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83 Cards in this Set
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- Back
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Difficulty swallowing; often results from a problem affecting the tongue or the swallowing reflex (Stroke or ALS); causes aspiration
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Dysphagia
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What are the dietary modifications that accompany Dysphagia?
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Avoid liquids initially
Start with globby foods |
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Cardiac or lower esophogeal sphincter does not close lightly (hiatal hernia, pregnancy)
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GERD (Gastroesophogeal Reflux Disease)
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What are/is the treatment(s) for GERD?
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Treatment is aimed at decreasng gastric acidity and lesson the irritation to esophogus. Short term - use of antacids.
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What are the dietary modifications that accompany GERD?
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Limit intake of coffee, tea, alcohol, cola, and chocolate.
Watch weight to decrease abdominal presure. Liquids in between meals Elevate head after eating - KEY! Pregnancy will increase. |
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An erosion of the top layer of cells from the GI tract lining which exposes other layers to GI acidity (gastric juices).
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Peptic Ulcer Disease
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What are the said causes of ulcers?
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Bacteria (H. Pylori)
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What is a possible treatment for Peptic Ulcer Disease?
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NSAIDS (nonsteroidal anti-inflammatory drugs)
Use NSAIDS, like aspirin, for treatment. |
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What are the dietary modifications that accompany Peptic Ulcer Disease?
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Avoid foods that increase gastric acid secretions, such as coffee, ETOH, spicy/greasy/pepper foods. Stick with bland diet (Diet as Tolerated)
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What are the characteristics of Dumping Syndrome?
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-Can result from gastric bypass surgery.
-Sudden shifting of food as it passes through GI tract. -Often occurs with hypoglycemia. -Nausea, exhaustion, diarrhea |
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What are the 4 common ailments that affect the Upper GI tract?
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Dysphagia
GERD Peptic Ulcer Disease Dumping Syndrome |
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Causes by invasion of it's own juices.
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Pancreatitis (secretes enzymes for all nutrients)
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What causes pancreatitis?
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Invasion of its own juices caused by gallstones or alcohol
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What are the symptoms of pancreatitis?
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Abdominal pain, nausea, vomiting, steatorrhea (fat in stool)
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What are the dietary modifications that accompany Pancreatitis?
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Acute Phase:TPN very important
Progress oral diet from clear liquids, low fat, Medical Nutrition Therapy |
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What is the difference between a clear liquid and a full liquid diet?
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Clear: water, broth, Jello, popsicles, etc. 72 hours max. NO protein!
Full: milk introduced, cream cereals, smooth cereals - transitional diet! |
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A hereditary disorder characterized by the production of a thick, sticky mucous by the glands.
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Cystic Fibrosis
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What are the characteristics of Cystic Fibrosis?
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Mucous stagnates in bronchial tubes and bacteria multiply.
Interferes with secretion of digestive enzymes - leads to malabsorption, malnutrition |
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What are the dietary modifications that accompany Cystic Fibrosis?
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Increase kcalories - due to infections; Enzyme replacements - vitamin & mineral supplementation.
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Characterized by intolerance to dluten and related barley and rye. Causes damage to intestinal mucosa.
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Ciliac Disease
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What are the dietary modifications for Ciliac Disease?
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Avoidance of whear, barley, and rye.
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Inflammation and ulceration along GI tract, usually in the small intestine.
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Crohn's Disease
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What are the causes and treatment of Crohn's Disease?
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Genetic or encironments, and disease-causing bacteria and viruses. Steroids can be used to lower inflammation; scarred tissue generally needs to be removed.
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What are the dietary modifications that accompany Crohn's Disease?
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Low fiber, especially with intestinal obstructions; after condition resolves, fiber can slowly be reintroduced (condition may improve); MNT, depending on symptoms; as with any bowel problems, TPN.
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Inflammation and ulceration of the colon and rectum.
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Ulcerative Colititis
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What are the symptoms of Ulcerative Colititis
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Sever diarrhea, rectal bleeding (leads to anemia), cramping, weight loss.
