Term
| how should a patient position themselves after taking an anti-osteoporotic drug? |
|
Definition
| they cant lay down after they take it, it will cause reflux |
|
|
Term
| What is a good fluid to take your iron supplement with? |
|
Definition
| fruit juice, bc iron is better absorbed in an acidic environment |
|
|
Term
| What can abx (esp. quinolones such as cipro) bind to in the diet? |
|
Definition
| PRO and then the abx will never reach optimum level |
|
|
Term
| What specific drug besides quinolones binds with PRO? |
|
Definition
|
|
Term
| why does mineral oil decrease fat soluble vitamin absorption? |
|
Definition
| increases transit time in the gut and it doesnt give us enough time to absorb it |
|
|
Term
| Methotrexate is a _________ antagonist |
|
Definition
|
|
Term
| Anticonvulsants increase metabolism of what vitamins? |
|
Definition
|
|
Term
| name two classes of drugs that are hepatotoxic |
|
Definition
|
|
Term
| name two classes of drugs that are toxic to the kidney |
|
Definition
anti-infectives
anti-neoplastic agents |
|
|
Term
| what type of drug can screw with glucose levels? |
|
Definition
|
|
Term
| If a patient comes in with diarrhea that you can't explain, why should you ask about tylenol intake? |
|
Definition
|
|
Term
| What are three reasons a woman should try and achieve a normal body weight prior to becoming pregnant? |
|
Definition
-underweight women are more likely to have low birth weight babies
-underweight women may have inadequate nutritonal stores to support healthy pregnancy
-overweight women are more likely to have gestational diabetes and deliver large babies |
|
|
Term
| Supplement of ________ mcg of folate per day to avoid neural tube defects` |
|
Definition
|
|
Term
| a low ______ diet may lead to folate deficiency |
|
Definition
| carb- because a lot of people meet the RDA by eating supplemented grains |
|
|
Term
| _______ is a recommended supplement for pregnant women to promote brain development of the fetus |
|
Definition
| DHA- an omega 3 fatty acid linked to brain development, american diet is low in this so it is good to supplement |
|
|
Term
| appropriate weight gain during pregnancy decreased the likelihood of a __________ birth weight baby |
|
Definition
|
|
Term
| how many pounds should a normal weight women gain during pregnancy? about how many extra kcal's per day is this |
|
Definition
25-35#
300 additional kcals per day |
|
|
Term
| If a pregnant woman is diagnosed with hyperemesis gravidarum what might she be rx? what may she require? |
|
Definition
zofran
TPN (watch blood sugars closely!!!) |
|
|
Term
| what are 3 things a pregnant woman can do to alleviate constipation and hemorrhoids? |
|
Definition
high fiber diet
stay well hydrated
safe amounts of exercise |
|
|
Term
| Gestational dibetes ______ after delivery in the mother. what may have to happen with these babies |
|
Definition
disappears
NICU- hypoglycemic |
|
|
Term
| give some reasons to breastfeed |
|
Definition
-decreases risk of obesity for mom and baby
-species specific
-decreases risk of SIDS
-increased IQ of baby
-less separation anxiety for baby
-decreased risk of breast cancer in mom
-less stinky diapers
-fewer ear infections |
|
|
Term
| what is colostrum? what is it very important for? |
|
Definition
the very concentrated nutrition that is produced by mom for the first 3-5 days after birth
very important for the development of normal gut nutrition. |
|
|
Term
| colostrum acts as a laxative to help meconium passage out of the gut and this is know to decrease the rate of ________ |
|
Definition
|
|
Term
| what type of milk is produced from day 7-14, compare the nutritional make up to that of colostrum |
|
Definition
transitional milk
more fat and lactose and less pro than colostrum |
|
|
Term
| ______ stores from pregnancy fuel lactation. how many more kcals/day may mom need during breast feeding? how many glasses of water? |
|
Definition
fat
500
1 glass with each feeding |
|
|
Term
| does the mom;s diet have a strong impact on composition of breast milk? |
|
Definition
