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88 Cards in this Set

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What are some clarities that Ms. Meredith made for us from the last test?
**extra notes for testing purposes/clarity: PMI is @ 4th or 5th ICS; more likely @ 5th, but ok @ 4th.
Documentation IS a nursing intervention; sometimes you just have to document that things are going well..and that is still an intervention.
A routine procedure for checking VS is q4hrs; unless a fresh post-op patient, High BP, high temp, etc would indicate more frequent checking; sometimes postpartum will be once a shift.
We don’t always call the doctor; if there is something that a nurse can do w/their nursing judgment, we should know if it is appropriate to call or make our own judgments (look @ big picture); even in a code, you call for help on floor 1st before you would call..then once, code is called and help is there (code team will come, which includes an ER doc).
What is the primary dietary deficiency of the strict vegan?
Vitamin B12 called cobaliamin. It can only be obtained through animal protein or special supplements or foods fortified w/ the vitamin. They are susceptible to development of megaloblastic anemia or neurological problems. Strict vegan & lacto-ovo vegetarians are both susceptible to iron deficiency, especially during child, adolescence, and pregancy. Other defiencies might include calcium, zinc, A & D and protein in general. Foods that are high in iron and aren't animal, would be enriched grains like: oats, cereals, and farina. Vegetarians eat protein, but they are incomplete proteins or those only having some of the 22 amino acids (like up to 9) Examples: Incomplete-grains (corn), legumes ( navy beans, soy beans, peas), nuts, seeds (sesame, sunflower).
Tell the basic role that carbs, fats, and protein play in the diet.
Carbs are the primary source of energy, 4 cal/gm, simple or complex, mono,di, or poly, recommended that 1/2 our calories be from complex carbs, (polys), Polys are whole grains, potatoes, and legumes. Fats currently take up 36% of diet, when it should be 20-35% range, 9cal/gm, Stored in adipose tissue, is a major source of energy and insulation from cold, and padding of vital organs.Act as carrieres of fatty acids and fat-soluble viatmins (ADKE). Proteins, obtained from animal and plant, provide 15-20% of daily cal needs. 4cal/gm. They are complex nitrogenous organic compounds of amino acid structure. There are 22 amino acids., They are essential for tissue growth repair and maint, body reg functions, and energy.
Name the vitamins and the overall function of vitamins in the body.
There are fat and water soluble vitamins. Fat soluble vitamins DEAK can be stored and so can build up toxicity and deficiency levels. Where as water soluble (B1, B6, B12(cobalamin), and folic acid) are urinated out and one can only have a deficiency. Vitamins main overall function is they are required in the body for normal METABOLISM. They function in enzyme reactions that facilitate the metabolism of amino acids, fats, and carbs.
Name the signs of toxicity and deficiency of fat-soluble vitamins in the body. Also name the recommended daily amounts of each.
Vitamin A: DRI in men: 900 mcg/retinol equivalents; Women: 700 mcg/retinol equivalents. A toxicity in A will show hair loss, dry skin, headaches, dry mucous membranes, liver damage, bone and joint pain, blurred vision, nausea and vomiting. Deficiency will cause dry scaly skin; increased sus. to infection, night blindness, anorexia; eye irritation, xerosis(dry skin,) keratinization of resp and GI mucosa, bladder stones; anemia, and retarded growth. D DRI: Adults: 5-10 mcg of cholecalciferol. 40IU. Toxic D: Deposits of calcium & phosphorus in soft tissue; kidney and heart damage; bone fragility; constipation, anorexia, nausea, vomiting, and headache. Deficient D: Muscular weakness; excessive sweating, diarrhea, and other GI disturbances; bone pain; active rickets; healed rickets, and osteomalacia. DRI E: is Adults 15mg. Toxic E: Relatively nontoxic; Defiecient E: Neurologic deficits; Toxic K: DRI men 120 mcg/women 90mcg. Toxic K: Anemia/ Deficient K: Defective blood coagulation.
What is the general overall function of minerals? What are the minimum amounts that we need of trace and macro-minerals. Name the minerals and trace minerals.
