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Unit 8 - Nutrition
Test 3
136
Nursing
Undergraduate 3
04/07/2014

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Cards

Term
What is the primary source of energy for the body?
Definition
Carbohydrates
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
Complex carbohydrate
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
What are lipids?
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
Milk
Eggs
Meat
Fish
Soybeans
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
What is a glyceride?
Definition
triglycerides (true fats composed of fatty acid)
Term
What is a sterol?
Definition
lipids, contain carbon, water insoluble, ex: cholesterol
Term
What is a phospholipid?
Definition
contains a phosphate group, water soluble
Term
What is a phospholipid + a protein?
Definition
Lipoprotein
Term
What do lipoproteins do?
Definition
are transport vehicles for lipids in the bloodstream
Term
What are the 2 kinds of lipoproteins?
Definition
-LDL
-HDL
Term
What is an LDL?
Definition
transport cholesterol to body cells, high saturated fat diet increase LDL’s = CVD


BAD
Term
What is an HDL?
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
What is trans-fat?
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
Calcium
Term
What is water?
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
2.7-3.7 L
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
Kcal consumed = what?
Definition
Kcal burned to maintain weight
Term
How are Kcals burned measured?
Definition
BMR-measures energy used at rest, rarely measured directly
Term
What affects BMR?
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
Lean mass vs % of fat
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
B and C
Term
What do oral contraceptives do to vitamin levels?
Definition
Lowers B and C
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
Smokers
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
What is a vegetarian?
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
DASH diet
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
NO!
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
BG less than 50mg/dL
Term
What are the causes of hypoglycemia?
Definition
insufficient food intake, physical exertion, hypoglycemic medications
Term
What is hyperglycemia?
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
What is transferrin?
Definition
A protein that binds with iron.
Term
How is transferrin measured?
Definition
Total-iron-binding capacity
Term
What is urea?
Definition
an end product of protein metabolism, formed in liver and excreted in kidneys
Term
What tests measure urea?
Definition
Measured by blood urea nitrogen (BUN)
Term
What is BUN an indicator of?
Definition
of liver an kidney function
Term
When is BUN elevated?
Definition
Elevated with impaired kidney function, dehydration, excessive protein breakdown (DM, hyperthyroidism, starvation)
Term
What is BUN low?
Definition
Low with impaired liver function, fluid overload, low protein intake
Term
W
Definition
Term
What is creatinine?
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
What is hemoglobin?
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
Newborns
Term
Who needs vitamin D?
Definition
Breastfed infants
Term
Who needs iron?
Definition
Infants at 4-6 months
Term
Who needs folic acid?
Definition
Preggers
Term
Who needs foods rich in b12?
Definition
Adults 50+
Term
Who needs calcium with vitamin d?
Definition
Women and men 50+
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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