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174 Cards in this Set

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Signs/symptoms of Vit A deficiency
Xerophthalmia (abn dryness of conjunctiva and cornea), night blindness, cessation of bone growth
Signs/symptoms of Vit A toxicity
Fatigue, muscle soreness, bone and joint pain, decreased clotting time
S/S of Vit B1 (thiamin) deficiency
Beriberi: loss of appetite, N/V, loss of feeling in hands and feet, muscle paralysis/loss of fxn in lower legs, and nystagmus (strange eye movements). Seen in alcoholics
S/S of Vit B1 (thiamin) toxicity
Rapid pulse, weakness
S/S of Vit B2 (riboflavin) deficiency
Cheilosis (fissures at corners of mouth), sore tongue, skin rash.
S/S of B3 (niacin) deficiency
Pellagra - the 4 D's: Diarrhea, Dermatitis, Dementia, Death
S/S of B3 (niacin) toxicity
Diarrhea, nausea, abnormal heart beat
S/S of Pyridoxine (B6) deficiency
Hypochromic, microcytic anemia
S/S of Pyridoxine (B6) toxicity
Depression, fatigue, neurological disorders
S/S of folate/folic acid deficiency
Macrocytic, megaloblastic anemia, birth defects
S/S of folate/folic acid toxicity
Diarrhea, can mask B12 deficiency
S/S of cobalamin (B12) deficiency
Pernicious/megaloblastic anemia (toxicity is rare)
S/S of Vit C (ascorbic acid) deficiency
Scurvy: impaired wound healing, hemorrhages, weakening of bones, connective tissue and teeth
S/S of Vit C (ascorbic acid) toxicity
Diarrhea, possible increased risk of kidney oxalate stones
S/S of Vit D deficiency
Rickets, osteomalacia
S/S of Vit D toxicity
Kidney stones, removal of calcium from bones
S/S of Vit E deficiency
Anemia, red cell breakage
S/S of Vit E toxicity
May interfere with anticoagulants
S/S of Vit K deficiency
Hemorrhage
S/S of Vit K toxicity
May interfere with anticoagulant drugs
S/S of calcium deficiency
Osteoporosis, tetany
S/S of calcium toxicity
Reduced renal function, kidney stones; elevated serum levels can lead to heart or respiratory failure
S/S of chromium deficiency
Abnormal glucose tolerance (toxicity rare)
S/S of copper deficiency
Anemia, skeletal disorders, Menkes Disease: genetic d/o characterized by retarded growth, impaired keratinization of hair ("kinky" or steel wool hair), deteriorating nervous system, etc.
S/S of copper toxicity
Wilson's disease: genetic d/o characterized by accumulation of copper in the tissues due to a defect in the ability to form ceruloplasmin, in addition the liver does not release copper into the bile as it should
S/S of fluoride deficiency
Increased risk for tooth decay
S/S of fluoride toxicity
Fluorosis: discoloration of teeth
S/S of iodine deficiency
mental retardation, goiter (enlargement of the thyroid gland)
S/S of iodine toxicity
May lead to hypothyroidism, goiter, or hyperthyroidism
S/S of iron deficiency
Anemia: microcytic, hypochromic
S/S of iron toxicity
Hemosiderosis: a storage d/o in through high intakes or genetic defect leading to excessive iron absorption without tissue damage.
Hemochromatosis: excessive iron absorption with tissue damage.
S/S of magnesium deficiency
Nausea, muscle tremors, confusion (toxicity rare)
S/S of potassium deficiency
Tachycardia, weakness, paralysis, may be fatal
S/S of potassium toxicity
Kidney failure, heart weakness, irregular heartbeat
S/S of sodium toxicity
Hypertension (deficiency rare)
S/S of zinc deficiency
Growth retardation, slow wound healing, reduced taste sensitivity,
S/S of zinc toxicity
Anemia, heart muscle degeneration
Describe 3 documentation formats
ADIME: Assessment, nutrition Diagnosis, Intervention, Monitoring, Evaluation
SOAP: Subjective, Objective, Assessment, Plan
DAR: Document, Assessment, Response
Harris Benedict Equation for males
Males = 66.47 + (13.75 x weight in kg) + (5.00 x height in cm) - (6.76 x age in years)
Harris Benedict Equation for females
Harris Benedict for females: 655.10 + (9.56 x weight in kg) + (1.85 x height in cm) - (4.68 x age in years)
What does the nutrient claim "free" mean?
