Nutrition Exam 4

Weight loss benefits of even 3-5% of body weight

Losing just 3-5% of body weight can result in significant health improvements, including a reduced risk of developing type 2 diabetes, lower blood pressure, improved cholesterol levels, and enhanced overall well-being. This amount of weight loss can also lead to better physical fitness, increased energy levels, and a decrease in joint pain, supporting better mobility and quality of life.

Weight loss recommendations

Smaller plates, wait 10 minutes after the first signs of hunger to see if it dissipates , weight loss based on calorie levels of 3,500 calories.

3-5% weight loss can result in significant health improvements

5-10% of weight over six months

24 weeks in 6 months

calculate lbs per week range ex. 350, 200 lbs, and 420 lbs

Bullimia nervosa-management strategies

Small, fréquent meals every 4-5 hours, recognizing hunger cues, 3 meals and 2-3 snacks daily, eat slowly, avoid restricting/binging

Most effective way to control weight and sustain good health?

The best method for managing weight and maintaining good health includes a balanced diet with a focus on whole foods, regular physical activity, and mindful eating practices. It's important to create sustainable lifestyle changes rather than relying on quick fixes or extreme diets.

Anorexia-management strategies

Increasing caloric intake is good overall

Complications associated with obesity

Obesity can lead to serious health issues like type 2 diabetes, heart disease, hypertension, sleep apnea, and mental health disorders.

Candidacy for bariatric surgery includes what co-morbid conditions?

Candidates typically have obesity-related co-morbidities such as type 2 diabetes, hypertension, and sleep apnea. For a BMI of 30-39, two co-morbitites needed to have the surgery, for BMI 40 or over, no other co-morbidities to need the surgery

The MOST Important factor affecting weight loss is…

The key factor in weight loss is maintaining a calorie deficit

Underlying etiology for eating disorders-

Factors contributing to eating disorders include genetic, psychological, environmental, and sociocultural influences.

Underlying etiology for obesity-what are the factors

Obesity is influenced by genetic, behavioral, environmental, and metabolic factors.

choose a low calorie meal sample

Select meals with fewer calories, such as salads, grilled chicken, or vegetable stir-fries.

Which type of diet is most likely to result in weight loss?

A low-calorie diet that emphasizes whole, nutrient-dense foods is most effective for weight loss. This type of diet includes a variety of fruits, vegetables, lean proteins, whole grains, and healthy fats. It also reduces processed foods, added sugars, and high-calorie snacks. Combining this dietary approach with regular physical activity, portion control, and mindful eating can enhance weight loss and improve overall health.

Understanding hallmarks of both bulimia and anorexia as well as appropriate treatment modalities

Key features of bulimia include binge eating followed by compensatory behaviors, while anorexia is characterized by severe weight loss and a distorted body image, requiring distinct treatment approaches.

Nitrogen balance review

Nitrogen balance refers to the difference between nitrogen intake and nitrogen loss, indicating whether the body is in a state of anabolism (positive balance) or catabolism (negative balance). Protein catabolism puts people in a negative nitrogen balance (Burn patients).

Burn injury patients-what diet is appropriate/examples of how to get those extra calories and protein in

High protein and high calorie diet that includes protein shakes, eggs, chicken, healthy fats, dairy, and cheese. Also frequent, smaller meals

Refeeding syndrome-what happens physiologically in the body?

Refeeding syndrome occurs when a person who’s been malnourished begins eating again, and the sudden intake of nutrients causes a rapid shift in electrolytes, particularly phosphate, potassium, and magnesium. This shift happens because the body, now re-stimulated by food, uses these electrolytes to process glucose (sugar) for energy. Since stores are depleted from malnutrition, this sudden demand can lead to dangerously low levels in the blood, potentially causing heart, respiratory, or neurological issues.

Grams of protein per kg for severe burn injury patients

1.5-2.0 g/kilograms

Be able to select high calorie/high protein hospital foods used to boost patients’ nutrition

• High-Protein Shakes (e.g., Ensure, Boost)

• Greek Yogurt (full-fat)

• Cottage Cheese or Cheese Slices

• Peanut Butter packets

• Eggs (boiled, scrambled)

When to use enteral vs. parenteral nutrition

“if the gut works, use it! (enteral)”

What has the greatest impact on intensity of the stress response?

The severity of the injury or illness has the greatest impact on the intensity of the stress response, as more severe conditions trigger a stronger physiological reaction to promote healing and survival.

When is the ideal time to initiate nutrition support post injury?

The ideal time to initiate nutrition support post-injury is within 24-48 hours, as early support helps reduce complications and promotes recovery.

What past medical history ailments would put a patient at higher risk for refeeding syndrome?

Patients with a history of chronic malnutrition, alcoholism, anorexia nervosa, prolonged fasting, gastrointestinal disorders, or uncontrolled diabetes are at higher risk for refeeding syndrome.

Benefits of enteral nutrition over parenteral nutrition

Enteral nutrition has several benefits over parenteral nutrition:

1. Preserves Gut Integrity: Stimulates the digestive tract, reducing the risk of gut atrophy.

2. Lower Infection Risk: Reduces bloodstream infection risk by avoiding intravenous lines.

3. Better Immune Support: Promotes a stronger immune response by supporting gut-associated lymphoid tissue.

4. More Cost-Effective: Generally less expensive than parenteral nutrition.

5. Fewer Complications: Lowers risk of liver dysfunction and metabolic complications associated with parenteral feeding.

Clinical indicators present during the first phase of the stress response are clue-signs of shock

In the first phase of the stress response, clinical indicators of shock include low blood pressure, rapid heart rate, cold/clammy skin, and reduced urine output—all signs of decreased blood flow and oxygen to tissues.

