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116 Cards in this Set
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renal arteriogram
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catheter inserted to femoral artery and ran to renal artery; successive x-rays are taken; assess blood flow to distant to insertion site after procedure and apply pressure to site.
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diagnostic test to measure profusion of kidneys
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renal biopsy
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used to detect renal disease, malignancy and transplant status; percutaneous--aided by US thru skin; incisional--surgical incision
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glomerulonephritis
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inflammation of kidney; more freq. in children who have had a recent case of strep throat
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*MOST COMMON KIDNEY DISEASE*
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pylonephritis
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bacterial infection that can either start in the bladder and work up or can enter thru the bloodstream
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hydronephritis
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H2O accumulates in kidney; urine flow is obstructed and backs up into the kidney; can happen during pregnancy
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polycystic kidney
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hereditary fluid filled sacs/cysts; treatment includes controlling BP
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renal failure
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acute--insult/injury to kidney; chronic--gradual build up of waste causes failure
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kidney stones/calculi
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caused by dehydration, infection, diet, urinary stasis
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cystitis
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lower UTI; inflammation of bladder; more common in women or ppl. w/ diabetes
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uti
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urinary tract infection; can be upper or lower
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incontinence
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F=functional--unpredictable passage of urine; O=overflow--overdistended, voluntary or involuntary; U=urge--involuntary after a strong sense of urgency to void; R=reflex--involuntary occuring @ somewhat predicatable intervals; S=stress--sudden increase in pressure caused by laughing, sneezing, coughing
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FOURS
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3 types of urine sample
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1=routine/random
2=clean catch/mid-stream 3=sterile |
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routine/random sample
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clean, voided sample; not sterile; measures glucose, specific gravity, ketones
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clean catch/mid-stream
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checks for bacteria; use sterile specimen cup
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sterile sample
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straight or indwelling (Foley) cath; can take out of bag one time only, after that you must take it out of port w/ needle and syringe
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timed urine sample
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have pt. tell you when they need to void; start time and FLUSH first voided urine; save all other voids for 24 hours
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types of catheters
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straight (in & out); indwelling (Foley)
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Factors affecting urination
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disease, age, meds, foods, social/cultural factors, surgery, social/cultural issues
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diagnostic tests for urinary systems
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Blood--BUN (blood, urea, nitrogen), creatinine level, electrolytes (salt & potassium) and radiologic
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KUB
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kidneys, ureters, bladder x-ray
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IVP
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intravenous pylogram; IV radio-opaque dye and series of x-rays
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renal scan
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nuclear IV; pictures taken w/ gamma ray camera
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cystoscopy
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endoscopic test; used for biopsy, removal of calculi, measures bladder capacity, stent placement
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top complications are 1)infection 2)perforation 3)hematuria
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retro-grade pylogram
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uses cystoscopy to complete an IVP; Dr. puts catheters into ureters and injects dye to assess kidney and ureter function
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renal CT
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non-invasive cross section view of kidneys
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renal US
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high frequency sound waves; differentiates cysts from tumors; identifies kidney stones
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3 basic homeostatic mechanisms of the urinary system
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P=regulate blood pressure
V=regulate blood volume C=controls composition of blood |
PVC
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renin
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secreted by kidneys when BP is too low to increase vasoconstriction and raise BP
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Erythropoietin
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secreted by kidneys to stimulate RBC production when hypoxia is sensed
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ADH
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anti-diuretic hormone; secreted by anterior pituitary gland to tell kidneys to reabsorb more H2O
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diuresis
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producing a lot of fluid
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diabetes insipidus
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insufficient ADH; a lot of urination
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30mL
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the amount of urine a body should produce every 24 hours
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properties of urine
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A=amount--1 1/2-2L/day
C=clarity--clear C=color--straw, yellow, amber C=Concentration 1.005-1.030 O=odor--slightly aromatic P=pH--4.8-8; 6 is normal S=STERILE G=glucose--no K=ketones--no P=protein--no C=cast--no |
ACCCOPSGKPC
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oliguria
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low amount of urine; 100-400mL/day
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anuria
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absence of urine; <100mL/day
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capacity of bladder
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600mL
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urge to void
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150-200mL
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pathogenicity
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is it capable of causing disease?
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virulence
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ability to produce disease
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modes of transmission
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contact--direct/indirect
air--droplet/airborne vehicles--inanimate objects/equipment vector--animate/internal, mosquitoes, louse, flea, tick |
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four stages of infection
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1) incubation period--from entrance to body until 1st symptom
2) prodromal stage--general symptoms, turning into more specific symptoms 3) illness stage--manifest signs and symptoms specific to type of illness 4)convalescence--acute symptoms disappear |
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inflammation response
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one of the body's defenses against infection. This is a non-specific response.
