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179 Cards in this Set
- Front
- Back
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TP is an 85 year old female brought to her PCP by her family. TP has not been feeling well and they are concerned. Which of the following pairs of assessment parameters are most consistently correlated with poor nutritional status?
a) vision/ hearing deficits b) alcohol use and polypharmacy c)poverty, social isolation d) involuntary weight loss, poor appetite |
D) involuntary weight loss and lack of appetite
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DA is a 74 y/o male with Type 2 DM. He is currently on metformin. Which vitamin deficiency is associated with long term metformin use? Why?
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Vitamin b12 - decreased vitamin absorption
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ML is an 82 y.o female in assisted living facility. Her family asks about falling and how much vitamin D she should take. What dose of Vit D should be prescribed for older adults?
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800IU daily
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RB is a 69 y/o male whose wife is expressing concern over his drinking daily. According to american Geriatrics Society, risky drinking habits for an older man is what?
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More than 3 drinks/day or more than 7 drinks/week
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Which group in the US is at an increased risk of malnutrition due to inadequate funds for purchasing food?
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Females, Minorities, those in Urban dwellings. (all of the above)
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JN is an 88y/o man living in a nursing home. He has lost 10% weight over past 6 months. This is unplanned weight loss most likely due to what?
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Underlying disease process
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Malnutrition in the elderly is associated with what factors?
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Poor appetite, problems chewing and swallowing, and medical illness (all of the above)
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CJ is an 81 y/o female living in assisted living. She is having only 1-2 BM/ week. What would you prescribe to address constipation?
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Increased consumption of whole grains.
(other options: increase garlic consumption, decrease dairy, decrease fried foods) |
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Minorities are expected to represent approximately what percent of the elderly population by 2030
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25%
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Older adults are less likely to experience signs and symptoms of dehydration due to what physiological changes in aging?
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Decline in thirst perception
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The incidence of periodontal disease is higher in elderly with what chronic conditions?
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Cardiovascular disease, Diabetes
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RF is an 83/F in assisted living. Labs show low B12 despite adequate intake. What is the most likely explanation?
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Decreased ability to absorb protein-bound B12
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HJ is a 91/M in nursing home. He has lost 10lbs in one month. What is his estimated daily protein requirement for repletion if he currently weighs 150 lbs (68kg)
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102g/day
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According to the NCEP TLC diet, what is the recommended range for total dietary fat as a percentage of the total calorie intake?
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23-35% total calories
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Which of the following can cause secondary hyperlipidemia?
Diabetes Obesity Hypothyroid |
Diabetes, obesity, hypothyroidism (all)
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Recent evidence suggests that trans fatty acids raise LDL levels compared to unsaturated fatty acids. What is true concerning fatty acids?
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1. Trans fats are found in partially hydrogenated margarines and shortenings
2. Trans fats add shelf life and flavor to foods 3. Trans fats may reduce HDL levels |
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TK is 49/M with hyperlipidemia and frequents fast food restaurants. What is most likely contributing to elevated LDL levels?
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Saturated fats
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What vitamin is used to treat hypercholesterolemia when used in pharmacological doses?
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Niacin
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Which of the following contains the highest amount of omega-3 fatty acids/ serving?
- salmon - soybeans -yogurt - olive oil |
Salmon
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Whch of the following are cardiovascular benefits from omega-3 fatty acids, in addition to lowering triglycerides?
- decreased platelet aggregation - decreased clotting time - increased foam cell production - increased free radical formation |
Decreased platelet aggregation
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According to the National Cholesterol Education program, a 35/F iwht LDL of 145 and HDL of 30 with fam hx of heart disease should have what target LDL?
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<130mg/dL
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PR is 25/M with BMI 30 and recent DX HTN. He has a family hx of HTN. He is 5'7" and 210 lbs. What is the most likely etiology of his HTN?
