Ch 57 Pharm

Front 1

____________is the amount estimated to provide adequate intake in 50% of healthy persons in a specific group.

Back 1

Estimated Average Requirement (EAR)

Front 2

_____________ is the amount estimated to meet the needs of approximately 98% of healthy children and adults in a specific age and gender group. The RDA is used to advise various groups about nutrient intake. It should be noted, however, that RDAs were established to prevent deficiencies and that they were extrapolated from studies of healthy adults. Thus, they may not be appropriate for all groups, such as young children and older adults.

Back 2

Recommended Dietary Allowance (RDA)

Front 3

_______________is the amount thought to be sufficient when there is not enough reliable, scientific information to estimate an average requirement. The AI is derived from data that show an average intake that appears to maintain health.

Back 3

Adequate Intake (AI)

Front 4

______________is the maximum intake considered unlikely to pose a health risk in almost all healthy persons in a specified group; it is not intended to be a recommended level of intake.

Back 4

Tolerable Upper Intake Level (UL)

Front 5

What are the fat soluble vitamins?

Back 5

A, D, E, K

Front 6

This vitamin is required for normal vision, growth, bone development, skin, and mucous membranes

Back 6

Vitamin A (retinol)

Front 7

Signs & Symptoms of deficiency of this vitamin are Night blindness; xerophthalmia, which may progress to corneal ulceration and blindness; changes in skin and mucous membranes that lead to skin lesions and infections, respiratory tract infections, and urinary calculi

Back 7

Vitamin A

Front 8

These are symptoms of excess use of this vitamin: Anorexia, vomiting, irritability, skin changes (itching, desquamation, dermatitis); pain in muscles, bones, and joints; gingivitis; enlargement of spleen and liver; increased intracranial pressure; other neurologic signs.

Congenital abnormalities in newborns whose mothers took excessive vitamin ? during pregnancy.

Back 8

Vitamin A

Front 9

The function of this vitamin is Antioxidant in preventing destruction of certain fats, including the lipid portion of cell membranes; may increase absorption, hepatic storage, and use of vitamin A

Back 9

Vitamin E

Front 10

This vitamin can be found in Cereals, green leafy vegetables, egg yolk, milk fat, butter, meat, vegetable oils

Back 10

Vitamin E

Front 11

Deficiency is rare in this vitamin

Back 11

Vitamin E

Front 12

To much of this vitamin E results in this?

Back 12

Fatigue; nausea; headache; blurred vision; diarrhea

Front 13

This vitamins is essential for normal blood clotting. Activates precursor proteins, found in the liver, into clotting factors II, VII, IX, and X

Back 13

Vitamin K

Front 14

This vitamin can be found in green leafy vegetables (spinach, kale, cabbage, lettuce), cauliflower, tomatoes, wheat bran, cheese, egg yolk, liver

Back 14

Vitamin K

Front 15

A deficiency of this vitamin can lead to: Abnormal bleeding (melena, hematemesis, hematuria, epistaxis, petechiae, ecchymoses, hypovolemic shock)

Back 15

Vitamin K

Front 16

When __________ is given to someone who is receiving warfarin (Coumadin), the client can be made “warfarin-resistant” for 2-3 wk.

Back 16

Vitamin K

Front 17

What are the water soluble vitamins?

Back 17

B-Complex

Front 18

_______ is essential in fat and carbohydrate metabolism

Back 18

Biotin

Front 19

This water soluble vitamin can be found in meat, egg yolk, nuts, cereals, most vegetables

Back 19

Biotin

Front 20

A deficiency of this water soluble vitamin results in anorexia, nausea, depression, muscle pain, dermatitis

Back 20

Biotin

Front 21

This water soluble vitamins function is essential for normal metabolism of all body cells; normal red blood cells; normal nerve cells; growth; and metabolism of carbohydrate, protein, and fat

Back 21

Cyanocobalamin (B12)

Front 22

A deficiency of this water soluble vitamin results in pernicious anemia: decreased numbers of RBCs; large, immature RBCs; fatigue; dyspnea

Back 22

Cyanocobalamin (B12)

Front 23

A severe deficiency of this water soluble vitamin can lead to: leukopenia, infection, thrombocytopenia, cardiac dysrhythmias, heart failure

Back 23

Cyanocobalamin (B12)

Front 24

A deficiency of this water soluble vitamin has these Neurologic signs and symptoms: paresthesias in hands and feet; unsteady gait; depressed deeptendon reflexes; loss of memory; confusion; delusions; hallucinations; psychosis. Nerve damage may be irreversible.

