcard Set

Details

Inman domain 2 topic C
planning and intervention
287
Other
Post-Graduate
06/15/2018

Additional Other Flashcards

 


 

Cards

Term
Nutrition interventions influence the ____ or ____ of a diagnosis.
Definition
etiology or effects
Term
What organization evaluates health fraud?
Definition
NCAHF National Council Against Health Fraud
Term
When evaluating for healthcare fraud, obtain info about the claim via questions about CARS which stands for
Definition
credibility, accuracy, reasonableness, supporting documentation
Term
HIPAA
Definition
Health Insurance Portability and Accountability Act
Term
Discharge plan begins when?
Definition
Day 1 of hospital stay
Term
Discharge note includes summary of
Definition
nutrition therapies and outcomes
Term
ranitidine is an
Definition
H2 blocker for tx of gastric ulcers
Term
Diet for gastric ulcers
Definition
as tolerated, avoiding peppers, caffeine, alcohol
Term
Hiatal hernia diet
Definition
same as gastric ulcer diet: as tolerated, avoiding peppers, caffeine, alcohol
Term
Dumping syndrome occurs after
Definition
a gastrectomy (billroth 1 or 2)
Term
Physiology of dumping syndrome
Definition
Processed sugar enters jejunum, water is drawn in to achieve osmotic balance (diarrhea)- blood pressure drops. 2h later, CHO is digested and rapidly absorbed, BG increases rapidly, insulin is overproduced and hyperglycemia is follow by hypoglycemia.
Term
symptoms of dumping syndrome
Definition
cramps, dizziness, diarrhea (weakness, perspiration, rapid pulse)
Term
Billroth 1 (gastroduodenostomy)
Definition
attaches the remaining stomach to the duodenum.
Term
Billroth 2 (gastrojejunostomy)
Definition
attaches remaining stomach to jejunum - duodenum is bypassed.
Term
Secretion of what is reduced with a billroth 2 surgery and why?
Definition
secretin and pancreozymin because they are stimulated by food entering the duodenum which is bypassed.
Term
Absorption of what 2 minerals is reduced w/ billroth 2 surgery because the duodenum is bypassed and why?
Definition
Ca because its most rapid absorption is in the duodenum and Fe because it needs acid
Term
Why is Ca absorption reduced in pt w/ billroth 2?
Definition
bc most rapid absorption is in the duodenum which is bypassed
Term
Why is Fe absorption reduced in pt w/ billroth 2?
Definition
because duodenum is bypassed and Fe needs the acid
Term
What test diagnoses pernicious anemia
Definition
schilling test
Term
Why can folate def mask B12 def?
Definition
because B12 is needed for folate tx inside cell, so B12 def = folate def
Term
Having all or part of stomach (billroth 1 or 2) removed interferes with absorption of which nutrients and why?
Definition
B12, because it needs to bind to intrinsic factor produced by the stomach. Folate, because it needs B12 to enter cells. To a lesser extend Fe (esp if no duodenum or bypassed), because it needs acid for better absorption.
Term
What pts might need B12 injections?
Definition
billroth 1 or 2, total/partial gastrectomy recipients; tropical sprue
Term
Dumping syndrome nutrition therapy
Definition
no [sweets]. 50-60% of CHO complex, protein at each meal, fluids before or after meals to slow passage, moderate fat consumption
Term
What pt population might poorly tolerate lactose d/t rapid transport?
Definition
billroth 1 or 2, total/partial gastrectomy recipients
Term
Delayed gastric emptying (gastroparesis) can be caused by
Definition
Surgery, DM, viral infections, obstructions
Term
Why does DM cause gastroparesis?
Definition
Bc mod-severe hyperglycemia has detrimental effects on gastric nerves
Term
What meds would you recommend for gastroparesis?
Definition
Prokinetics like erythromycin, metoclopromide
Term
erythromycin, metoclopromide are
Definition
Prokinetics
Term
Prokinetics
Definition
increase gastric motility
Term
Nutrition therapy for gastroparesis
Definition
SFM, pureed food, avoid high fiber/fat, do liquid fat
Term
when would a bezoar form?