Minerals are catalysts for biochemical reactions. Micronutrients are subdivided according to the quantities needed in the human diet. If more than 100 milligrams (mg) per day of an element is needed, it is classed as a mineral. The seven essential major minerals (need more than 100 mg a day) are calcium, magnesium, phosphorus, sodium, potassium, sulfur, and chloride. Substances that are essential but needed in amounts of less than 100 mg per day are called trace elements. These are iron, copper, iodine, manganese, zinc, molybdenum, selenium, chromium and fluoride.
Where does digestion begin and end? What parts of the body are involved in digestion.
Starts in the mouth ends in the small/lg intestine. Teeth, mouth, tongue, pharynx, larynx, trachea, esophaus, liver, gallbladder, stomach, pancreas, colon, rectum jejunum, cecum,
What is the primary site for absorption of nutrients?
Small intestine
What is the vital nutrient that we forget about?
Water, so important to the fluid environment and cells.
What are anabolic and catabolic reactions?
Anabolic: building going on in the cells; set of metabolic pathways in nutrient metabolism that build molecules from smaller units. (examples: anabolic process in the liver: forming glycogenesis (building glycogen)
Catabolic: set of metabolic pathways that breaking down molecules into smaller objects to make energy (anabolic process is glycolysis; glucogenesis; breaks down glycogen to give body glucose to use) Other examples:Anabolism is the building of more complex biochemical substances by synthesis of nutrients. Anabolism occurs when an individual adds lean muscle through diet and exercise. Amino acids are anabolized into tissues, hormones, and enzymes. Normal metabolism and anabolism are physiologically possible when the body is in positive nitrogen balance. Catabolism is the breakdown of biochemical substances into simpler substances and occurs during physiological states of negative nitrogen balance. Starvation is an example of catabolism, when wasting of body tissues occurs.
What substances are necessary to ensure absorption of nutrients in the body? What is the food substance called that goes into stomach and out of stomach to prepare for peristalsis
Digestive enzymes. Going down through esophagus into stomach food is a formed bolus, Going out of the stomach, the food substance is chyme as it enters the small intestine.
What is the food pyramid called now?
Called My Pyramid-with consideration to the fact that many cultures have their own food styles to fit into the pyramid, i.e. beans and tortillas, or fish and rice....Nurse should know what different demographics might be lacking or getting too much of, like African Americans high fat soul food, or poor people who eat lots of sodium-filled canned foods, or Asians who don't get enough calcium...
Explain flouride.
Flouride is trace mineral that is present in minute amounts in the body tissue. Recommended DA is Adults: 1.5 to 4.0 mg., Children 7 and up: 1.5 -2.5 mg.; Children 4-6 yers: 1.0-2.5; children 1-3 yr. 0.5-1.5 mg. Infants 0.1-1.0mg. The function is to protect developing mature teeth from caries and to help stimulate osteoblastic activity to increase bone mass. Inversely related to pH, so when gastric acid is high, absorption goes up. Found in foods like: salmon w/bones, seafood, tea leaves m sardines, and meat bones in stew. Excess flouride is called fluorosis exceeding 2/1000000 parts water. Most commonly caused by kids eating toothpaste w/fluoride causing white or brown stains on teeth, plus itching, vomiting, stiffness, or pain in joints, osteoporosis of long bones. ...Fluoride deficiency can also cause osteoporosis and dental carries.
Explain Iodine
Iodine is found in the thyroid gland and functions as part of thyroxine or synthesis of t3, and t4, to regulate growth and development, bone turnover, and metabolic rate and body temp. RDA of iodine: adolesc-adults:-150 ug, Preg wom-175 ug, lactating wom.:200 ug, children: (7-10yr):120 ug; 4-6yr: 90ug; 1-3yr: 70 ug; infants: 50 ug. 75% of iodine is concentrated in thyroid. Sources are found in the ocean and deep layers of soil, present there as iodide until oxidated to form iodine, by the sun. Nutritional sources: fresh saltwater fish, shellfish, iodized salt, vegies in iodine-rich soil, milk and milk products. Iodine is stored in the liver until needed in the thyroid, and be eliminated through the urine and feces. Excess is called iodism: rare, but can cause hyperthyroidism or Grave's disease.w/bulging eyeballs, tachycardia, hypertension. Can take antithyroid meds or radioiodine and has to discontinue eating things w/iodine. Deficiency is called iodine deficiency. Hypothyroidism can cause goiters to develop because iodine isn't present and so hormones are released to try and stimulate more making more thyroid hormones, which makes the thyroid to enlarge (called goiter). Lack of iodine can also stunt mental dev. in children. It is the most common cause of preventalbe mental deficiency. Other signs: cold intolerance, constipation, depression, menorrhagia, dry skin....managed by increase iodine and medication.
