Term
Nutrition interventions influence the ____ or ____ of a diagnosis. |
|
Definition
|
|
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
|
Definition
Health Insurance Portability and Accountability Act |
|
|
Term
Discharge plan begins when? |
|
Definition
|
|
Term
Discharge note includes summary of |
|
Definition
nutrition therapies and outcomes |
|
|
Term
|
Definition
H2 blocker for tx of gastric ulcers |
|
|
Term
|
Definition
as tolerated, avoiding peppers, caffeine, alcohol |
|
|
Term
|
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
|
|
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
|
|
Term
|
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
|
Definition
bacterial, viral, or parasitic infection |
|
|
Term
nutrition therapy for tropical sprue |
|
Definition
high kcals/pro, IM B12, PO folate supps |
|
|
Term
|
Definition
|
|
Term
Celiac disease affects what organs and what do they react to? |
|
Definition
jejunum and ileum, gliadin |
|
|
Term
|
Definition
Malabsorption: diarreah, steatorrhea, FSV def, Fe def an, macrocytic anemia, wt loss |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
GF cannot have thickeners because |
|
Definition
they are usually made from starch |
|
|
Term
|
Definition
weakened colon muscles, can cause constipation |
|
|
Term
Constipation nutrition therapy |
|
Definition
increase fiber/fluids + exercise rare - cause is too much fiber |
|
|
Term
|
Definition
the presence of diverticula: small sacs protruding from intestinal wall d/t structural weakness r/t constipation. |
|
|
Term
|
Definition
when diverticula become inflamed as a result of food and residue accumulation and bacterial action |
|
|
Term
|
Definition
high fiber diet!!!!! Increases volume/weight/transit time |
|
|
Term
|
Definition
CLD, low fiber diet, gradual return to high fiber diet |
|
|
Term
|
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
|
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
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
CLD, ADAT, avoid gastric irritants |
|
|
Term
2 types of IBD inflammatory bowel disease |
|
Definition
|
|
Term
Regional enteritis (Crohn's disease) |
|
Definition
affects any part of GI tract, causes wt loss, anorexia, diarrhea, B12 DEF --> megaloblastic anemia |
|
|
Term
|
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
|
Definition
antidiarrheals, WSV/FSV, Fe, folate, MCT oil, limit fat only if steatorrhea |
|
|
Term
|
Definition
Inflammatory bowel diease |
|
|
Term
|
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
|
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
|
|
Term
Normal stool fat is 2-5g. Steatorrhea is indicated by stool fat of |
|
Definition
|
|
Term
|
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
|
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
|
|
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
|
|
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
|
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
|
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
|
Definition
inflammation, necrosis, jaundice, anorexia, nausea, fatigue |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
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
|
Definition
|
|
Term
|
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
|
Definition
esophageal veins --> portal vein --> liver --> vena cava |
|
|
Term
Ascites occurs when blood cannot leave through the |
|
Definition
|
|
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
|
|
Term
Low serum albumin in ascites may be due to |
|
Definition
|
|
Term
Ascites occurs when blood can't exit the liver, esophageal varices occur when blood can't |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
25-40% of kcals, or <40g/d if malabsorption |
|
|
Term
The body's preferred fuel source in the presence of cirrhosis is |
|
Definition
|
|
Term
|
Definition
|
|
Term
diet for edema or ascites |
|
Definition
|
|
Term
|
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
|
|
Term
|
Definition
Liver cannot convert ammonia (NH3) into urea so it build up and causes sleepiness, confusion, and coma |
|
|
Term
|
Definition
flapping jerking motions in ESLD that are a sign coma is coming |
|
|
Term
ESLD if not comatose pro/kcals |
|
Definition
|
|
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
|
Definition
an ABX that destroys the bacteria that produce ammonia |
|
|
Term
an ABX that destroys the bacteria that produce ammonia |
|
Definition
|
|
Term
|
Definition
inflammation of the gallbladder |
|
|
Term
|
Definition
|
|
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
|
Definition
bile now secreted from liver directly into intesine |
|
|
Term
|
Definition
pancreatic inflammation with edema, fat necrosis |
|
|
Term
|
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
|
Definition
NPO, IV fluid, can tolerate EN past ligament of treitz, ADAT to low fat |
|
|
Term
|
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
|
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
|
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
|
Definition
primary HTN, not caused by something (secondary) |
|
|
Term
|
Definition
|
|
Term
Obesity is a major factor in what disease? |
|
Definition
|
|
Term
Tx for HTN/CAD may include thiazide diuretics which may cause |
|
Definition
|
|
Term
4 factors in prevention and tx of CAD/HTN |
|
Definition
Obesity, physical activity, alcohol, high Na intake |
|
|
Term
|
Definition
DASH, Na restriction, lose wt if needed |
|
|
Term
|
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
|
Definition
fish, poultry, eggs, breads, low in beef |
|
|
Term
|
Definition
F/V in abundance, beans, legumes, yogurt, cheese, resveratrol from grapes/wine, high good fat, lean meat |
|
|
Term
|
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
|
Definition
Hard, narrow arteries from plaque buildup |
|
|
Term
|
Definition
blood def d/t obstruction |
|
|
Term
|
Definition
loss of elasticity of blood vessel walls |
|
|
Term
|
Definition
|
|
Term
|
Definition
tx chol from diet/liver to all cells |
|
|
Term
|
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