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What is the treatment for Ulcerative Colitis?
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Surgery - unlike Crohn's, this will not reoccur once the damaged portion is removed (colectomy).
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What are the dietary modifications that accompany Ulcerative Colititis?
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Low residue diet (undigested, unabsorbed in colon), TPN often used, vitamin/mineral supplementation, especially iron.
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What is true about intestinal resections (large bowel vs. small intestine)?
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Not as likely to have nutrient deficiencies result from large bowel resection as compared to resections in the small intestine.
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What dietary modification usually accompanies most chronic or sever bowel problems?
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TPN - Total Perenteral Nutrition. Feeding a person intravenously, circumventing the gut. When a person's digestive system cannot absorb nutrients due to chronic disease, or, alternatively, if a person's nutrient requirement cannot be met by enteral feeding (tube feeding) and supplementation.
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Removal of entire colon and rectum
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Illeostomy
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A surgically formed opening which a portion of intestine is brought through abdominal wall (ostomy)
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Stoma
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Results in watery stool because colon is removed
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Illeostomy
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What are the concerns with a stoma?
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Odor, gas-producing and stringy foods.
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Healthcare profesional who deals in stoma care
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Enterostomal Therapist
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Removal of rectum and anus; part of colon remains, so stools are less watery.
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Colostomy
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With this procedure, there are less concerns with nutritional deficiency than with its alternative.
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Colostomy
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Inflammation of the gallbladder
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Cholecystitis
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What are the dietary modications that accompany Cholecystitis?
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Low fat diet
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Pouches of intestinal wall bulge out
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Diverticulosis
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What are the dietary modifications that accompany diverticulosis?
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High fiber, no seeds.
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Wxtensive tissue scarring; tissue death. Results from fatty liver into fibrosis.
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Cirrhosis
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What are the most likely causes of cirrhosis?
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26% - Hepatitis C
Alcoholic Cirrhosis occurs in up to 20% of chronic alcoholics |
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What are the consequences of Cirrhosis
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PEM - Protein Energy Malnutrtion; Ascites - accumulation of fluid in abdominal cavities.
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What are the dietary modifications that accompany Cirrhosis?
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Individualized for each patient. Typically, restric sodium (fluid) to control steatorrhea and maintain nitrogen balance.
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Abnormally low blodd sugar (<60 mg/dl)
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Hypoglycemia
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Generally a result of poor management of diabetes - a condition rather than a disease.
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Hypoglycemia
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What are the causes of Hypoglycemia?
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Poor management of diabetes; delayed or skipped meals; consumption of ETOH without food
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What are the symptoms of Hypoglycemia?
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Hunger, sweatiness, shakiness, heart palpatations, slurred speech, confusion, dizziness, headache, irritability.
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A group of metabolic disorders characterized by hyperglycemia and an absolute or relative deficiency of insulin.
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Diabetes Mellitis
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Explain the pathophysiology of Diabetes Mellitis.
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Key and loc theroy - insulin acts as a key that unlocks cell doors to let sugar in.
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What are some of the causes of Diabetes Mellitis?
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Something damages cells in pancreas, and sugar gets built up in blood (lock and key theory). Overweight, cells can seal shut.
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How does your urine change if you have Diabetes Mellitis?
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After sugar gets built up in blood, it builds up in urine. Dibetes Mellitis means "sweet urine"
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Which type of diabetes has a stronger gentic link?
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Type 2 Diabetes
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What are the differences between Type 1 and Type 2 Diabetes?
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Type 1 diabetes occurs when the body's own immune system destroys the insulin-producing cells of the pancreas (called beta cells).
Normally, the body's immune system fights off foreign invaders like viruses or bacteria. But for unknown reasons, in people with type 1 diabetes, the immune system attacks various cells in the body. This results in a complete deficiency of the insulin hormone. Type 2 diabetes, often called non-insulin dependant diabetes, is the most common form of diabetes, affecting 90% - 95% of the 18.2 million people with diabetes. Unlike people with type 1 diabetes, people with type 2 diabetes produce insulin; however, the insulin their pancreas secretes is either not enough or the body is unable to recognize the insulin and use it properly. |
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Breakdown of fats, causing acid in the blood.