Explain Iron
Essen.nutrient found in abundant food sources. 70% iron is found in hemoglobin in rbc. Is critical for O2 transfer, norm brain dev.,& fx & synth & fx of neurotrans. Remainder of iron is stored in liver, spleen, and bone marrow. Norm values of iron: RDA of iron in men: 10mg, women 15 mg, preg women 30mg, lactating 15mg, infants 6mg, children 1-10yrs 10mg, woemn 11-24 15mg, men 11-24 10-12mg. Sources: diet-liver, oysters, shrimp, kidney, heart, lean meat, poultry, fish, prune juice, dried beans, drk grn vegies, whole grn bread, cereals, egg yolks, dark molasses, wines raisns, grn peas, strawb., toma. juice, brussel sprouts, winter sq., blackb, and nuts. Fe supp, and iron-fort foods are poorly absorbed, but can contribute. Aborp. of Fe is enhanced by vitamin C. Only 10% of diet Fe is absorbed. Transferrin is the protein that binds to Fe. If your transferrin is saturated it is the highly bound to iron. If you take a blood test called TIBC (total iron binding capacity) & it is high, then that means you have lots of room for iron, and no iron is binding- meaning you have anemia. Poor gastric secretion or increased intestinal motility & poor dig. can decrx Fe absorp. Excess iron called hemochromatosis is a genetic men disorder that causes iron accum. in liver and results in heart prob. or cirrhosis, stroke..... Treat wih phlebotomies (give away blood), Iron deficiency is usually caused by mal absorption. RbC needs iron -if it doesn't get-called anemia. Symptoms: anemia, pallor, fatigue, cardiac arrhthmia, impaired mental, weak, headaches, apathy...poor resist to cold, pica...Take iron, best on empty stom, but patient can't handle, when anemia severe, might have to have transfusion. Absorption enhancers: Vit. C, meat, fish, poultry, and calcium. Things that INHIBIT absorbp. coffee, tea, wine, legumes, grains, rice, tofu, acid-pump inhibitors, H2blockers, antacids, tetracycline.
Explain Selenium
Selenium is an essential mineral that is essential component of the antioxidant enzyme glutathione peroxidase. This enzyme protects rbc and cell membranes from damage caused by free radicals, and toxic effects of mercury and cadmium. Selenium also aids in immunoglobulin synthesis. High R in the liver, kidney, heart, and spleen. Smaller amounts of selenium R widely distributed as part of the nzyme glutathione peroxidase structure. Sources of selenium in food depends on soil and water where food is grown. Foods high in Sel.=Brzl nuts, whole wheat, brwn rice, oats, poultry, low-fat milk products, xlean meant, organ meats, and fish. STATES high: Montana, Utah, S. Dakota, Wyoming, NM, Colarado, TEnn.RDA: adolesc and adults: 40-70 ug, preg women: 65ug, lactating women 70ug, children 7-10 30 ug, children 1-6 20 ug, and infants up to a year 10-15 ug. Absorp occurs in upper seg. of sm. intestine. If there is an increase it will excrete in urine, 2-3 times(over 3xis called selenosis) the RDA can result in hair/nail loss, nausea, fatigue, nerve damage, and muscle problems. Children are more susept to selenium toxicity-tooth decay, and tooth loss. Works w/ vitamin E, May help fight cancer, reduce hot flashes, ....Selenium deficiency is rare causing cardiomyopathy, macular degeneration, chronic liver disorders from alcolholism...Vitamin C may inhibit aborption. Works w/ iodine and vitamin E.
