Nutrition - Fundamentals Exam 5

what are the six classes of nutrients

carbohydrates, proteins, fats (lipids), vitamins, minerals, and water

what is the difference between macronutrients and micronutrients

macronutrients (carbohydrates, proteins, and fats) provide energy and support tissue growth

micronutrients (vitamins and minerals) regulate body processes and do not provide calories

what are essential nutrients

nutrients that must be obtained through the diet because the body cannot produce them in sufficient amounts

what is the primary function of carbohydrates

to provide energy

the body breaks digestible carbohydrates down into simple sugars, primarily glucose, which cells use for energy

how many calories are provided by each macronutrient

carbohydrates: 4

protein: 4

fat: 9

what is the difference between simple and complex carbohydrates

simple carbohydrates contain one or two sugar units

complex carbohydrates contain longer chains of sugars, including starches and fiber

what happens to carbohydrates during digestion

digestible carbohydrates are broken down into simple sugars, absorbed into the bloodstream, and transported to the liver and other tissues for energy or storage

what is the primary function of protein

growth, maintenance, and repair of tissues

protein also helps produce enzymes, hormones, and antibodies

what are amino acids

the building blocks of proteins that the body uses to form and repair tissues

what is the difference between complete and incomplete proteins

complete proteins contain all nine essential amino acids in adequate amounts

incomplete proteins lack sufficient amounts of one or more essential amino acids

what are examples of complete protein sources

eggs, meat, poultry, fish, dairy products, and soy products

what are anabolism and catabolism

anabolism builds tissues and proteins

catabolism breaks down tissues and proteins to release or recycle components

what is the recommended daily protein intake for most healthy adults

approximately 0.8 grams per kilogram of body weight per day

requirements may be higher during growth, illness, or recovery

what are the main functions of fats

provide concentrated energy, protect organs, insulate the body, support cell membranes, and assist with absorption of fat-soluble vitamins

what is the difference between saturated and unsaturated fats

saturated fats are commonly solid at room temperature and can increase LDL cholesterol

unsaturated fats are commonly liquid and are generally healthier for cardiovascular function

what role does bile play in fat digestion

bile emulsifies fats into smaller droplets, allowing pancreatic enzymes to digest them more efficiently

which vitamins are fat-soluble

vitamins A, D, E, and K

they are absorbed with dietary fat and can be stored in body tissues

which vitamins are water-soluble

vitamin C and B-complex vitamins

most are not stored in large quantities, so regular intake is important

what are the primary functions of vitamins A, C, D, and K

vitamin A supports vision and immunity

C supports collagen and wound healing

D supports calcium absorption

K supports blood clotting

what are the primary functions of calcium, iron, potassium, and sodium

calcium supports bones and muscle contraction

iron transports oxygen

potassium supports nerve and muscle function

sodium regulates fluid balance and nerve impulses

why is water essential for nutrition

it supports circulation, digestion, nutrient transport, waste removal, temperature regulation, and cellular function

why do infants have increased nutritional needs

they grow rapidly and require relatively high energy, protein, fat, vitamins, and minerals to support physical and neurological development

what nutritional considerations are important for toddlers

provide balanced meals, healthy snacks, appropriate portions, and safe food textures while allowing independence with eating

what nutrients are particularly important during adolescence

protein for growth, calcium and vitamin D for bones, and iron for expanding blood volume and replacing menstrual losses when applicable

why do nutritional requirements increase during pregnancy

to support fetal growth, placental development, increased maternal blood volume, and changes in maternal tissues

why is folic acid especially important during pregnancy

it supports early neural tube development and decreases the risk of neural tube defects

why are iron requirements increased during pregnancy

iron is required to support increased red blood cell production and fetal development

what nutritional changes occur during lactation

energy and nutrient requirements increase to support breast milk production

adequate hydration and a balanced diet are also important

how do nutritional needs change in older adults

calorie requirements often decrease, but protein, vitamins, minerals, and fluid remain essential for maintaining health, muscle mass, and tissue repair

