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160 Cards in this Set

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What is Nutrition
The process by which a living organism ingest, digest, absorbs, transports and uses and excrete nutrients
What is an Optimal diet necessary for
-promoting normal growth and development
-preventing deficientcy states
-maintaining health
-preventing disease
-maintaining bodily functions and healthy tissue
-promoting healing
-building resistance to infection
Nutrients
Biochemical substances obtained from ingested food and fluids
What are the three nutrients that provide the body with energy
Carbohydrates, protein, fats
What are the nutrients that are essential in regulating body processes
Vitamins, minerals, trace elements and water
What are essential nutrients
Nutrients that the body cannot synthesize in adequate amounts
What does each cell in the body require to fullfill its daily task
Energy
What acts and reacts to regulate body processes
Chemicals in the form of nutrients
What is Metabolism
The process by which cells use or store energy from nutrients
Anabolic Processes
Build up body substances and body tissue
Catabolic Processes
Break down substances or body stores
How is energy obtained from food measured
In the form of large calories or kilocalories
What is a kilocalorie
The amount of heat required to raise one kilogram of water 1 degree centigrade
Carbohydrate: Simple Sugars
Monosaccharides and disaccharides
Carbohydrate: Complex sugars
polysaccharrides
What are carbohydrates composed of
Carbon, Hydrogen, oxygen
What are some food that are simple carbohydrates
Sugars, honey, fruit, milk
What are some food that are complex carbohydrates
Bread, pasta, rice, pototoes
What are the functions of carbohydrate
-To provide energy (main function)
-important in oxidizing fats in normal fat metabolism
-promote desirable bacterial growth in intestine
-each gram of carb. yields 4 kcal
Carbohydrates: Polysaccharide
not digested in the GI tract; one of the main components of dietary fiber
Dietary Fiber
Is a minimal source of energy, but is essential in stimulating peristalsis and maintaining normal bowel function
Carbohydrate: Protein sparing function
Use carbs rather than protein for energy; leaves protein available for function of tissue building
-supplies glucose to cells
Hyperglycemia
Elevated blood sugar
Hypoglycemia
Lower than normal blood sugar
Protein
Organic compounds composed of polymers of amino acids connected by peptide bonds
-Contain carbon, hydrogen, oxygen and nitrogen
What are the protein that the body synthesizes
Hemoglobin, insulin, albumins
What are proteins necessary for
growth and tissue building
-regulate body functions
-play role in regulating immune system, digestion, absorption, metabolism and catabolism
-protein catabolism supplies 4kcal/g
Complete proteins
contain sufficient amounts of essential amino acids to maintain body tissues and to promote growth
Partially complete proteins
contain suffiecient amounts of amino acids to maintain life but not promote growth
Incomplete proteins
do not contain suffiencient amounts of all essentail amino acids to maintain life, build tissue or promote growth
An adequate diet must contain a good supply of complete protein. What are some of the source of complete protein
meat, fish, poultry, milk, cheese and eggs
Fats
organic subastances composed of carbon, hydrogen and oxygen
-component for all body cells and ideally makes up approximately 20% of body weight
-supply 9 kcal/g of oxidized fat
-provide a feeling of satiety because they remain in the stomach longer than carbs or protein
-may be saturated or unsaturated depending on the number of hydrogen molecules bound to the fat
What are fats necessary for
cellular transport, insulation, protection of organs, provision of energy, absorption an transport of some vitamins
Unsaturated Fat
Liquid at room temperature
-sources: plant origin (corn, olive, safflower, soybean and sunflower oils) and nuts
Saturated Fats
Solid at room temperature
-sources: animal products (meat, poultry), whole milk, cheeses, cream and plant sources (coconut oil, cocoa butter)
Vitamins
Organic compounds that are essential to the body in small quantities for growth, development, maintenance and reproduction
-most cannot be synthesized by the body
Fat soluble vitamins
A, D, E, K - body does not excrete excess amounts
Water soluble vitamins
B complex and C
Vitamin A
-maintainance of normal vision
-maintainance of healthy epithelium
-promotion of normal skeletal and tooth development
-promotion of normal cellular proliferation
Signs and Symptoms of Vitamin A deficiency
-night or total blindness