Explain Zinc
Found abundantly in body. 2nd only to iron in abundancy. Involved in numerous catalytic structural and reulatory functions. and is a component in 100 different enzymes. High concentr. found in liver, pancreas, kidney, bone and mucles. Other areas w/ high concen. are eye, prostate, spermatozoa, skin, hair, fingernails, and toenails. Total body content of zinc is 2-3gm. Sources 80% found in meat, fish, poultry, milk, and oysters, shellfish, liver, cheese, whole grn. cereals, dry beans, soy and nuts. Most is excreted in feces. Abundant in nucleus stabilizing RNA and DNA. maintains body cholesterol levels, and normal growth, and benefits immune system, increasing t-lymph and some antiboidies & inhibits growth of diseas-cause bacteria. Zinc toxicity caused by excessive zinc ingestion 100-300 mg aday. Chronic will interfere w/copper absorp. Signs of anemia, fever, CNS alterations. Zinc deficiency: result of low protein diet or a high unrefined unleavened breads which can bind to zinc and reduce aborption. cereals. Signs: decrease taste, growth retar, delated sex maturation, decresased semen, baldness, delayed wouldnt healing, impaired appetite, immune deficiencies. Eye problems. RDA Adoles-Adult: 12-15 mg/day, Children ages 1-10 yrs: 10mg/day; Infants up to 1 yr: 5 mg/day.
What are the calorie requirements for newborns per kg.
108-198 cal/kilo
What is the important vitamin that helps calcium absorption?
Vitamin D
What is important to know about nutrition for toddlers?
Brain development is vital. Try to avoid fast foods.
What is vital to remember for school-age children and nutrition?
Slow and steady growth.
Vitamin C helps absorp what, but hinders what?
Vitamin C increases iron absorption, but hinders selenium absorption.
What can excessive iron accumulation cause?
Coronary heart disease, cirrhosis, stroke, diabetes, arthritis, and blood clots.
What are important things to remember about adolescents and nutrition?
They need increased calcium and they are at increased risk for teen pregn, anorexia and bulimia.
What are nutrition concerns for the young to middle adult?
Young & Middle Adults: growth; risk for bad habits (more sedentary; eating ) increased nutritional needs for woman that are pregnant; 500 extra calories a day needed during lactation; need vit a, b,c, avoid caffeine, alcohol and drugs that can cross breast milk (caffeine will cause babies to be too awake; it will interfere with calcium; and ); gas good cause baby to be caulicky too)
What are nutrition concerns for the elderly?
Older Adults:Protein, energy needs; need vitamins and minerals; teach them not to take meds w/grapefruit juice (it decreases absorption); they have fixed income which affects what they can afford to eat (older woman that eats cat food) eat more canned foods, high sodium...
What is the highlighted vitamin lately that has caused concern for deficiency?
Vitamin D because we don't spend as much time in the sun.
Name the 4 vegetarian types and what they mean.
Vegetarian diet: 4 types.
Ovolactovegetarian: will eat eggs, milk products, and vegies.
Lactovegetarian: milk products, and vegies.
Vegans: vegies only
Fruitarian: fruit, nuts, oils
What is the term for these types of adipocyte hypertrophy in apple shaped and pear shaped obesity? What are the health concerns for these types?
Android for apple shape adipose tissue is carried in the gut and gynoid is adipose tissue is carried in the glueteofemoral area. Concern for gynoid is osteoporosis, varicose veins, cellulite, subcutaneous fat traps and sotres dietary fat, adn trapped fatty acids stored as triglycerides. Health risks for android are heart disease, diabetes, breast cancer, endometrial cancer, visceral fat is more active causing insulin sensitivity, increased triglycerides lowered HDL cholesterol, Increased Blood pressure, and Increased fatty acid released into the blood.
How does the hormone/peptide Leptin relate to obesity?
