NTR 371

LEARNING OBJECTIVES (julie update! 9/8) NTR care process, fluid/elec, ac-base, kidney disease

age, sex, genetics are examples of [ ] factors that affect nutritional status

biological

these factors, such as attitudes, knowlegde, and behaviors also affect nutritional status

lifestyle factors

determine the type & amount of nutrients available for use by the body

give some examples of factors that affect a person’s nutritional status

biological, environmental (social, economic, food availability), intake & quantity, healthcare system, food supply

give the parts of the nutrition care process

ADIME (assessment, diagnosis, intervention, monitoring and evaluation)

what is the point of standardized nutrition language

creates uniform terminology used and a common language for documentation and communication (ex: Food/Nutrition Related History (FH) is an assessment term)

links assessment to intervention in NCP

diagnosis

what is a PES statement

a written description of the problem related to etiology as evidenced by signs and symptoms

all are functions of water in our body except:

transports nutrients

soaks up dry membrane residues

supports cell shape & structure

lubricates friction-generating surfaces

sustains normal body temperature

soaks up dry membrane residues

what are the 3 body fluid compartments

ICF, ECF (interstitial, intravascular, transcellular) & third spaces (peritoneal, pericardial, thoracic cavities & joins and bursae)

fluid in the body (water) moves across a semipermeable membrane through the process of [ ] & the force that pulls fluid across the membrane is referred to as [ ]

osmosis; osmotic pressure

the movement of fluid & solutes in the body is called [ ] - think of kidney function

the pressure that is exerted by fluid on a membrane is

filtration

hydrostatic pressure (ie. blood pressure)

high osmolarity in the blood indicates; while low indicates

dehydration; overhydration

T or F: fluid intake includes soup & icecream

TRUE (anything fluid & room temperature!)

fluid output is the total of measurable, [ ] losses & unseen/unmeasurable [ ] losses

sensible, insensible (sensible → urine, feces & insensible → sweat, breathing)

describe the difference between obligatory urine & facultative urine

obligatory is release of waste (minimal necessary amt) & facultative is excess fluid beyond this (depends on how much fluid you intake)

describe the RAAS system & regulation of fluid/electrolytes

thirst mechanism: low hydrostatic pressure in the blood signals to baroreceptors that blood volume is decreased, the pituitary releases arginine vasopressin* in response to (1) the increasing ECF osmolarity & (2) the hydrostatic pressure decrease( as recognized by the baroreceptors

(*same as ADH - anti diruetic hormone)

how does pain, trauma or stress impact vasopressin secretion in RAAS? thirst?

increases (& more water retained, but not related to H2O balance) & no affect on thirst

how do consumption of alcohol & caffeine impact vasopressin secretion in RAAS? thirst?

decrease secretion (unrelated to H2O balance) & no effect on thirst (increase loss of fluid & ECF hypertonicity)

how does drymouth impact vasopressin secretion in RAAS? thirst?

no effect, increases thirst

the hormone that assists in control of sodium is

ANP (atrial natiuretic peptide)

high ANP when blood volume is high causes what physiological response

increased urinary output of sodium & fluid (decreasing blood volume)

what hormone produced by the adrenal glands regulates potassium? and where is it excreted?

aldosterone; the kidney

which electrolytes have a reciprical relationship? what are the 2 hormones involved?

calcium and phosphorus; PTH (parathyroid hormone) raises Ca2+ levels; calcitonin decreases Ca2+ levels