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167 Cards in this Set
- Front
- Back
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nutrition
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the sum of all interactions between and organism and the food it consumes
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nutrients
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organic and inorganic substances found in foods that are required for body functioning
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nutrients ex.
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carbs, fats, proteins, vitamins, minerals, water
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nutritive value
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the nutrient content of a specified amount of food
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3 functions of nutrients
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providing energy for body processes and movements
provides structural materials for body tissues regulating body processes |
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most basic nutrient
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water
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energy providing nutrients
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protein, fat, carb
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macronutrients
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nutrients needed in large amounts ex:protein, fat, carb
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micronutrients
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nutrients needed in small amounts ex: vitamins, minerals
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composition of carbs
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carbon, hydrogen and oxygen
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2 types of carbs
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simple: sugar
complex: starch, fiber |
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sugars:
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simplest carb
water soluble produced by plants and animals |
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monosaccharide
disaccharide |
single molecule (glucose, fructose, galactose)
double molecule |
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starches
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insoluble
nonsweet carb polysaccharide plants and animals |
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fiber
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complex carb
plants cannot be digested by humans helps gi tract functioning and eliminating |
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carb digestion
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enzymes act
desired end product is monosaccharides |
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major enzymes of carb digestion
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ptyalin, pancreatic amylase, disaccharidases
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carb metabolism
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body breaks carbs down to glucose, some continue to circulate in blood, remainder used as energy or is stored
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glycogen
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large polymer of glucose
stored in liver or skeletal muscles |
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proteins
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made of C,H,O,N
amino acids are building blocks 3/4 of body solids are proteins |
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essential amino acids def.
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cannot be manufactured by body, must be eaten
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essential amino acids (9)
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hisitidine,isoleucine,leucine,lysine,methionine,phenyalanine,tryptophan,threonine,valine
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nonessential amino acid def.
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body can manufacture
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nonessential amino acids (8)
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cystine,glutamic acid,glycine,hydroxyproline,proline,serine,tyrosine
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complete protein
found where? |
contain all essential amino acids plus some nonessential ones
meats,fish,dairy,eggs |
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incomplete protein
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lacks one or more essential amino acids
usually found in vegs |
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protein digestion
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begins in mouth, pepsin breaks protein into smaller units, pancreas secretes enzymes to break down into amino acids
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3 parts of protein metabolism
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anabolism,catabolism,nitrogen balance
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anabolism
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proteins are synthesized from amino acids
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catabolism
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excess amino acids are degraded for energy or converted to fat
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nitrogen balance
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measure of the degree of protein anabolism and catabolism- net intake and loss of nitrogen
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lipids
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organic substances that are greasy and insoluble in water but soluble in alcohol or ether
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fats
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lipids solid at room temp
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oils
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lipids liquid at room temp
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lipid composition
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contains C,H,O but has higher concentration of H than carbs
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fatty acid
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made of carbon chains and hydrogen- units of lipids
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saturated fatty acid
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all C atoms are filled to capacity with H
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unsaturated fatty acid
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could accomodate more H than it does, has a double bond between carbons
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glycerides
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simple lipids
glycerol molecule with up to 3 fatty acids attached |
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trigycerides
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glyceride with 3 fatty acids attached
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cholesterol
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fatlike substance made in body and found in foods of animal origin
creates bile acids/steroid hormones |
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lipid digestion
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digested mainly in s.intestine by bile, pancreatic lipase,enteric lipase
end products are glycerol, fatty acids, and cholesterol |
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lipoproteins
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various lipids and a protein-->product of lipid digestion
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lipid metabolism
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enzyme breaks down trigycerides releasing glyercol and fatty acids into blood
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vitamin
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organic compound, cannot be made in body-necessary for body functions
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nitrogen balance
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measure of the degree of protein anabolism and catabolism- net intake and loss of nitrogen