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Obesity
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What is true considering excess alcohol consumption (>2drinks/day men, >1drink/day women)
- increases BP - it is cardioprotective - reduces risk of cardiomyopathy - Reduces triglyceride levels |
Increases BP
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Which of the following would be most likely to reduce HTN without drugs?
- reduce fat intake -increase low-fat dairy - increase fruits and veggies |
ALL of the above
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What is the most appropriate MNT for a patient with heart failure?
- limit sodium to 2000mg/day - limit total fat to <30% calories - limit K+ to less than 2000mg/day - limit cholesterol to <200mg/day |
Limit Sodium <2000mg/day
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What is the mechanism of how soluble fiber reduces LDL?
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Binding with bile salts
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SR is 59/F with recent dx hyperlipidemia. WHat physical exam finding should be checked?
- eye exam for corneal arcus senilis - mouth exam for glossitis or cheilosis - skin exam for xantehlasma or xanthoma - exam for edema in limb |
Skin exam for xanthelasma or xanthoma
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Which of the following should be prescribed MNT for patients with heart failure?
- control sodium and water retention - provide adequate energy, vitamins, and minerals - Replete protein stores |
ALL of the above
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Which of the following risk factors for metabolic syndrome has different criteria among different ethnic groups?
- HTN - Fasting glucose - Waist - HDL levels |
Waist
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Which ethnic group is at highest risk for hypertension?
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African Americans
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What is the most likely cause of unintentional weight loss in a patient with Crohn's disease?
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Malabsorption
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MNT for patients with peptic ulcer disease includes what?
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Reducing alcohol, reducing tobacco, reducing caffiene
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What is the best non-dairy source of calcium to recommend for those who are lactose intolerant?
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Enriched soy milk
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Which of the following is most likely to contribute to poor dietary intake in a patient with chronic liver disease and ascites?
-hyperkalemia - hypoglycemia - dehydration - early satiety |
Early satiety
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Which of the following would be most helpful in reducing GERD symptoms that occur in the middle of the night?
- avoid eating 2H before bed-time - sleep with 2+ pillows - Drink warm milk before bed - Take an OTC sleeping med |
avoid eating <2H before bed
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According to CDC, what level of weight loss helps define and AIDS diagnosis?
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Greater than 10% with diarrhea, or fever > 30 days.
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MG is a 29/M with HIV. He complains of poor appetite, decreased food intake, and frequent diarrhea. After testing, it is noted his extracellular fluids are elevated. This indicates what?
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Presence of an underlying infection
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What nutritional measure is frequently abnormal in presence of advanced HIV?
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Low albumin
low cholesterol anemia |
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Why are PT levels elevated in patients with advanced or end stage liver disease?
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reduced production of clotting factors
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What is the most likely cause of megaloblastic anemia in alcoholic patients?
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Vitamin B12 deficiency
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What is the most likely cause of fat malabsorption in patients with Crohn's?
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Inability to reabsorb bile salts
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What is the nutritional recommendation for a patient experiencing fat malabsorption secondary to GI surgery?
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- eat small frequent meals
- increase consumption of soluble fiber - maintain lactose-free diet |
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What is the expected outcome from MNT for diabetes
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1-2% decrease in A1C, should be evaluated between 6weeks and 3 months of initiation
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What is the first priority of MNT for patients with type 2 DM?
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Focus on nutrition interventions that will improve glycemia, lipid profiles and blood pressure
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What is correct about carb intake in patients with type 2 DM:
- amount is more important than source or type - any increase in fiber will improve glycemia - implementing a low glycemic index will improve glucose and lipid levels - Bolus insulin doses are based on total carbs and protein in a planned meal |
Total amount is more important than source or type.
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American diabetes association, AHA, and surgeon general agree on which of the following:
- carbs in diet should be restricted - high-protein diet is best for weight reduciton - saturated fat and trans fat should be restricted - only monounsaturated fats should be used to replace saturated fats. |
Saturated and Trans fats should be restricted
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What percent weight loss was necessary to achieve reduction of risk for true diabetes in patients dx with pre-diabetes?
