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Protein required for Nephrotic Syndrome |
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Definition
Get a 24 hour urine collection, which will show protein loss. Protein requirement= RDA (.8gm/kg) + LOSS |
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Sodium restriction for Nephrotic Syndrome |
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PUSH FLUIDS! (Cranberry juice is good because it prevents adhesion of bacteria to the urethral wall by changing the urine pH) |
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Requirements with NO Dialysis |
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Definition
.6 gm/kg protein
2-4 g Na
2 gm K
Fluid: 500-1000 (insensible losses) + U/O
RDA for K is 3.5g, btw |
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Requirements with hemodialysis |
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Definition
Protein: 1-1.2gm/kg
Na : 2-4g
K: 2-3 gm
Fluids: Insensible loss (500-1000cc) + U/O
RDA for K is 3.5g, btw |
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Requirements with peritoneal dialysis |
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Definition
Protein: 1.2-1.3g
Individualized (most liberal)
K: 3-4g
Individualized
RDA for K is 3.5g, btw |
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Definition
Target oxylate, which is high in green leafy veggies; coffee; tea; rhubarb; Watch vitamin C!!! |
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Avoid alcohol and purines(organ meats) |
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Avoid alcohol and purines(organ meats) |
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Definition
Occurs with urine pH changes; increased in immobilized patients. Give meds. |
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Fixing N/V and early satiety |
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Definition
Make every bite count! (high cal)
Give high cal meals earlier when they're less tired (like COPD)
CHO foods digest faster
colorless, odorless and low grease are less likely to cause N/V
give antiemetics 30 minutes before meals for best effectiveness
rest, with no abrupt moving after the meal
avoid empty stomachs--everything is more nausiating on an empty stomach |
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Definition
(when foods don't taste right) Different foods w/in a group. (Dont' discount all meat if chicken tastes bad)
try to change the temp (cold protein doesn't taste as bad)
don't use metal utensils
coffee and tea tend to taste bad
try different textures |
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a general bad taste in the mouth; fix by taking in fluids w/foods. |
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(trouble swallowing; picture having a sore throat)
cool, non acidic foods
straws
no rough/textured foods |
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(no saliva)
artifical saliva
gravies, sauces
casseroles
dairy, creams
avoid dry foods
humidify the room |
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Definition
(also called mucositis; mouth sores)
give liquids/soft foods
use a straw to get past the site
avoid acid
cool foods
use lidocane at meals |
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Term
HIV: Boost Nutritional Status with: |
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Definition
energy; protein; fluid; vitamin/minerals |
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Definition
(unique related to AIDS enteropathy)
try to clear infection, if present
Watch fluid/electrolyte losses....try to maintain a balance
decrease caffine (remember that it stimulates peristalsis)
lower fat
watch sugar alcohols (diabetic candy is a laxitive!)
check for lactose intolerance
use trial and error
soemtimes do soluable fibers |
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AIDS patients are at risk for food borne illnesses. Make sure to follow these rules |
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Definition
No uncooked meats (cook >165 degrees)
Never put uncooked meats above produce in the fridge or during grocery shopping
cold foods less than 40 degrees, hot foods greater than 140 degrees
NO raw fruits and veggies
Sometimes bottled water; never drinking out of streams/lakes
wash hands!
DAIRY/ JUICE MUST be pasturized
no raw herbs
no sushi
no raw eggs
no nuts
no soft cheese (increases the level of bacteria) |
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Definition
When a starved patient starts eating their metabolic needs and electrolyte balance shift. They start using more K and phorphorus to amek ATP. |
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Definition
Vitamin K, r/t clotting issues
Vitamin E (excess increases clotting time)
Herbs ginko, ginseng, garlic (change blood clotting)
Valerian, kava kava and St. John's wart can make patients more succeptable to anesthesia. |
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Definition
Basal energy expenditure increases 7% for each degree F over normal |
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Definition
Direct tissue destruction; hormal hypercatoblism...A head injury has stress factor of 40-50% |
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Definition
Amount of CO2 generated by certain nutrients |
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To decrease respiratory quotent |
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Definition
increase fat calories, and decrease carbohydrate calories |
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Definition
Need 2-2.5 gm of protein
The Curreri formula can help determine the increase in calories, but doesn't account for degree of the burn
Increase fluids to 2.5-4L/day
Give healing vitamins, RDA plus A/C/Zinc |
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Term
Challenges with a burn patient |
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Definition
Intubation
Curlings Ulcer
Pain
Depression, loss of appetite |
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Definition
Needs increased because of healing, and exudate produces fluid, lyte and protein loss.
Protein: 1.5g/kg
Energy: 50% greater than basal metabolic rate (depdends on wound deepness)
Increase fluids
RDA plus healing vitamins (A/C/Zinc)
Also pay attention to Fe balance, b/c low iron could decrease RBC which would decrease O2 which is required for healing |
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DMII Drugs that stimulate insulin production |
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Definition
Sulfonylurias; meglintide (repaglinde); incretin (exenatide) |
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Affects of SNS stimulating drugs |
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Definition
(like norepinepherine or epinepherine)
Increase BP, Increase blood flow to skeletal muscles, heart and brain
increases pulse (arrythmias possible; watch for them!!)
GI smooth muscle relaxation
increase glucose, lactate, fatty acids
Averse effects are like stage fright |
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Term
Affects of SNS inhibiting drugs |
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Definition
(like Beta blockers)
Decrease BP by decreasing peripheral vascular resistance
Orthostatic hypotension; syncope/vertigo; weakness; palpations; bradycardia; headache |
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"Can't see, can't pee, can't shit; can't spit"
Ex: Atropene
Decrease respiratory tract secretions
antispasmotic
Increases interocular pressure (check for glaucoma)
relaxation of ureters, gall bladder ducts ect
Increase HR |
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Definition
Use a soft toothbrush
report bleeding/ bruising
Avoid activities that lead to injury
Use an electric razor
No OTC drugs w/out MD/NP knowledge
Wear a med a lert tag
Coumidin: no increase in high Vitamin K foods |
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