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77 Cards in this Set
- Front
- Back
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APA Criteria
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dfined by behaviors affecting food consumption fueled by emotional (not just physiological) needs
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Anorexia Nervosa
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refuesal to maintain body weight at or above minimally normal weight for age and height (body weight less than 85% of expected)
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signs/symptoms of anorexia nervosa
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- perfectionist
- skin & bones - calorie counters & food rituals - distorted body image - intense fear of fat on body or in food (excessive exercise) |
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Bulimia Nervosa
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recurrent episodes of binge eating characterized by eating in a discrete period of time, an amount of food larger than others would, or a sense of lack of control with over eating; followed by recurrent inappropriate compensatory behavior to prevent weight gain (self-induced vomiting, laxatives, fasting, excessive exercise)
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Bulimic: purging types
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regular engagement of self-induced vomiting or misuse of laxatives, diuretics or enemas
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bulimic: nonpurging types
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use of inappropriate compensatory behavior such as fasting or excessive exercise only
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Binge Eating Disorders (Compulsive overeating)
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- recurrent episodes of binge eating characterized by eating in a discrete period of time amounts of food larger than others would
- binge episodes are associated with 3 or more of the following |
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eating rapidly
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- eating until discomfort
- eating large amounts when not hungry - eating alone - feeling disgusted or angry, guild about intake |
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Individuals most likely to struggle with an eating disorder
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- involvement of activities emphasizing thinness
- poor self esteem or perfectionist - OCD tendencies, depression, anxiety or substance abuse - family issues, sexual abuse, success with dieting in past, possible genetic link - 1/3 of young women with type I diabetes |
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EDNOS = eating disorders not otherwise specified
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- estimated that the incidence of disordered eating, not meeting strict diagnostic criteria may be twice as common
- often involves fear of eating in public places, along with frequent dieting, obsessive desire for weight loss, distorted body image |
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Scoff Questionnaire
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questions designed to raise suspicion that an eating disorder might exist prior to rigorous clinical assessment
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Health implications of eating disorders
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- hair & bone loss
- lack of protein in diet = serious implications - hypotension and bradycardia - muscle wasting and subnormal body temp -erosian of esophagus and teeth from purging |
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early symptoms of eating disorder
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- thinning hair and brittle nails
- cold sensitivity - going to bathroom right after eating - lightheadedness |
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Common triggers of eating disorders
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- intentional or even necessary dieting
- diet shifts from reliance on physiological hunger to cognitive control over food behaviors - a choach's comment about an athletes appearance or food intake - stressful events such as school pressures, death in the family, divorce, etc. |
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People eat because of:
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hunger, availability, emotions, religious, entertainment (enjoyment, status, peer pressure, norms, tradition (culture))
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cultural food traits: consciously or unconsciously known
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- values and attitudes
- habits learned or ingrained - ying/Tang (hot/cold) concepts of food and disease in Chinese, Cuban and Hispanic cultures |
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southern black cultural aspects of food
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extensive intake of startch, sodium, fat and limited calcium
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jewish cultural aspects of food
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kosher!
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Suggestions for Cross-cultural diet consumption
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- admit what you do not know and educate yourself ahead of time
- involve the family and avoid judgements - ask open ended questions and remain RESPECTFUL |
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Acid Ash Diets
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meats, poultry, fish & eggs, cheese, grains, corn and lentils, cranberries, prunes & plums
- all decrease urine pH |
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Alkaline Ash Diets
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milk products, all other fruits & veggies, increase urine pH
** inhibition of Uric acid calculi (kidney stones) and cystic stones (gallbladder) |
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Liquid Diets
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full liquid diet (milk based) includes all clear liquid foods.