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7%
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What is correct about carb counting:
- bolus insulin is based on total carbs and protein in meal - one carb serving is 15g - Compared to carbs, protein and fat have 1/2 expected glucose response - basal insulin doses are adjusted to cover the carbohydrate content of meals. |
one carb serving is based on proportion of food that contains 15g carbs.
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WHich of the following is appropriate for treating hypoglycemia in a pt on insulin?
- 15g carb, wait 15 mins, if still low try again - retest 1 hr after treatment to see if additional carbs needed - Treat with 20g fast-acting carb - treat with food or beverage source of carb and proteins |
- 15g carb, wait 15 mins, if still low try again
- retest 1 hr after treatment to see if additional carbs needed |
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Select 2 correct statements about alcohol:
- moderate amounts always raise triglycerides - moderate amounts always raise blood glucose - moderate amounts with food does not affect glucose or insulin levels - moderate amounts without food for pt using insulin can lower blood glucose levels |
- moderate amounts with food does not affect glucose or insulin levels
- moderate amounts without food for pt using insulin can lower blood glucose levels |
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How has MNT for DM changed over recent years based on the idea that diabetes is a progressive disease?
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MNT is aimed at achievement of blood glucose AND lipid goals.
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What is the target range for pre-meal glucose value for non-pregnant adults with DM?
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90-130mg/dL
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What is considered an optimal HgA1C for patients with DM?
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less than 7%
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Most normal weight adult patients with Type I DM require 1 unit of insulin for what carb intake?
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8-15g CHO
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What factors increase risk for developing insulin resistance
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- personal hx of impaired glucose tolerance.
- first degree relative with type 2 DM - obesity, especally abdominal or central cavity. |
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- According to american diabetes association, fiber intake for those with type I and type 2 DM is recommened as :???
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25g/day for women, 38g/day for men
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Instant oatmeal contains 30g carbs, how many servings of carbs is that?
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2 servings
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What nutrients commonly fall below RDAs in elderly population? (7)
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1. total calories
2. fluids 3. fiber 4. calcium 5. vitamin D 6. Vitamin b12 7. Folate |
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Name risk factors for poor nutrition in the elderly? (8)
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1. acute and chronic disease
2. oral health, ill fitting dentures 3. cognitive, emotional impairment 4. isolation 5. sleep patterns 6. tobacco, ETOH, drug use 7. polypharmacy 8. socioeconomic status |
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What does the acronym DETERMINE help you remember? What does it mean?
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1. warning signs of poor nutritional health
D: Disease E:eating poorly T: teeth loss/ mouth pain E: economic hardship R: reduced socialization M: multiple medications I: involuntary weight change N: needs assistance for care E: elderly >80 |
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What are the 6 ADLs?
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1. bathing
2. Dressing 3. using toilet 4. transferring 5. continence 6. Feeding |
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Incontinence can affect what?
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skin, increased risk of infection, health, quality of life
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What are the 8 IADLS?
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1. telephone use
2. walking 3. shopping 4. meal prep 5. housework/laundry 6. home maintenance 7. Taking medications 8. managing money |
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What is the RDA for calcium in elderly? What is the UL?
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1. RDA: 1200mg/day
2. UL: 2500mg/day |
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What is the RDA for vitamin D for ages 51-70? 70+?
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RDA: 400IU/day 51-70, 70+ 600IU
Lecture: 700-800IU/day for 70+ |
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In elderly, vitamin D should be routinely assessed using what test?
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25OHD
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What are preventative doses of vitamin D and Calcium to prevent hip fx?
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VitD: 700-800IU daily
Ca: 1200mg/day |
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What is the osteoporosis treatment with vitamin D and calcium?
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D: 800IU daily
Ca: 1200mg daily |
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When should B12 be supplemented?
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when levels are borderline or below normal.
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What percent of elderly cannot absorb protein-bound B12?
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10-30%
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What is the RDA for B12 for those >50 yrs
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2.4μg/day
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Identify risk factors and causes of involuntary weight loss in elderly?