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lipids
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organic substances that are greasy and insoluble in water but soluble in alcohol or ether
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fats
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lipids solid at room temp
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oils
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lipids liquid at room temp
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lipid composition
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contains C,H,O but has higher concentration of H than carbs
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fatty acid
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made of carbon chains and hydrogen- units of lipids
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saturated fatty acid
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all C atoms are filled to capacity with H
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unsaturated fatty acid
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could accomodate more H than it does, has a double bond between carbons
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glycerides
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simple lipids
glycerol molecule with up to 3 fatty acids attached |
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trigycerides
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glyceride with 3 fatty acids attached
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cholesterol
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fatlike substance made in body and found in foods of animal origin
creates bile acids/steroid hormones |
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lipid digestion
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digested mainly in s.intestine by bile, pancreatic lipase,enteric lipase
end products are glycerol, fatty acids, and cholesterol |
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lipoproteins
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various lipids and a protein-->product of lipid digestion
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lipid metabolism
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enzyme breaks down trigycerides releasing glyercol and fatty acids into blood
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vitamin
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organic compound, cannot be made in body-necessary for body functions
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water soluble vitamins
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C and B complexes
body cannot store, must eat daily |
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B1
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thiamine
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B2
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riboflavin
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B3
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niacin
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B6
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pyridoxine
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B9
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folic acid
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B12
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cobalamin
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fat soluble vitamins
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A, D, E, K
body can store these |
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minerals
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found in organic compounds, organic compounds, and as free ions
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macrominerals
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need in daily amounts >100mg
calcium, phosphorus, sodium, potassium, magnesium, chloride, sulfur |
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microminerals
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need in daily amounts <100mg
iron, zinc, fluoride |
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energy balance
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relationship between energy derived from food and energy used by body
energy intake vs energy output |
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small calorie
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amount of heat required to raise temp of 1 gram of water by 1 degree celsius
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large calorie
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amount of heat energy required to raise temp of 1 gram of water by 15 or 16 degree celsius
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__calories/g carb
__calories/g protein __calories/g fat |
4-4-9
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metabolism
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all biochemical and physiologic processes by which body grows/maintains itself
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BMR
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basal metabolic rate-- rate body metabolizes food to maintin energy requirements of person awake, at rest
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REE
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resting energy expenditure-- amount of energy required to maintain life
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IBW
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ideal body weight-- optimal weight recommended for optimal health
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rule of 5
rule of 6 |
100 lb for first 5 ft, 5 lbs for each additional inch
106 lb for first 5 ft, 6 lbs for each additional inch |
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BMI
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body mass index-- indicator of changes in body fat stores and whether persons weight is right for height
=weight in kg/height in meters squared |
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nutritional assessment steps
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A-anthropometric data
B- biochemical data C- clinical D- Dietary data |
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Risk factors for nutrition problems
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Chewing/swallowing difficulties
poor IV living alone alcohol abuse dental problems med history |
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Calorie
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unit of heat energy, amount of heat required to raise temp
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1g carb
1g protein 1g fat |
4 kCal
4 kCal 9 kCal |
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metabolism def
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all cellular chem reactions that make it possible for body cells to continue living
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variables affecting calorie needs
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age, gender, climate, sleep, activity
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water
% of body in a healthy adult |
60-70% of body
in a healthy adult, intake=output |
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carbs
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consist of C H O
organic compounds primary source of energy |
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glucose transport facilitated by:
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insulin
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high blood glucose
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hyperglycemia
insulin- pancreas beta cells |
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low blood glucose
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hypoglycemia
glucagon- pancreas alpha cells |
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fiber functions:
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weight control, constipation, diarrhea, lowers lipid levels, blood glucose control
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how to increase fiber
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whole grains
dried peas/beans 2-3 times/week 5 servings of fruits and vegs adequate fluid |
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lactose intolerance
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shortage of lipase