Definition
in gastroparesis w/ undigested food
Term
what is tropical sprue
Definition
bacterial, viral, or parasitic infection
Term
nutrition therapy for tropical sprue
Definition
high kcals/pro, IM B12, PO folate supps
Term
non-tropical sprue is
Definition
celiac disease
Term
Celiac disease affects what organs and what do they react to?
Definition
jejunum and ileum, gliadin
Term
Sx/sx of celiac disease:
Definition
Malabsorption: diarreah, steatorrhea, FSV def, Fe def an, macrocytic anemia, wt loss
Term
gluten free cannot have
Definition
wheat rye oats barley
Term
Gluten free CAN have
Definition
corn, potato, rice, soy
Term
GF cannot have thickeners because
Definition
they are usually made from starch
Term
Atonic colon
Definition
weakened colon muscles, can cause constipation
Term
Constipation nutrition therapy
Definition
increase fiber/fluids + exercise
rare - cause is too much fiber
Term
Diverticulosis
Definition
the presence of diverticula: small sacs protruding from intestinal wall d/t structural weakness r/t constipation.
Term
Diverticulitis
Definition
when diverticula become inflamed as a result of food and residue accumulation and bacterial action
Term
DiverticuLOSIS MNT
Definition
high fiber diet!!!!! Increases volume/weight/transit time
Term
DiverticuLITIS MNT
Definition
CLD, low fiber diet, gradual return to high fiber diet
Term
fiber fx
Definition
provides indigestible CHO (lignins) bulk, promotes intestinal fx. Binds water
Term
How does fiber lower cholesterol and what type of fiber
Definition
Oat bran and soluble fibers, by binding bile acids causing more cholesterol to need to be used to make bile
Term
What effect do soluble fibers have?
Definition
delay gastric emptying, absorb water, delays/inhibits absorption of CHO/chol in SI by forming a gel
Term
What are soluble fibers?
Definition
Pectins, gums; F/V, legumes, oats, apples, citrus fruits, bananas
Term
A high fiber diet may increase the need for
Definition
nutrients (Ca, Mg, P, Cu, Se, Zn, Fe)
Term
A low fiber diet may lead to
Definition
constiption
Term
gastritis
Definition
inflammation of stomach
Term
gastritis causes
Definition
N/V/D anorexia
Term
Gastritis MNT
Definition
CLD, ADAT, avoid gastric irritants
Term
2 types of IBD inflammatory bowel disease
Definition
Crohn's and UC
Term
Regional enteritis (Crohn's disease)
Definition
affects any part of GI tract, causes wt loss, anorexia, diarrhea, B12 DEF --> megaloblastic anemia
Term
Ulcerative Colitis (UC)
Definition
ONLY AFFECTS COLON so removal of colon = DISEASE GONE. Causes chronic bloody diarrhea, wt loss, anorexia, electrolyte abnormalities, dehydration, anemia, fever, negative nitrogen balance
Term
MNT for IBD (UC/Crohns)
Definition
antidiarrheals, WSV/FSV, Fe, folate, MCT oil, limit fat only if steatorrhea
Term
IBD stands for
Definition
Inflammatory bowel diease
Term
UC MNT
Definition
Elemental diet may be needed to minimize fecal volume
Term
Acute crohn's flare-ups MNT
Definition
bowel rest, PN or low fiber diet
Term
Diet for when IBD is in remission or under control?
Definition
high fiber to stimulate peristalsis
Term
Irritable bowel syndrome IBS
Definition
Chronic abd discomfort, altered intestinal motility, bloating
Term
IBS Irritable bowel syndrome MNT
Definition
Tailor to specific GI issues; avoid large meals, excess caffeine/alcohol/sugars; track triggers (food diary to identify)
Term
Lactose intolerance d/t LACTASE DEFICIENCY
Definition
When lactase isn't there to break lactose into glucose and galactose, whole lactose exerts hyperosmolar pressure --> water in GI tract --> diarrhea, + bacteria fermenting undigested lactose --> CO2 gas (farting)
Term
Lactose intolerance d/t LACTASE DEFICIENCY can be dx by
Definition
breath hydrogen test, lactose tolerance test
Term
Lactose intolerance d/t LACTASE DEFICIENCY MNT
Definition
Ca/riboflavin supps, no milk/milk pdts, no whey; yogurt and small amount of aged cheese might be tolerated
Term
Acute Diarrhea MNT in infants/ children
Definition
aggressive and immediate rehydration, replace fluids/electrolytes; that is CHEAPER than PN and AS EFFECTIVE. reintroduce PO w/in 24h.