-epithelial changes (degeneration of cells leading to infections or eyes, ears, nasal passages)
-skin changes (dry, rough, scaly skin)
-inadequate tooth and bone development
Food Source of Vitamin A
yellow vegetable, peaches, cantaloupe, fish oils, fortified milk and dairy products
Vitamin D
changed to an active form by exposure of the skin to ultraviolet light
-necessary for:
--intestinal absorption of calcium
--mobilization of calcuim and phosphorus from bone
--renal transport of calcium
Vitamin D Diffiency
-rickets i children
-poor dental health
-tetany (abnomal muscle contraction and spasm
-osteomalacia (soft bone)
Food sources for Vitamin D
fortified milk, margarin, cereals
Vitamin E
Has a role as an antioxidant, in which it assists in maintaining the integrity of cellular membranes
Signs of Vitamin E deficiency
increased hemolysis of red blood cells
-poor reflexes and impaired neuromuscular functioning
Food sources of Vitamin E
Vegetable oils, soy beans, corn, peanuts
Vitamin K
Adequate intake is needed in the liver for the formaiton of prothrombin and other clotting factor
Signs of Vitamin K deficiency
increased tendency to hemorrhage
Food sources for Vitamin K
green leafy vegetables, cabbage, cauliflower, egg yolk and liver
Vitamin B-1 (thiamine)
Necessary for carbohydrate metabolis and adequate nerve functioning
Sign of Vitamin B-1 deficiency
poor appetite, apathy, mental depression, fatigue, constipation and neuritis
-Beriberi (adversely affects the cardiac, nervous and GI systems)
Food sources of vitamin B-1
organ meats, pork, whole and enrcihed grains, nuts, potatoes, eggs and milk
Vitamin B-2 (riboflavin)
functions in protein an carbohydrate metabolism
-contributes to healthy skin
Signs of Vitamin B-2 deficiency
crackin and fissures on sides of the mouth (cheilosis)
-vision irregularities
Food sources of Vitamin B-2
Milk, dairy, eggs, organ meats, green leafy vegetables
Vitamin B-3 (Niacin)
involved in glycogen metabolism, tissue regenaration and fat synthesis
Deficiency of Vitamin B-3
Pallagra:niacin deficiency disease
-fatigue, headaches, loss of appetitie, weight loss, diarrhea, neurologic degeneration and dematitis
Food sources for Vitamin B-3
kidney, liver, poultry, lean meat, fish, yeast, peanut butter, dried peas and beans
Vitamin B-6 (pyridoxine)
necessary for amino acid metabolism, blood formation and maintenance of nervous tissue
Deficiency of Vitamin B-6
dermatitis, convulsion and anemia
Food sources for Vitamin B-6
Chicken, fish, wheat germ, organ meats, egg yolk, whole grains, potatoes and bananas
Vitamin B-12
Functions in the formation of healthy red blood cells and synthesis of RNA & DNA
-Requires intrinsic factor for absorption
Deficiency in Vitamin B-12
Pernicious anemia
-pallor, dyspnea, weakness, fatigue and palpitations
Food Sources of Vitamin B-12
Liver, kidney, shrimp, meats, milk and cheese
Vitamin C
Protects against infection, provides for adequate wound healing, promotes iron absorption and collagen formation
Signs of deficiency of Vitamin C
poor wound healing, joint pain, anemia, increased susceptibility to infection
Food sources for Vitamin C
citrus fruits, brocolli, green peppers, strawberries tomatioes and cabbage
Calcium
-most abundant mineral in the body
-necessary for:
conversion of prothrombin to thrombin and other steps of the coagulation process
-nerve impulse transmission
-regulation of materials in and out of the cell
-contaction and relaxation of muscles, most importantly in the cardiac muscle
-bone and tooth formation
-adequate amounts of vitamin D, parthyroid hormone, ascorbic acid, lactose and physical activity assis in calcium absorption
Deficiency of Calcium
stunted growth, rickets, osteomalacia, osteoporosis and tetany
Iron
most iron in the body is found in hemoglobin
-required for oxygen transport
Deficiency of Iron
anemia
Food Source of Iron
Liver, lean meats, dried beans, fortified cereals
Sodium
Found primarily in the extracellular fluid
-helps maintain fluid and acid base balance
-often restricted in the diet when pt. has heart disease, hypertension, renal disorders, liver disease
-only 10% sodium intake is from natural sources
-75% comes from processed foods
-15% from diecretional salt addition
Potassium
found primarily in the intracellular fluid
-furnctions in protein synsthesis, fluid balance and regulation of muscle contraction
-deficiency can occur w/ vomiting, diarrhea, non-pottassium sparing diuretics and ketoacidosis
-sources: yellow fruits, bananas, cantaloupe, oranges ,some vegetables
Deficiency of Vitamin B-6
dermatitis, convulsion and anemia
Food sources for Vitamin B-6
