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Unit 13 - Nutritional Meds
Test 3
94
Nursing
Undergraduate 3
04/01/2014

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Cards

Term
What is the RDA for vitamins?
Definition
amount thought to provide needs of 98% of well children and adults) and tolerable upper level intake (max amts)
Term
What are the FAT soluble vitamins?
Definition
A D E K
Term
What are the water soluble vitamins?
Definition
B complex vitamins and C
Term
How are vitamins often taken?
Definition
Vitamins often taken prophylactically-insurance
Term
Which type of vitamin can become toxic if taken too much?
Definition
Fat soluble

Fat soluable-metabolized slowly/stored in fat, liver, muscle/excreted slowly in urine
A and D toxic if taken in large doses over time
Term
When should vitamin administration be increased
Definition
Should be increased in those with rapid growth, pregnant or breastfeeding, debilitating illness, inadequate diets, malabsorptive issues (crohn’s)
Term
What is Vitamin B6? What does it cause an increase and decrease in?
Definition
Pyridoxine.

Causes INCREASE in ISONIAZID
Causes DECREASE in LEVADOPA
Term
What is Vitamin B9?
Definition
Folic Acid
Term
What causes a deficiency in Vitamin B9 (Folic Acid)?
Definition
chronic alcoholism, poor nutritional intake, pregnancy, malabsorption syndromes
Term
What are the symptoms of Vitamin B9 (FA) deficiency?
Definition
anorexia, nausea, fatigue anemias
Term
What does a deficiency of Vitamin B9 (FA) cause in the first trimester of pregnancy?
Definition
can be at risk for neural tube defects such as Spina Bifida
Term
What is Vitamin B12 used in treatment for?
Definition
Pernicious anemia
Term
What destroys Vitamin B12?
Definition
Ascorbic Acid (Vitamin C) and folic Acid may destroy Vitamin B 12
Term
What are the types of polyneuritis?
Definition
Beriberi
Wernicke-Korsakoff syndrome
Term
What is BeriBeri?
Definition
(fatigue, irratability, poor memory)
Term
What is Wernicke-Korsakoff Syndrome?
Definition
CNS disorder (impaired speech and congition)
Term
How is polyneuritis treated?
Definition
IV thiamine
Term
WHat is Polyneuritis associated with?
Definition
Alcoholism
Term
What is vitamin K needed for?
Definition
Adequate blood clotting
Term
What nursing actions should be taken with Vitamin k?
Definition
assess for signs of bleeding
Teach foods high in Vitamin K
Term
What is Ferrous Sulfate?
Definition
A mineral called iron
Term
How should iron be administered?
Definition
Z track method for IM
Term
What are the sources of iron?
Definition
liver, legumes, leafy greens
Term
What is a common reaction of iron supplements?
Definition
Black poop
Term
What is vitamin A used for?
Definition
bone growth, maintenance of epithelial tissues, skin, eyes, hair
Term
What is an early sign of vitamin a deficiency?
Definition
NIGHT VISION (early sign deficiency---night blindness---may progress to blindness)
Term
What are the physical manifestations of vitamin a?
Definition
Night Blindness, dry skin, poor tooth development
Term
Is vitamin A used to treat acne?
Definition
Yes
Term
What does an excess of vitamin A cause?
Definition
teratogenic effects
Term
When is IM vitamin a used?
Definition
use for acutely ill or with malabsorptive illness
Term
Where is vitamin a exerted?
Definition
Excreted in kidneys and feces
Term
Where is excess vitamin A stored?
Definition
the liver
Term
What foods are Vitamin A found in?
Definition
milk, butter, eggs, leafy green and yellow vegetables
Term
What are the symptoms of excess vitamin a?
Definition
hypervitaminosis A (hair loss, peeling skin, anorexia, abdominal pain, lethargy, NV)
Term
What is vitamin D used for?
Definition
Promotes use of Phosporous and Calcium
regulates calcium and phosphorus metabolism, calcium absorption
Term
What are the 2 compounds of vitamin d?
Definition
Vitamin D3-influenced by UV light
Vitamin D2-synthetic
Term
Where is vitamin d mainly excreted?
Definition
In bile
Term
What is the activation of vitamin D dependent on?
Definition
Activation of Vitamin D dependent on serum Ca+
Excess Vitamin D may cause Hypercalcemia
Term
What does a deficiency in vitamin D cause?
Definition
Rickets in children (abnormal shape structure and strength of the skeleton.
osteo (bone) malacia (softening) in adults
Term
What are the early symptoms of vitamin D toxicity?
Definition
Anorexia, N/V
Term
What is the purpose of vitamin C?
Definition
absorption of iron and conversion of folic acid
Carbohydrate metabolism, protein & lipid synthesis
Term
Where is vitamin C excreted?
Definition
Readily excreted in urine-excess is unchanged in urine
Term
What does massive doses of vitamin C cause?
Definition
GI upset and diarrhea
Term
Are there benefits with megadoses?
Definition
No, they are questionable.
Term
What are the food sources for vitamin C?
Definition
Citrus fruit
Term
What causes scurvy?
Definition
Vitamin C deficiency
Term
What is the action of B9 (FA)?
Definition
Essential for body growth (DNA)
Term
What does a deficiency of B9 (FA) cause in pregnancy?
Definition
neural tube defects
Spina bifida, anencephaly
Supplements recommended during pregnancy
Term
What are the symptoms of B9 deficiency? (FA)
Definition
anorexia, nausea, stomatitis, diarrhea, fatigue, alopecia
Blood dyscrasias: megablastic anemia
Term
What is the action of vitamin B12?
