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137 Cards in this Set
- Front
- Back
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Which groups of people are most vulnerable to undernutrition?
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infants, children, pregnant women, recent immigrants, persons with low income, hospitalized people and aging adults.
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Besides hypertension, type 2 diabetes and heart disease what are some other diseases that have been linked to over nutrition?
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Stroke, gallbladder disease, sleep apnea, certain cancers and osteoarthritis.
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What percentage of children and adolescents are overweight?
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17%
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According to BMI, when is an adult considered overweight?
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When their BMI is greater than 25.
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If your BMI is over 30, does this mean you are are overweight or obese?
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Obese
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True or False: Infants double their birth weight by 4 months of age.
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True
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List some advantages of breast feeding.
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1) fewer food allergies and intolerance
2) reduced likelihood of overfeeding 3) Less cost than formulas 4) Promotes natural immunity |
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True or False: HIV can not be transmitted via breast milk.
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False, HIV can be transmitted through breast milk.
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Why should children aged 2 years and younger, not drink skim or low-fat milk?
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Because fat is required for proper growth and central nervous system development.
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True or False: Infants increase their length by 50% during their first year.
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True
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True or False: Calcium and iron requirements increase in adolescence.
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True
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Which 3 minerals/vitamin are essential for fetal growth and development during pregnancy?
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Iron, Folate and Zinc
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For a woman of normal weight what is the recommended weight gain during pregnancy?
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25-35 lbs
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If a woman is underweight, what is the recommended weight gain during pregnancy?
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28-40 lbs.
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How much weight gain is recommended during pregnancy, it the woman is obese?
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11-20 lbs
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Are older adults at risk for undernutrition, overnutrition or both?
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Both
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True or false: The elderly tend to loose fat body mass as they continue to age.
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False: there is an increase in fat mass, and a loss of lean body mass.
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For the aging adult, which types of food are suggested to offset lower energy/calorie needs?
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Nutrient-dense foods like milk, eggs, cheese and peanut butter.
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What are some common nutrition-related problems of new immigrants from developing countries?
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general undernutrition, hypertension, diarrhea, lactose intolerance, osteomalacia, scurvy and dental caries.
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True or False: Hispanic immigrants to the United State have increased risk of being overweight and obese as they adapt to a diet in the United states.
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True
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True or False: Black woman have higher hemoglobin level than white women.
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False, they have lower hemoglobin levels.
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Is a black woman at more or less risk for osteoporosis than a white woman?
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Lower risk, despite overall calcium intake.
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What are the three primary purposes of a nutritional assessment?
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1 )identify individuals who are malnourished
2) provide date about designing a nutrition plan 3) establish baseline data |
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What is the first step in assessing nutritional status?
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Nutritional Screening
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What type of information is obtained during the nutrition screening?
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weight and weight history, conditions associated with increased nutritional risk, diet info and lab data.
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What happens if an individual is identified at nutritional risk during the initial screening?
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Comprehensive Nutritional Assessment
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What is included in the comprehensive nutritional assessment?
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diet history, clinical info, physical examination for clinical signs, anthropometric measures and lab tests.
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What is the easiest and most popular method for obtaining formation about dietary intake?
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24-hour recall
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During a nutritional assessment, why is it important to ask about medication or nutritional supplements?
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Analgesics, antacids, anticonvulsant, antibiotics, and oral contraceptives interact with nutrients, impairing their digestion, absorption, metabolism and utilization.
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Where are malnutrition deficiencies readily detectable and why?
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Skin, hair, mouth, lips and eyes, because clinical signs are late manifestations of malnutrition, only in areas of rapid turnover of epithelial tissue readily detectable.
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What do anthropometric measures evaluate?
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Growth, development and body composition.
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What does waist-to-hip ratio assess?
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Assesses body fat distribution.
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If a woman has a wait-to-hip ration greater than 0.8, what does this indicate?
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Android (upper body) obesity and increasing risk for obesity-related diseases and early mortality.
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A waist circumference of ____ or greater in a woman is at increased risk for heart disease, type 2 diabetes mellitus and metabolic syndrome.
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35
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A waist circumference of ____ or greater in a man is at increased risk for heart disease, type 2 diabetes mellitus and metabolic syndrome.
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40
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Which layer of skin is thin, but tough, and its cells are bound tightly together into sheets?
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Epidermis
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What is the inner layer of the epidermis called?
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The basal cell layer
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What does the inner basal cell layer do?
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It forms new skin cells
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Which tough, fibrous protein is found is new skin cells?
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Keratin
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True or False: All people have the same number of melanocytes?
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False
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If its not the number of melanocytes that accounts for differences in skin color, what accounts for the degree of variance among people?
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It is not the number of melanocytes, but the amount of melanin that is produced.
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What is the outer layer of the epidermis called?
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The horny cell layers/stratum corneum
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What makes up the horny cll layers?
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Dead keratinized cells that are interwoven and closely packed.
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How often is the epidermis replaced?
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every 4 weeks
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Besides melanin what other sources that affect skin color?
