Fund Ch 29 Nutrition

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Six categories of nutrients

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Carbohydrates, proteins, fats, vitamins, minerals and water

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Macro-nutrients of the body

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Carbohydrates proteins fats. Used by the body in large quantities

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Micronutrients of the body

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Vitamins and minerals. Used by the body in small quantities

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Metabolism

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Process by which cells use or store energy from nutrients

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Types of carbohydrates

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Monosaccharides and disaccharides which are simple sugars and polysaccharides which is complex sugars

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What foods are simple carbohydrates

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Sugars syrup, molasses, honey, fruit, and milk

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What are carbohydrates composed of

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Carbon, hydrogen, and oxygen

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Foods that are complex carbohydrates

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Bread, cereal, potatoes, rice, pasta, crackers, flower products and legumes

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Why are carbohydrates important to the body

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Main source of energy. Oxidizing fats and normal fat metabolism; promoting desirable bacterial growth in the GI tractcomma which contributes to the synthesis of vitamin K and B12. Reduce the carbon component in synthesis of non-essential amino acids and produce other essential body acids and compounds

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Protein sparing

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When body uses carbohydrates are than protein as a source of energy and tissue rebuilding

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Fiber

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Essential role in stimulating peristalsis to maintain normal Bell emanation. Not digested in GI tract

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Proteins

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Organic compounds composed of polymers of amino acids connected by peptide bonds. They contain carbon, hydrogen, oxygen, and nitrogen. Sometimes iron or copper.

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The body synthesizes proteins for what specific functions?

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Hemoglobin for carrying oxygen to tissues, insulin for blood glucose regulations, and albumin for regulating osmotic pressure in the blood.

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Proteins are vital to what?

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Growth, development, in normal functioning of almost all body systems. Bones, skin, teeth, muscle, hair, blood and serum

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Complete proteins

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Contain sufficient amounts of essential amino acids to maintain body tissues and to promote growth. Meat, fish, poultry, milk, cheese and eggs

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Partially complete proteins

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Sufficient amount of amino acids to maintain life but do not promote growth

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Incomplete proteins

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Do not contain sufficient amounts of all essential amino acids to maintain life, build tissue, or promote growth. Dried peas and beans, peanut butter, seeds, fruits and vegetables, bread, cereal, rice, and pasta

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Fats

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Lipids. Neutral fats, oils, fatty acids, cholesterol, and phospholipids. Organic substance composed of carbon hydrogen and oxygen. Make up 20% of body weight of a healthy non-obese person

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Importance of fats in the body

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Cellular transport, insulation, protection of vital organs, provision of energy, energy storage of adipose tissue, vitamin absorption, and transport of fat soluble vitamins

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Fat soluble vitamins

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A , d, e, and K

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Vitamins

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Organic compounds essential to the body in small quantities for Grove, development, maintenance, and reproduction.

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Vitamin A

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Maintenance of normal vision and healthy epithelium, promotion of normal skeletal in tooth development and normal cellular proliferation. Vitamin A is stored in the liver an excessive intake can be toxic

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Vitamin D

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Important in intestinal absorption of calcium, mobilisation of calcium and phosphorus from bone, renal absorption of calcium

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Signs of vitamin A deficiency

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Night or total blindness, epithelial changescomma eyes nose or ear infections, dryness of eyes, and adequate tooth and Bone development

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Vitamin D deficiency signs

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Rickets in children, poor dental health, tetany, osteomalacia.

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Vitamin e

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Antioxidant, assistant maintaining the Integrity of cellular membranes and protecting vitamin A from oxidation

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Vitamin K

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Meeting in the liver for the formation of prothrombin and other clotting factors

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Water soluble vitamins

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B complex vitamins and vitamin C

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Vitamin B1 thiamine

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Functions in carbohydrate metabolism and healthy nerve functioning in normal appetite and digestion.