| no- digestion in the adult takes food down to molecular components so it is unusual for mom's diet to have a strong impact on breastmilk |
|
|
Term
| is taking prenatal vitamins during lactation often encouraged? |
|
Definition
|
|
Term
| what vitamin can be particularly problematic during lactation? |
|
Definition
|
|
Term
| what reflex must be absent before solids can be introduced into a babies diet? how old is baby? |
|
Definition
| protrusion reflex- usually at 4-6 months |
|
|
Term
| when introducing solid foods, you should start with one type of food every _______ days to monitor for allergies |
|
Definition
|
|
Term
| what is the most common deficiency in the US? |
|
Definition
|
|
Term
| what are 3 things you may see in a child who is overweight? |
|
Definition
diabetes
high cholesterol
sleep apnea |
|
|
Term
| the elderly are at an increased risk for what 4 deficiencies? |
|
Definition
vitamin D
calcium
B12
protein due to decreased lean muscle and increased PRO requirements |
|
|
Term
| In COPD pt's have increased work of breathing, which translates to increased ____________ requirements |
|
Definition
|
|
Term
| T/F: dairy increases mucous and thereby worsens SOB |
|
Definition
|
|
Term
| Pt's with COPD usually acquire multiple infections and are on chronic dosages of steroids. name one disadvantage and one advantage to being on chronic steroids |
|
Definition
appetite stimulant
increases blood sugars and insulin is the only thing that can bring them back down since it is medication induced |
|
|
Term
| why does research show that mechanical thick foods are better than anything more liquid? |
|
Definition
| because anything thinner is gross and people won't eat leading to malnutrition- an aspiration PNA is easier to fix than malnutrition |
|
|
Term
| CF patients have mucous obstruction of the pancreas which leads to _____________ |
|
Definition
|
|
Term
| what is usually the first sign of lung CA? |
|
Definition
|
|
Term
| Tx of lung cancer is associated with what? |
|
Definition
| N,V,D so need to watch patients hydration status |
|
|
Term
| whats the best thing to encourage a patient with sleep apnea to do? |
|
Definition
|
|
Term
| more than 82.6 million americans have at least one form of CVD, rank the top four in order from most prevalent to least prevalent |
|
Definition
| HTN>CHD>Stroke>Heart failure |
|
|
Term
Give the values for the parameters of metabolic syndrome (must have three or more of the following):
-abd obestiy
-triglyceride levels
-HDL cholesterol
-SBP
-DBP
-fasting glucose |
|
Definition
-men >40", women>35"
-trig >150 mg/dL
-HDL < 40 in men or <50 in women
-SBP >130 mmhg
-DBP >85 mmhg
-FG >100 mg/dL
*glucose intolerance or insulin resistance |
|
|
Term
| what are the target ranges for blood lipids in men and women? |
|
Definition
-Total cho: <200
-HDL >45 women, >35 men
-LDL <100 and <70 with RFs
-Trigs <150 |
|
|
Term
| name 5 factors that modify LDL goals |
|
Definition
-cigarette smoking
-HTN
-Low HDL (<40, >60 counts as a negative RF)
-family hx of premature CHD
-age (m>45, w>55) |
|
|
Term
| dietary cholesterol raises total cholesterol and LDL but not as significantly as what two things? |
|
Definition
|
|
Term
| what is the phenomenon that is seen when cholesterol intake is increased, a smaller intake in cholesterol levels are seen? |
|
Definition
|
|
Term
| dietary SFA and cholesterol have __________ on LDL level |
|
Definition
|
|
Term
| Risk reduction is most effective when SFA and TFA are replaced with unsaturated fats, particularly __________/______/_______ |
|
Definition
|
|
Term
| what is the daily goal for SFA, TFA, and cholesterol intake? |
|
Definition
-SF: <7% of total cals (15 g)
-TF: <1% of total cals (2 g)
-Cho: <200 mg per day for CHD pt, or <300 for others |
|
|
Term
| what fatty acid pathway has more thrombotic and pro-inflammatory metabolites omega 6 or omega 3? |
|
Definition
|
|
Term
| Since we eat meat fed a corn diet, we naturally have a lot of omega-___ in our diets. we need to focus on getting omega-____ from supplement or food sources |