What vitamins/minerals assist in wound healing?

vitamin C, folic acid, B12, and zinc

Fat intake and type two DM-what matters-the type of fat or the exact amount of fat in the diet?

The type of fat is what matters, The diet can include unsaturated fats. The fats that should be avoided are saturated fats and foods with added sugars in them.

Managing a sick day when you have diabetes-what are the recommendations?

3 carb serving every 4 hours

What changes in macronutrient consumption should be made for those with type II DM?

Macronutrient consumption can be the same as regular people for people with diabetes. However, they could be in more trouble after eating “unhealthy” things that regular people usually consume. Diabetics should eat carbs with a lower glycemic index, eat lean proteins to stabilize their blood sugar, and prioritize healthy fats.

Causes of hypoglycemia

Causes of hypoglycemia include:

1. Excessive insulin or medication (too much for the food intake or activity level)

2. Skipping meals or delayed meals

3. Intense physical activity without adjusting food or insulin

4. Alcohol consumption (especially on an empty stomach)

5. Kidney or liver dysfunction, affecting glucose metabolism

6. Illness (especially with vomiting or diarrhea) that affects food intake or medication absorption

How much fiber should a client with DM II take in daily?

A client with type 2 diabetes should aim for 25-30 grams of fiber daily, primarily from whole grains, vegetables, fruits, and legumes, to help manage blood sugar levels and improve digestive health.

Your client should eat carbs prior to working out if their BG level goes below what level?

A client with diabetes should eat carbohydrates prior to working out if their blood glucose level drops below 100 mg/dL to prevent hypoglycemia during exercise.

What are the benefits of an advanced carb counting and what type of patient would you recommend this for?

Advanced carb counting helps individuals with diabetes more precisely manage blood sugar levels by tracking the exact amount of carbohydrates in meals. It's particularly beneficial for patients who:

- Use insulin pumps or multiple daily injections

- Have unstable blood sugar levels

- Need tight control over their diabetes management

This method provides flexibility in food choices and insulin dosing, enhancing overall control.

Why might a DM II require insulin?

A person with type 2 diabetes may require insulin when their body no longer produces enough insulin, or their cells become resistant to insulin, making it difficult to maintain normal blood sugar levels through oral medications alone. Insulin helps regulate blood glucose by facilitating its entry into cells for energy.

What are the guidelines for alcohol intake in diabetic patients?

they can still drink alcohol but in moderation. The lesser, the better.

Supplements for diabetics- are they needed?

They are not needed if the diabetic person is receiving everything they need.

Meal planning for diabetics-do they need low carb meal plans? How strict does the meal plan need to be?

Diabetics do not necessarily need low-carb meal plans, but carb control is important to manage blood sugar levels. The meal plan should focus on:

- Balanced carbs: Choose complex, fiber-rich carbs (whole grains, vegetables) over refined carbs.

- Consistent carb intake: Spread carb consumption evenly throughout the day to prevent blood sugar spikes.

- Protein and healthy fats: Include lean proteins and unsaturated fats to improve insulin sensitivity.

The meal plan does not need to be extremely strict, but it should be consistent, flexible, and personalized based on the individual's blood sugar goals and lifestyle.

Best way to manage risk for hypoglycemia for your type 1 diabetic patient? Hint-what should you recommend they always carry with them?

they should carry around lifesavers, jolly ranchers, etc.

A “pre-diabetic” patient asks what is the best thing he or she can do to modify their risk for Type II DM?

Exercise and have a healthy diet

Metabolic syndrome-defined by what trifecta?

Metabolic syndrome is defined by a trifecta of three or more of the following risk factors:

1. Abdominal obesity (waist circumference >40 inches in men, >35 inches in women)

2. High blood pressure (≥130/85 mm Hg)

3. High blood sugar (fasting glucose ≥100 mg/dL or insulin resistance)

4. High triglycerides (≥150 mg/dL)

5. Low HDL cholesterol (<40 mg/dL in men, <50 mg/dL in women)

HgB A1C that defines pre-diabetes

A hemoglobin A1C of 5.7% to 6.4% defines prediabetes.

When meeting with a client, what is the first thing you want to address? (think about motivational interviewing)

The first thing to address is building rapport and understanding the client’s motivations. Use open-ended questions to explore their concerns, goals, and readiness for change, creating a collaborative and supportive environment.

What is the benefits of a bridled NG tube compared to a taped NG tube?

The benefits are lower risk of dislodgment, less exposure to radiographs for placement, less emergency department visits and increases weight gain as well as nutritional status

What is the meaning of a primary tube?

A primary tube refers to the main or initial tube used in a medical procedure or treatment, such as a feeding tube or intravenous line. It is typically the first or most essential tube in a series, serving as the primary route for medication, nutrition, or drainage.

When can the surgically placed GT be changed for the first time?

After six weeks

SATA- the benefits of an enteral feeding program include…

The benefits of an enteral feeding program include:

- Preserves gut integrity by stimulating the digestive system.

- Reduces infection risk compared to parenteral feeding.

- More cost-effective than intravenous nutrition.

- Supports immune function through the gut-associated lymphoid tissue.

- Fewer complications like liver dysfunction or metabolic imbalances.

T/F: The bridle should ideally be placed prior to the nasogastric tube.

True

Why should medications be administered via G tube flushed with water afterwards?

So that the medication can actually go to the person’s stomach and not get stuck in the tube.