Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
154 Cards in this Set
- Front
- Back
Vitamin C
(ascirbic acid) 60mg (60-100 mg for smokers) sources: |
citrus fruits
green pepper strawberries greens |
|
Vitamin C
(ascirbic acid) 60mg (60-100 mg for smokers) functions: |
collagen formation
antioxidant enhances iron absorption |
|
Vitamin C
(ascirbic acid) 60mg (60-100 mg for smokers) s/s of deficiency: |
scurvy
hemorrhaging delayed wound healing |
|
Vitamin C
(ascirbic acid) 60mg (60-100 mg for smokers) s/s of excess: |
kidney stones
scurvy on withdrawal nausea diarrhea |
|
vitamin B complex
thiamin sources: |
pork
liver whole and enriched grains legumes |
|
vitamin B complex
thiamin functions: |
coenzyme in key energy reactions
|
|
vitamin B complex
thiamin s/s of deficiency |
fatigue
beriberi mental confusion (especially in alcoholism) |
|
vitamin B complex
thiamin s/s of excess |
none known
|
|
Riboflavin sources
|
dairy
organ meats enriched grains greens |
|
Riboflavin functions
|
nutrient metabolism
|
|
Riboflavin s/s of deficiency
|
inflammation
poor healing |
|
Riboflavin s/s of excess
|
none known
|
|
Niacin sources
|
grains
lean meat nuts |
|
Niacin functions
|
nutrient metabolism
|
|
Niacin s/s of deficiency:
|
pellagra
dermatitis |
|
Niacin s/s of excess:
|
flushing
itching nausea vomiting |
|
B6 (pyridoxine)sources:
|
fruit
dark green vegetables |
|
B6 (pyridoxine)functions:
|
coenxyme in metabolism
|
|
B6 (pyridoxine)s/s of deficiency
|
anemia
CNS problems confusion |
|
B6 (pyridoxine)s/s of excess:
|
difficulty walking
numbness of feet and hands |
|
Folate (180-200 mcg) sources:
|
green leafy vegetables
liver |
|
Folate (180-200 mcg) functions:
|
RNA and DNA synthesis
formation and maturation of RBC |
|
Folate (180-200 mcg) s/s of deficiency:
|
macroxytic anemia
fatigue weakness pallor fetal risk of spina bifida |
|
Folate (180-200 mcg) s/s of excess:
|
none known
|
|
B12 (cobalamin) sources:
|
only animal and fortified foods:
organ meats meat seafood |
|
B12 (cobalamin) functions:
|
coenzyme in protein metabolism
formation of heme portion of hemoglobin |
|
B12 (cobalamin) s/s of deficiency:
|
pernicious anemia due to lack of intrinsic factor or alcoholism
|
|
B12 (cobalamin) s/s of excess:
|
none knonw
|
|
water soluble vitamins:
|
Vitamin C
Bitamin B Complex (Thiamin) Riboflavin Niacin B6 (pyridoxine) Folate B 12 |
|
Fat soluble vitamins:
|
Vitamin A
Vitamin D Vitamin E Vitamin K |
|
Vitamin A (retinol, retinal, retinoic acid) 800-1000 Retinal equivalent
sources: |
liver
carrots egg yolk fortified milk |
|
Vitamin A (retinol, retinal, retinoic acid) 800-1000 Retinal equivalent
functions: |
visual acuity
healthy skin and mucous membranes |
|
Vitamin A (retinol, retinal, retinoic acid) 800-1000 Retinal equivalent
s/s of deficieny: |
night blindness
rough skin |
|
Vitamin A (retinol, retinal, retinoic acid) 800-1000 Retinal equivalent
s/s of excess: |
anorexia
loss of hair dry skin bone pain |
|
Vitamin D (cholecalciferol, ergosterol)
sources: |
sunlight
fortified milk fish liver oils |
|
Vitamin D (cholecalciferol, ergosterol)
functions: |
calcium and phosphorus metabolism
stimulates calcium absorption |
|
Vitamin D (cholecalciferol, ergosterol)
s/s of defeciency: |
retarded bone growth