Normal function of leptin that is produced by adipocytes and interacts w/hypothalamus to suppress the appetite and so it regulates eating behavior. In the obese leptin is associated with high levels; leptin resistance develops, thus obese people may lose the effect of appetite suppression.
How does the hormone insulin relate to obesity?
Insulin that is produced in the pancreas will normally interact w/hypothalamus to decrease the appetite, but int eh obese there will be circulating high levels because it is losing its effect.
How does the peptide/hormone ghrelin relate to obesity?
Normally, Ghrelin that is produced primarily in the stomach will interact w/ hypothalamus to stimulate the appetite when a person is deprived of food, and will decrease upon receiving food. In the obese, ghrelin does not decrease even upon receiving food.
What does the peptide YY have to do with obesity?
Peptide YY is produced in the descending colon and rectum and will normally interact w/ hypothalamus to inhibit appetite by slowing GI motiility and gastric emptying. In the obese the circulating levels of YY are decreased overall and even after eating.
What does cholecystokin have to do with obesity?
Is is produced in the duodenum and jejunum and interacts w/hypothalamus to carry out normal function to inhibit gastric emptying and sends satiety signals to hypothalamus.
Calculate the BMI for a man who is 5'6" and weighs 180lbs. Is he considered under weight, normal, overweight or obese? What are the BMI parameters for the following: Morbidly obese, obese, overweight, normal weight, and underweight?
BMI calculation formula is weight/height squared times 703. Sooo, 180lbs/(66" squared) 4356=29......His BMI is 29 which is considered overweight.

morbidly obese - those with a BMI of more than 40 kg/m2
obese - those with values of 30 kg/m2
overweight - Individuals with a BMI of 25 to 29.9 kg/m2
Normal 19-24
Underweight 18 and under...
What are the most common health risks associated with obesity?
Cardiovascular: High LDL, and hypertension, increased cardio outbput; Respiratory: sleep apnea, hypoventilation syndrome, reduced chest compliance, increased work of breathing, decreased total lung capacity/functional residual capacity; Diabetes: Hyperinsulinemia, and insulin resistance. Insulin resistance is more related to visceral fat or in android obesity. 80% of DMII patients are obese; Musculoskeletal: Increased incidence of osteoarthritis due to weightbearing on joints. Hyperuricemeia and gout are common as well, ; GI/liver: Gerd, gallstones, superstauration of bile w/cholesterol/ NASH nonalchoholic steatohepatitis more common in obese patients. In nash, lipids are stored in liver causing fatty liver eventually leading to cirrhoisis; Cancer: breast, endometrial, ovarian and cervical are more common in obese women probably becasue of estrogen levels that can be stored in fat in postmeno women. Colorectol cancer has been linked to hyperinsulinemiam, and obese men have higher mortality rates w/ cancer of the prostate.
What are the different types of malnutrition?
PCM: Protein Calorie Malnutrition: most common undernutrition, results from primary or secondary factors. PPCM is when nutrit. needs R not met as result of poor eating habits, SPCM is result of alteration or defect in ingestion,digestion, absorption, or metabolism. Tissue needs are not met even through adequate intake. Marasmus is result of concomtant deficiency of both caloric and protein intake leading to generalized loss of body fat and muscle. Patients generally appear wasted or emaciated,but have normal serum protein levels. Kwashiorkor is caused by defiency of protein intake that is superimppolsed on a cataboli stress event like GI obstruction or surgical procedure, cancer, or malabsorption syndrom or infectious disease. These patients will appear well nourished, but have very low protein levels (hypoalbuminemic malnutrition.
In the starvation process what will be used up first, second, third in energy to sustain the body.
In starvation mode, the body will use carbohydrates from the liver and muscles within 18 hours, (protein will only be used for obligatory processes), but once carbs are used up then proteins: alanine and glutamine are the first to form glucose through glucogenesis allowing metabolic processes to continue. The person can then have a negative nitrogen balance. Finally, after about 5-9 days, body fat is fully mobilized as 97% of the calories and protein will be conserved. If all 3 of these are used up, then finally the body resorts to proteins once again and this time the liver will be impaired and synthesis of proteins will be diminished. Since albumin is needed to maintain osmotic pressure of the blood, without it there is a shif in body fluids taht occurs from the vascular space to the interstitial compartment, causing edema which might mask weight loss.