No amount or a trivial amount of calories, fat, sat fat, cholesterol, sodium.
What does the nutrient claim "calorie-free" mean?
A "calorie-free" food must have less than 5 calories per serving.
What does the nutrient claim "good source"(or "contains" or "provides") indicate?
"Good source" is defined as 10-19% of the daily value of a certain nutrient per serving.
What do the nutrient claims "high" (or "rich in" or "excellent source of") indicate?
"High" is defined as more than 20% of the daily value of a certain nutrient per serving.
What does the nutrient claim "less" indicate?
"Less" is defined as having 25% less of a certain nutrient than a standard food.
What does the nutrient claim "light" indicate?
"Light" is defined as containing 1/3 less calories or 1/2 the fat of a standard food.
What does the nutrient claim "low" indicate?
"Low" is defined in certain nutrient terms.
What does the nutrient claim "low fat" indicate?
"Low fat" is defined as 3 grams or less of fat per serving
What does the nutrient claim "low saturated fat" indicate?
"Low saturated fat" is defined as 1 gram or less saturated fat per serving.
What does the nutrient claim "low sodium" indicate?
"Low sodium" is defined as 140 mg or less per serving.
What does the nutrient claim "low calorie" indicate?
"Low calorie" is defined as 40 calories or less per serving.
What do the nutrient claims "more," "fortified," "enriched," "added," "extra," or "plus" indicate? (All defined in the same way)
"More" et al is defined as containing 10% more of a nutrient's daily value when compared to a standard food.
Diabetes is diagnosed when the A1C is at what level?
Diabetes is diagnosed when the A1c is 6.5% or greater (diagnostic tests should be performed on 2 occasions to confirm diabetes diagnosis)
Diabetes is diagnosed when the fasting blood glucose is at what level?
Diabetes is diagnosed with a fasting blood glucose of 126 mg/dl or above (performed on 2 occasions to confirm diagnosis)
Diabetes is diagnosed with a random glucose test is at what level?
Random glucose test of greater than or equal to 200 mg/dl (performed on 2 occasions to confirm diagnosis)
What is the goal for preprandial blood glucose?
The goal for preprandial blood glucose is 80-120 mg/dl
What is the goal for postprandial blood glucose test?
The goal for postprandial blood glucose is <180 mg/dl
What is the goal A1c levels for glycemic control in a person with diabetes?
<7% is the goal A1c for an individual with diabetes
Prediabetes is diagnosed when the blood glucose is at what level?
Prediabetes is diagnosed when the blood glucose is 100-125 mg/dl.
Prediabetes is diagnosed when the A1c is at what level?
An A1c of 5.7% - 6.4% indicates prediabetes.
How do you calculate grams of CHO needed by a diabetic?
Total calorie needs x percentage of CHO = calories from CHO divided by 4 = grams CHO
How do you calculate grams of protein needed?
Total calorie needs x percentage of protein = calories from protein divided by 4 = grams protein
How do you determine the grams of fat needed by an individual?
Total calorie needs x percentage of fat = calories from fat divided by 9 = grams fat
How do you determine and calculate exchanges (based on grams CHO, pro and fat)?
First determine needs for milk, vegetables and fruits and calculate exchanges, i.e. grams CHO, pro and fat. Next, use remaining CHO for bread/starch exchanges; Then determine needs for meats and calculate exchanges; provide fat exchanges spread throughout the day using leftover fats (generally not more than 2-3 exchanges)
What is a typical insulin to carbohydrate ratio to cover CHO eaten?
Generally, 1 unit of rapid or short acting insulin to 15 g CHO (i.e. 45 g CHO consumed at dinner, 45 g/15g = 3 units of rapid or short acting insulin needed to cover CHO at dinner) *note insulin needs vary and must be individualized*
What is the action onset, peak action, and effective duration of Lispro (Humalog) insulin?
Lispro (Humalog) is a "rapid acting" insulin with action onset of <15 min, peak action of 1-2 hours, and effective duration of 3-4 hours.