bone malformation |
|
Vitamin D (cholecalciferol, ergosterol)
s/s of excess: |
excessive calcification of bones
renal calculi |
|
Vitamin E sources:
|
vegetable oils
wheat germ whole grain products |
|
Vitamin E functions
|
antioxidant
protexts vitamin A heme synthesis |
|
Vitamin E s/s of defeciency:
|
anemia
|
|
vitamin E s/s of excess:
|
large doses can cause fatigue diarrhea
|
|
Vitamin K 65-80 mcg
sources: |
dark green leafy vegetables
synthesized in intestines from gut bacteria |
|
vitamin K 65-80 mcg
functions: |
blood clotting
|
|
vitamin K 65-80 mcg s/s of deficiency:
|
hemorrhagic disease of newborn, delayed blood clotting
|
|
Vitamin K 65-80 mcg
s/s of excess: |
hemolytic anemia & liver damage w/ synthetic vitamin K
|
|
Calcium (at least 800 mg)
lab data: |
9.5-10.5 mg/dL
4.5-5.3 mEq/L |
|
Calcium (at least 800 mg)
sources: |
dairy
canned fish with bones greens |
|
Calcium (at least 800 mg)
functions: |
bone and tooth formation
blood clotting nerve transmission muscle contraction |
|
Calcium (at least 800 mg)
s/s of deficiency: |
tetany
osteoporosis |
|
Calcium (at least 800 mg)
s/s of excess: |
renal calculi in susceptible people
|
|
Phosphorus lab data:
|
3.0-4.5 mg/L
|
|
Phosphorus sources:
|
soft drinks, processed foods, dairy
|
|
Phosphorus functions:
|
bone and tooth formation
acid-base balance energy metabolism |
|
Phosphorus s/s of deficiency:
|
hypophosphatemia: muscle weakness
|
|
Phosphorus s/s of excess:
|
hyperphosphatemia: symptoms of hypocalcemic tetany
|
|
Magnesium lab data:
|
1.3-2.1 mEq/L
1.4-1.9 mg/dL |
|
Magnesium sources:
|
green leafy vegetables
nuts beans grains |
|
Magnesium functions:
|
bone and tooth formation
protein synthesis metabolism |
|
Magnesium s/s of deficiency:
|
hypomagnesemia: poor heart function, Torsades de Pointe
|
|
Vitamin K 65-80 mcg
s/s of excess: |
hemolytic anemia & liver damage w/ synthetic vitamin K
|
|
Calcium (at least 800 mg)
lab data: |
9.5-10.5 mg/dL
4.5-5.3 mEq/L |
|
Calcium (at least 800 mg)
sources: |
dairy
canned fish with bones greens |
|
Calcium (at least 800 mg)
functions: |
bone and tooth formation
blood clotting nerve transmission muscle contraction |
|
Calcium (at least 800 mg)
s/s of deficiency: |
tetany
osteoporosis |
|
Calcium (at least 800 mg)
s/s of excess: |
renal calculi in susceptible people
|
|
Phosphorus lab data:
|
3.0-4.5 mg/L
|
|
Phosphorus sources:
|
soft drinks, processed foods, dairy
|
|
Phosphorus functions:
|
bone and tooth formation
acid-base balance energy metabolism |
|
Phosphorus s/s of deficiency:
|
hypophosphatemia: muscle weakness
|
|
Phosphorus s/s of excess:
|
hyperphosphatemia: symptoms of hypocalcemic tetany
|
|
Magnesium lab data:
|
1.3-2.1 mEq/L
1.4-1.9 mg/dL |
|
Magnesium sources:
|
green leafy vegetables
nuts beans grains |
|
Magnesium functions:
|
bone and tooth formation
protein synthesis metabolism |
|
Magnesium s/s of deficiency:
|
hypomagnesemia: poor heart function, Torsades de Pointe
|
|
Magnesium s/s of excess:
|
CNS depression
coma hypotension |
|
Sodium (500 mg) lab values:
|
136-145 mEq/L
|
|
Sodium (500 mg) sources:
|
salt and *"hidden sodium"
IV saline |
|
Sodium (500 mg) functions:
|
major ion of extracellular fluid
|
|
sodium (500 mg) s/s of deficiency:
|
skin clammy/ cold