Chicken, fish, wheat germ, organ meats, egg yolk, whole grains, potatoes and bananas
Vitamin B-12
Functions in the formation of healthy red blood cells and synthesis of RNA & DNA
-Requires intrinsic factor for absorption
Deficiency in Vitamin B-12
Pernicious anemia
-pallor, dyspnea, weakness, fatigue and palpitations
Food Sources of Vitamin B-12
Liver, kidney, shrimp, meats, milk and cheese
Vitamin C
Protects against infection, provides for adequate wound healing, promotes iron absorption and collagen formation
Signs of deficiency of Vitamin C
poor wound healing, joint pain, anemia, increased susceptibility to infection
Food sources for Vitamin C
citrus fruits, brocolli, green peppers, strawberries tomatioes and cabbage
Calcium
-most abundant mineral in the body
-necessary for:
conversion of prothrombin to thrombin and other steps of the coagulation process
-nerve impulse transmission
-regulation of materials in and out of the cell
-contaction and relaxation of muscles, most importantly in the cardiac muscle
-bone and tooth formation
-adequate amounts of vitamin D, parthyroid hormone, ascorbic acid, lactose and physical activity assis in calcium absorption
Deficiency of Calcium
stunted growth, rickets, osteomalacia, osteoporosis and tetany
Iron
most iron in the body is found in hemoglobin
-required for oxygen transport
Deficiency of Iron
anemia
Food Source of Iron
Liver, lean meats, dried beans, fortified cereals
Sodium
Found primarily in the extracellular fluid
-helps maintain fluid and acid base balance
-often restricted in the diet when pt. has heart disease, hypertension, renal disorders, liver disease
-only 10% sodium intake is from natural sources
-75% comes from processed foods
-15% from diecretional salt addition
Potassium
found primarily in the intracellular fluid
-furnctions in protein synsthesis, fluid balance and regulation of muscle contraction
-deficiency can occur w/ vomiting, diarrhea, non-pottassium sparing diuretics and ketoacidosis
-sources: yellow fruits, bananas, cantaloupe, oranges ,some vegetables
Water
Necessary to maintain cell function
-obtained through dring fluids and eating foods with a high water content
-thirst signals the need for water
-thirst is usually diminished in the aged
The Food Pyramid
-developed by the department of agriculture
-provides a guide for planning nutritious meals
-emphasizes food from five major food groups
What are the five food groups
-bread, cereal, rice, grain
-vegetable
-fruit
-meat, poultry, fish, dry beans and eggs
-milk, yougurt and cheese
-fats, oils and sweets
Bread, cereal, rice, pasta
6-11 servings recommended
-provide sources of thiamine, iron, niacin, and riboflavin
-good source of carbs, low in fats
-many foods are enriched with vitamins and minerals
Vegetable
5 servings recommended
-provide sources of vitamin A and C and minierals
Fruit
2-4 servings recommened
-source of potassium, vitamin A and C, low in fat and sodium, high in water
meat, pultry, fish, drybeans and eggs and nuts
2-3 serving recommend
-source of protein, B vitamins
-may contain large amounts of fats and cholesterol
Milk, yougurt, and cheese
Adults: recommended 2-3 servings
- source of calcium and riboflavin, and many other vitamins and minerals
-contains no iron
Fats, oils and sweets
should be used sparingly
-minimize the intake or saturated fats
Digestion
Process by which foods ae broken down for the body to use in growth, development, healing and prevention of heart disease
-includes mechanical and chemical processes necessary to convert foods into their physically absorable states
Mechanical Processes of Digestion
Mastication: food particles are reduced in size and mixed with enzymes in saliva
-Swallowing: mouth-->pharynx-->esophagus
-Churning and peristalsis mix and move the ingested material through stomach and into the duodenum
-further churning occurs in small intestine, food mixed w/ enzymes, food comes in contact w/ intestinal mucosa to allow for absorption
-Peristalsis moves material to large intestine
-further churning, peristalsis and absorption move residual mass along the large intestine where it is stored untial it is evacuated from the body
Chemical Processes of digestion
ensymes are an essential component of the chemistry of digestion
-ensymes are protein like substances that act as catalyst to speed up chemical reactions
-each enzyme functions best as a specific pH
-saliva is neutral, gastric juice is highly acidic and small intestin is alkaline
Chemical processes: Saliva
contains pytalin (salivary amilase), which begins to digest cooked starch
Chemical processes: Stomach
Pepsinogen is secreted and then activated by HCL (hydrochloric acid) to pepsin, a protein splitting enzyme