Term
chronic nonspecific infantile diarrhea MNT (no significant malabsorption)
Definition
40%kcals as fat, limited fluids, restrict or dilute fruit juice
Term
Adult diarrhea MNT
Definition
remove cause, bowel rest, replace fluids/electrolytes. once diarrhea STOPS, begin low fiber diet follow by protein, don't restrict fat. Feed prebiotic foods (banana flakes, oats), and probiotics.
Term
Steatorrhea is a consequence of
Definition
malabsorption
Term
Normal stool fat is 2-5g. Steatorrhea is indicated by stool fat of
Definition
>7g
Term
Steatorrhea MNT
Definition
High pro/complex CHO, fat as tol, V/M, MCT oil
Term
Short bowel syndrome SBS length
Definition
Less than 2m (6.6ft) left
Term
SBS sx
Definition
Diarrhea, fluid/electrolyte imbalances, malabsorption, weight loss, malnutrition
Term
Removal of what parts of the digestive system in SBS are of particular concern?
Definition
Distal 1/3rd of ileum, ileocecal valve, colon
Term
Most digestion takes place in the first ___cm of intestine
Definition
100cm - duodenum, upper jejunum
Term
the first 100cm of intestine duodenum, upper jejunum is where
Definition
most digestion takes place
Term
if the jejunum is resected, how can the digestive system respond to this?
Definition
The ileum can adapt and take over its functions
Term
Major complications are seen when this part of the small intestine is significantly resected.
Definition
ileum
Term
What can happen if the distal ileum is removed?
Definition
absorption of B12 and intrinsic factor and bile salts decreases
Term
What part of the digestive system normally absorbs most of the fluid back into the body from the GI tract?
Definition
ileum
Term
What happens when the ileum is significantly resected and cannot adequately or at all recycle bile salts?
Definition
Lipids cannot be emulsified and are malabsorbed, forming "soaps" with Ca, Mg, Zn; colonic absorption of oxalates increase forming stones, increased colonic motility and fluid/electrolyte secretion
Term
What happens if the colon is removed?
Definition
water and electrolyte loss, loss of salvage absorption of CHO and other nutrients
Term
MNT for SBS
Definition
PN initially, then trophic EN increasing; may takes weeks to months to transition to foods
Term
MNT for SBS without jejunum
Definition
avoid lactose, oxalates, and [sweets]; add V/M supps
Term
MNT for SBS without ileum
Definition
limit fat, use MCT oil, supplement FSV, Ca, Mg, Zn, parenteral B12 followed by monthly injections
Term
Fx of liver
Definition
Store and release blood, filters toxic elements, metabolizes and stores nutrients, regulates fluid and electrolyte balance
Term
What causes LFTs to elevate
Definition
liver damage which causes damage to liver cells so they spill their contents including liver enzymes into the blood
Term
Acute viral hepatitis
Definition
inflammation, necrosis, jaundice, anorexia, nausea, fatigue
Term
Jaundice occurs when
Definition
bile ducts are blocked
Term
hep A is transmitted
Definition
fecal oral
Term
hep B is transmitted
Definition
sexually or blood
Term
Hep B/A MNT
Definition
Increase fluids to prevent dehydration, 50-55% CHO to replenish liver glycogen, limit fat if steatorrhea, SFM (for anorexia), encourage coffee (antioxidant), multivitamin with B complex, C, K, Zn
Term
Hep B/A protein
Definition
1-1.2g
Term
Cirrhosis
Definition
Damaged liver tissue is replaced by bands of connective tissue which divides the liver into clumps and reroutes many of the veins and capillaries, disrupting blood flow.