Which organ is most effected from protein deprivation?
The liver! It will lose the most mass during protein deprivation and will gradually become infiltrated w/fat secondary to decreased synthesis of lipoproteins.
What are the causes of malnutrition?
Socioeconomic status, cultural influences, psychologic disorders, medical treatments, and the following medical conditions: Dementia, Depression, Chronic alchoholism, excessive dieting to lose weight, swallowing disorders, decreased mobility in access to food or prep, nutrient losses from malabsorption, dialysis, fistulas, or wounds, drugs with antinutrient, or catabolic properties suchas : corticosteroids and oral antibiotics, an extrem need for nutrients because of hypermetabolism or stresses like burns-infection-trauma-or fever. Nor oral intake or reception of stanadard IV for 10 or 5 days. Malnutrition can also come from: Physical Illness like: surgery, nausea, anorexia, vomiting, diarrhea, abdominal distention that will interfere w/metabolism; Malabsorption Syndrom-impaired absorption fromt eh GItract; Fever; Incomplete diets w/vitamin deficiencies,; Food-Drug interactions.
What is the drug-nutrient effect of analgesics: acetaminophen and aspirin
Acetominophen: decreased absorption with food. Overdose is associated w/ liver failure. Aspirin: Absorbed directly through stomach. Decreased absorptions w/food and decreased folic acid, vitamins C, K and iron absorption.
What is drug-nutrient reaction with antacids: aluminum hydroxide and sodium bicarbonate?
Aluminum hydroxide: Decreased phospate absorption, and Sodium bicarbonate: decreased folic acid absorption.
What is the drug/nutrient reaction for anitarrhythmics: amiodarone and digitalis?
Amiodarone: Taste alteration and Digitalis: Anorexia, decreased renal clearance in older persons.
What is the drug-nutrient reaction in the following antibiotics? Penicillin, Cephalosporin, rifampin and tetracycline, trimethoprim/sulfamethoxazole
Penicillin-decreased drug absorption w/food, and taste alteration. Cephalosporin-decreased vitamin K, rifampin-Decreased vitamin B6 niacin and vitamin D, Tetracycline- decrx drug absorp w/milk, and antacids, decrx nutrient absorp of calcium, riboflavin, vit C; trimethoprim/sulfamethoxazole: decrx folic acid.
What is the drug/nutrient interaction for the anticoagulant: coumarin
Acts as antagonist to vitamin K
What is the drug/nutrient reaction for anticonvulsants: carbamazepine and phenytoin?
Carbamazepine: Incrs drug absorp w/food Phenytoin: decrz calcium aborp. decreased vitamins D, K, and folic acid; taste alteration; decrz drug absorp wi/food.
What is the drug/nutrient reactions of antidepressants: amitriptyline, clomipramine, fluoxetine (selective serotonin reuptake inhibitors) or SSRIs.
amitriptyline is an appetite stimulant; clomipramine alters taste and stimulates appetite; fluoxetine: alters taste and can cause anorexia.
What is the drug/food interaction for these antihypertensives: captopril, hydralazine, labetalol, methyldopa?
captopril: taste alteration and anorexia; hydralazine: enhanced drug aborption w/food and decrz vitamin B6; labetalol: taste alteration and weight gain; methyldopa: decrz vB12, folic acid and iron.
What is the drug/food interaction w/ antiinflammatory all steroid drugs.
Increased appetite, and weight. Incrz folic acid, decrz calcium (possible osteoporosis w/long term use), promotes glucogenesis of protein.
What is the drug/nutrient effect of antiparkinson drug levodopa?
Taste alteration, decrz vitamin B, and decrz drug absorp w/ food.
What is the drug/nutrient reaction with antipsychotic drug chlorpromazine and thiothixene?
chlorpromazine: Increases appetite; and thiothixene: decrz riboflavin and increased need for riboflavin.
What is the drug/nutrient reaction for the bronchodilators: albuterol sulfate and theophlline?