-parietal cells secret intrinsic factor (necessary for absorption of vitamin B12
Chemical Processes: Small Intestine
Chyme (liquified food) mixes w/ bile, intestinal jices and pancreatic secretions
-Bile manufacured in the liver and acts as a detergent, as it emulsifies fat to permit enzyme action while suspending fatty acids in solution
-Pancreatic secretions contain six enzymes: amlase (starch), lipase(fats), trypsin, elatase, chymotrypsin and carboxypeptidase (protiens)
Metabolism: Carbohydrate
-the liver cells change short term glucose excesses into glycogen in the presence of insulin (Glycogenesis)
-glycogen is stored in the liver and skeletal muscles until needed, when it is converted back by glyogenolosis
-longer term storage of glucose in the presence of insulin takes th form of adipose tissue
Metabolism: Fat
converted to adipose tissue and stored
-makes up the bodies largest reserve of energy
Metabolism: Protein
Anabolism builds tissue, produces antibodies, replaces bloo cells and repairs tissue
-temporary excesses or protein are stored in the liver and skeletal muscle or converted to fat
Characteristics of Nutritional Status: BMI
-measure that describes a person's relative weight by height
-correlated w/ total body fat content and is recommend for use to asssess overweight, obesity and to keep tract of weigth changes
-Ideal Body Weight -weight appropriate for height and frame
Characteristics of Nutritional Status:Physical Status
-general appearance should reflect alertness and responsiveness
-normal skin tone and turgor
-mouth, gums and lips pink and moist
-hair and nails appear healthy
-normal reflexes, muscle tone
-body should appear erect
Characteristic of Nutritional Status: Laboratory Values
-Hemoglobin: women 12-16 g/dl, men 14-17.4 g/dl
-Hematocrit: women 36-48%, men 42-52%
-Plama protein
-Albumin: 3.5-5 g/dl
Factors Affecting Nutrition: Physiologic factors
-diseased teeth or gums
-diseased GI system
-hormone production (insulin)
Factors Affecting Nutrition: Inability to acquire or prepare food
-immobility
-inadequate energy
-inadequate resources
Factors Affecting Nutrition: Knowledge defice
lack of information about nutrition
Factors Affecting Nutrition: Sallowing impairment
-neurologic dysfunction
-muscle weakness
Factors Affecting Nutrition: Discomfort during or after eating
-acid reflux
-sore throat
Factors Affecting Nutrition: Anorexia
-depression
-GI dysfunction
-side effect of medication
Factors Affecting Nutrition: Nausea and vomiting
-motion sickness
-infections
-GI disorders
Factors Affecting Nutrition: Excessive intake or calories and fat
overeating
Factors Affecting Nutrition: metabolic demand
-periods of rapid growth
-conditions taht increase BMR
-stress (physiologic and psychological)
Factors Affecting Nutrition: Ability to use ingested nutrients
-inflammation of the gastrointestinal tract
-obstruction of the GI tract
-malabsorption of nutrients (eg. ciliac disease)
-diabetes mellitus
Factors Affecting Nutrition: Life style and habits
-food patterns usually set during childhood
-peer pressure
-food fads
-active verses inactive life style
Factors Affecting Nutrition: Cultural and beliefs
-dietary preferences and law vary among cultures
Factors Affecting Nutrition: Drug and nutrient interactions
-ingestion of cerain foods interfere with drug actions (vitamin K and coumadin)
-some drugs may deplete certain nutrients (diuretics and potassium)
Factors Affecting Nutrition: Gender
nutritional requirements vary between men and women
Factors Affecting Nutrition: Surgery
-increases risk for nutritional deficits due to increased metabolic demands related to stress of normal healing
--Cancer and cancer treatment -: cancer increases metabolic demands
-treatment causes anorexia, nausea, vomiting, mouth ulcers
Factors Affecting Nutrition: Alcohol and drug use
excessive alcohol intake limits the intake of other nutrients
-heroin and cocaine can decrease the user's desire for food because of preoccupation w/ need to by drugs
--Psychological state
-mental illness
-anorexia nervosa, bulimia
Manifestations of altered nutrition
-overweight: (BMI 25-29.9 kg/m2)
-Obesity: 30 kg/m2 or more)
-Underweight: (15-20% below weight standards
-recent significant weight gain or loss
-decreased energy
-altered bowel patterns
-altered skin, teeth, hair and mucous membranes
Assessment: Subjective Data
-normal eating patterns
-24 hour diet recall
-food likes and dislikes
-food allergies
-presence of anorexia, nausea, vomiting, diarrhea, constipation
-any dysphagia
-changes in appetitie
*History of GI disorders
*Ability to prepare food
*economic resources
*medication history
*any significant weight loss or gain
