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8 Cards in this Set
- Front
- Back
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Gastroesophageal reflux disease (GERD) |
- gastric fluid moves into the esophagus creating acid --> leading to heartburn - decrease in lower esophageal spinchter pressure, and irritation of esophageal mucosa by gastric acid, bile and pancreatic secretations; also assoicated with abnormal esophageal acid clearance or dealyed gastric emptying -T: decrease total fat intake, and reduce: chocholate, mint, alcohol, citrus juices, tomato, coffee - weight loss may be beneficial; keep an upright posture after eating; may be useful to inc bed to 45 degrees during and several hours after eating |
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Dumping syncrome - or Jejunal hyperosmolic syndrome |
- usually post gastrectomy surgery - etiology: alteration, ablation or bylass of the pyloric spincter - food mass enteres teh jejunum and --> cramping --> full + rapid pulse, weakness, seating, dizziness, n, v, d within 1-2 hours post meal or 10-15 min post (early dumping) - especially common in meals post high cho loading - increases in osmotic pressure --> water is shifting from teh blood to the intestines and there is a relesease of inestinal hormones (including: serotonin, bradykinin, enteroglucagon, gastric inhibiitory peptie, neurotensisn) - often corresponds with mild hypoglycemia; anxiety and weight loss - T: try 5-6 small meals daily; relatively high fat content to reduce the speed of foods and help with weight management; choose low CHO to prevent the fast passage of these foods - Diet order: no milk, no sugar, no sweets or desserts, no alcohol, no sodas, no liqudis at meals, no fluids for at least one hour before and after meals; low fiber foods; and raw foods |
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Inflammatory bowel disease (IBD) |
- UC and Chrohn's disease - malnutrition is common - and there is often low food intake, dec abs, excessive losses and increased requirements - medications = may interfere with nutrient metabolism - cholestryramine with fat-soluble vitamins, corticosteriods with calciium and sulfasalizine with folate - T: maintain K and pro intake; monitor for vit and min def. (Vit a, B12, D, K, ascrobic acid, folate, iron, ca, K, zinc); choose low fiber, low residue diet for long term care; PN may bee needed essecially with small bowel crohn's. anti-inflammatory drugs - associated with fistual, bowel performation, obstruction, and abscess; bowel resut with formul adets in some cases with distal conditions |
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Ulcerative colitis |
- chronic inflammation of the mucosa of the large intestine - s/s: rectal bleed, diarrhea, pain, anemia, fever, negative N balance, anorexia, dehydration, malnutrition - E - unknown - immune / emotional factors - Complications - toxic megacolon, fistula, hemmorrhage, obstruction, and growth retardation in children. |
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chronic peptic ulcer disease |
- repeated peptic ulcers (eroded lesions or excavated scores in the stomach and the dudodenum due to injury from digestive secretions) - causes - heliobacter pylori bacteria, aspriin and nonsterodial anti-inflammatory agents, stress; high / prolonged doses of corticosteriods can increase the risk; inc with alochol and smoking - t: histamine h2 receptor blockers, Proton pump inhibitors, antacids; antimicrobial regimines; * note: excessive and long-term use of calcium antaacids may induce hypercalcemia na dkidney stones; bland diet may not be helpful - det: eat three or more well balanced meals / day; avoid late night eating which can increase acid production in the eve hours, dec alcohol, dec salicylates adn smoking, limit caffeine and decaff beverages, adn avoid spicy foods and other foods that may increase problems |
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gastric resection - |
- surgical removal of part of all of the stomach - partial is less damaging / dramatic than full - total gastrectomy - the esophagus is joined to teh jejunum (anastamosis) - Vagotomy - cutting the vagus nerve to reduce the impuses carried by the vagus nerve -- reducing acidity, gastric fullness and distention that can cause food fermentaiton, gas and diarrhea - nutr related problems: weight loss, dumping syndrome, diarrhea, malabsorption, anemia, def. of iron, b12, foalte, metabolic bone disease adn bezoar formation - T: 2 weeks post gastrectomy - progressive inc the diet while keeping meal size small adn more frequent; choose mild foods with low bulk; limit volume and give beverages betwen feeding; nutritional support may be used when patients have problems transitioning to oral intake. - if the patient cannot handle nutrient formula - an elemetnal forumula may be appropriate -PN is primarily indicated for aptients with gastric resection and/or small bowel resection due to intractable diarrhea and or severe malnutrition |
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gastric bipass |
- a surgical intervention that is used for extreme obesity when weight is 100 to above # overweight with failure of other dietary and behavioral interventions - high pro meals used post surgery; with bev between meals and supplemention of essential nutrients |
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celiac disease ( gluten-sensitive enteropathy) |
- sensitivity to gliadin - part of gluten - patients have damage to the villi of the intestinal mucosa = deficiency of enzymes for gluten digestion ; some foods with gluten that do not cause a digestion problem are allowed - T: lifelong gluten restriction - free ofthe glutamine-bound fraction gliadin; common accepted foods are: vegetable proteins (rice, corn, potatoes, beans, fish, meat) |