Back 24

Cyanocobalamin (B12)

Front 25

This water soluble vitamin is essential for normal metabolism of all body cells; normal red blood cells; and growth

Back 25

Folic acid (folate)

Front 26

This water soluble vitamin can be found in Liver, kidney beans, fresh green vegetables (spinach, broccoli, asparagus), fortified grain products (e.g., breads, cereals, rice)

Back 26

Folic acid (folate)

Front 27

A deficiency of this water soluble vitamin manifests as megaloblastic anemia that cannot be distinguished from the anemia produced by B12 deficiency; impaired growth in children; glossitis; GI problems

Back 27

Folic acid (folate)

Front 28

This water soluble vitamin is essential for glycolysis, fat synthesis, and tissue respiration. It functions as a coenzyme in many metabolic processes (after conversion to nicotinamide, the physiologically active form).

Back 28

Niacin (B3)

Front 29

A deficiency of this water soluble vitamin leads to Pellagra: erythematous skin lesions, GI problems (stomatitis, glossitis, enteritis, diarrhea), central nervous system problems (headache, dizziness, insomnia, depression, memory loss)

Back 29

Niacin (B3)

Front 30

A severe deficiency of this water soluble vitamin presents in a patient as delusions, hallucinations, impairment of peripheral motor and sensory nerves

Back 30

Niacin (B3)

Front 31

To much of this water soluble vitamin can lead to flushing; pruritus; hyperglycemia; hyperuricemia; increased liver enzymes

Back 31

Niacin (B3)

Front 32

This water soluble vitamin is
essential for metabolism of carbohydrate, fat, and protein (e.g., release of energy from carbohydrate; fatty acid metabolism; synthesis of cholesterol, steroid hormones, and phospholipids)

Back 32

Pantothenic acid (B5)

Front 33

This water soluble vitamin can be found in eggs, liver, salmon, yeast, cauliflower, broccoli, lean beef, potatoes, tomatoes

Back 33

Pantothenic acid (B5)

Front 34

This water soluble vitamin is a coenzyme in metabolism of carbohydrate, protein, and fat; required for formation of tryptophan and conversion of tryptophan to niacin; helps release glycogen from the liver and muscle tissue; functions in metabolism of the central nervous system; helps maintain cellular immunity

Back 34

Pyridoxine (B6)

Front 35

This water soluble vitamin can be found in yeast, wheat germ, liver and other glandular meats, whole grain cereals, potatoes, legumes.

Back 35

Pyridoxine (B6)

Front 36

Deficiencies of this water soluble vitamin lead to skin and mucous membrane lesions (seborrheic dermatitis, intertrigo, glossitis, stomatitis), neurologic problems (convulsions, peripheral neuritis, mental depression)

Back 36

Pyridoxine (B6)

Front 37

This water soluble vitamin is a coenzyme in metabolism; necessary for growth; may function in production of corticosteroids and red blood cells and gluconeogenesis

Back 37

Riboflavin (B2)

Front 38

This water soluble vitamin is found in milk, cheddar and cottage cheeses, meat, eggs, green leafy vegetables

Back 38

Riboflavin (B2)

Front 39

Deficiency of this water soluble vitamin can present as glossitis, stomatitis, seborrheic dermatitis, eye disorders (burning, itching, lacrimation, photophobia, vascularization of the cornea)

Back 39

Riboflavin (B2)

Front 40

This water soluble vitamin is a coenzyme in carbohydrate metabolism; essential for energy production

Back 40

Thiamine (B1)

Front 41

This water soluble vitamin is found in meat, poultry, fish, egg yolk, dried beans, whole-grain cereal products, peanuts

Back 41

Thiamine (B1)

Front 42

A mild deficiency of this water soluble vitamin leads to fatigue, anorexia, retarded growth, mental depression, irritability, apathy, lethargy

Back 42

Thiamine (B1)

Front 43

A severe deficiency of this water soluble vitamin leads to beriberi: peripheral neuritis; personality disturbances; heart failure; edema; Wernicke-Korsakoff syndrome in alcoholics

Back 43

Thiamine (B1)

Front 44

This water soluble vitamin is essential for formation of skin, ligaments, cartilage, bone, and teeth; required for wound healing and tissue repair, metabolism of iron and folic acid, synthesis of fats and proteins, preservation of blood vessel integrity, and resistance to infection

Back 44

Vitamin C (ascorbic acid)

Front 45

This water soluble vitamin is found in fruits and vegetables, especially citrus fruits and juices

Back 45

Vitamin C (ascorbic acid)

Front 46

Mild deficiency of this water soluble vitamin leads to irritability, malaise, arthralgia, increased tendency to bleed

Back 46

Vitamin C (ascorbic acid)

Front 47

A severe deficiency of this water soluble vitamin leads to scurvy and adverse effects on most body tissues (gingivitis; bleeding of gums, skin, joints, and other areas; disturbances of bone growth; anemia; and loosening of teeth). If not treated, coma and death may occur.