Term
Protein def w/ cirrhosis leads to
Definition
ascites, fatty liver, impaired blood clotting
Term
Normal liver blood flow
Definition
esophageal veins --> portal vein --> liver --> vena cava
Term
Ascites occurs when blood cannot leave through the
Definition
liver
Term
Ascites patho (super interesting)
Definition
When blood cannot exit liver into vena cava bc cirrhosis, it hold liver until it reaches 1 liter, the max it can hold, at which point the blood sweats out into the peritoneal cavity as almost pure plasma with high osmolarity which draws even MORE fluid into it to help dilute it.
Term
Ascites leads to ___ and ___ retention.
Definition
Na, water
Term
Low serum albumin in ascites may be due to
Definition
the dilution factor
Term
Ascites occurs when blood can't exit the liver, esophageal varices occur when blood can't
Definition
enter the liver
Term
Portal HTN causes
Definition
esophageal varices
Term
kcals/pro for cirrhosis
Definition
0.8-1g/kg, 25-35kcals
Term
fat for cirrhosis
Definition
25-40% of kcals, or <40g/d if malabsorption
Term
The body's preferred fuel source in the presence of cirrhosis is
Definition
fat
Term
esophageal varices diet
Definition
low fiber
Term
diet for edema or ascites
Definition
low Na
Term
hyponatremia diet
Definition
fluid restriction 1-1.5L, mod Na intake
Term
3 parts of alcoholic liver disease
Definition
hepatic steatosis, alcoholic hepatitis, cirrhosis
Term
why does fatty liver happen in alcoholic liver disease?
Definition
H replaces fat as fuel in the krebs cycle so fat accumulates in the liver and blood (high TGs)
Term
Why does H replace fat as fuel in alcoholic hepatitis?
Definition
Because excess alcohol is converted to acetaldehyde and excess H which disrupts liver metabolism
Term
Describe alcoholic malnutrition
Definition
Alcohol replaces food in the diet, inflames GI tract and causes malabsorption of thaimin, B12, VC, folate. Increased need for Mg because it's excreted w/ alcohol. Malnutrition increases alcohol's destructive effects. thiamin def leads to wernicke-korsakoff syndrome.
Term
Wernicke-korsakoff syndrome
Definition
encephalopathy from severe thiamin def which can be caused by alcoholism.
Term
ESLD is when you have less than __% liver fx left.
Definition
25%
Term
What happens in ESLD?
Definition
Liver cannot convert ammonia (NH3) into urea so it build up and causes sleepiness, confusion, and coma
Term
Asterisix
Definition
flapping jerking motions in ESLD that are a sign coma is coming
Term
ESLD if not comatose
pro/kcals
Definition
1-1.5g, 30-35kcals
Term
fat for ESLD if not comatose
Definition
30-35% of kcals, MCT if needed
Term
When do you use BCAAs in ESLD?
Definition
When pt does not tolerate standard therapy/protein
Term
Why are lactulose and neomycin used in ESLD?
Definition
Lactulose is a hyperosmotic laxative that removes N, neomycin is an ABX that destroys the bacteria that produce ammonia.
Term
Neomycin
Definition
an ABX that destroys the bacteria that produce ammonia
Term
an ABX that destroys the bacteria that produce ammonia
Definition
Neomycin
Term
Cholecystitis
Definition
inflammation of the gallbladder
Term
Cholelithiasis
Definition
gallstones
Term
Tx for chronic and acute gallbladder disease
Definition
acute - 30-45g fat/d (low fat), chronic fat 25-30% of kcals. Also cholecystectmy
Term
Cholecystectomy
Definition
bile now secreted from liver directly into intesine
Term
Pancreatitis
Definition
pancreatic inflammation with edema, fat necrosis
Term
Pancreatitis etiology
Definition
blockage of ducts leading to buildup of panc enzymes in panc or premature activation of panc enzymes so it starts to digest itself
Term
acute pancreatitis MNT
Definition
NPO, IV fluid, can tolerate EN past ligament of treitz, ADAT to low fat
Term
Chronic pancreatitis MNT
Definition
PO pancreatic enzymes, eat max lvl tolerated fat for weight gain, FSV in WS form if malabsorbing fat, avoid large meals w/ fatty foods, alcohol
Term
PN is needed in pancreatitis if
Definition
it is severe and prolonged chronic
Term
PERT therapy is
Definition
pancreatic enzymes for chronic pancreatitis or cystic fibrosis
Term
cystic fibrosis is a disease of
Definition
the exocrine glands where they excrete a thick mucus that obstructs the ducts everywhere in the body
Term
CF diet
Definition
High protein/kcal, unrestricted fat, liberal salt. Supplement FSV in water soluble forms. Normal amounts of V/M. If growing normally though, normal amounts of everything
Term
Essential HTN is
Definition
primary HTN, not caused by something (secondary)
Term
Normal BP
Definition
120/80
Term
Obesity is a major factor in what disease?