*any chronic illness
*alcohol intake
*cultural and social influences
Assessment: Objective Data
-General appearance
-measurements
-calorie count
-mouth inspection
-swallowing evaluation (gag reflex)
*Diagnostics
-hgb and hct (aid in determining presence and severity of anemia)
-Serum albumin (relfexs protein intake or absorption
-Serum Fe
Nursing Diagnosis: Altered Nutrition -less than body requirements
-state in whih a person's intake of nutrients is insufficient to meet metabolic needs

*Related Factors: inability to absorb nutrients, increased body require ments, difficulty swallowing, muscle weakness

*Defining characteristics: loss of weight, food intake less than adequate
Nursing Diagnosis: Altered Nutrition -more than body requirements
State in which a person's intake of nutrient exceeds metabolic needs
*Related Factors: sedentary lifestyle, dysfuncctional eating patterns, emotional distress
*Defining characteristics: body weight more than 10-20% ideal
Nursing Diagnosis: Impaired swallowing
Abnormal functioning of the swallowing mechanisms associated with deficits in oral, pharyngeal, or esophageal structure or function
*Related FactorsL neuromuscualr impairment, decreased or absent gag reflex, mechanical obstruction (edema), fatigue
*Defining Characteristics: stasis of food in oral cavity, coughing, choking
Planning
Develop goals and outcome related to:
-achieving and maintaining optimal weight
-ingesting nutritionally sound food to meet body requirements and to promote health
-developing adequate knowledge of nutrition
-intake adequate to meet body's energy expenditures
Implementation: Types of Diets - NPO: withholding food
-to rest the GI tract and promote healing
-to clear the GI tract of contents before surgery or a procedure
-to prevent aspiration during surgery
-to give normal intestinal motility time to return
-to treat severe vomiting or diarrhea
-to treat medical problems such as bowel obstruction or acute inflammation of the GI tract
Implementation: Types of Diets - NPO: Nursing Measures
-provide frequent oral hygiene
-give ice chips, hard, candy, or gum if permitted
-avoid exposing client's to others eating, food odors or advertisements for food
**In NPO for longer than a few days, alternate forms of nutritional support may be necessary
Implementation: Types of Diets - Clear Liquid
includes liquids that lack residue, such as juices without pulp, tea, gelatin, soda, clear broth
Implementation: Types of Diets - Full Liquid
Includes all fluids and foods that become liquid at room temperature (ice cream, sherbert)
Implementation: Types of Diets - Soft
Soft foods that have been furhter chopped or pureed for those who have difficulty chewing
Implementation: Types of Diets - Diet as tolerated
Ordered when a clients ability to tolerate foods is like to change, i.e. during the postoperative period
Implementation: Types of Diets - Restrictive Diet
Sodium, fat, calories
Implementation: Nutritional Supplements
-may be necessary during periods of increased metabolic demands
-provide necessary nutrients
-available in milk shake type drinks, pudding, or powders to add to food or fluids
Implementation: Enteral tube feedings
Provides direct delivery of food to stomach, bypassing the mouth
-nutritionally balanced preparations
-provide nutrition to clients who canno swallow
-may be fed continuous or intermitently
**Types of tubes:
-nasogastric
-gastronomy
Enteral tube feedings: Hazards and Complications
-aspiration (pt. should be elevated when feeding)
-vomiting
-diarrhea
-obstruction of the tube
-hyperglycemia
Evaluation
Does the client behaviors match the behavior in the stated goals and outcomes
Gastritis
Inflammation of the mucosal lining of the stomach
Gastroenteritis
inflammation of the stomach and intestinal tract caused by vomiting, diarrhea
Gastrostomy
surgical creation of a gastric fistula throughthe avdominal wall for the purpose of introducing food into the stomach
Gingivitis
Inflammation of the gums; characterized by redness, swelling or bleeding
Hepatitis
Inflammation of the liver caused by exposure to an infectious agent or drug
Abdominal
Pertaining to the abdomen
Dysphagia
Inability to swallow or difficulty in swallowing
Dyspepsia
Upper abdominal discomfort, often chronic or persistent (referred to as indigestion)
Nasogastric
Pertaining to the nasal passages and the stomach, esp. relating to intubation
Peritioneal
concerning the peritoneum
Reflux
A return or backward flow
Flatus
gas in the gastrointestinal tract
Gavage
liquid food instilled in the stomach through the nasogastric tube: also called enterral nutrition
Sublingual
under the tongue
Hematemesis
vomiting of blood