what age-related changes increase the risk of poor nutrition

decreased appetite, changes in taste and smell, poor dentition, difficulty swallowing, reduced mobility, and social isolation

what is basal metabolic rate (BMR)

the energy the body requires at rest to maintain essential functions such as breathing, circulation, and cellular metabolism

what factors increase BMR

fever, infection, rapid growth, pregnancy, lactation, prolonged stress, and exposure to extreme cold

what factors decrease BMR

aging, starvation, prolonged fasting, malnutrition, and reduced lean body mass

what is malnutrition

a condition caused by inadequate, excessive, or imbalanced nutrient intake or use that negatively affects body function

what are common risk factors for malnutrition

older age, chronic illness, poor dentition, dysphagia, depression, dementia, poverty, limited mobility, and certain medications

what are common physical signs of malnutrition

unintentional weight loss, muscle wasting, loss of body fat, weakness, dry skin, brittle hair, and poor wound healing

what should a nurse assess when evaluating nutritional status

dietary intake, recent weight changes, height, BMI, muscle and fat stores, chewing and swallowing ability, medical history, and food access

what is BMI, and how is it calculated

body mass index estimates weight relative to height

BMI = weight in kilograms divided by height in meters squared

what are the adults BMI classifications

underweight: below 18.5

normal: 18.5-24.9

overweight: 25-29.9

obese: greater than 30

why is BMI not always an accurate indicator of nutrition

it does not distinguish muscle from fat and may be misleading in patients with high muscle mass, edema, or significant changes in body composition

what is the significance of waist circumference

it helps identify abdominal obesity, which is associated with increased cardiovascular and metabolic disease risk

what waist measurements indicate increased health risk

approximately 40 inches or more for men and 35 inches or more for women

what are the albumin and prealbumin reference ranges

albumin: 3.5-5 g/dL

prealbumin: 15-36 mg/dL

both are influenced by inflammation and illness and cannot diagnose malnutrition alone

why is unintentional weight loss concerning

it may indicate inadequate nutritional intake, impaired nutrient absorption, increased metabolic requirements, or underlying illness

what social factors influence nutritional status

income, transportation, education, food availability, cultural practices, religious beliefs, and social support

what nursing interventions promote appetite

offer small, frequent meals, preferred foods, oral care, a pleasant eating environment, and appropriate treatment for nausea or pain

how can nurses assist patients who have difficulty feeding themselves

provide adaptive utensils, prepare food for eating, assist with positioning, encourage independence, and allow adequate time

what is the best position for a patient with dysphagia during meals

upright at approximately 90 degrees to promote safe swallowing and reduce aspiration risk

what are signs of dysphagia or aspiration during eating

coughing, choking, wet or gurgly voice, difficulty swallowing, respiratory distress, or food remaining in the mouth

what should the nurse do when a patient begins coughing and choking during a meal

stop feeding, assess airway and breathing, and initiate appropriate aspiration or emergency interventions

what interventions help a patient with ill-fitting dentures maintain adequate nutrition

arrange dental evaluation, provide appropriate food textures, promote oral care, and monitor nutritional intake

how should the nurse monitor whether nutritional interventions are effective

monitor weight trends, food and fluid intake, strength, hydration, wound healing, and relevant clinical findings

what are examples of measurable nutritional goals

the patient will consume at least 75% of meals, maintain stable weight, or demonstrate improved nutritional intake within a specific period

what is a therapeutic diet

a diet modified in nutrient content, food selection, or consistency to help manage a medical condition

what diet is commonly recommended for cardiovascular disease

a heart-healthy diet that emphasizes fruits, vegetables, whole grains, lean proteins, and unsaturated fats while limiting sodium and saturated fats

why is sodium restricted in some patients with heart failure

excess sodium promotes fluid retention and can worsen edema, hypertension, and heart failure symptoms