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
half fiber soluble fiber, get enough fiber, <7% kcals from sat fats, 30 mins mod exercise most days |
|
|
Term
|
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
|
Definition
Diuretics (glucose intol), low Na diet, DASH diet, FR if needed, 1.2g/kg, normal kcals i guess, evaluate thiamin needs |
|
|
Term
|
Definition
aspart (novolog), lispro (humalog) |
|
|
Term
rapid acting insulin duration |
|
Definition
|
|
Term
Short acting insulin length |
|
Definition
|
|
Term
intermediate acting insulin |
|
Definition
|
|
Term
|
Definition
|
|
Term
need bedtime snack w/ what insulin |
|
Definition
|
|
Term
|
Definition
glargine (lantus), determir (levemir) |
|
|
Term
long acting insulin length |
|
Definition
|
|
Term
DM drug that promotes insulin secretion |
|
Definition
|
|
Term
|
Definition
enhances insulin action, suppress liver glucose production |
|
|
Term
|
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
|
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
|
Definition
excess secretion of thyroid hormones, increased BMR leading to weight loss |
|
|
Term
|
Definition
|
|
Term
hypothyroidism def and MNT |
|
Definition
thyroid hormone def. decreased BMR leading to wt gain. MNT- wt reduction |
|
|
Term
|
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
|
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
|
Definition
treatable inheritable disorder of AA metabolism. Severe elevated levels of methionine and homocystiene |
|
|
Term
|
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
|
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
|
Definition
NONE May have FE, folate, Ca, fiber, B12 def May show sx of celiac disease May have not diet related anemia |
|
|
Term
|
Definition
400-800 IU VD/d, 1.2g Ca/d, not more than 500mg at a time |
|
|
Term
|
Definition
malnutrition, lack of exercise, decline in estrogen |
|
|
Term
|
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
|
|
Term
epilepsy anticonvulsants phenobarbital and dilantin cause |
|
Definition
|
|
Term
Supps needed w/ epilepsy anticonvulsants phenobarbital and dilantin |
|
Definition
1mg folate, VD, Ca, thiamin |
|
|
Term
|
Definition
hold TF for 2h bc it decreases bioavailability of the drug |
|
|
Term
|
Definition
|
|
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
|
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
|
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
|
|
Term
|
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
|
Definition
|
|
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
|
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
|
|
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
|
|
Term
|
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
|
Definition
adequate, not excessive kcals, at RMR. 1.5-2.0g protein |
|
|
Term
|
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
|
Definition
N/V malabsorption, anorexia, stomatitis (from riboflavin def), |
|
|
Term
mucositis offer ___ and ___ food. |
|
Definition
|
|
Term
|
Definition
protein calorie starvation |
|
|
Term
|
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
|
Definition
damage to teeth, throat, knuckles, esophagus; rectal bleeding; low K/Cl lvls |
|
|
Term
|
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
|
Definition
elevated LDL, normal to low HDL |
|
|
Term
bariatric surgery eligibility |
|
Definition
BMI >40 OR >35 + comorbidities |
|
|
Term
|
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
|
Definition
using staples to create a small gastric pouch |
|
|
Term
|
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
|
Definition
cheddar cheese, nuts, meat |
|
|
Term
Sugar alcohols do not ___ tooth decay. |
|
Definition
|
|
Term
|
Definition
get enough riboflavin, rinse mouth with water after meals, no spicy |
|
|
Term
|
Definition
bland diet, no spicy foods |
|
|
Term
|
Definition
disorder of lower esophageal sphincter motility, does not relax and upon upon swallowing (causes dysphagia), need pureed/thick food |
|
|
Term
|
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
|
|
Term
Hyperemesis gravidarum def and MNT |
|
Definition
severe N/C, acidosis, wt loss. need bed rest, and small frequent amounts of CHO |
|
|
Term
|
Definition
diarrhea, malabsorption, N/V weight loss |
|
|
Term
|
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
|
Definition
High pro/kcals for wt gain, double V/M; LBM can be obscured by edema |
|
|
Term
|
Definition
high kcal/pro, SFM/snacks, easy to prepare/eat, nutrient dense supplements/foods |
|
|
Term
|
Definition
1.5-2g. If EN - formula w/ EPA, linoleic acid, antioxidant vitamins. |
|
|
Term
|
Definition
have poor taste. peptamen, vivonex |
|
|
Term
A large bore TF for blenderized foods is |
|
Definition
|
|
Term
A small bore TF thats more comfortable for ready prepared formulas is |
|
Definition
|
|
Term
Hang time for open EN systems |
|
Definition
|
|
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
|
|
Term
How to check tube placement? |
|
Definition
|
|
Term
short term peripheral pn (PPN) would be used for |
|
Definition
|
|
Term
PPN solutions are limited to what osmolality? |
|
Definition
|
|
Term
|
Definition
Gut-associated lymphoid tissue |
|
|
Term
max glucose infusion rate for TPN? |
|
Definition
|
|
Term
min fat rate in TPN to prevent def |
|
Definition
500cc 10% fat emulsion 1-2x a week |
|
|
Term
|
Definition
|
|
Term
You cannot ___ during period of cardiac instability. |
|
Definition
|
|
Term
D/C TPN when pt tolerates __% of needs met by EN. |
|
Definition
|
|
Term
Populations at risk for refeeding syndrome |
|
Definition
anorexia, chronic alcoholism, starvated for 7-10 days, significant weight loss, phos-def TPN |
|
|
Term
|
Definition
|
|
Term
|
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
|
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
|
|
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
|
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
|
|
Term
SMART goals or objectives |
|
Definition
specific, measurable (action verb), achievable, relevant, time frame |
|
|