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1. acute or chronic disease
2. oral health 3. cognitive/ emotional impairment 4. isolation 5. sleep patterns 6. tobacco, etoh, drugs 7. finances |
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What should you use to assess weight change in the elderly?
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usual body weight reported
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What screening tools can be used to assess nutrition related medical problems in the elderly
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1. DETERMINE
2. subjective global assessment 3. Meals on Wheels mnemonic 4. Mini nutritional assessment 5. NSI care alerts 6. diet recall 7. labs 8. easy bruising/ bleeding |
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What are medical problems common among the elderly?
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malnutrition, underweight, VitD deficiency, anemia
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Identify some community referrals for geriatric population.
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meals on wheels, church, friends/ family, home health aide, social work, council on aging, veteran's affairs, senior community center
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How many meds does the average elderly take daily?
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4
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___ is very important for aging adults.
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Physical activity, maintaining a varied nutrient rich diet
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Nutrient deficiency is more common among whom?
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frail, homebound, isolated, or those who rely on others as in institutional care (nursing home)
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the body composition of elderly is altered how?
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Increased fat, decreased water
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How does the GI system alter in the elderly?
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decreased gastric acid secretion, decreased motility, decreased lactase activity
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What changes occur in the liver of the elderly?
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reduced size and flow, decreased activity of drug-metabolizing enzymes
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In what way is the immune system of elderly altered?
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Decreased Tcell function
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In what way is the neuro system of elderly altered?
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Brain atrophy
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In what way does the renal system of the elderly change?
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Decreased GFR
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What changes occur in the skeletal system of the elderly?
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decreased bone density
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What changes occur in the sensory-perceptual functioning of elderly?
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decreased taste buds (may attribute to poor appetite), reduced olfactory nerve endings
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What effect do saturated fats have on LDL?
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Elevate LDL levels and lead to atherogenesis
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Foods with high ____ content are solid at room temp and have ___ double bonds.
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Saturated fat, no double bonds
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What is a MUFA? How many double bonds?
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MonoUnsaturated Fatty Acid, 1 double bond
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What is the most common form of MUFA?
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oleic acid, as in canola and olive oil
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What are good food sources of MUFAs?
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avocados, peanuts, pecans, olive oil, canola oil
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What is the importance of MUFAs on cardiac health?
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1. lower triglycerides, lower LDL, keep HDL high, reduce inflammation
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What are the main types of PUFAs?
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omega 3 and omega 6 fatty acids
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What are PUFAs? How many double bonds?
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PolyUnsaturated Fatty acids, >1 double bond
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Another name for omega-6 fatty acids is what?
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Lineoleic acid
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What is a downside of omega-6?
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Can cause inflammation
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Omega-6 fatty acids help build what components?
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cell membranes, prostaglandins
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What are good food sources of omega 3 fatty acids?
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cold water fish, fish oil, krill, flax seed, grass fed beef or lamb
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What are good sources of omega-6?
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cooking oils (sunflower, corn, soybean), grain fed meats especially organ meats, farm raised fish, pretty much all processed foods
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What is the benefit of omega 3 fatty acids/
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- decrease serum triglycerides, platelet aggregation, inflammation
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____ are found in vegetable oils, cookies, crackers, chips, all things bad... What is their effect on lipid levels?
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Trans fatty acids... raise LDL, lower HDL (BAD, BAD, BAD!)
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How can MUFAs and PUFAs be used as dietary substitutions?
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MUFAS may be substituted for carbs
PUFAs may be substituted for saturated fats No trans fats ever |
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Risk factors for cardiac disease include what?
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1. cigarettes smoking
2. HTN 3. Low HDL 4. Fam hx of premature CHD, 5. Age >45 men, 55 women Goals to reduce risks: Decrease serum LDL, WAVE, weight control, MNT, decrease alcohol |
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What is the WAVE acronym? What does it help with?
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Helps obtain balanced nutrition.