Back 47

Vitamin C (ascorbic acid)

Front 48

To much of this vitamin leads to renal calculi.

Back 48

Vitamin C (ascorbic acid)

Front 49

True or false?

DRIs for vitamin A are expressed in retinol activity equivalents (RAEs), which include both preformed vitamin A and carotenoids. 1 RAE = 1 mcg retinol or 12 mcg beta carotene.

Back 49

True

Front 50

True or false?

Vitamin E activity is expressed in milligrams of alpha-tocopherol equivalents (alpha TE).

Back 50

True

Front 51

What is the recommended daily dose of vitamin A for females 14yrs and older?

Back 51

700 mcg

Front 52

What is the recommended daily dose of vitamin A for pregnant females?

Back 52

750-770 mcg;

Front 53

What is the recommended daily dose for vitamin A for lactating females?

Back 53

1200-1300 mcg

Front 54

What is the recommended daily dose of vitamin A for males 14yrs and older?

Back 54

900 mcg

Front 55

What is the recommended daily dose of vitamin a for children?

Back 55

1-3 y, 300 mcg
4-8 y, 400 mcg
9-13 y, 600 mcg

Front 56

What is the recommended daily dose of vitamin A for infants?

Back 56

0-6 mo, 400 mcg
6-12 mo, 500 mcg

Front 57

What is the recommended daily dose of vitamin E for females 14yrs and older?

Back 57

15 mg

Front 58

What is the recommended daily dose of vitamin E for pregnant females?

Back 58

15mg

Front 59

What is the recommended daily dose for vitamin E for lactating females?

Back 59

19 mg

Front 60

What is the recommended daily dose of vitamin E for males 14yrs and older?

Back 60

15 mg

Front 61

What is the recommended daily dose of vitamin E for children?

Back 61

1-3 y, 6 mg
4-8 y, 7 mg
9-13 y, 11 mg

Front 62

What is the recommended daily dose of vitamin E for infants?

Back 62

0-6 mo, 4 mg
7-12 mo, 6 mg

Front 63

What is the recommended daily dose of vitamin K for everyone?

Back 63

1 mcg/kg

Front 64

_____ are structural an functional components of all body tissues; the recommended amount for adults is 50 to 60 grams per day.

Back 64

Proteins

Front 65

_________ and fats mainly provide energy for cellular metabolism

Back 65

Carbohydrates

Front 66

Energy is measured in ________ per gram of food oxidized in the body.

Back 66

Kilocalories

Front 67

Carbohydrates and __________ supply 4 kcal per gram; fats supply 9 kcal per gram.

Back 67

proteins

Front 68

________ are required for normal body metabolism growth and development.

Back 68

Vitamins

Front 69

A parenteral drug used to remove excess iron from storage sites (e.g.ferritin, hemosiderin) in the body.

Back 69

Deferoxamin (desferal)

Front 70

Chelates copper zinc mercury and lead to form soluble complexes that are excreted in the urine

Back 70

Penicillamine (cuprimine)

Front 71

Used to treat Hyperkalemia

Back 71

Sodium poylstyrene sulfonate (Kayexalate)

Front 72

Chelates lead to form water soluble complexes that are excreted in the urine

Back 72

Succimer (chemet)

Front 73

An oral Iron chelating agent used to treat chronic iron overload.

Back 73

Desferasirox (exjade)

Front 74

Mrs Ridley present to the physicians office for her yearly physical examination. When you ask about her current drug regimen, she states taht she self administers megadoses of vitamin C to prevent cancer. Which of the following statements is an appropriate response?

a. You require large doses of multiple vitamins to prevent cancer.

b. Large doses of single vitamins do not prevent cancer.

c. Large doses of vitamin C will also prevent cardiovascular disease.

d. Large doses of vitamin C will prevent HIV

Back 74

b

Front 75

Mr. Theordore tells you that he obtains all of his nutrients from vitamins. Which of the following is the correct explanation to give this patient?

a. The effectiveness of the vitamins depends on the brand.

b. you cannot obtain enough vitamin B6 from vitamins.

c. You should consult your physician for the correct strength of the vitamins.

d. Nutrients are best obtained from foods.