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Vitamin B1 thiamine deficiency symptoms

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Poor appetite, apathy, mental depression, 40, constipation, edema comma cardiac failure, and neuritis

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Beriberi

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Disease associated with deficiency of vitamin B1 thiamine intake

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Vitamin B2 riboflavin

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Functions in protein and carbohydrate metabolism and contributes to healthy skin and normal vision

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Vitamin B2 riboflavin deficiency symptoms

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Cracking and fissures at the corners of the mouth, dermatitis, increased vascular ization of the cornea, and other Vision irregularities

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Vitamin B3 niacin

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Involved in glycogen metabolism comma tissue regeneration, and fat synthesis

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Vitamin B3 niacin deficiency symptoms

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Fatigue, headache, loss of appetite and weight loss, abdominal pain, diarrhea, dermatitis, and neurologic deterioration

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Pellagra

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Disease associated with deficiency of vitamin B3 niacin

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Vitamin B12 cyanocobalamin

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Functions in the formation of mature red blood cells and in the synthesis of DNA and RNA. Found only in animal Foods Meats, fish, poultry, milk, and eggs

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Vitamin B12 cyanocobalamin deficiency symptoms

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Pernicious anemia, other forms of anemia, and neurologic deterioration

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Folic acid

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A vitamin B that is a coenzyme in protein metabolism and cell growth. Is necessary for red blood cell formation.

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Folic acid deficiency symptoms

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Glossitis, diarrhea, macrocytic anemia, and birth defects

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Who's most at risk for folic acid deficiency

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Women of childbearing years, black women, and people with alcohol dependence, and people with malabsorption disorders

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Vitamin C

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Antioxidant that protects vitamins A and E from excessive oxidationperiod protection against infection, adequate wound healing, collagen formation, iron absorption, metabolism of several important amino acids

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Signs of vitamin C deficiency

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Inadequate formation of collagen or poor wound healing, increased susceptibility to infection, retardation and growth and development, joint pain, and anemia.

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Scurvy

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Rare but associated with deficiency of vitamin C from lack of fresh fruits vegetables and particularly citrus fruits in the diet

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Minerals

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Inorganic substances found in nearly all body tissues and fluids. More than 25 known minerals in the adult body. Calcium, iron, sodium, potassium, iodine, fluoride, water

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Location and importance of calcium in the body

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Found in bones and teeth. Important for conversion of prothrombin to thrombin and other steps of coagulation process, nerve impulse transmission by participating in formation of acetylcholine, regulation of materials in and out of cells, contraction and relaxation of muscles, most notably the heart muscle.

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Iron

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Found in hemoglobin in myoglobin

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Iron deficiency

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Iron deficiency anemia. Circulating hemoglobin is reduced in the blood cannot provide for oxygen needs of the tissues

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Sodium

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Primarily found in extracellular fluid in the body. Helps maintain fluid as ion and acid-base balance.

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Potassium

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Found in intracellular fluidperiod functions and protein synthesis, and fluid balance as an ion, and in regulation of muscle contraction

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Iodine

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Trace element, but important mineral. Primary location is in thyroid gland. Component of thyroid hormones that help regulate energy metabolism, nervous and muscle cell functioning, and mental and physical growth

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Iodine deficiency

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Can lead to endemic goiter, enlarged thyroid gland Dash this condition is especially significant and pregnant women because it can lead to physical and mental retardation

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Fluoride

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Trace element primarily found in bone and teeth. Maintains bone structure reduces tooth decay by strengthening tooth enamel

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Mechanical process of digestion

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Mastication, deglutition into pharynx and esophagus, churning movements and peristalsis mix moving material through stomach into duodenum, in small intestine ingested material is further turned in mixed with enzymes and comes into contact with intestinal mucosa to allow for absorption, peristalsis moves ingested material into large intestine, further turning christophsis in absorption move the residue of ingested Mass along the large intestine where to store it until evacuation from the body

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Metabolism

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Complex chemical process occurs in cells to allow energy use in cellular growth and repair. Involves catabolic and anabolic processes

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Catabolic process

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Break down complex substances into simpler substances example - tissue breakdown

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Anabolic process

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Convert simple substances into more complex ones example - tissue repair