What is the action onset, peak action, and effective duration of Regular insulin
Regular insulin is a "short acting" insulin with an action onset of 1/2 to 1 hour, peak action of 2-3 hours, and effective duration of 3-6 hours.
What is the action onset, peak action, and effective duration of NPH insulin?
NPH insulin is considered an "intermediate acting" insulin with action onset of 2-4 hours, peak action of 4-10 hours, and effective duration of 10-16 hours
What is the action onset, peak action, and effective duration of Glargine (Lantus) insulin?
Glargine (Lantus) is considered a "long acting" insulin with an action onset of 2-4 hours, no peak action, and effective duration of 20-24 hours.
What is galactosemia and what dietary restriction is required?
Galactosemia is a metabolic d/o that is characterized by inability to convert galactose to glucose due to an enzyme deficiency. Galactose restriction is required.
What is gout?
Gout is characterized by high concentrations of uric acid in the bloodstream, which can then build up in joints, causing pain typically in one joint. Need low purine diet - purines found mostly in organ meats, anchovies, mackerel, etc.
What are the symptoms of hypoglycemia?
Symptoms of hypoglycemia are: hunger, shakiness, nervousness, sweating, dizziness or light-headedness, sleepiness, confusion, difficulty speaking, anxiety, weakness.
When blood glucose is less than ____, it is considered hypoglycemia.
70 mg/dl: less than 70 is considered hypoglycemia
How do you treat hypoglycemia
15 g of CHO should be given, wait 15 min and retest. If blood glucose is still below 70 mg/dl, and additional 15 g of CHO should be given; repeat until blood glucose is back in normal range.
What is phenylketonuria (PKU)?
PKU is the inability to break down phenylalanine. Avoidance of high protein foods is required for this disorder; foods containing aspartame contains phenylalanine and should be eliminated.
What is Prader-Willi syndrome?
Prader-Willi syndrome is a genetic disorder characterized by mental disabilities, decreased muscle tone, persistent hunger than can lead to overeating and morbid obesity. Tx: Low calorie diet and limited access to food.
What is diabetic ketoacidosis?
DKA is due to inadequate insulin to allow the body to use CHO as an energy source; body uses fat instead resulting in ketone production. Characterized by high blood glucose (usu 250-600 mg/dl), polydipsia, polyuria, dehydration, and ketones in blood & urine; tx includes insulin, fluid and electrolyte replacement, etc.
Name some nutritional concerns with cancer patients.
Malnutrition, cachexia (tissue wasting) due to malnutrition, malabsorption, altered taste, hypermetabolism, nausea
Treatment to aid in wt. maintenance in cancer pts include what?
1. Kcal recs: 1.1-1.45 x BEE
2. Offer several small meals to reduce nausea
3. Comfort foods, frequent snacking, avoidance of dietary restrictions, and encourage pt to eat whenever they feel the urge
4. Avoid strong spices when mouth is sore and when taste aversions are found
Vitamin B12 or folate deficiency can cause what type of anemia?
Macrocytic - megaloblastic
Iron deficiency causes what type of anemia?
Hypochromic, microcytic; iron deficiency could be due to chronic loss of blood, diet, malabsorption.
Normocytic, normochromic anemia may occur in what circumstances?
Pregnancy, renal disease, overhydration
ATP III Therapeutic Lifestyle Changes (TLC) recommendations for fat intake.
<7% saturated fat, up to 10% PUFA, up to 20% monounsaturated fat, <200 mg cholesterol,
ATP III (TLC) recommendations for % of kcal distributions for total fat, CHO, pro.
25-35% calories from total fat, 50-60% kcal from CHO, 20-30 g fiber, ~15% from protein
DASH diet plan includes what?
Limited sodium, rich in calcium, magnesium, fiber.
Symptoms of Crohn's disease.
Anorexia, blood loss, diarrhea, fatigue
Treatment for Crohn's disease.
Low fiber diet (during acute inflammation), include adequate kcal and pro; medications
Cystic fibrosis is inability of _______ ________ to function correctly in the body.
Exocrine glands
Treatment of cystic fibrosis.
High calorie and protein diet, vitamin supplements, pancreatic enzymes.
