Nutrition Test info D440

BMI ranges

normal 18.5-24.9

overweight 25-29.9

obese 30 and over

Albumin

markers for malnutrition, kidney or liver disease

dysphagia

which pt would be most at risk for malnutrition

Breastfeeding

at risk for dehydration

What diet would a pt who lost their dentures be on?

mechanical soft

Low calcium

Athlete is cramping due to _______

high calcium foods

dairy, kale, broccoli, fish, fortified foods (broccoli and cheese)

nutrient dense foods

contain lots of vitamins and minerals relative to the number of calories

Where can you find folic acid?

YOGURT; Leafy green vegetables and legumes, seeds, orange juice, and liver; now added to most refined grains

How many mL is one ounce?

30 mL

How many oz are in a cup?

8 oz

How many oz are in a glass?

6 oz

How any calories are in one gram of fat?

9

How many calories are in one gram of protein?

4

How many calories are in one gram of carbs?

4 cal

What causes glomerulonephritis?

untreated strep throat

glomerulonephritis diet

fluid restriction

sodium restriction

decrease protein

increase carbs (carbs provide energy and stop the breakdown of proteins)

renal disease diet

fluid restriction, low sodium, low protein, low potassium, high calcium

UTI diet

berries, probiotics (yogurt),

avoid coffee, tea, soft drinks, chocolate and smoking

Heart failure diet

fluid restriction - spread fluids out throughout the day; suck on hard candy to decrease thirst

decrease sodium, fat and cholesterol

Heart health diet

increase fiber, decrease saturated fat

Dash diet for lowering B/P and LDL

low sodium, low fat, low sugar

high calcium, high potassium, high fiber

4-6 servings of fruits and veggies

celiac disease diet (gluten intolerance)

Gluten free diet: No BROW Barley Rye Oats Wheat

Remember NO OATMEAL

foods to avoid: ice cream, malted milk, prepared puddings, grains that are made with BROW such as breads, rolls, cookies, cakes, crackers, cereal, spaghetti, macaroni noodles, beer, and ale

Stomatitis diet (inflammation of the oral mucous lining of the mouth)

soft and easy to eat foods, room temp, high protein, high calorie

avoid alcohol, salty, spicy, and citrus foods

peritonitis diet (inflammation of the inner lining of the stomach)

Eat foods high in B-vitamins and calcium (almonds, beans, whole grains (if no allergy), dark leafy green vegetables.

avoid refined foods: such as white breads, pasta, sugar.

Use healthy oils like olive oils and vegetable oils

Cholecystitis diet

low fat

high fiber, protein and carbs

avoid gassy foods (like broccoli)

Diverticulitis diet

high fiber; no nuts/seeds

hemorrhoids diet

high fiber and increase fluids

Diabetes diet

low carbs, low sugar, count carbs

What isn't a refined sugar/carbs? avocado

hyperthyroidism diet

high protein, high calorie, low fiber, low iodine

low iodine foods

non-iodized salts, decaf coffee or tea, egg whites, fresh or canned fruits, unsalted nuts and nut butters, homemade breads or bread without salt, dairy and eggs, popcorn with non-iodized salt, oats, potatoes, honey, maple syrup, broccoli, brussels sprouts, cauliflower, collard greens, kale, mustard, rutabaga

Osteoporosis diet

high calcium, high vitamin D

Cancer preventative diet

High protein and soft diet

limit salty foods and salt preserved foods, limit consumption of energy dense foods such as processed foods that are high in sugar, low fiber, high fat,

Vitamin K

K for Kale

found in dark green leafy vegetables, eggs, carrots, liver, tomatoes, potatoes, peanut butter, soybeans, vegetable oil

What is vitamin K needed for and what is seen in a deficiency?

Essential for blood clotting.

Deficiency can present as bruising easily/bleeding

What is important about vitamin K while taking warfarin (anticoagulant [prevents blood clotting])

Vitamin K is the antidote to warfarin. While taking it, make sure to keep a consistent intake of vitamin K.

Vitamin E

Think E for extra virgin olive oil

found in vegetable oils, nuts, seeds, and green leafy vegetables

Vitamin E deficiency

peripheral neuropathy, ataxia, decreased immune response

Vitamin E toxicity

impaired blood coagulation and increased risk for bleeding

Vitamin A

A for apricots and orange foods

found in orange-yellow fruits vegetables (cantaloupe, carrots, mango, sweet potatoes), fatty fish, dairy, , leafy greens, liver

Vitamin A deficiency

xerophthalmia (night blindness and drying of the cornea and conjunctiva)

Vitamin A toxicity

increased intracranial pressure, nausea, headache, joint pain, coma, liver damage, birth defects in developing fetus, joint pain, jaundice, pruritis, hair loss

potassium

fruits like bananas, apricots, orange juice, cantaloupe, tomatoes

vegetables potatoes, spinach, broccoli

legumes, milk, salt substitutes

Hyperkalemia (high potassium)

dysrhythmias, muscle twitching/weakness, paresthesia (burning/prickling sensation), diarrhea

Hypokalemia (low potassium)

dysrhythmias, muscle weakness, constipation/ileus, hypotension, weak pulses

calcium

electrolyte critical for bone/teeth formation, muscle/nerve function, and clotting

sources: dairy, leafy greens like kale, broccoli, fish (sardines and salmon), fortified foods (cereal)

Hypercalcemia (high calcium)

kidney stones, GI upset, constipation, bone pain, muscle weakness, confusion

Hypocalcemia (low calcium)

positive Chvostek's (facial twitch) and Trousseau's signs (spasm induced by blood pressure cuff), muscle spasms, paresthesia (burning/prickling sensation.