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glycogenesis

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The liver cells change short-term glucose excess into glycogen in the presence of insulin

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Gluconeogenesis

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Formation of glucose from protein and fat in the liver

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BMI

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Weight in pounds divided by height in inches squared times 703

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Overweight BMI

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Between 25 and 29.9 kg/m^2

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Obesity BMI

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30 kilograms per meter squared or more

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Underweight BMI

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Under 20 kg/m^2

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Ideal BMI

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20 - 25 kg/m^2

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Anthropometric measurements

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Include height and weight, waist measurement, skinfold measurements, and arm circumference measurements

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A waist measure higher than 42 and women in 47 inches and men has been associated with what

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Higher risk of health problems such as heart disease, diabetes, hypertension, and dyslipidemia

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Hematocrit

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Percentage of red blood cells found in a hundred milliliters of blood. Combined with hemoglobin value aids and determining the presence and severity of anemia

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Hemoglobin count

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Measures the Bloods oxygen and iron carrying capacity

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Serum albumin in prealbumin

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Protein markers that help assess nutritional status

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Serum albumin

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Accounts for more than half of the body's total serum protein. Serum albumin values reflect protein intake or absorption.

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Serum albumin value less than 3.5 grams per deciliter May indicate what?

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Nutritional deficits. Could also be related to over-hydration.

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Prealbumin

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accurately assesses protein synthesis and nitrogen balance period is considered very sensitive and specific marker for nutritional status

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Serum transferrin

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Blood protein that binds with iron and is important in its transport, is considered sensitive indicator of protein deficiency. *Changes in protein intake or visceral protein are more rapidly reflected in the transferrin than in albumin levels. It is synthesized in the liver. *increases when iron stores are low and decreases when iron stores are high.

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Creatinine excretion

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Its formation is proportional to Total muscle mass. Measured by collecting and measuring creatinine in urine during 24 hours. As muscles atrophy during malnutrition creatinine excretion decreases

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Dietary modification for renal disease

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Restrict intake of sodium potassium protein and possibly fluids

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Dietary modification for liver disease / cirrhosis

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Restrict intake of sodium increase intake of protein, unless hepatic coma is pending, I which time protein is virtually eliminated

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Dietary modification for congestive heart failure

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Restrict intake of sodium and calories

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Dietary modification of coronary artery disease

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Restrict intake of sodium, calories, and saturated fats and cholesterol

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Dietary modification for burns

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Increase intake of calories, protein, vitamin C, and the B complex vitamins

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Dietary modification for Respiratory - emphysema disease

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A soft, high-calorie, high-protein diet is recommended

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Dietary modification for tuberculosis

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Increase intake of protein, calories, calcium, and vitamin A

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Dietary modification for hypertension

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Restrict sodium intake period lose weight, if appropriate

Front 84

Gastrostomy tube

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In the stomach

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Jejunostomy tube

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Feeding tube in the intestine

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Peg percutaneous endoscopic gastrostomy

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Procedure for Gastronomy placement

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Small bore feeding tube

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Tube to deliver enteral feedings for use when tube feeding is indicated for short. Of time. Varies in size from 8 to 10 French, is flexible

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Grv gastric residual volume

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Used to test tolerance of internal feeding period usually done by inserting a catheter tip syringe into proximal end of feeding tube and aspirating gastric contents. High levels are more than 400 to 500 milliliters

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Type of feeding tube recommended for patients who are at risk for aspiration

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Jejunal feeding tube

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Positioning of patient during tube feedings

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Fowler's position head of bed elevated at least 30 to 45 but best at 90 degrees at all times when feeding and 30 minutes after

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Adequate hydration for patient on feeding tube

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200 milliliters of free water every 6 hours

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How to prevent clogged tubing

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Flushing tube with 32618 oz of warm water before and after giving medications and when disconnecting to feedings

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How to unclog feeding tube

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Instill a solution of meat tenderizer and 30 milliliters of warm water, let the solution sit for 5 minutes and the feeding tube dissolved particles, follow up with warm water flush