Dumping syndrome treatment
Several small meals throughout the day, usu high in protein and fat with low CHO to prevent quick dumping into the jejunum.
Dumping syndrome symptoms
Cramping, weakness, n/v, diarrhea, quickly after consuming a meal
Short bowel syndrome cause
Resections of small intestine
Short bowel syndrome treatment
TPN may be initially indicated depending on extent of resection (in some cases TPN may be long term/permanent) progression to nutrition by mouth as tol; several small meals instead of 3 large meals may be better tolerated.
Recommendations for liver cirrhosis
Adequate kcal and pro, with restricted fluid and sodium generally recommended.
End stage liver disease is characterized by ____? (3)
ESLD is characterized by ascites, encephalopathy, and portal hypertension.
Treatment for end stage liver disease.
Adequate kcal (increased kcal with ascites or malabsorption), vitamin and mineral supplementation in part due to the liver's extensive role in utilizing these nutrients.
What is the treatment for hepatic encephalopathy?
Branched chain amino acid (leucine, isoleucine, valine "liv") enriched formulas may be indicated among pts with severe encephalopathy who do not respond or comply with lactulose or do not tolerate standard protein.
What is pancreatitis?
Inflammation of the pancreas; may be acute or chronic. Symptoms include cramping and diarrhea
Treatment of pancreatitis.
Pancreatic enzymes, low fat diet, and avoidance of alcohol.
Osteoporosis
Progressive bone loss associated with increased risk of fractures. Characterized by increased risk for fx, loss of height, and curvature of upper spine.
Risk factors for osteoporosis
Female gender, Caucasian or Asian ethnicity, post menopausal, inactivity, smoking, excessive alcohol.
The name for curvature of the upper spine
Dowager's hump
Treatment for osteoporosis
Calcium and vit D may slow progression, weight bearing exercises, estrogen replacement therapy, medications to decrease bone loss.
What is Glomerulonephritis?
Inflammation of renal glomeruli; can be acute or chronic.
Symptoms of glomerulonephritis (3)
Edema, HTN, proteinuria
Treatment of glomerulonephritis
Fluid control, protein control, adequate calories
Acute renal failure is characterized by what?
Decreased Glomerular Filtration Rate (GFR) and change in the kidneys' ability to excrete waste.
Acute renal failure nutritional care
Nutritional care is based on lab values and recovery; protein, fluids, phosphorus, calcium, potassium, and sodium should all be considered.
Characteristics of End Stage Renal Disease
Decreased ability to excrete waste, diminished fluid and electrolyte balance, uremia.
What is uremia?
Excessive amounts of nitrogen waste in the blood characterized by n/v, weakness, etc. Results from ESRD.
Treatment of End Stage Renal Disease (ESRD)
Dialysis or transplantation; nutrition care - protein is increased, potassium phosphorus, sodium and fluids are monitored, nutrient recommendations vary based on treatment.
Which of the following is the best information source for nutrient content in foods?
a. FDA food values
b. USDA Food Guide Pyramid
c. FDA Handbook on Food
d. USDA Handbook No. 8
d. USDA Handbook No. 8
The USDA Handbook No. 8 is a standard reference of nutrient composition in foods.
57. Which mineral is required for blood coagulation?
a. magnesium
b. calcium
c. potassium
d. zinc
b. Calcium
Calcium aids in blood coagulation, nerve and muscle contraction, and mineralization of bones and teeth.
A client at the WIC clinic reveals she has been giving her 6 month old whole cow's milk instead of breast milk. Nutritional differences include:
a. cow's milk is lower in CHO and higher in protein
b. cow's milk is higher in CHO and lower in calcium
c. cow's milk is higher in fat and higher in kcal
d. cow's milk is higher in kcal and lower in protein
a. Cow's milk is lower in CHO and higher in protein.
Cow's milk is lower in kcal, CHO, and fat, and higher in protein and calcium in comparison to breast milk.
Which of the following is NOT a function of sodium in the body?
a. major ion of extracellular fluid
b. major ion of intracellular fluid
c. maintains fluid balance
d. aids in nerve impulse transmission
b. Major ion of intracellular fluid
Sodium is a major ion of extracellular fluid, aids in maintaining fluid balance, and aids in nerve transmission. Potassium is an example of an ion of intracellular fluid.