Weight, Activity, and diet in terms of Variety and Excess |
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What is 1 serving of alcohol?
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5oz wine, 1.5oz (80 proof) liquor, 12 oz. beer,
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What is the normal lab value for glucose?
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70-99
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What are normal values for Homocysteine?
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<12mg/dl
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What are normal values for total cholesterol?
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<200mg/dl
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What are normal levels for triglycerides?
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<150mg/dl
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What are normal values for HDL?
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>40mg/dl males
>50mg/dl females |
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What is the normal value for LDL?
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<130mg/dl
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What MNT can be done to lower LDL?
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1. Decrease saturated fat by limit portion size of meats, using leaner meats and fat-free stuff
2. Replace saturated fats with PUFAS or MUFAS 3. Limit trans fats 4. Limit cholesterol (yolks, organ meats, butterfat) |
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What MNT can be done to lower TG?
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Sub MUFAs, use olive or canola oils, eat peanuts, pecans,
eliminate alcohol weight control |
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What MNT can be done to increase HDL?
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Use MUFA instead of PUFAs, lose weight, eat omega-3 FA
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What is MNT for HTN?
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- reduce sodium
- increase K+ and Ca+, - limit alcohol - weight control - DASH is all of this!! |
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What is MNT for CHD?
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- Nutrition (Use WAVE)
- weight control - limit alcohol - calorically balanced, low in saturated fats |
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What should MNT for heart failure include?
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-Controlled sodium (2-3g/day) and fluid (1500-2000mL/day reduction) intake,
-restore and maintain body weight, - provide adequate calories, protien, vitamins, minerals. -Supplement with thiamine and Cq10 |
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What is the role of omega-3 in heart health?
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- decrease triglycerides, platelet aggregation, inflammation
- intake of 1g/day may reduce death from cardiac events? |
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What is a downside to omega-3 fatty acids?
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may slightly elevate LDL while lowering HDL
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What is the role of fiber in reducing cholesterol levels?
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Fiber lowers LDL,
Should include 10-25g viscous fiber daily to reduce hyperlipidemia Liver must use cholesterol to form more bile because fiber removes bile acids. |
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What are good dietary sources of soluble fiber?
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dried beans (lima, pinto, kidney), oatmeal, oat bran, citrus fruits, pears, brussel sprouts
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How do you calculate BMI?
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703 x (lbs/in*in)
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How do you calculate IBW?
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males: 106+ (6 x (#in> 60)
females: 100 + 5(in>60) PLUS OR MINUS 10%!!! |
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How do you calculate ABW?
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**If weight >125% IBW:
[0.25 x (acutal - IBW)]+IBW |
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How do you calculate % IBW?
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(Actual weight/ IBW) x100
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What is important to remember about using EER or Harris-Benedict equations for overweight patients?
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If Pt is >125% IBW, use ABW instead of actual weight.
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What is appropriate physical activity for patients with cardiovascular?
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- moderate exercise 200kcal/day
- exercise may need to be adjusted for patients with failure, etc |
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What is considered moderate alcohol consumption for adults?
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2 drinks/ day for men, 1 drink/day for women
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___ describes ANY elevation in total cholesterol, LDL, or triglycerides.
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Hyperlipidemia
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What is MNT for hyperlipidemia? What are the components?
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TLC diet:
- Limit LDL raising nutrients (low sat. fat, no trans fats, <200mg cholesterol daily) - 2g/day plant stanol and sterol esters - viscous fiber intake 10-25 - adjust kcal to maintain healthy weight - exercise to expent 200kcal/day |
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What are causes of Peptic ulcer disease?
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eroded lesion in esophageal, gastric, or duodenal mucosa. Caused by H.pylori, gastritis, asa, nsaids, stress.)
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SxS of duodenal ulcer include:
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Pain 2-5 hours after meals and relieved by eating
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SxS of gastric ulcer include:
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vague epigastric pain when eating
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What is MNT for peptic ulcer disease?