Back 75

d

Front 76

Which of the following are fat soluble vitamins? (select all that apply)

a. A

b. D

c. K

d. B

Back 76

a,c, d

Front 77

Which of teh following are water soluble vitamins? (select all that apply)

a. B complex

b. K

c. C

d. A

Back 77

a, c

Front 78

As the home care nurse visiting a patient which of the following is your responsibilities?

a. Providing care to the client with physicians orders

b. Assessing the nutritional status of the client you have physicians orders to visit.

c. assessing the nutritional status of all members of the household.

d. Providing nutritional counseling to the person who is the primary cook within the family.

Back 78

c

Front 79

For patients receiving tube feedings at home which of the following may be a subject of teaching by the home care nurse? (select all that apply)

a. The goals of treatment and techniques of administration.

b. Preparation or storage of solutions

c. Adjustment of the nutrition formula

d. Monitoring of responses (ex weight and urine output)

Back 79

a, b, d

Front 80

You are caring for a critically ill patient in the unit. An IV is dedicated to fluid and electrolyte replacement. To prevent imbalances and adverse reactions, which of the following should you closely monitor?

a. Hemoglobin and hematocrit levels.

b. Serum electrolyte levels

c. Serum albumin levels

d. BUN and creatine levels.

Back 80

b

Front 81

You are responsible for the administration of total parental nutritional for a client. The physician orders a fat emulsion. How should the fat emulsion be administered?

a. Rapidly over 30 mins.

b. over 1 to 2 hrs

c. Slowly over an 8hr period

d. Slowly over 24hrs.

Back 81

d

Front 82

You are comparing the recipe for a TPN with the physicians orders for an adult male age 35. How will vitamin K be administered?

a. Separately by injection

b. Separately orally

c. Included in the TPN order

d. Monthly Subcutaneously

Back 82

a

Front 83

Mr. Springer is diagnosed with COPD. His enteral feeding formula will be individualized and will contain which of the following combination of nutrients?

a. More carbohydrates and less protein

b. Less carbohydrate and more fat

c. Less carbohydrate and more protein.

d. Less fat and more protein.

Back 83

b

Front 84

Patients with cardiac or renal impairment who require fluid restriction may benefit from a more ____________ enteral formula (ex 1.5kcal/ml)

Back 84

Concentrated

Front 85

Mr. Powers admitted to your unit for treatment for pneumonia. His diagnoses include cirrhosis of the liver. You would expect his diet to include restriction of which of the following elements?

a. Carbohydrate

b. Fat

c. Calcium

d. Protein

Back 85

d

Front 86

With enteral nutrition ________ - _____ may be given to provide amino acids carbohydrates and a few electrolytes for patients with renal failure.

Back 86

Amin - aid

Front 87

IV fat emulsions should not be given to patients with ARF if serum triglyceride levels exceed which of the following levels?

a. 400mg/dL

b. 300 mg/dL

c. 200 mg/dL

d. 100 mg/dL

Back 87

b

Front 88

Mr. Smith age 75 is admitted to your unit. His diagnosis include diabetes mellitus type 2 arthrosclerosis and a PMH of MI in 1989. You should be concerned if his enteral feeding contains with of the following elements?

a. Animal fats

b. Low amounts of glusose

c. Potassium

d. Calcium

Back 88

a

Front 89

To prevent accidental ingestion of iron containing medications by children products with 30mg or more of iron must be provided in which of the following ways?

a. They must have childproof caps

b. They must be packaged as individual doses

c. They must be supplied by prescription only.

d. They must be prescribed only for adults.

Back 89

b

Front 90

All such drugs should be kept out of reach of young children and should never be referred to as "__________________"

Back 90

Candy

Front 91

Preterm infants need proportionately more vitamins than term infants for which of the following reasons?

a. They often experience electrolyte imbalances.

b. There growth rate is faster.

c. There metabolism is slower

d. Their growth rate is slower.

Back 91

b

Front 92

Mrs. Pearson is diagnosed with a sizure disorder and the physician prescribes phenytoin. She is preparing to conceive her second child and begins to self administer folic acid. The concurrent use of these medications places the client at risk for which of the following adverse effects?

a. Phenytion toxixity

b. Seizures

c. Folic acid toxicity

d. Subtherapeutic levels of folic acid

Back 92

b

Front 93

Water is required for cellular metabolism and excretion of metabolic waste products. How much daily is needed?

Back 93

2000 to 3000 mL

Front 94

_______________are required for absorption of carbohydrates, protein, and fat. Pancrelipase and others are commercial preparations used as replacement therapy in deficiency states, including cystic fibrosis, chronic pancreatitis, pancreatectomy, and pancreatic obstruction. Dosage is 1 to 3 capsules or tablets with each meal or snack.

Back 94

Pancreatic enzymes (amylase, protease, lipase)

Front 95

The maximum intake of calcium should not exceed ________ this also includes all dairy products consumed.

Back 95

2500mg