Definition
HTN
Term
Tx for HTN/CAD may include thiazide diuretics which may cause
Definition
hypokalemia
Term
4 factors in prevention and tx of CAD/HTN
Definition
Obesity, physical activity, alcohol, high Na intake
Term
CAD/HTN diet
Definition
DASH, Na restriction, lose wt if needed
Term
DASH DIET
Definition
whole grains, F/V low fat dairy, chicken, fish, mod Na, limit alcohol, decrease sweets, Don't supp Ca
Term
Mediterranean diet is rich in what compound
Definition
alpha linolenic acid, MUFAs
Term
Fat sources in Mediterranean diet
Definition
olive oil, canola, soy, nuts
Term
Mediterranean diet meats
Definition
fish, poultry, eggs, breads, low in beef
Term
Mediterranean diet food
Definition
F/V in abundance, beans, legumes, yogurt, cheese, resveratrol from grapes/wine, high good fat, lean meat
Term
Atherosclerosis
Definition
accumulation of lipids; structural and compositional changes in the large arteries
Term
risk factors for atherosclerosis
Definition
HTN, obesity, smoking, elevated blood lipids, heredity
Term
CAD
Definition
Hard, narrow arteries from plaque buildup
Term
ischemia
Definition
blood def d/t obstruction
Term
arteriosclerosis
Definition
loss of elasticity of blood vessel walls
Term
Dyslipidemia
Definition
high TG, low HDL
Term
LDL fx
Definition
tx chol from diet/liver to all cells
Term
HDL fx
Definition
tx cholesterol from cells to liver for excretion
Term
Metabolic syndrome - 3/5 of
Definition
HTN, hyperTG, hyperglycemia, waist >40in men or >35in women, low HDL <40 in men <50 in women
Term
optimal LDL lvls
Definition
<100
Term
Optimal total chol lvls
Definition
<200
Term
diet to reduce chol
Definition
half fiber soluble fiber, get enough fiber, <7% kcals from sat fats, 30 mins mod exercise most days
Term
Heart failure etiology
Definition
weakened heart muscles cant adequately pump blood so blood builds up in tissues (SOB, edema)
Term
heart failure effect on kidneys
Definition
reduced blood flow to kidneys (reduced perfusion) causes them to release hormones that lead to the retention of Na and therefore fluid leading to wt gain
Term
Heart failure MNT:
Definition
Diuretics (glucose intol), low Na diet, DASH diet, FR if needed, 1.2g/kg, normal kcals i guess, evaluate thiamin needs
Term
Rapid acting insulin
Definition
aspart (novolog), lispro (humalog)
Term
rapid acting insulin duration
Definition
4h
Term
Short acting insulin length
Definition
3-6h
Term
intermediate acting insulin
Definition
NPH
Term
NPH length
Definition
10-18h
Term
need bedtime snack w/ what insulin
Definition
NPH
Term
long acting insulin
Definition
glargine (lantus), determir (levemir)
Term
long acting insulin length
Definition
18-24h
Term
DM drug that promotes insulin secretion
Definition
glucotrol
Term
what does metformin do
Definition
enhances insulin action, suppress liver glucose production
Term
dawn phenomenon
Definition
increased morning BG and need for insulin d/t livers natural response to create/release insulin after fasting all night
Term
complications of uncontrolled DM acutely
Definition
acute DKA, acute hyp-O-glycemia (from excess or lack of insulin)
Term
LT complications of uncontrolled DM
Definition
nephropathy, neuropathy, retinopathy
Term
reactive hypoglycemia
Definition
hypoglycemia that happens a few hours postprandially
Term
Addison's disease def and MNT
Definition
adrenal cortex atrophy - no adrenal hormones. high pro, frequent meals, high Na
Term
hyperthyroidism
Definition
excess secretion of thyroid hormones, increased BMR leading to weight loss
Term
hyperthyroidism MNT
Definition
increase calories
Term
hypothyroidism def and MNT
Definition
thyroid hormone def. decreased BMR leading to wt gain. MNT- wt reduction
Term
Gout is a disorder of
Definition
purine metabolism. increased serum uremic acid deposits in joints causing swelling and pain.