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Ketoacidosis
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What are the symptoms of Ketoacidosis.
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Polydipsia (frequent thirst), Polyuria, glycosuria (sugar in urine), Ketosis (breakdown of body fat because of starvation), frequent infections, drowsiness, tiredness
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What conditions create risks for Diabetes?
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Gentic, overweight, stress, history during pregnancy, chronic illness, age (greater than 40), ethnic background (higher with blacks, hispanics, Native Americans.
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What are the recommended normal blood sugar ranges?
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80 mg/dL to 120 mg/dL before meals and 100 mg/dL to 140 mg/dL at bedtime when using a blood sample drawn from a vein (a whole-blood sample).
90 mg/dL to 130 mg/dL before meals 110 mg/dL to 150 mg/dL at bedtime Less than 180 mg/dL one to two hours after meals. |
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What are the ranges for "Prediabetes"?
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100-125 mg/dl or 140-200 mg/dl 2 hours after a 75g glucose load (GTT)
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Diabetes glucose levels
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Fasting = >126 mg/dl
Random, or after 75g glucose load = >200 mg/dl |
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What is the treatment for diabetes?
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Main goal is to maintain blood glucose levels; medications, exercise (its a vascular disease); meal planning (MNT); see dietary mods.
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What are the dietary modifications for Diabetes?
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MNT; CHO counting instead of exchanges; monitor simple sugar intake; 3 R's - right kinds, right amounts, and right times for food (4.5-5 hours)
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What are the chronic complications of Diabetes?
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Coronary artery disease - thicker blood, stress on heart; higher BP, retinopathy; nephropathy, neuropathy, gangrene, impotence
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The growth of malignant tissue
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Cancer
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A cancer initiating substance; an inherited vulnerability.
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Carcinogen
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A risk factor for a number of cancers, including colon and postmenopausal breast cancer
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Obesity
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These antioxidants kill free radicals
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Vitamins A, C, and E
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This Antioxidant helps eliminate caracts
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Vitamin A
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This antioxidant helps eliminate cancer
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Vitamin C (in US, mostly potatoes and tomatoes)
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This antioxidant helps eliminate heart disease
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Vitamin E
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Contain phytochemicals and antioxidants
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Fruit and veggies
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What are three main treatments for Cancer?
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Sugery, Chemotherapy, Radiation Therapy
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What are the side effects with Chemo and Radioation?
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Anorexia, nausea, vomiting, diarrhea, taste changes.
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What are the dietary modifications with Cancer?
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Increase kcalories, increase protein (1.5-2.0g/kg likely). EEnterol products, like Ensure, may be necessary. Tube feeding if refuse to eat.
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Develops suddenly to a condition that causes kidney damage, such as heart attack, blood loss, or infection. Often reversible.
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Acute Renal Failure
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Gradual and irreversible deteroration of the kidneys.
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Chronic Renal Failure
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What are the most common causes of Chronic Renal Failure
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43% - diabetes; 26% - hypertension
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What are the consequences of Chronic Renal Failure?
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Blood chemistry changes (primarily electrolytes); N2 waste accumulates (BUN) -Blood Uria Nitrogen; PEM - Protein Energy Malnurtrition.
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What are the treatments for Chronic Renal Failure?
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A combination of medications, MNT diet, and dialysis (main on is hemodialysis).
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What are the side effects of Chronic Renal Failure?
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Increase in Potasium causes heart to enlarge and beat rapidly (Calcium/Phosphorus balance).
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What are the dietary modifications that accompany Chronic Renal Failure?
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Balance the protein, sodium restriction, potassium restriction, phosphorus restriction (Three Ps). Once dialysis is started, protein is less restricted.
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What is true with a patient who has Chronic Renal Failure and is comorbid?
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The Renal diet takes priority over any other diet.
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