not milk allergy sx:fullness, discomfort, cramps, nausea risk for Ca deficiency |
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sugar facts
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no definite link to diabetes but can lead to obesity
linked to dental caries |
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protein functions
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growth/replacement of body cells
immunity,antibody production, WBC production sodium and K balance energy |
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lipids examples
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animal products,meat,butter,cheese
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"good fat"
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polyunsaturated
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minerals
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inorganic elements that serve as catalysts in biochemical rxns
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factors influencing nutrition
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gender, culture, beliefs, preference, meds, alcohol, economics
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ABCD system
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assessing nutritional status
A:anthropometric data B:biochemical data C:clinical signs D:dietary history |
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anthropometric data
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height,weight,IBW,UBW,BMI
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Calculate IBW
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%IBW=current weight/ideal weight x100
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BMI normal
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20-25
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Biochemical data
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Hemaglobin-O2 carrying component of blood
Hematocrit, Albumin, BUN |
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vitamin C
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function: healing, collagen formation, absorption of Fe
def:long healing times tox: kidney stones found in: OJ, fresh fruit |
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Vitamin B6
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Pyridoxine
Fun: amino acid synthesis, CNS cell functioning def: skin issues,cracks on side of mouth Found in: whole grains, meats |
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Vitamin B1
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Thymine
function: CNS, carb oxidation def: peripheral nerve function issues Found in: meats, fish, eggs |
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Vitamin B2
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Riboflavin
function: growth/coenzyme for metabolic processes, tissue growth def: skin issues found in: whole grains, milk light sensitive |
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Vitamin B3
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Niacin
function: protein/fat synthesis/metabolism, lowers cholesterol def: anorexia, digestion issues tox: vasodilation, flushing found in: meats, dairy, grains |
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Folic Acid
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function: RBC formation
def: anemia found in: liver, green leafy vegs |
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B12
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function: metabolism of other nutrients
def: anemia found in: milk, eggs, cheese, meat,no plants pts with stomach issues cannot absorb this |
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Vitamin A
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Retinol
function: visual acuity, maintanence and growth of epithelial tissue def: vision issues, skin issues tox: GI sx found in: whole milk, eggs, vegs |
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Vitamin D
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function: calcium absorption, bone development
def: bone/dental developmental issues tox: GI sx found in: milk, fish, liver, oil, margarine make from sun |
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Vitamin E
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function: antioxidant, protects A&C, absorption of A&C, synthesis of hemaglobin
def: anemia tox: interfere with A&C, impacts K, prolonged bleeding times found in: oils, green leafy vegs, milk, eggs |
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Vitamin K
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function: clotting sign(prothomblin formation)
def: hemorrhage tox: GI sx found in: green leafy vegs |
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signs/sx of malutrition
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dry. dull, brittle hair
swollen glands dry skin delayed wound healing thin muscle wasting edema depressed |
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malnutrition risk factors
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med history
diet history-dysphagia,income,IV,living alone,disability,fad diet |
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7 guidelines for Americans
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Eat variety of foods
Maintain reasonable body weight Avoid saturated fat Adequate fruits/vegs Sugar in moderation Na in moderation Alcohol in moderation |
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Nutrition for older adults
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Monitor h2o intake
Decreased BMR, calorie demands Reduce fat intake Intake of fiber Lower sodium intake |
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Enteral feedings
candidate: NG vs PEG intermittent vs continuous |
pt with working GI
nasogastric vs endoscopic gastronomy one time period vs all the time |
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Check tube placement by:
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ausculate air bubble
pH of aspirate xray |
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Check if feeding is being digested by:
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aspirating contents and check to see if digested and then replace
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feedings are:
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hypertonic
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Parentarel
PPN vs TPN |
PPN- can use small vessels, contains some amino acids
TPN- Giving pt all nutritional needs, more amino acids |
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Fluids and Electrolytes
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Almost every illness threatens the balance of F&E
Transport medium for cellular and tissue function Electrolytes: minerals that carry electrical charge when dissolved in h2o |
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concentration in body expressed as:
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mEq per liter
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functions of water
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assist with temp regulation
lubricant component of blood, lymph, saliva, urine supplies trace minerals |
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ICF
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intracellular compartment
fluid within cell primary cations K and Mg primary anions are Phosphate, Sulfate 2/3 of body fluid |
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ECF
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Extracellular compartment
inside cells divided into compartments: intravascular, interstitial, transcellular- csf, synovial, pleural, pericardial primary cations is NA primary anion is CL- |
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Filtration
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fluid and solute move together across a membrane from one compartment to another
higher pressure to lower pressure |
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Hydrostatic pressure
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pressure exerted by fluid with a closed system
ex: BP |
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Tonicity
Isotonic Hypertonic Hypotonic |
-refers to osmolality of a solution
-same osmolality as body fluids -higher osm than body fluids -lower osm fluids than body fluids |
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osmotic pressure