When storing milk in a clear container, which of the following vitamins are you concerned with being destroyed? Correct
a. riboflavin
b. vitamin B3
c. vitamin A
d. vitamin B12
Riboflavin is easily destroyed when exposed to light.
a. riboflavin
Riboflavin is easily destroyed when exposed to light.
An endurance athlete is concerned with fluid consumption. How much water do you recommend he consumes during a training bout?
a. 6-12 fl oz every 15-20 minutes
b. 4-6 fl oz every 15-20 minutes
c. 6-12 fl oz every 30 minutes
d. 4-6 fl oz every 30 minutes
a. 6-12 fl oz every 15-20 min
Which of the following is NOT a function of folate?
a. DNA synthesis
b. metabolism of amino acids
c. red blood cell maturation
d. fat metabolism
d. fat metabolism
Folate functions include DNA synthesis, metabolism of amino acids, and red blood cell maturation
The process of Beta oxidation involves:
a. the breakdown of fatty acids to acetyl CoA
b. the use of lipoprotein lipase for fat storage
c. transport of fats in a fed state
d. none of these
a. the breakdown of fatty acids to acetyl CoA.
Beta oxidation involves the breakdown of fatty acids to acetyl CoA which is then used for energy production via the Krebs cycle.
In glycogenolysis, _____ is converted to glucose.
a. glucose 6-phosphate
b. OAA
c. pyruvate
d. none of these
a. glucose 6-phosphate.
In glycogenolysis, glucose 6-phosphate is converted to glucose.
Which of the following combines with CoA in 2 carbon fragments to make acetyl CoA to then enter the Krebs Cycle to make energy?
a. glucose
b. fatty acids
c. fructose
d. lactic acid
b. fatty acids
In fatty acid oxidation, fatty acids are broken apart to 2 carbon fragments, and combine with CoA to make acetyl CoA
Long chain fatty acids enter the liver in the form of ______ (make up mostly triglycerides) and leave the liver in the form of lipoprotein.
Chylomicrons
____ signals contraction of the gallbladder to release bile to aid in fat digestion and secretion of pancreatic juices.
Cholecystokinin
Which of the following is true about VLDL cholesterol?
a. composed primarily of cholesterol
b. carries cholesterol out of the liver for excretion
c. composed primarily of protein
d. carries cholesterol and lipids synthesized by the liver out from the liver
d. carries cholesterol and lipids synthesized by the liver out from the liver.
VLDL cholesterol carries cholesterol and lipids synthesized by the liver out from the liver. VLDL transports triglycerides to cells and picks up cholesterol, ultimately becomes LDL cholesterol.
The net number of ATP molecules produced from glycolysis is:
a. 4
b. 36
c. 2
d. 0
c. 2
Glycolysis requires 2 molecules of ATP and provides 4 molecules of ATP = 2 molecules ATP net produced.
Which of the following is true of LDL cholesterol?
a. product of VLDL cholesterol breakdown
b. comprised primarily of triglyceride
c. aids in excretion of cholesterol
d. none of these
a. product of VLDL cholesterol breakdown.
LDL cholesterol is a product of VLDL cholesterol breakdown. As VLDL transports triglycerides to cells and picks up cholesterol it eventually Becomes LDL cholesterol (LDL make up is high in cholesterol).
When fats are oxidized for energy which of the following is produced?
a. urea
b. pyruvate
c. glucose-6-phosphate
d. acetyl CoA
d. acetyl CoA
Fat oxidation produces acetyl CoA
You have identified that those at risk for type 2 diabetes at a local clinic are in need of nutrition education. Which step of screening have you completed?
a. selection
b. parameters
c. methodology
d. purpose
d. purpose
Purpose involves identifying those who are in need of nutrition education/intervention
A1c tests and patient interviews of those at risk for type 2 diabetes will be used to screen participants. This is an example of:
a. methodology
b. purpose
c. selection
d. parameters
a. methodology
Methodology identifies how to screen and may include interviews or medical charts.