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1) the yellow-orange tones of carotene
2) from the red-purple tones in the underlying vascular bed |
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What material makes up the dermis?
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Connective tissue or collagen
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What purpose does collagen serve?
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It is a tough fibrous protein that enables the skin to resist tearing.
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Where are nerves, sensory receptors, blood vessels and lymphatics located in the skin?
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In the dermis
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What is the purpose of the subcutaneous tissue in the skin?
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1) stores fat for energy
2) provides insulation for temperature control 3) protection/ cushioning effect |
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True or False: Hairs are threads of melanin.
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False, hairs are threads of keratin.
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Which muscles around responsible for contracting and elevating the hair so that is resembles "gooseflesh"?
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Arrector pili muscles
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Which types of hair cover most of the body?
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Vellus hair
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What is the other type of hair that is darker, thicker and grows on the scalp and eyebrows and after puberty, on the axillae, pubic area?
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Terminal hair
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Which glands produce a protective lipid substance, sebum, which is secreted through the hair follicles?
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Sebaceous glands
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What is the two functions of sebum?
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1) Lubricates the skin and hair
2) Forms an emulsion with water that retards water loss |
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True or False: Dry skin directly results from loss of oil.
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False: Dry skin result from loss of water, not directly from loss of oil.
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Which type of sweat glands are coiled tubules that open directly onto the skin?
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Eccrine glands
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What solution does eccrine glands produce?
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Sweat
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True or false: The evaporation of sweat increases body temperature.
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False: Reduces body temperature, promoting heat loss.
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Which type of sweat gland produces a thick, milky secretion and open into the hair follicles?
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Appocrine glands
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When do apocrine glands become active?
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During puberty.
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True or False: Nails are hard plates of carotene.
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False, nails are hard plates of keratin.
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Where are new keratinized cells formed in the nail?
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Nail matrix
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Which part of the nail works like a gasket to cover and protect the nail matrix?
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Cuticle
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Present at birth for some infants, is vernix caseosa, what is this?
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A thick, cheesy substance made up of sebum and shed epithelial cells.
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True or False: All of the functions of the skin are fully developed at birth.
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False
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A newborn's skin is more permeable than that of an adults why is this a problem?
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The infant is at great risk for fluid loss.
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Why is a newborn baby's skin unable to help regulate temperature?
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1) Eccrine sweat glads do not secrete in response to heat until the baby is a few months older
2) Cannot contract and shiver because subcutaneous layer is inefficient. |
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Sometime pregnant women develop striae gravidarum, what is this and why does this occur?
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It is another term for stretch marks. Connective tissue develops increased fragility.
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In the aging adult, does vascular fragility increase or decrease?
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Vascular fragility increases.
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Why are chemicals allowed easier access into the body as individuals age?
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The epidermis's outer layer thins and flattens.
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Why does wrinkling ocur?
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Because the underlying dermis thins and flattens.
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How is the body affected, when older adults loose collagen?
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Increases their risk for shearing, tearing injuries.
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Do the number of sweat and sebaceous glands decrease or increase in the aging adult?
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Decreases, leaving them with dryer skin.
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Why is the aging adult's body more likely to produce dark red discolored areas (senile purpura) as a a result of only minor trauma?
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Due to the decrease of skin vascularity and the increase in vascular fragility.
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What is the relationship between the amount of melanin and skin cancer.
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Increased melanin decreases the incidence of skin cancer.
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Why does the hair appear gray or white in the aging population?
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Because the number of functioning melanocytes decreases.
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Why might a post menopausal woman acquire bristly facial hair?
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As a female's estrogen decreases, testosterone is unopposed.
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Why does more melanin lower the incidence of skin cancer among darkly pigmented blacks and American Indians?
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Because melanin protects the skin against harmful ultraviolet rays.
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Scars that form at the site of a wound and grow beyond the normal boundaries are called what?
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Keloids
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Which skin condition, found among Blacks is known as the "mask of pregnancy?" How does it appear?
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Melasma, which appears a patchy tan to dark brown discoloration of the face.
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What is pseudofolliculitis?
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"razor bumps" or "ingrown hairs" caused by shaving too closely with a razor.
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What are 4 skin conditions specific to Blacks?
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1) Keloids
2)Pigmentary Disorders 3) Melasma 4) Pseudofolliculitis |
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How might nutrition affect hair texture?
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Hair texture becomes dry, brittle and lusterless with inadequate nutrition.
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What might a generalized change of pigmentation suggest?
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Might suggest systemic illness: pallor, jaundice cyanosis.
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What is the most common skin symptom?
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Pruritus
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Why would you be interested in a person's medication history when assessing the skin?
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Certain drugs may increase sunlight sensation and give Burn response.
Drugs can cause hyperpigmentation and allergic skin eruption. |
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How might fear or anger affect skin color assessment?
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May give a false pallor due to peripheral vasoconstriction.
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How might cigarette smoking affect skin color assessment?
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May give a false pallor due to vasoconstriction
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How might prolonged elevation affect skin color assessment?
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May give a false pallor or coolness due to decreased arterial perfusion.
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How might dependent position affect the assessment of skin color?