Term
Gout diet (although may not be effective)
Definition
low purine diet (low fish/organs) - avoid broth, anchovies, sardines, organ meats, sweetbreads, herring, mackerel
Term
Galactosemia def and MNT
Definition
missing type of galactose enzyme, CANNOT have galactose OR lactose. Avoid: organs, MSG, milk, dates, bell peppers
Term
okay to have w/ galactosemia
Definition
hydrolyzed casein, lactate, lactic acid, lactalbumin
Term
urea cycle defects def and MNT
Definition
unable to synthesize urea from ammonia so ammonia builds up, MNT: protein restriction
Term
Phenylketonuria (PKU) def
Definition
missing enzyme phenylalanine hydroxylase which converts phenylalanine to tryptophan so phenylalanine metabolites build up to toxic lvls.
Term
Phenylketonuria (PKU) MNT
Definition
NO PHENYLALANINE IN DIET. Supplement tyrosine. PKU free formulas for infants. This leads to a low pro, high CHO diet which can lead to dental caries.
Term
glycogen storage disease def and MNT
Definition
def of glucose-6-phosphatase in liver, impairs gluconeogenesis and glycogenolysis --> hypoglycemia. high CHO, low fat diet; eat raw cornCHO at reg intervals for glucose
Term
homocystinurias
Definition
treatable inheritable disorder of AA metabolism. Severe elevated levels of methionine and homocystiene
Term
homocystinurias MNT
Definition
causes low folate, B12, B6; supplement and if that doesn't work, low pro, low methionine diet
Term
Maple syrup urine disease def and MNT
Definition
inborn error of metabolism of the BCAAs. Restrict BCAAs, avoid eggs, meat, nuts, dairy
Term
Arthritis MNT
Definition
lose weight if needed, normocytic anemia may develop, "anti-inflammatory" diet MAY help, would resemble mediterranean diet. NOT DIET RELATED, arthritis prevents reuse of iron
Term
lupus MNT
Definition
NONE
May have FE, folate, Ca, fiber, B12 def
May show sx of celiac disease
May have not diet related anemia
Term
Osteoporosis MNT
Definition
400-800 IU VD/d, 1.2g Ca/d, not more than 500mg at a time
Term
causes of osteoporosis
Definition
malnutrition, lack of exercise, decline in estrogen
Term
osteoporosis patho
Definition
defective Ca absorption --> decreased bone density
Term
rickets is to kids as ___ is to adults
Definition
osteomalacia, adult rickets. VD def
Term
osteomalacia MNT (really easy)
Definition
VD/Ca supps
Term
epilepsy anticonvulsants phenobarbital and dilantin cause
Definition
Ca absorption
Term
Supps needed w/ epilepsy anticonvulsants phenobarbital and dilantin
Definition
1mg folate, VD, Ca, thiamin
Term
If EN + phenobarb, what?
Definition
hold TF for 2h bc it decreases bioavailability of the drug
Term
keto diet supplements
Definition
Ca, VD, folate, B6, B12
Term
cerebral palsy spastic form (difficult stiff movement) MNT
Definition
low kcal, high fluid, high fiber
Term
cerebral palsy non-spastic (athetoid) form MNT
Definition
high kcal/pro finger food diet
Term
Paralysis
Definition
immobilization leads to decreased ability to absorb Ca; also N loss happens
Term
Spinal cord paralysis MNT
Definition
energy needs 10% below predicted, 1.5L fluid/d
Term
Pressure ulcers MNT
Definition
Stage 1+2: 1.2-1.5g.
Stage 3+4: 1.5-2g and supplement vitamin C and Zn, daily dietary VA
Term
Hyperactivity is NOT CAUSED BY
Definition
sugar
Term
Alzheimer's MNT
Definition
avoid distractions during meal times, may need cues to eat, finger foods can help, avoid dehydration, low sat fat, one course at a time, soft calming background music
Term
Anemia def
Definition
decrease in total RBC #.