Albuterol: Increased appetite; Theophylline: Anorexia.
What is the drug/nutrient reaction for cholesterol lowering durg: cholestyramine?
Decrz fat sol. vitamins ADKE; vitamin B12 and iron.
What is the drug/nutrient reaction for the diuretics: furosemide, spironolactone, thiazides?
Furosemide:Decrz drug absorp w/food, Spironolactone: Incrz drug aborp w/ food, and Thiazides: Decrz magnesium, zinc, and potassium.
What is the drug/nutrient reaction for laxatives: mineral oil?
Decrz absorp of fat sol vitamins ADKE, and carotene.
What is the drug/nutrient effect with platelet aggregate inhibitor: dipyridamole?
Decrez drug absorption w/food
What is the drug/nutrient effect on potassium replacement: potassium chloride?
Decrz Vitamin B12
What is the drug nutrient effect on tranquilizer: benzodiazepines?
Incrx appetite.
What is the drug nturient effect on dygoxin?
diuretics decrz drug absorption
Name the dietary restrictions for Islam.
Pork, alcohol, caffeine, ramadan fasting, ritualized methods of animal slaughter required for meat ingestion.
Name the dietary restrictions for some Christians
Minimal or no alcohol, holy day observances may restrict meat.
What are the dietary restrictions for Hinduism?
All meats No alcohol.
What are the dietary restrictions for Judaism?
No pork, pred fowl, shellfish (can only eat fish w/scales), rare meats, blood, mix of milk or dairy products w/meat dishes, must adhere to kosher food prep methods, 24 hr of fasting on Yom Kippur (day of atonement), and no leavened bread during passover, and no cooking on the sabath day.
What are the dietary restrictions for Mormons?
No alcohol, tobacco, caffeine, and limit meat.
What are the dietary restrictions for 7thday adventists?
No pork, shellfish, alcohol, coffee, tea.
Vegetarian diets are encouraged.
Patients that become malnourished just because they stop eating because of physical illnesses are said to be wasting away or...
Kakectic (cachectic from the book)
How have the portion sizes changed since 20 years ago?
Turk sand: 320/820
Bagel: 3in 140/ 6in 350
Ch.Burger: 333/590
Soda: 61/2 oz 85/ 20 oz250
What is the integument sign of malnutrition?
Bedsores
From the neck up what are indications of nutritional status?
Neck: enlargement might indicated thyroid problem; Eyes: are they pale, dry, red, dull or soft cornea; Teeth: Cariesk, missing teeth, worn surfaces, mottled (fluorosis) or malpositioned, lost weight so dentures don't fit?; Tongue: swelling, scarlet, raw, magenta, beefiness (glossitis) hyperemic, and hypertorophic papillae; atrophic paillae; Gums: spongy?, bleeding, marginal redness, inflammation, receding; Mouth: swollen, boggy; Lips: Dry scaly, swollen, redness, swelling, fissures or lesions at corners; Skin on face: rough dry, scaly, pale, pigmented, irritated, bruises, petecheiae, subcutaneous fat loss.; hair: stringy, dull, brittle, dry, thin, and sparse, depigmented; easily plucked. Face and neck: Greasy, discolored, scaly, swollen, dark skin over cheeks, and under eyes, lumpiness, or flakiness of skin around nose and mouth.
What are some physical signs of nutritions from the neck down?
posture: sagging shoulders, sunken chest, and humped back. Muscles: flaccid, poor tone, underdeveloped tone, wasted, impaired ability to walk properly; nervous system: inattention, irritability confusion, burning tingling(paresthesia), loss of postion and vibratory sense, weakness and tenderness of muscles, decrease of ankle or knee reflexes,; anorexia: indigestion, constipation, diarrhea, liver or spleen enlargement: Cardio: rapid heart beat, enlarged heart , abnormal rhythm, easy fatigue, Nails: Spoon shape (koilonychia); brittleness, ridges. Legs & feet: edema, tender calf, weakness,; Skeleton: bowlegs, knock-knees, chest deformity, at diaphragm, prominent scapulae, and ribs.