- for short term use, especially inadequate in iron, fiber & possibly Kcals |
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Clear liquid diets
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(jello) no milk products
= very short term use, pre & post operation, inadequate in many nutrients & Kcals |
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Soft diet
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many types of soft-well cooked foods, generally no frying and veggies cooked
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General diets
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used when no modifications are necessary, heart healthy
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Diet History
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the portions of the meds and social history related to diet (occupation, activity, sleep patterns, culture, dentition, chronic diseases, use of meds)
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24 hour Recall
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intake of food in the pst 24 hours, include use of meds, vitamins/minerals, use of alchy & tobacco
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Food diaries
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written records of actual intake ** 7 days is the best
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iatrogenic malnutrition
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malnutrition that is health care induced (30-55% of hospital patients are malnourised)
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NPO (mil per os order)
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nothing by mouth, used pre or post testing or surgery, HIGH RISK FOR MALNUTRITION, use only when absolutely necessary
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Enternal = intestines
= T.E.N |
total enternal nutrition, refers to feedings that are totally supplied by tube, used anytime there is an inability to ingest sufficient kcals orally
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Enternal = intestines
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- nonsurgical, for short term use, most common placement is a naso-gastic tube
- neonates enternal tube placements are often oral gastric tubes - less risk of aspiration for enteral tubes placed in gut - small bowel placements are not common - risk for patients with poor gag reflex |
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Parenteral = outside of GI tract
- PPN - TPN |
- peripheral parenteral nutrition, uses a small diameter vein in arm, short term use (less than 10 days)
- total parenteral nutrition, uses right subclavian vein leading to the superior vena cava to the hear, for long terms use of weeks/months |
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Isotonic
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same osmolality as blood, lipids
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Hyposmolar
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lower osmolality than blood
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Hyperosmolar
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higher osmolaity than blood; CHO's are in most hyperosmolar of the macronutrients
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Osmolality
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measurement of osmotically active particles per kg of solvent
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Intact Enternal Formula
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intact nutrients, requires functioning GI tract
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Hydralized Enteric Formula
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nutrients predigested or broken down, for those with impaired GI ability
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Elemental/defined Enternal Formula
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Vivonex HN, Peptamen
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Bolus
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all at one time enternal delivery, fed directly to stomach usually by syringe, in a short amount of time
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open system
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hang time 24 hour
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closed system
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hang time 48 hours, more aseptic, decrased rate of infection, less labor intensive
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Glutamine
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role as a fuel for bowel during catabolic stress
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Dumping Syndrome(Jejunal Hyperosmolic Syndrome)
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10-15 minutes post eating, cramping and bloating, N & V, weakness, tachycardia, as water is drawn from the blood into the intestine to help achieve osmolar balance
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BCAAs
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type of enternal formula speciality (leucine, isoleucine, valine)
- use for stressed trauma and liver disease clients, somewhat controversial if costs justifies its use |
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Tube feeding Orders
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the product name, strength (=full) and the rate (ml or cc/hour)
- also specified in the order is the rate of advancement and the H2O flushes (for hydration maintenance) |
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Pyrosis
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(heartburn) a painful or burning sensation in the esophagus, just below the breastbone aused by regurgitation of gastric acid
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Flatulence
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gas, a symptom, caused by eating too fast or swallowing of air, bacterial fermentation, food intolerance/allergies, malabsorption of CHO's
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Syncope
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a temporary suspension of consciousness due to cerebral ischemia (fainting)
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Steaorrhea
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is the formation of bulky, grey or pale feces. Stools may also float (due to excess gas from carbohydrate malabsorption)
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Diverticulitis/osis/itis
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pouch-like hernia ions protruding from the muscular layer of the GI tract, most frequently occuring in the colon.