Definition
Essential for DNA synthesis and hemato(poesis)= formation
Aids in conversion of folic acid to active form
Term
Vitamin B12 is an _________ ________ needed for absorption?
Definition
Intrinsic factor made by gastric parietal cells
Term
Is b12 excreted quickly or slowly?
Definition
slowly
Term
What causes a deficiency in b12?
Definition
Pernicious anemia-due to lack of intrinsic factor
Malabsorptive syndromes
Use of metformin and proton pump inhibitors
PPI= omeprazole (Prilosec), lansoprazole (Prevacid)
Term
How is b12 given for severe deficiency?
Definition
Given IM
Term
What are the symptoms of vitamin b12 deficiency?
Definition
numbness and tingling in extremities, weakness and fatigue
Term
What are the minerals?
Definition
Iron
Copper
Zinc
Chromium
Selenium
Term
What is the action of iron?
Definition
Hemoglobin regeneration
Most iron found in HGB
Term
What is the RDA of iron?
Definition
5-20 mg/day
50 mg/day for Hgb regeneration
Term
Why is iron given?
Definition
Given to control iron deficiency anemia: microcytic (small), hypochromic (pale), erthyrocytes (RBC)
Term
What are the symptoms of anemia?
Definition
Symptoms of anemia: fatigue, SOB, pallor and if severe, GI bleeding
Term
What is the adverse effects of iron toxic?
Definition
hemorrhage, shock
Term
What is the onset of iron?
Definition
Takes days
Term
Which age group is most susceptible to iron toxicity?
Definition
CHILDREN
Term
What is the action of zinc?
Definition
Essential for growth and tissue repair, wound healing
Taste and smell
Term
What causes a deficiency of zinc?
Definition
Long term TPN patients at risk
Term
What is enteral?
Definition
Involves GI tract
Given orally or by feeding tube
Depends on ability to swallow
Term
What is Parenteral?
Definition
Administration of high-caloric nutrients
Given through large vein (ie. subclavian)
Term
Are D5W, NS, LR forms of nutritional support?
Definition
NO
Term
What is the amount of calories needed for a day?
Definition
2000
Term
Who might need more calories?
Definition
Critically ill-3000 to 5000 cal/day-may be greater for burn pts
Term
What are the routes for enteral feedings?
Definition
- Nasogastric
- Nasoduodenal/nasojejunal
- Jejunostomy
- Gastrostomy
Term
What route should be used if aspiration is an issue?
Definition
Small intestine
Term
What routes are used for long term enteral feedings?
Definition
-Gastrostomy
-Nasoduodenal/Nasojujenal
-Jejunostomy
Term
What are the 3 types of enteral solutions?
Definition
Blenderized
Polymeric (milk based or lactose-free)
Elemental or monomeric
Term
What is a blenderized formula?
Definition
blended natural foods, formulas come ready to use
Term
What is a polymeric formula?
Definition
Supplements for normal or near normal GI
Most commonly prescribed, tastes good, contains protein, carb, fat, vitamins, minerals
Powdered form, many isotonic, solutions offer 1 cal/ml of feeding
Characteristics of formula may be targeted for a certain disorder: diabetes, pulmonary disorders, renal
Term
What is an elemental/monomeric formula?
Definition
partially digested, used for various gastrointestinal diseases-nutrients rapidly absorbed (more expensive)
Ie. Peptinex DT
Term
What are the advantages of enteral feedings over parenteral feedings?
Definition
Less costly than parenteral
Lower infection rate than parenteral
Promotes effective GI integrity
Promotes hepatic function
Promotes body weight gain
Term
What does enteral nutrition absolutely require?
Definition
REQUIRES GASTROINTESTINAL FUNCTIONING!
Term
What are the methods of delivery for enteral nutrition?
Definition
Bolus
Infusion
Term
What are the types of infusion of enteral nutrition?
Definition
Intermittent drip
Continuous drip
Cyclic infusion
Term
What is cyclic infusion?
Definition
continuous feeding over 8-16 hrs /day
Term
Why should some patients be fed during the day?
Definition
if greater risk for aspiration or restless
Term
Why should some patients be fed during the night?
Definition
allows for freedom during day
Term
What are the complications of enteral nutrition?
Definition
Aspiration
Diarrhea
Term
How should you avoid contamination with enteral feedings?
Definition
wash hands, use system with med ports (wipe with alcohol), wear non sterile gloves, dispose tubing/bag after 24 hrs, expiration date, refrigeration
Term
How can you prevent enteral induced diarrhea?
Definition
dilute the feeding or decrease the rate.
Term
How are medications given enterally?
Definition
Water added to medication before administration
Term
What is TPN?
Definition
Total parenteral nutrition

AKA: hyperalimentation (HA) or IV HA
Term
Who is TPN used for?
Definition
Clients with severe burns
Clients with GI disorders
Clients whose GI system needs a rest
Clients with debilitating diseases (ie. metastatic cancer, AIDS)
Term
What is the nutrient content of TPN?
Definition
Hyperosmolar glucose, amino acids, vitamins, electrolytes, minerals, trace elements
Term
Does TPN meet every nutritional need?
Definition
YES!
Term
What are the complications of TPN?
Definition
Air embolism (prevention: Valsalva maneuver)
Pneumothorax, hemothorax
Hyperglycemia or hypoglycemia
Infection
Fluid overload
Term
What does fat emulsion provide?
Definition
Increased number of calories and carrier of fat soluble vitamins
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