|
Definition
|
|
Term
| what are the three major omega 3's |
|
Definition
|
|
Term
| what are the two omega 6-s? |
|
Definition
|
|
Term
| Name 6 benefits of EPA and DHA |
|
Definition
-reduce TG levels
-decrease platelet adhesion
-favorably effect endothelial function
-decrease vasoconstriction
-reduce inflammation
-decrease Ventricular arrhythmias |
|
|
Term
| ALA may protect against CVD by interfering with the production of proinflammatory ___________ produced via the _____ pathway |
|
Definition
|
|
Term
| Describe primary, secondary, and high triglyceride level recommendations for omega-3 intake |
|
Definition
-PP: 2 or more servings of oily fish/week
-SP: 850-1000 mg of EPA and DHA
-High TG levels: 2-4 g EPA and DHA |
|
|
Term
| if a patient is taking omega 3 supplements it needs to be under the care of a physician, why? |
|
Definition
| PTT and INR need to be watched because blood thinner effects will be enhanced |
|
|
Term
| what are good sources of DHA/EPA and ALA? |
|
Definition
dha/epa: fish
ALA: nuts and seeds |
|
|
Term
| what type of fiber has a greater LDL lowering potential? |
|
Definition
|
|
Term
| what should be your goal fiber intake? |
|
Definition
| 25-30 grams/day with 7-13 grams soluble |
|
|
Term
| plant sterols displace _______ in micelles |
|
Definition
|
|
Term
| plant sterols and stanols are associated with decreased in what two things? |
|
Definition
|
|
Term
| plant sterols and stanols can decrease absorption fo what? |
|
Definition
|
|
Term
| what are some natural sources of plant sterols and stanols? |
|
Definition
| avocado, corn oil, soybeans, chickpeas, almonds, olive oil |
|
|
Term
| what program,started in 1985, focuses on hypercholesterolemia? |
|
Definition
| NCEP national cholesterol education program |
|
|
Term
| NCEP designed ATP 3 to do what? |
|
Definition
calls for more LDL lowering tx
focuses on primary prevention for those with multiple RFs
dietary recommendations; TLC diet (therapeutic lifestyle change) |
|
|
Term
| what does DASH want you to do with your Na, K, and fiber? |
|
Definition
|
|
Term
| what type of diet is associated with the least amount of heart disease? explain it. |
|
Definition
mediterranean
meat monthly, oils fruits veggies beans legums and grains daily, eggs poultry fish weekly with daily PA and wine in moderation |
|
|
Term
| excessive consumption of alcohol is associated with increased risk of ____ |
|
Definition
|
|
Term
| at what level is alcohol beneficial for men and women? |
|
Definition
2 glasses/day men
1 glass per day women |
|
|
Term
| are supplements of antioxidants and b vitamins recommended for CVD prevention? |
|
Definition
|
|
Term
| how many cups of coffee is moderate intake? |
|
Definition
1-2 cups
use paper filter to reduce saturated fat |
|
|
Term
| what is the consensus on vitamin E supplements and heart disease? |
|
Definition
| stop giving them for that, have actually shown to raise the risk of dz |
|
|
Term
| what is glucosamine/chondroitin used for? drug interactions? be careful in pts with? |
|
Definition
OA and other joints DOs
warfarin
diabetics |
|
|
Term
| what is saw palmetto used for? |
|
Definition
|
|
Term
|
Definition
| nausea, motion sickness, arthritis |
|
|
Term
|
Definition
| dementia, age related memory loss |
|
|
Term
| what is st johns wort used for? |
|
Definition
| mild to moderate depression |
|
|
Term
| st johns wort has lots of drug interactions, name three biggues |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| seizure, anxiety,depression, insomnia, pain, muscle spas |
|
|
Term
| garlic used for? adverse rxns? who shouldnt use? |
|
Definition
hyperlipidemia and HTN; bacterial, fungal, viral infxn
reduce clotting time and increase blood level of HIV med
breast feeding moms |
|
|
Term
| what is valerian used for? huge side effect? |
|
Definition
|
|
Term
| name 6 meds with high interaction potential with herbs? |
|
Definition
coumadin (warfarin)
dilantin (phenytoin)
digoxin
cyclosporine
tagamet (cimetidine)
theophylline |
|
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