Term
microcytic, hypochromic anemia
Definition
small pale RBCs d/t Fe def
Term
small pale RBCs d/t Fe def
Definition
microcytic, hypochromic anemia
Term
Macrocytic, megaloblastic anemia
Definition
FEW large cells d/t folate or B12 def
Term
FEW large cells d/t folate or B12 def
Definition
Macrocytic, megaloblastic anemia
Term
Foods high in Fe
Definition
liver, kidney, beef, dried fruit, dried peas and beans, nuts, leafy green veggies
Term
Most common food allergens
Definition
peanuts, eggs, soy, milk, wheat, shellfish
Term
gold standard for detecting allergies
Definition
double-blind, placebo-controlled food challenges
Term
Food least likely to cause an allergy
Definition
rice
Term
Food intolerance differs from allergy why
Definition
no antibodies are produced
Term
In the immediate shock period following a burn, BMR increases by
Definition
50-100%
Term
Burn MNT
Definition
Increase kcals based on burn size, 1.5-3g, VC, 2xRDA WSV, 10,000 IU VA, VK if on ABX, Zn if def
Term
Results of physiologic trauma
Definition
hyperglycemia, hyperinsulinemia, little or no ketosis, increased glucagon; protein catabolism to be converted to glucose for energy. Unavoidable N/pro losses
Term
Trauma kcals/pro
Definition
adequate, not excessive kcals, at RMR. 1.5-2.0g protein
Term
Cancer MNT
Definition
taste changes: seasonings, PO infections: avoid spicy/acidic food and eat bland, throat/neck CA: PEG
Term
radiation nutrition challenges (think of what you would do)
Definition
loss of taste, dry mouth, mucositis, diarrhea, malabsorption
Term
Chemo nutrition problems
Definition
N/V malabsorption, anorexia, stomatitis (from riboflavin def),
Term
mucositis offer ___ and ___ food.
Definition
cold and soft
Term
Marasmus
Definition
protein calorie starvation
Term
iatrogenic malnutrition
Definition
malnutrition brought on by hospitalization
Term
Immediate concern w/ anorexia?
Definition
correct electrolyte abnormalities (K)
Term
Refeeding increases ____ load.
Definition
cardiac. so refeed slowly
Term
bulimia damages
Definition
damage to teeth, throat, knuckles, esophagus; rectal bleeding; low K/Cl lvls
Term
MNT for obese children
Definition
wt maintenance + multidiscp team + heavy parental involvement, usually don't recommend wt loss unless child has serious medical conditions.
Term
A dieter reaching a plateau is the manifestation of
Definition
BMR dropping to reflect their weight loss
Term
healthy obese lab values
Definition
elevated LDL, normal to low HDL
Term
bariatric surgery eligibility
Definition
BMI >40 OR >35 + comorbidities
Term
roux-en-y creates
Definition
a small gastric pouch connected directly to the jejunum
Term
Potential s/e of roux-en-y
Definition
dumping syndrome, anemia, K/mg/folate/B12 def (NEED to supplement)
Term
gastroplasty
Definition
using staples to create a small gastric pouch
Term
Gastric banding
Definition
full reversible inflatable adjustable gastric band, does not require supplements
Term
Prader willi syndrome MNT
Definition
Grehlin lvls elevated --> excess growth hormone, appetite, intake, fat deposits; no sense of satiety, early childhood obesity, best treatment to control food intake
Term
Foods anticariogenic
Definition
cheddar cheese, nuts, meat
Term
Sugar alcohols do not ___ tooth decay.
Definition
promote
Term
Stomatitis MNT
Definition
get enough riboflavin, rinse mouth with water after meals, no spicy
Term
esophagitis MNT
Definition
bland diet, no spicy foods
Term
Achalasia
Definition
disorder of lower esophageal sphincter motility, does not relax and upon upon swallowing (causes dysphagia), need pureed/thick food
Term
GERD MNT
Definition
don't eat before bed, avoid soda, caffeine, acidic foods; need small low fat meals, liquids empty more rapidly
Term
Do NOT limit ___ w/ preeclampsia/eclampsia.