A senior citizen fills out a self assessment nutrition health tool at the local senior center. What level of NSI assessment is this?
a. DETERMINE
b. ASSESS
c. Level I
d. Level II
a. DETERMINE
NSI developed by American Academy of Physicians, American Dietetic Association, and National Council on Aging to focus on improved nutrition status of elderly. DETERMINE your nutrition health - focus on raised awareness for public; can be used as a self assessment tool.
A social worker visiting a Meals on Wheels participant identifies the senior as needing more comprehensive follow up based on eating habits. What level of assessment of the NSI is this?
a. Level II
b. Level III
c. Level I
d. DETERMINE
c. level 1
Level 1 screen identifies who should be referred for a more comprehensive follow up and/or other community services. Includes eating habits, recent weight loss, etc.
When chyme enters the small intestine it becomes:
a. acidic in pH
b. basic in pH
c. neutral in pH
d. waste
c. neutral in pH
Bicarbonate in the pancreatic juices aids in neutralizing the acidic chyme. Chyme is acidic in the stomach but is neutralized in the intestine.
Tryptophan aids in the synthesis of:
a. niacin
b. thiamin
c. riboflavin
d. vitamin D
a. niacin
Niacin can be synthesized from tryptophan. About 1 mg of niacin is made from 60 mg of dietary tryptophan. Vitamin B6 is needed for this conversion
A patient taking phenytoin may experience which of the following?
a. decreased serum calcium and folate levels
b. decreased vitamin B2 and B6 levels
c. decreased magnesium and folate levels
d. decreased serum magnesium and calcium levels
a. decreased serum calcium and folate levels.
Serum calcium and folate levels can be decreased due to central nervous system medications including Phenytoin and Phenobarbital.
Creatinine Height Index is an indicator of lean body mass when:
a. renal function is normal
b. fluid intake is adequate
c. all of these
d. no presence of rapid muscle breakdown
c. all of these
Creatinine height index is an index of lean body mass; indicator when renal function is normal, fluid intake is adequate, and there is no presence of rapid muscle breakdown.
A woman has pale conjunctiva
and dry, scaly skin. What nutrient deficiency might this be an indicator of?
a. vitamin A
b. protein
c. vitamin C
d. thiamin
a. vitamin A
Vitamin A deficiency characteristics include pale conjunctiva and dry scaly skin.
A patient has been diagnosed with hypochromic anemia. Which of the following nutrients may help with this disorder?
a. Cobalamin
b. Folate
c. Pyridoxine
d. Thiamin
c. pyridoxine
Pyridoxine (B6) deficiency includes hypochromic, microcytic anemia.
All of the following nutrient toxicities may lead to kidney stones except:
a. vitamin C
b. vitamin D
c. calcium
d. vitamin A
d. vitamin A
Vitamins C, D, and calcium may lead to kidney stones when taken in toxic amounts.
Males with WHR (waist:hip ratio) of ___or greater and females with WHR of ____or greater can indicate android obesity and risks for disease associated (ie: heart disease, type 2 diabetes, etc.)
1.0 - males
0.8 - females
Nutrition treatment for chronic obstructive pulmonary disease (COPD)
Increased energy to aid in maintaining adequate body weight. Micronutrients to support a favorable respiratory quotient (RQ) - fat 30-45% of calories, protein 15-20% of calories, CHO 40-55% of calories
What acid/base imbalance is characterized by a reduced pCO2 and/or pH, with causes such as starvation, low CHO diet, diabetic ketosis, uremia?
Metabolic acidosis.
What acid/base imbalance is characterized by increased pH and bicarbonate, with causes such as diuretic use or persistent vomiting?
Metabolic alkalosis.
What acid/base imbalance is characterized by reduced pH and is generally due to reduced breathing (hypoventilation) secondary to COPD, emphysema, or asthma?
Respiratory acidosis.
What acid/base imbalance is characterized by increased pH and generally due to increased breathing (hyperventilation)
Respiratory alkalosis.
How does the body compensate for metabolic acidosis?
Lungs try to exhale carbon dioxide (breathing is increased); kidneys increase hydrogen secretion and increase ammonia production.
How does the body compensate for metabolic alkalosis?
Lungs attempt to preserve CO2 (breathing decreases); kidneys decrease hydrogen secretion and increase bicarbonate excretion.
How does the body compensate for respiratory acidosis?