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1. medical management to reduce gastric secretions, or reduce NSAIDS, ASA, or use abx)
2. behavioral (no smoking) 3. nutritional management: - limit caffiene - limit alcohol - 3 small meals, no skipping - limit spicy, fatty, or bothersomef oods - avoid bedtime snacks - increase omega 3 and 6 FAs |
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What are SxS of GERD?
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backward flow from stomach to esophagus,
Symptoms: - burning in upper middle of chest, increased belching, painful spasms - decreased esophageal clearance - delayed gastric empthying |
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What is behavioral and MNT for GERD?
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Behavior:
- avoid: eating within 3 hrs of sleep, lying down, smoking, tight-fitting clothes, Nutrition: Avoid: decreased LES pressure, decrease frequency of volume, reduce irritaiton, Avoid: fat, alcohol chocolate, coffee - Lose weight, - Avoid acidic foods |
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What are the 4 categories of malabsorption?
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1. impairment of mechanical digestion
2. impairment of chemical digestion 3. impairment of solubilizaiton 4. pathological impairment of absorption |
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Symptoms of fat malabsorption include:
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steatorrhea, weight loss, muscle wasting, osteomalacia, bone pain, infertility, dysmenorrhea
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If a person suffers fat malabsorption, they may also have what vitamin deficiencies?
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K, A, D, E
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What causes malnutrition in liver disease?
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1. poor dietary intake
2. maldigestion and absorption 3. abnormal metabolism and storeage of nutrients |
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What tool should be used to assess liver disease? What does it include?
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Subjective Global assessment tool.
Includes: - weight loss during past 6 mos - change in intake - GI symptoms - metabolic demands -s/s muscle wastin - presence of edema |
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Why may you see poor dietary intake in liver disease?
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- anorexia
- dietary restrictions (sodium - nothing tastes good) - pressure from ascites |
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Maldigestion and malabsorption results in ____ in 50% of cirrhosis patients.
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Steatorrhea
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Abnormal metabolism of proteins in liver failure results in what?
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reduced albumin (edema), PAB, transferrin, PTT, BUN
Elevated amonia |
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Abnormal metabolism of CHO in liver disease may lead to what?
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Hyper or hypo glycemia
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Abnormal fat metabolism in liver disease may result in ___, and deficiency of which vitamins
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fatty liver, deficient in thiamin, folate, pyridoxine, vitamin D
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What would MNT for liver disease include?
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- correct existing malnutrition
- supply adequate calories and protein to encourage hepatic regeneration - Base calculations on "dry weight" |
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How do you figure out "dry weight" in a liver failure patient?
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1L fluid = ~1kg body weight,
ascites estimate 5kg fluid ascites + edema in extremities 10kg |
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How many calories should a patient with compensated cirrhosis consume? Complicated cirrhosis and malnutrition?
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Uncomplicated: 25-35ckal/kg
Complicated: 35-40kcal/kg |
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How much % diet should the calories from fat be in a patient with liver failure but not steatorrhea?
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20-40%
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How are protein needs for a liver failure patient calculated?
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1. 1-1.2g/kg/day = stable cirrhosis
2. Up to 1.5/kg/d for complicated cirrhosis 3. Protein restrictions may help lower ammonia levels |
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Crohn's disease affects what layer(s) of the mucosa, in contrast to ulcerative colitis which affects which?
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Crohn's : all layers,
Ulcerative colitis: mucosa/ submucosa |
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Describe Crohn's disease.
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Young age of onset, affects all layers of the mucosa resulting in narrowed ilium. Slow, progressive, with occasional bleeding. Arthritis may also be present (commonly)
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Describe Ulcerative Colitis.
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onset at young to middle age, affects the mucosa/ submucosa, small bowel is normal, malignant >10 years, continuous. Bleeding is common, arthritis and fistulas are uncommon (vs. crohn's)
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What are dietary goals for IBS?
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Medical management: corticosteroids or anti-inflammatories, abx, etc
Nutritional: foods that are well-tolerated, promote healing, minimize stress, prevent symptoms of malabsorption, promote normal growth and development |
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Dietary restrictions for IBS shold include what?