agitated/ confusion leg cramps too little Na+ |
|
Sodium (500 mg) s/s of excess:
|
Edema
Thirst Pattern of weight gain High BP *(E.T. Phone Home) |
|
Potassium (1600-2000 mg) lab values:
|
3.5-5.0 mEq/L
|
|
Potassium (1600-2000 mg)sources:
|
whole grains
fruits leafy vegetable |
|
Potassium (1600-2000 mg)functions:
|
major ion of intracellular fluid
|
|
Potassium (1600-2000 mg)s/s of deficiency:
|
hypokalemia:
muscle cramps and weakness irregular heart beats EKG: u-wave |
|
Potassium (1600-2000 mg) s/s of excess:
|
Hypekalemia:
irritability ventricular dysrrhythmia heart block tall, tented T's |
|
Iron (10-15 mg) sources:
|
lean and organ meats
enriched and whole grain breads and cereals |
|
Iron (10-15 mg) functions:
|
oxygen transport by way of hemoglobin
constituent of enzyme systems |
|
Iron (10-15 mg) s/s of deficiency:
|
microcytic anemia
pallor fatigue |
|
Iron (10-15 mg) s/s of excess:
|
hemosiderosis
acute iron poisoning GI symptoms shock |
|
Iodine sources:
|
iodized salt
seafood food additives |
|
Iodine function:
|
component of thyroid hormones
|
|
Iodine s/s of deficiency:
|
goiter
|
|
Iodine s/s of excess:
|
acne-like lesions
|
|
What is the reccommmended to cut back sodium in persons with high blood pressure?
|
2 grams/2000 mg or less
|
|
medical nutrition therapy:
|
is prescribed for an individual by a physician or (when delegated by MD) by the dietitian or certified diatary educator in some states for disease control
|
|
____% to _____% of hospital patients are starving- not receiving adequate nutrition.
|
40-55
* a primary role of a RN is to keep pt. from starving in the hospital |
|
Nutritional Screning:
|
Self-reported check-list (inexpensive)
Calculation of BMI (inexpensive, more objective than self-reported check list) Limited anthropometric data (somewhat more expensive, not a good way to estimate- done by pinching fat. not good to use on children) *screening especially useful for very young and the elderly |
|
What foods do dilantin and tetracyclines interact with that should not be given with these meds?
|
dairy
|
|
What kind of juice interacts with a number of meds and the nurse should be cautious about"?
|
grapefruit juice
|
|
What do greens contain that interact with a number of meds?
|
iron
|
|
Anthropometry
|
height and wight
BMI Body fat measurement |
|
ideal body weight for males =
|
106 lbs for 5 feet + 6lbs per inch over 5 feet
|
|
ideal body weight for women =
|
100 lbs for 5 feet plus 5 lbs per inch over 5 feet
|
|
Albumin
|
3.5-5g/dL is normal
*cheap test for nutritional level- takes at least 1 week for it to fall if patient is malnourished |
|
total lumphocyte count
|
1800-3000
|
|
transferrin
|
iron stores- done after an anemic blood count
|
|
total iron-binding capacity and hemoglobin
|
250-460mcg/dL
if <250 indicates poor nutrition |
|
prealbumin
|
15-36 mg/dl
a sensitive indicator of protein status. shorter half-life:2-3 days, most useful |
|
mild malnutrition prealbumin levels
|
10-15 mg/dl
|
|
moderate malnutrition prealbumin levels:
|
5-10 mg/dl
|
|
severe malnutrition prealbumin levels:
|
<5 mg/dl
|
|
Carbohydrates should be __________% of your intake unless you're trying to lose weight
|
50-60
|
|
Good fiber level
|
25-30 g/day
|
|
How would you need to increase a patient's fiber intake?