Increase bicarbonate resorption.
How does the body compensate for respiratory alkalosis?
Increase bicarbonate excretion.
Which of the following is NOT usually needed for supplementation in breast fed infants?
a. iron
b. fluoride
c. vitamin D
d. zinc
d. zinc
Zinc is highly absorbable and does not usually require supplementation.
1 gram dextrose = _____ kcal
3.4 kcal
1 gram protein = _____ kcal
4 kcal
Lipids in TPN sol'n:
10% fat = ___ kcal/mL
20% fat = ___ kcal/mL
30% fat = ___ kcal/mL
10% fat = 1.1 kcal/mL
20% fat = 2.0 kcal/mL
30% fat = 3.0 kcal/mL
What percent of kcals should amino acids be in TPN?
~12-15% kcals
How much calcium should be in TPN?
0.2 - 0.3 mEq/kg
How much chloride is in TPN?
1-2 mEq/kg (same as sodium)
How much sodium is in TPN?
1-2 mEq/kg (same as chloride)
How much potassium is in TPN?
1 mEq/kg
What is the formula for calculating milliequivalents (mEq) from mg.
mEq = (mg. divided by atomic weight) x valence
ex. how many mEq are in 2000 mg sodium? (2000/23) x 1 = 87 mEq
What is the atomic weight and valence of calcium?
Atomic weight = 40
Valence = 2
What is the atomic weight and valence of chlorine?
Atomic weight = 35.4
Valence = 1
What is the atomic weight and valence of potassium?
Atomic weight = 39
Valence = 1
What is the atomic weight and valence of sodium?
Atomic weight = 23
Valence = 1
A low fiber diet may be used for what conditions?
Nausea, gastritis, diverticulitis, or IBS.
What foods should be avoided on a low fiber diet?
berries, several raw fruits, legumes, and vegetables, whole grain breads, yogurt containing seeds, peanut butter.
What is a low residue diet?
Includes total amount of material in colon; foods to avoid include high fiber foods as well as milk or potatoes.
What type of diet is followed when a fecal fat test is performed?
Instructions include eating 100 g of fat each day for 3 days before collection of stool and during the 3 days of collection one should continue with 100 g of fat each day.
How is a glucose tolerance test performed?
A blood sample prior to taking ~75 g of CHO, followed by additional blood sample.
When calculating nutrition support, ml x % = _____
Grams
A patient is receiving an 1800 ml solution with 25% dextrose, 7.5% amino acids. The patient also receives 250 ml of 30% lipids twice a week. How many calories does this patient average on a daily basis?
a. 2600 kcal
b. 2100 kcal
c. 2300 kcal
d. 1500 kcal
c. 2300 kcal
Dextrose = 1800 ml x 25% = 450 g x 3.4 kcal/g = 1530 kcal; amino acids = 1800 x 7.5% = 135 g x 4 kcal/g = 540 kcal; lipids = 250 ml x 3.0 kcal/ml = 750 kcal x 2 days per week = 1500 kcal divided by 7 days per week = 214 kcal; 1530 + 540 + 214 = 2284 kcal; the best answer is 2300 kcal
A patient weighs 125 lbs and receives 2200 kcals via TPN. How many grams of nitrogen is given if the ratio is 150/1?
a. 18
b. 10
c. 20
d. 15
d. 15
2200 kcal divided by 150 = 15 grams nitrogen
A patient with a GFR of 35 ml/min and oliguria is being treated for acute renal failure. You recommend: Correct
a. 1.0 g protein/kg and unrestricted fluids
b. .5-.8 g protein/kg and 500 ml fluids
c. .5-.8 g protein/kg and 24 hour output of fluids plus 500 ml
d. none of these
C. With acute renal failure and a pt. experiencing oliguria, protein is recommended to be .5-.8 g/kg and the last 24 hours of fluid output plus 500 ml.
Multiply BEE x ____ for weight maintenance
1.3
Multiply BEE x ____ for weight gain
1.5
A patient weighs 175 lbs and receives 2700 kcals via TPN. How many grams of nitrogen are given if the ratio is 200/1? Correct
a. 18
b. 10
c. 20
d. 14
d. 14
2700 kcals divided by 200 = 14 grams of nitrogen.