- symptoms include coughing, bad breath, abdmoinal disention, vommitinng, diarrhea, constipationa and may be asymptomatic due to high fat and low fiber diets |
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Ulcers
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An eroded lesion (loss of tissue), depends on location, often feels better when client eats (often gains weight), may be anemic if ulcer is bleeding, may be asymptomatic
- caused by imbalance of gastric acid and pepsin and tissue resistance |
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Gastritis
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inflammation of the stomach and intestines, very common, both acute and chronic types, symptoms of nausea vommiting bleching epigastric pain and feeling of fullness
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Irritable Bowel syndrome
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irritation of the intestinal mucos membrane causing irregular bowel contractions, caused gut responders to stress, abnormal innervations of the GI tract, lactose intolerance, or irregular meals and bowel movements
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Short Bowel Syndrome
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a malabsorption seen following a resctino of a large portion of the small intestine, challenged diet therapy, nutrition is highly individualized, usually start with TPN then move to oral enteral, then to regular food, goal is to reach a high protein and low fat diet
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Causes of constipation
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lack of exercise, poor bowel habits, poor diet (low fiber & fluid) obstruction
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Causes of Diarrhea
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dehydration, loss of water and electrolytes
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Predisposing factors of ulcer disease
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irregular, fast paced meals, excessive smoking, excessive NSAIDS or aspirin ingestion, heredity, stress, type A personality, excessive caffinee
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Treatment of ulcer disease
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antacids, anti-secretory, antibiotics, binders (bind to surface of the ulcer to protect it and promote healing)
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Esophageal reflux disease (Esophagitis)
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- The result of the erosion of acidic gastric reflux on the esophageal mucosa, symptoms of heartburn and may lead to ulcers (may also be mistaken for heart attack)
-can precede from achalasia) |
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Treatment of Esophageal reflux disease (Esophagitis)
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antacid therapy and antisecretory therapy, avoid foods that decrease LES (decaf coffee, chocolate, cola, tomatoes, citrus etc) pressure and avoid lying down after meals
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Crohn’s Disease
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-symptoms of abdominal pain and cramping, bleeding diarrhea, weight loss, and growth
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treatment of Crohn’s Disease
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antibacterial, anti-inflammatory, diets that generally lack milk, fiber and gluten, high DRI multivitamin/mineral supplements
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Ileostomy
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opening of the ileum following the removal of the colon, rectum and anus leaving the excretory contents more liquid and messier to manage
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Colostomy
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opening of the colon following the removal of the rectum and anus leaving the excretory contents relatively formed but may carry odors.
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Ulcerative Colitis
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when inflammatory process involves the colon (and sometimes the rectum only) no cobblestones, segmented in appearance
-often seen in young adults, bleeding common |
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Probiotics
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cultures of MO’s that promote health and help maintain healthy intestinal function
-some come directly from foods (cultures in yogurt) -categorized as dietary supplement (not medication) |
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Celiac Disease
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-Glladin (in the protein gluten) ingestion causes shortening and flattening of the brush border if the intestinal villi (loss of absorption surfaces due to lesions in the intestinal mucosa)
-symptoms of diarrhea and steatorrhea, distention, flatulence, poor growth and weight loss |
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Fiber
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= indigestible CHO’s in fruits, veggies, legumes, grains
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Residue
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indigestible CHO’s from other unabsorbed constituents (minerals, meats, bacteria, gristle)
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ACS Dietary Guidelines to Prevent Cancer
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- eating at least 5 servings of veggies and fruits per day
-exercising on a regular basis and controlling one’s weight - avoiding carcinogens (nitrosamines, cyclamates) - Aflatoxins -polycyclic aromatic hydrocarbons -heterocyclic aromatic hydrocarbons |
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ultimate goal of cancer patients
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high protein and high Kcal diet
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low microbial diet (foods to avoid) to prevent cancer
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- well-cooked foods
-no ground pepper -no aged- cheeses or yogurt with live bacterial cultures -used before and after transplants |
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cancer cachexia
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The condition of extreme emaciation and wasting seen in patients with advanced diseases such as cancer and AIDS. Due partly to an inadequate intake of food and mainly the effects of the disease in increasing metabolic rate (hypermetabolism) and the breakdown of tissue protein. ...
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Potential Nutritional Problems seen with HIV/AIDS patients
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-AIDS wasting syndrome (energy needs higher than standard)
-lactose intolerance -gluten intolerance - medication resistant side effects (GI) -easily affect by food-borne illnesses -anorexia -mouth sores |
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Safe food Handling w/ HIV/AIDS patients
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very susceptible to food-borne illnesses due to immunodeficiency
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