|
slowly, to decrease bloating, flatulence, and diarrhea (increase fluid intake should accompany increased fiber intake
|
|
Sources of carbohydrates
|
grain products
fruits vegetables (corn, potatoes, dried beans, peas) milk/dairy products refined sugars |
|
Carbohydrates: Water soluble fiber effects on body:
|
slows gastric emptying/lower serum cholesterol
delays glucose absorption which helps in persons with diabetes soluble fiber adds weight to stool (but no bulk to aid elimination, so may still need laxative) |
|
Carbohydrates: Water insoluble fiber effects on body:
|
absorbs water to increase fecal bulk in the large intestine and to aid elimination
decreases intestinal transit time may also reduce fat absorption (and indirectly lower cholesterol) |
|
Very-low density lipoproteins function
|
transport triglycerides from liver to tissue
VLDLs |
|
Low density lipoproteins function
|
plasma proteins with triglyceride components that carry cholesterol to cells (bad cholesterol)
|
|
High density lipoproteins
|
plasma proteins that carry fat in bloodstream to tissue or to liver to be excreted.
cardioprotective- "good cholesterol" 1:3 ratio |
|
VAP analysis
|
a way to genetically determine risk factor for heart disease.
*genetics play into it because our liver produces cholesterol |
|
clear liquid diet-
|
you can see through them- no milk! ex. coffee is clear if drank black
|
|
full liquid diet:
|
same as clear liquid but can add dairy (so liquid doesn't have to be see-through)
transition between clear and soft |
|
pureed diet used for:
|
patients who have difficulty chewing/swallowing
|
|
mechanical soft diet used for:
|
patients with poor dentition
|
|
soft diet:
|
ex. easily digested foods (like mashed potatoes)
|
|
dysphagia diet
|
thickened diet provided for clients with difficulty swalling
ex. buttermilk consistency, pudding consistency, etc. |
|
gastric by-pass diet:
|
small meals, low fat, high protein, no carbonated bverages, or high fiber
a restrictive/modified diet. is long-term. |
|
low residue diet:
|
minimizes elimination, restrict high fiber foods, fried foods, pepper, alcohol, heavy seasonings
a restrictive/modified diet, is long-term |
|
fat-controlled diet:
|
diet for malabsorption, chronic pancreatitis, gallbladder disease or clients with CVD, CHF
a restrictive/modified diet, is long-term |
|
Protein=controlled diet
|
for patients with renal disease (ex. renal failure, ESRD, dialysis, and transplant) and liver diesase (liver failure, hepatic encephalopathy, cirrhosis, transplant, and hepatitis)
a restrictive/modified diet- is long-term |
|
food allergy diet-
|
ex. an egg free diet for clients with known sensitivity
ex. glyten-restricted for celiac disease (malabsorption syndrome) etc. is a restrictive/modified diet- is long-term |
|
purine-controlled diet
|
due to elevated uric acid levelsfor gout, tumor lysis syndrome, multiple myeloma
use dairy products. restrict organ meats, anchovies, alcohol, and seafood. a restrictive/modified diet- is long-term |
|
sodium-controlled diet
|
usually 2400mg/day to as low as 500mg/day in renal failure
used to treat hypertension, fluid restrictions, CVD is a restrictive/modified diet, is long-term |
|
carbohydrate-controlled diet
|
diabetes mellitus
a restrictive/modified diet. is long-term |
|
high fiber diet
|
includes complex carbs; low fat, wholegrain products; vegetables/fruits to promote normal bowel function
is a supplemental/enhanced diet |
|
high-potassium diet
|
includes orange juice, apricots, cantaloupes, and bananas
for clients with K+ losses is a supplemental/enhanced diet |
|
high-calcium diet
|
includes milk/dairy products
for clients with low Ca++ losses (i.e. osteoporosis, kidney failure) is a supplemental/enhanced diet |
|
high protein diet:
|
for atheletes
dietician or MD needs to prescribed (because can be metabolized into ketones) is a supplemental/enhanced diet |
|
neutropenic diet