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- low fat, low fiber, low lactose, small frequent meals,
- MCTs - limit caffine and alcohol - avoid sugar alcohols - avoid diarrhea causing foods |
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Identify the goals for the following MNT in IBS?
- kcal - protein - vitamins/ minerals |
kcal_ 35-45 kcal/kg/day
protein: 1-1.5g/kg vit/min: monitor iron not too high, vitamin b12, mag, zinc. add ca+D, folate, Fiber: reduce Fat: omega3 increased, omega 6 decreased |
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__ is a syndrome precipitated by immunologic interaction to gluten.
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Celiac disease
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What are the causes of celiac disease?
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genetics, immune problems, gluten intolerance
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What is nutritional management for celiac?
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NO WHEAT, rye, barley. Substitute with corn, potato, rice, soy, etc
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What is the plasma glucose for hypoglycemia?
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<70
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Identify plasma glucose in pre-diabetes/
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100-125 fasting, 140-199 2 hours after meal
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Identify the plasma glucose diagnostics for diabetes.
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1. Fasting >126mg/dl
2. Casual >200 mg/dl 3. 2 hour >200mg/dl *retest next day unless other symptoms present** |
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Who (adults) should be screened for DM?
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- overweight/ obese
- >45 with risk factors - 1st deg. relative with DM - african, latino, native, asian, islander - pregnant females - mothers with >9lb baby delivered - polycystic ovarian disease |
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What children should be screned for DM?
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- 10yrs with risk factors of obesity + 2:
- family hx in 1st or 2nd relative - high-risk ethnicity - signs of insulin resistance (acanthosis nigricans, HTN) - maternal hx of GDM |
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If DM screening results for adults or children come back negative, when should they be retested?
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3 years
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ID clincal goals for DM patients:
- A1c - Capillary glucose - Postprep cap glucose - LDL without CVD - LDL with CVD - TG - HDL - BP |
- A1C: 7%
- Glucose: 70-130 - post prep: <180 - LDL without CVD: <100 - LDL with CVD: <70 - TG: <150 - HDL >50 fem. >40male - BP < 130/80 |
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What is A1C a measurement of?
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glycosylated hemoglobin, glucose attaches to hemoglobin and proteins so the value indicates avg plasma glucose
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How does a1c help clinically?
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Can determine whether a glycemic goal is being maintained. Reflects avg of 6-8 weeks
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What are the (5) MNT goals for DM?
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1. improve health through food choices and physical activity
2. blood glucose levels in nml range as much as possible 3. lipid and lipoprotein profile to reduce risk of CVD 4. BP reducing risk of vasc. disease 5. Address individual nutrition needs |
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How many grams of CHO is 1 serving?
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15gm
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What are CHO contianing foods you should include in a healthy diet for DM?
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- fruits, veggies, whole grains, legumes, skim milk,
But keep CHO consistant |
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MNT for DM should include how much fiber?
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14g/ 1000kcal consumed.
44-50 g/day showed improved diabetic control |
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Prioritize goals and nutrition for pt with DM
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1. timing of meals/ physical activity
2. CHO counting, fat limitation 3. BGL monitoring 4. calorie restriction 5. Use DRIs 6. Protein 0.8 to 1g/kg/day |
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Describe Rx for physical activity for DM?
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minimum of 150min/week moderate aerobic activity. Resistance trianing 3xweekly
If pre-workout glucose <100 eat 1 serving CHO |
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What are simple forms of CHO for treatment of hypoglycemia?
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- glucose tabs (3-4 tabs)
- juice (4oz) - soda (6oz) - syrup/ frosting |
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What could be given to a patient in severe hypoglycemia?
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Glucagon
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Describe the protocol for treating hypoglycemia.
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1. recognize it
2. Treat with 15g CHO 3. Wait 15 mins 4. Retest. If < 70, repeat 15g CHO |