oncotic pressure |
-ability of soln to draw across a semipermeable membrane
-plasma proteins exerting water pulling pressure, pulling h2o from interstitial into intravascular |
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thirst control center is:
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hypothalamus
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fluid output
occurs through: major regulator of fluid balance: influenced by: |
-kidneys, skin, lungs, GI
-kidneys -ADH, aldosterone |
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ADH
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antidiuretic hormone
secreted by pituitary gland in response to low fluid levels or high sodium levels target organ is kidney which conserves water by reabsorption fluid is then returned to vascular system |
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Aldosterone
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secreted by adrenal gland
decreases excretion of sodium which causes kidneys to retain fluid |
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Atrial Natriuretic Factor
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Secreted by cells of atrium in heart- potent diuretic
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@ Risk for F&E imbalances
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Postop
Severe trauma, burns NG tubes NPO IV Diuretics Fluid restriction Elderly |
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Isotonic Imbalances
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water and electrolytes lost or gained in equal proportions
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Osmolar imbalances
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Loss or gain only of water so concentration is affected
Overhydration or dehydration |
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FVD
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Fluid volume deficit
-Isotonic FVD causes: vomitting, diarrhea, sweating, bleeding, 3rd spacing sx: weight loss, weak, fatigue, tenting, dry skin, weak rapid pulse, low BP Ix: Assess I&O, turgor, lung sounds, replace fluids |
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Dehydration
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Water loss without proportionate loss of electrolytes
Na becomes concentrated, not gained |
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FVE
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Hypervolemia: body retains both water and electrolytes in ECF in similar proportions
Na stays normal Causes: excess Na intake, renal failure, steroids sx: weight gain, lung crackles, strong bounding pulse, full neck vein, confusion, edema Ix: I&O, daily weight, SOB, raise head of bed, fluid restrict, diuretics |
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Overhydration
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h2o gain only
Na decreases, becomes diluted Water moves to cells causes: over intake of h2o, excessive ADH, SIADH sx: decreased LOC, edema |
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Na
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Sodium
-major ECF cation -normal: 135-145 mEq/L -water balance and plasma osmolality -movement of chloride closely associated with Na -regulated by ADH/aldosterone -essential for neuromuscular function -sources: ham, bacon, table salt |
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Hyponatremia
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-below 135 mEq/L
-pt will also have hypochloremia -loss of sodium/gain of water -sx: lethargy, confusion, anorexia, HA, nausea, coma, twitching -I&O, encourage fluids high in sodium, limit water intake, |
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Dilutional hyponatremia
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Water intoxication
-gain of water without proportionate gain of sodium -causes: SIADH, malignancy |
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hypernatremia
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-above 145 mEq/L
-thirst, restless, weak, flushed, LOC, tacycardia, hypertension -I&O, daily weights, restrict sodium, neuro assess, encourage fluids |
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Chloride
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-norm: 96-106 mEq/L
-major ECF anion -maintains ECF concen -combines with hydrogen ions to make HCl |
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Hypocholoremia
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-causes: vomiting, diuretics, suctioning, steroids
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K
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Potassium
-major ICF cation -role: neuromuscular function, controlling cardiac rate, nerve impulss -insulin needed to carry K -normal: 3.5-5.0 mEq/L |
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Hypokalemia
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-monitor dig pts
-replace lost K -sources: potato,bananas, melons, milk -monitor heart rate |
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Hyperkalemia
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-cause: decreased loss or increased intake of potassium
-sx: cardiac dys, muscle weakness, irritability, GIhyperactive -renal failure pts at risk for this -K binding enemas help |
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Calcium
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-major ECF cation in bones
-skeletal and heart muscle relaxation and contraction -nerve impulse transmission -role in blood clotting -controlled by parathyroid hormone -reciprocal relationship with phosphorus -excreted in urine and feces -normal: 4.5-5.5 mEq/L |
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Calcium regulation (2)
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Parathyroid Hormone: decreased CA, PTH increases stomach absorption by activating vit D, increases renal reabsorption and releases CA from bone (too little CA)
Calcitonin: increased CA thyroid secretes calcitonin which increases CA return to bone (too much CA) |
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Hypocalcemia
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-below 4.5 mEq/L
causes: vit D def, hypoparathyroidism, diarrhea, low intake, alcoholism sx: numb,tingling of extremities/around mouth, tremors/cramps, -monitor breathing, monitor pulse,teach about intake and excerise |
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Troussea Sign
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carpal spasms when BP cuff inflated
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Chvostek Signs
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twitching of muscles in face
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Hypercalcemia
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above 5.5 mEq/L
causes: hyperparathyroidism, immobility, bone disease, excess intake of CA or vit D sx: lethargy, weakness, fatigue, nausea, anorexia, depressed reflexes, constipation -I&O, encourage fluids to keep kidneys flushed, safety, teaching |
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Phosphorus
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Major anion in ICF
-reciprocal relationship with calcium -renal failure pts at highest risk |
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Magnesium
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-role in enzyme rxns
-powers sodium potassium pump -helps maintain normal heart rhythm -regulated by kidney -normal: 1.4-2.5 mEq/L |
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Hypomagnesemia
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-below 1.4 mEq/L
cause: loss from GI tract, poor intake, use of certain drugs sx: tachycardia, hypertension, disoriented, confusion, Troussea/Chvostek (if Mg is low, so will Ca- low Ca shows positive Troussea/Chvostek) -teaching diet high in Mg, provide safety |
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Hypermagnesemia
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above 2.5 mEg/L
cause: abnormal retention of Mg or increased intake, renal failure sx: vasodilation, flushing, nausea, hypotension, lethargy -monitor VS, LOC, heart rate and rhythm, diet teaching to avoid high Mg foods, (legumes, nuts, green vegs) |
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Renal failure patients at risk for:
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hyperkalemia
hyperphosphatemia hypermagnesemia |