|
for those who have impaired immune function
restricts: fresh fruits, raw vegetables, nuts, seeds, dried fruits, black pepper, any foods that carry pseudomonas aeruginosa heat treat ALL foods to destrow bacteria. so for ex., can't give raw fruits/veggies |
|
Cancer chemotherapy/radiation:
1.Radiation intended to destroy _______ 2. may also destroy ____ of ____ ______. 3. can cause these problems in GI: 4. Can cause these problems in Head/neck |
1.malignant cells
2. lining of GI tract 3. anorexia, stomatitis, severe diarrhea, strictures of intesines, and pain 4. can distort taste, smell, salivation, & can cause dysphagia. |
|
Nutrition care in cancer: chemotherapy and radiation
|
small, frequent meals
nutrient dense high calorie, high protein meals add extra nutrient dense food such as honey, powdered skim milk, peanut butter, cheese limit liquids with meals- contribute to nausea |
|
conditions causing nausea and/or poor appetite may also respond to:
|
-avoid spicy, gas-forming, or hard-to-digest foods
-small frequent meals or snacks -pay attention to nutrient density and individual preferences -make eating experience social if desired - take anti-nausea meds prior to eating - control environment (smells, excess stimulation) - appetite stimulants such as Megace, MArinol, Periactin, or small glass of wine may help |
|
Nutritional problems with HIV/AIDS:
|
-inadequate intake, body wasting, severe weight loss
- anorexia, stomatitis, oral thrush, N/V, severe diarrhea, GI malabsorption -altered metabolism- greater risk for systemic infections -medications to treat HIV/AIDS cause side effects that alter nutrition |
|
Nutritional Interventions w/ HIV/AIDS
|
-monitor weight, protein status (serum albumin, prealbimin, transferrin, and total lymphocyte count)
-good handwashing, food safety, low-fat diets, and small frequent nutrient-dense meals -possible neutropenic diet |
|
Client GI upset problems from N/V/D
|
-dehydration
-loss of electrolytes - metabolic alkalosis -metabolic acidosis -malabsorption/malnutrition |
|
Interventions for GI upset from N/V/D
|
- progress diet as tolerated
- NPO- progress to clear liquids to rest intestine -bland diet & small frequent meals - eliminate coffee, alcohol, pepper, spicy foods -BRAT diet - Provide limited protein and fat food for energy - replace fluid and electrolytes, limit sugars -daily weights - I&O |
|
BRAT diet
|
Bananas
Rice Applesauce Toast *good for peds *used in GI upset |
|
Surgical client problems with nutrition:
|
-anesthesia stops/decreases peristalsis
-auscultate for bowel sounds - place on progressive diet- begin with ice chips/ clear liquids & progress as tolerated (to prove they're able to use peristalsis) -hunger is a good indication to start food back- don't have to auscultate bowel sounds to give ice chips/clear liquids |
|
Nutritional Routs:
|
1. oral
2. Enteral (gastrostomy, jejunostomy, nasogastric) 3. Parenteral (cannot give any thing but lipids and TPN through it!) |
|
Parenteral nutrition
|
-TPN or hyperalimintation of lipids
-for clients who are unable to digest or absorb enteral nutrition -administration site- IV peripheral or CVL but central venous line is preferred - solutions: <10% dextrose can be given peripherally. >10% must be given in CVL (most ~D70W) -components: glucose, amino acids, vitamins/minerals, lipids |
|
Parenteral nutrition interventions:
|
-verify TPN w/ 2 RN's
-5 Rights - inspect bag integrity before hanging - infuse with infusion pump only -do not abruptly d/c- hypoglycemia can occur. -follow policy if it runs out- may hang D10W or D20W! -Inspect IV site for s/s of infection- very high risk of sepsis - assess for allergic reaction -assess Labs: phosphorus, Na, K, Cl, CO2, BUN, creatinine, blood glucose. |
|
IV lipids
|
-used to provide essential fatty acids
-exists in different concentrations 10-30% -considered isotonic - clients allergic to eggs should not get this soln. |