sodium

electrolyte important for nerve/muscle function and fluid volume maintenance

found in shellfish, meat, table salt, frozen and processed food, olives, deli meat, canned foods, cheese, and vegetable juice.

hypernatremia (high sodium)

thirst, lethargy, confusion, GI upset, muscle twitching, seizures, irritability/agitation

hyponatremia (low sodium)

confusion (common in elderly), fatigue, nausea, vomiting, headache, seizure

Vitamin D

increases calcium absorption. bone growth and remodeling, decreased inflammation

found in sunlight, fatty fish like tuna and salmon, fish oil, and fortified foods like milk and cereal

Vitamin D deficiency

rickets (decreased bone density, developmental delay, seizures, skeletal deformity)

osteomalacia (bone deformity, pain, seizures)

Low vitamin D can cause Decreased bone Density, bone Deformity

Vitamin D toxicity

hypercalcemia, nausea, vomiting, muscle weakness, dehydration

protein

wound healing

found in seafood, meat, poultry, eggs, beans, soy products, nuts, seeds, dairy

complete proteins

egg, meat, cheese, meat, poultry, fish, soy

Foods that are high in cholesterol

egg yolk, shellfish, organ meat, red meat, fried foods

low-density lipoprotein (LDL)

bad cholesterol

High-density lipoprotein (HDL)

good cholesterol

magnesium

found in nuts, seeds, legumes, whole grains, green leafy vegetables, milk, yogurt, fortified cereal, cocoa, legumes, tuna, chocolate

Vitamin B1 (thiamine)

pork

nuts

whole-grain cereals

legumes

Vitamin B2 (Riboflavin)

milk

lean meats

fish

grains

Vitamin B3 (Niacin)

meats

fish

poultry

beans

peanuts

grains

Vitamin B6 (pyridoxine)

yeast

corn

meats

poultry

fish

Vitamin B12 (cobalamin)

meat, liver

Vitamin B1 (thiamine) deficiency

Beriberi (affects cardio and neurovascular systems, leading to increased HR, peripheral neuropathy)

Wernicke-Korsakoff syndrome (degenerative brain disorder)

Vitamin B2 deficiency

Cheilosis (dry swollen lips, fissures at the corners of the mouth)

Your 2 lips will Be swollen and cracked from lack of B2

Vitamin B3 (Niacin) deficiency

Pellagra 3D's (Diarrhea, Dermatitis, Dementia)

Vitamin B6 deficiency

peripheral neuropathy, anemia

Vitamin B9 folic acid

green leafy vegetables, liver, beef, fish, legumes, grapefruit, oranges

folic acid deficiency

fetal neural tube defects

Vitamin B12 deficiency

pernicious anemia (lack of intrinsic factor in the gastric mucosa impairs absorption)

Iron

Dried beans

Dried fruits

egg yolks

iron-fortified cereals

liver

meat (especially lean meat and poultry)

oysters

salmon

tuna

whole grains

iron deficiency

anemia, pallor, cold extremeties, difficulty concentrating, fatigue, tachycardia

What helps with the absorption of iron?

Vitamin C

What decreases the absorption of iron?

dairy/calcium

What causes green or "tarry black" stools?

iron supplements

Vitamin C

citrus fruits, tomatoes, broccoli, cabbage, green leafy veggies

vitamin c deficiency

scurvy (swollen, bleeding gums, poor wound healing)

tissue bleeding, joint bleeding, bone fractures, tooth loss

caused by smoking, poor nutrition, alcohol abuse

How do you measure placement for NG tube?

start at the tip of the nose, go to the ear lobe, then the xiphoid process

How do you verify placement on the initial insertion?

xray

What is enteral nutrition?

Delivery through a tube into the stomach or the GI

What is parenteral nutrition?

nutritional feeding through the vein (IV)

When is an NG tube used?

used for pt with dysphagia, stroke, facial/neck burns, trauma to head/neck, end of life, impaired swallowing

What is the first thing you do before feeding through an NG tube?

check placement

What should you do to the bed before feeding through an NG tube?

elevate the head of the bed to 30-45 degrees

What should the temperature be like for tube feedings?

room temp to avoid cramps

What is the greatest risk for using an NG tube?

aspiration

What should you do when checking placement of an NG tube AFTER the initial placement?

aspirate contents and CHECK pH

What should you do before bolus feeding?

verify bowel sounds and position pt in Fowler's position on the right side to prevent vomiting

What should you have the pt do when removing the NG tube?

pt should take a deep breath and hold it

How often should you change the bags for tube feeding?

4 hours for open bags and 24-48 hours for closed bags to prevent bacteria growth

When is TPN (total parenteral nutrition) used?

used for pt with cancer of the digestive tract, IBD, Chron's disease, high risk for aspiration, GI obstruction

How should you increase the feeding rate for enteral nutrition?

slowly until order rate is acheived

Risks/complications of TPN

infection, hyper/hypoglycemia, fluid overload, electrolyte imbalance

What should you do when using TPN?

MONITOR GLUCOSE

What should you do when feeding bag is empty and a new bag is not yet provided?

use 10-20% dextrose when waiting for the next bag

What should you do when discontinuing TPN?

gradually reduce before disconnecting to avoid hypoglycemia

Clear liquid diet

limited nutrients; only used for a short period of time.

clear juice (no pulp), gelatin, popsicles, and clear broths.

prescribed to pt. with GI problems, pre-op, post-op and before diagnostic testing

Full liquid

Foods that are or may become liquid at room or body temp

juice with pulp. milk with milk products, yogurt, strained cream soups, liquid dietary supplements.

Used to advance a pt with GI disturbances, dental work or pt who cannot tolerate solid foods