What are the simple definitions of enteral nutrition and parenteral nutrition?
Enteral nutrition aka tube feeding is nutritiously balanced liquified food or formula that is given in persons that have a functional GItract. In can be inserted into the stomach duodenum or jejunum via different routes or incisions. They are considered physiologically more efficient and cost effective than parenteral nutrition, which is given when there is no functional gi tract through a central line intravenously that delivers nutritious hypertonic solution that consists of glucose, crystalline amino acids, fat emulsion, minerals, and vitamins.
When is an NG tube most commonly used?
Most commonly for short-term feeding problems. If there is long-term feeding then other means of feeding will be used: like esopho tube, gastrostomy tube or jejunum tube (feeding below pyloric sphincter).
What are anthopmetric measurements?
What is waist to hip ratio?
They include gross measure of fat and muscle contents. They include measure of skinfold thickness at various sites, which might indicate subcutaneous fat stores and midarm muscle circumference which indicates protein stores. They are then compared w/standards for healthy persons of the same age and gender.waist-to-hip ratio - can also be used to assess the health risks associated with obesity. This ratio is a method of describing the distribution of both subcutaneous and visceral adipose tissue. The waist measurement is divided by the hip measurement to calculate the ratio. A WHR of <0.80 is optimal. A WHR greater than 0.8 indicates that an individual is at greater risk for health complications.
A focused nutrition assessment would include what elements?
Anthropmetry, labs and biochemical tests, physical inspection assessment, and dietary health history.
What drug's longterm use will require increase intake of folic acid?
The antiseizure agent called: phenytoin or commonly known as Dilantin.
Which foods will impair zinc absorption?
Fiber, Milk and Casein
With which drugs will food slow absorption and increase absorption?
Food will slow absorption of antidepressants: trazodone, tricyclic antidepressants like: Desyrel, and Elavil. Food will increase absorption of phenothiazine: ticlopidine (ticlid).
What happens when you eat cheese, smoked-pickled meats or poultry, femented meat, beer, wine, liqueurs...with this drug Procarbazine (Matulane) and Selegiline (Eldepryl)
If used concurrently, it may cause sudden and severe hypertensive reaction; dietary restrictions need to continue for at least 2 wks after the MaO inhibitor is discontinued.
Which drugs will increase need for folate?
Antiseizure meds and Barbituates
What condition is known for causing dysphagia?
Stroke. Watch for paralysis or left side or face. Do swallow test.
What are the most common problems to watch for in tube feedings?
Vomiting-Aspiration, Diarrhea, Constipation, Dehydration.
What are the common reasons someone would need parenteral nutrition as opposed to enteral nutrition?
Chronic severe diarrhea, vomiting; complicated surgery or trauma; gi obstruction, gi tract anomalies/fistulae, severe anorexia, severe malabsorption, short bowel syndrome, and intractable diarrhea.
Central lines and pic lines may go in at different places, but will all end up where inside?
No matter where it goes in, at pic line site in cephalic or basilic veins or in the right subclavian for a central line, it will end up in central circulation @ right atrial junction.
What are the common mishaps with parenteral nutrition?
Infection, Metabolic problems, and Mechanical problems.
What is fiber?
Fiber is a poly saccharide carbohydrate that in some forms cannot be digested because enzymes are unable to break them down. There is insoluble kind (not digestible), that include cellulose, hemicellulose, and lignin. The soluble kind are pectin, guar gum, and mucilage.
What is nitrogen balance?
It is achieved when the intake and output of nitrogen are equal. Body needs to be in a positive nitrogen balance for growth, normal pregnancy and maintenance of lean muscle mass and vital organs and wound healing. Negative nitrogen balance occurs when the body loses more nitrogen than the body gains, which happens in starvation, elderly, infection, ....
What is important to remember when administering fluids to a client with one-sided weakness?
Nurse will need to thicken fluids and sit them up to prevent aspiration.
What are the different pH levels throughout the GI tract?
6-7 in the mouth, 1-3 in the stomach, 6-6.5 in the duodenum, 7-8 in jejunum and ileum, and 5-6 in the colon.