Definition
Na
Term
Hyperemesis gravidarum def and MNT
Definition
severe N/C, acidosis, wt loss. need bed rest, and small frequent amounts of CHO
Term
AIDS nutrition problems
Definition
diarrhea, malabsorption, N/V weight loss
Term
AIDS MNT
Definition
Kcals: BEE x1.3, reg pro or 1.2-2 if wasted LBM, neutropenic diet, DO NOT BREASTFEED
Term
AIDS drugs nutrition problems
Definition
anemia, loss of appetite, low B12/Cu/Zn/carnitine
Term
pediatric HIV MNT
Definition
High pro/kcals for wt gain, double V/M; LBM can be obscured by edema
Term
COPD MNT
Definition
high kcal/pro, SFM/snacks, easy to prepare/eat, nutrient dense supplements/foods
Term
ARDS MNT
Definition
1.5-2g. If EN - formula w/ EPA, linoleic acid, antioxidant vitamins.
Term
elemental EN formulas
Definition
have poor taste. peptamen, vivonex
Term
A large bore TF for blenderized foods is
Definition
#16
Term
A small bore TF thats more comfortable for ready prepared formulas is
Definition
#8
Term
Hang time for open EN systems
Definition
4 hours
Term
Short term EN access would be needed for
Definition
3-4 weeks, NG tube, bolus feeds
Term
A transpyloric tube is placed
Definition
past the pyloric sphincter
Term
Long term TF time and type
Definition
past 304 weeks, PEG/PEJ
Term
How to check tube placement?
Definition
x ray, NOT BLUE DYE
Term
short term peripheral pn (PPN) would be used for
Definition
5-7 days
Term
PPN solutions are limited to what osmolality?
Definition
800-900mOsm
Term
GALT
Definition
Gut-associated lymphoid tissue
Term
max glucose infusion rate for TPN?
Definition
4-5mg/kg/min
Term
min fat rate in TPN to prevent def
Definition
500cc 10% fat emulsion 1-2x a week
Term
sx essential FA def
Definition
petechiae (red spots)
Term
You cannot ___ during period of cardiac instability.
Definition
TPN
Term
D/C TPN when pt tolerates __% of needs met by EN.
Definition
75%
Term
Populations at risk for refeeding syndrome
Definition
anorexia, chronic alcoholism, starvated for 7-10 days, significant weight loss, phos-def TPN
Term
DRI replaced
Definition
RDA
Term
EAR
Definition
Estimated average requirement for 50% of the population, used when planning meals for healthy people
Term
AI (adequate intake) used when
Definition
insufficient data to form an EAR or RDA
Term
UL
Definition
Tolerable upper intake level NOT ASSOCIATED with adverse side effects in most individuals of a healthy population
Term
Dietary guidelines for americans are revised every
Definition
5 years
Term
Community nutrition programs use these guidelines when developing plans
Definition
Dietary guidelines for americans
Term
Dietary guidelines for americans - physical activity guidelines
Definition
30 mins mod a day, 60-90min mod-vig most days for wt loss
Term
Dietary guidelines for americans - general dietary guidelines
Definition
<10% kcals from sat fat, <300mg chol, 20-35% kcals from fat, <2300mg Na, limit trans fats
Term
Healthy eating index
Definition
USDA's overall measure of diet quality; measures how well americans follow the Dietary guidelines for americans
Term
Healthy People 2020 - National Health Program and Disease Prevention
Definition
Identifies broad goals and specific objectives for improving health. Targets healthy diet and healthy weight as critical goals.
Term
licensure laws for dietitians are
Definition
effective legal recourse for consumer protection from incompetent nutrition practitioners
Term
The Transtheoretical Stages of Change
Definition
Precontemplation, contemplation, preparation, action, maintenance
Term
Health belief model explains
Definition
why those at highest risk for disease don't participate in programs designed to detect or prevent it. It's because they don't perceive their risk as a threat either because they don't know about it or don't know about its risk factors.
Term
Goals are ___ while objectives are ___.
Definition
Broad, specific
Term
SMART goals or objectives
Definition
specific, measurable (action verb), achievable, relevant, time frame
Supporting users have an ad free experience!