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May give a misleading outcome of redness, warmth, and distended veins due to venous pooling.
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How might immobilization affect the assessment of skin color?
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Might give a misleading outcome of pallor, coolness,n ail beds pale, prolong capillary filling time due to slowed circulation.
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What equipment is needed for skin inspection and palpation?
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1) Strong direct lighting
2) Small centimeter ruler 3) Penlight 4) Gloves |
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Is it normal for a nail base to have a 160 degree or less angel from the nail itself?
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Yes, anything more than 160 degrees may indicate a problem.
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Is clubbing of nails a normal or abnormal finding?
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abnormal
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If the angle of a nail straitens out to 180 degrees and the nail base feels spongy to palpation, what is this called?
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Clubbing of nails
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What might clubbing of nails indicate?
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Congenital cyanotic heart disease and neoplastic and pulmonary diseases.
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What color should the nail bed be?
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pink
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True of False: Brown linear streaks seen through the nail plate are normal in light-skinned people.
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False: not normal for light-skinner people may indicate melanoma.
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When pressing the nail edge to blanch and then releasing it, is it normal for it to take longer than 3seconds for the color to return?
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No it is abnormal.
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Describe the skin condition known as vitiligo.
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It is the complete absence of melanin pigment in patchy areas of white or light skin on the face, neck, hands, feet, body folds, and around orifices.
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A proliferation of melanocytes, tan to crown color, flat or raised are called what?
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Moles (nevus)
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When the red-pink tones from the oxygenated hemoglobin in the blood are lost, what happens to the skin color?
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The skin takes on the color of connective tissue (collagen), which is mostly white. (PALLOR)
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Where can generalized pallor be best observed?
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The mucous membranes, lips and nail beds
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What is erythema?
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It is an intense redness of the skin from excess blood in the dilated superficial capillaries.
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WHy is pallor common in acute high-stress states such as anxiety and fear?
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It is because of the powerful peripheral vasoconstriction from sympathetic nervous system stimulation.
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During what conditions or states might erythema occur?
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Occurs with polycythemia, venous stasis, carbon monoxide poisoning, and extravascular presence of red blood cells.
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What does cyanosis directly signify?
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This is bluish color that signifies decreasing perfusion; that tissues do not have enough oxygenated blood.
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What type of pigmentation would you expect to find for an individual who is in shock, has heart failure, chronic bronchitis and congenital heart disease?
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Cyanosis
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Would you expect to see changes in level of consciousness for someone who has cyanosis?
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Yes, because it is also possible oxygen is not getting to the bran.
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A yellowish skin color indicates rising amounts of _______ in the blood.
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bilirubin
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To determine if someone has jaundice where will it first be evident on a patient's body?
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First noted in the junction of the hard and soft palate in the mouth and in the sclera.
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What type of skin pigmentation might you suspect for someone who has sickle-cell disease?
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Jaundice
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If someone just had a transfusion reaction what color skin pigmentation might you be likely to see?
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Jaundice.
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What temperature would you expect the skin to be?
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Warm. This suggests normal circulatory status.
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Would you expect the skin to be moist or dry?
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Dry
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Is it normal to find hot spots across the patient's skin?
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No
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How you would expect the texture of skin to feel?
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Smooth and firm, even throughout.
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Would you expect the skin to be thin and shiny?
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NO
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What is the tugor of skin refer to?
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Turgor is its ability to return to place promptly when released.
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If a patient has edema where is the fluid accumulating in the body?
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In the intercellular spaces.
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If the skin "tents" would this indicate normal or poor turgor?
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poor turgor
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True or False: Edema is most evident in dependent body parts.
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True
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When assessing for edema, what does "pitting" refer to?
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If your pressure leaves a dent in the skin, this is known as pitting, and indicates that edema is present.
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How is edema measured?
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It is measured on four point scale of pitting "mild to very deep pitting"
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If there is only mild pitting, or slight indentation, is there a perceptible swelling of the leg?
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NO
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If edema is considered to be a local or peripheral cause what type of edema is this called?
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Unilateral edema
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If edema is spread out over the whole body and is caused by a central problem such as heart or kidney failure, what type of edema is this called?
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Bilateral or generalized edema
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If lesions are present on the body, what type of information would you want to document?
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Color, elevation, border, location, size in cm, presence of odor, description of drainage.
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How often should adults examine their skin?
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Once a month
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What are individuals looking for when they follow the ABCDE rule?
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asymmetry, border, color, diameter, elevation and enlargement.
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What causes the vascular lesions known as hemangiomas?
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Caused by a benign proliferation of blood vessels in the dermis.
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What is the name of the condition that exhibits a large, flat, macular patch covering the scalp or face, that is dark red or purplish in color?
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Port-Wine Stain
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True or False: Port-wine stain is usually present at birth.
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True
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Which hemangioma is classified by a raised, bright red area with well-defined borders about 2 to 3 cm in diameter.
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Strawberry Mark
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Around what age does a strawberry mark usually disappear?
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By age 5-7.
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Is a strawberry mark considered a mature or immature hemangioma?
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Immature
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