localized--edema, errythmia, pain, tenderness, lower fx. of area systemic--fever, malaise, nausea, vomiting, |
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immune response
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specific response; cell mediated immunity, humoral immunity, passive immunity
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cell-mediated response
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t-lymphs go to infected area and release antigens to fight
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humoral immunity
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B cells stimulated and cause antibody to be formed
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formation of antibodies
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active immunity--antibodies are produced by our own body due to exposure; natural active--you had the illness; artificial active--vaccines; passive immunity--antibody is produced at another source and given to you; natural passive--mother to child; artificial passive--immunoglobulins
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complement
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inactive blood proteins activated by antigens
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interferon
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chemicals always in our body, they prevent viral replication and suppress tumor growth
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nosocomial infection
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an infection acquired in a hospital #1 is UTI, #2 is pneumonia
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latrogenic infection
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typre of nosocomial that results from diagnostic and therapeutic procedure
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asepsis
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absence/decrease in organisms
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medical asepsis
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clean technique
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disinfection
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use chemicals to eliminate microorganisms (not spores)
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surgical asepsis
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sterile technique; gets rid of everything (including spores)
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purpose of drug therapy for infection control
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to lower # of pathogens in a pt. body until pt. own immune system can take over
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a system of moral principles or stds. that determine conduct/character in an individual
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ethics
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conduct/character relationships between different human beings
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morality
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abstract standards that give people a sense about what is right and wrong
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values
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difficult issues that arise in healthcare settings
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bioethics
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process of becoming more aware and able to name the values we deem worthy to us
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values clarification
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self control; freedom to make decisions that will impact welfare and to take action
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autonomy
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preventing harm
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non-maleficence
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emphasis on doing what is best for the pt.
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beneficence
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remaining faithful to ethical commitments and beliefs
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fidelity
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fair and equitable appropriate tx. for pt.
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justice
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telling the truth
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veracity
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speaking up for pt. welfare
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advocacy
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accept ownership for what you did/did not do
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accountability
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maintaing privacy of pt. and family
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confidentiality
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be answerable to actions we have taken; reliability and dependability
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responsibility
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powers of free action
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rights
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code of ethics for nurses
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est. by ANA in 1950; provides us w/ guidelines
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pt. bill of rights
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est. by AHA in 1973 to affirm pt. rights
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rights of a pt
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respectful, considerate care
privacy and confidentiality information re: tx. and dx. to refuse any and all tx. |
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analysis of ethical dilemma
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ask "is this an ethical dilemma?"
gather info values stmt verbalize problem consider course of action negotiate outcome |
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what kind of laws are healthcare laws?
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CIVIL
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standards of care
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legal guidelines for nsg. practice
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intentional tort
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assault/battery, defamation of character, false imprisionment, invasion of privacy
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a willfull attempt (no touching)
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assault
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touching w/o consent
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battery
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unintentional tort
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negligence, malpractice
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conduct that falls below the std. of care; omission to do something that a reasonable person would/would not have done
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negligence
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professional negligence or unreasonable amount of skill
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malpractice
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to prove malpractice
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1)there must be a duty
2)nurse did not carry out duty 3)pt. was injured 4)the nurse's failure to carry out duty caused pt. injury |
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debt to pt.
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liability
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nutrition
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study of food and health
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nutrient
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elements used by body for growth, dev, activity, repro, maint, recovery of health
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essential nutrient
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not made in body
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macronutrients
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carbs--4k/cal
proteins--4k/cal fats--9k/cal |
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essential macrominerals
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greater than 100mg/day (Na, Ca, K, Phosphorous)
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micronutrients
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vitamins, trace minerals
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fat soluble vits
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a, d, e, k
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non-essential nutrients
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body makes it; vit. D and cholesterol
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6 classes of nutrients
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carbs
proteins fats minerals vits h2o |
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bmi
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18-25 normal
26-30 overweight over 30 obese |
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carbs
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carbon, oxygen, hydrogen; most abundant, least expensive, prevents ketosis
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proteins
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carbon, oxygen, hydrogen, nitrogen; amino acids, key of life, repair muscles
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fats/lipids
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carbon, hydrogen, oxygen; insoluble in blood and water, concentrated energy source;
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water soluble vits
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not stored
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fat soluble vits
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stored in body
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nutritional assessment
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D--disease
E--eating poorly T--tooth, mouth pain E--economic hardship R--reduced social contact M--Meds I--involuntary weight loss/gain N--needs help E--elderly |
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anthropometry data
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measuring system of the size and make-up of body; BMI, head circumference, skin folds
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clear liquid diet
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clear fluids @ room temp, coffee w/ no cream, broth, popsicles, clear juice; low in calories
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full liquid diet
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contains milk; plain frozed desserts, eggs, cream of wheat, creamy soups, ice cream
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soft diet
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modified reg. diet, eliminates foods hard to digest or chew; eliminates high fiber foods; low in fiber and residue
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npo diet
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nothing by mouth
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enteral nutrition
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directly to GI
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parental nutrition
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TPN; not thru GI tract; into a large vein;
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salem sump
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suctions out; use saline to flush
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fats
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most concentrated energy source in the body
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saline
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isotonic
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alcohol
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depletes vit. B store
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what plant protein contains all essential amino acids necessary to support growth?
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SOY
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triamterene
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used to prevent CHF; avoid foods high in K
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strawberries
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high in vit. C
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