what is the DASH diet

Dietary Approaches to Stop Hypertension: an eating pattern rich in vegetables, fruits, whole grains, and low-fat dairy, with reduced sodium and saturated fat

what diet is commonly recommended for constipation

a high-fiber diet with adequate fluid intake, unless contraindicated by the patient’s medical condition

what foods are high in fiber

whole grains, beans, fruits, vegetables, nuts, and seeds

when might a low-fiber diet be prescribed

for selected gastrointestinal disorders, during certain acute flare-ups, or before or after specific procedures

what diet is required for celiac disease

a gluten-free diet that excludes wheat, barley, and rye

what dietary changes may help patients with GERD

eat smaller meals, avoid lying down after eating, and limit foods that trigger symptoms

what dietary restrictions may be needed for chronic kidney disease

individualized control of sodium, potassium, phosphorus, protein, and fluid intake based on kidney function and laboratory values

why might potassium need to be restricted in renal disease

impaired kidneys may be unable to excrete potassium adequately, increasing the risk of hyperkalemia and dangerous cardiac dysrhythmias

what are examples of potassium-rich foods

bananas, oranges, potatoes, tomatoes, and some beans

what is a consistent-carbohydrate diet

a meal plan that distributes carbohydrate intake appropriately throughout the day to support blood glucose management

why is coordinating meals with insulin important

to reduce the risk of hypoglycemia when insulin is active without sufficient carbohydrate intake

what dietary precautions are important for immunosuppressed patients

avoid raw or undercooked animal products and unpasteurized foods, wash produce thoroughly, and use safe food-handling practices

what is a clear-liquid diet

a temporary diet consisting of clear liquids such as water, clear broth, and gelatin

what is a full-liquid diet

a diet containing liquids and foods that become liquid at room temperature, such as milk, strained soups, and pudding

what is a pureed diet

a diet of smooth foods that require minimal chewing, used when appropriate for chewing or swallowing difficulties

what is a mechanically altered diet

a modified-texture diet containing foods prepared to make chewing and swallowing easier

what is enteral nutrition

the delivery of nutrients directly into the gastrointestinal tract through a feeding tube

when is enteral nutrition indicated

when the patient cannot consume adequate nutrition orally but has a functioning gastrointestinal tract

what is the difference between an NG tube and a PEG tube

an NG tube passes through the nose into the stomach and is typically used short term

a PEG tube enters the stomach through the abdominal wall and is commonly used for long-term feeding

what is the difference between gastric and jejunal feeding tubes

gastric tubes deliver nutrition into the stomach

jejunal tubes deliver nutrition into the jejunum of the small intestine

what is the priority nursing intervention before starting a new tube feeding

verify tube placement using the approved method

initial placement generally requires radiographic confirmation

what position should a patient be in during enteral feeding

keep the head of the bed elevated 30-45 degrees unless contraindicated

what are the common complications of enteral nutrition

aspiration, nausea, vomiting, diarrhea, constipation, tube obstruction, and tube displacement

what is gastric residual volume (GRV)

the amount of stomach contents present during gastric feeding

its use in assessing tolerance depends on clinical circumstances and facility policy

what should the nurse do if a patient receiving enteral feeding develops respiratory distress

stop the feeding immediately, assess airway and breathing, and initiate appropriate emergency interventions

how can feeding tube obstruction be prevented

flush the tube with water as prescribed, administer medications appropriately, and avoid mixing incompatible medications or formulas

what is parenteral nutrition

nutrition delivered intravenously when adequate nutrition cannot be provided through the gastrointestinal tract

what are the three primary macronutrients provided in TPN

amino acids (protein), dextrose (carbohydrates), and lipids (fats)

why is TPN generally administered through a central venous catheter

TPN is highly concentrated and hypertonic, requiring a large vein with sufficient blood flow for safe dilution

what are the priority nursing responsibilities for TPN administration

use an infusion pump, maintain sterile central-line care, verify the solution and rate, and monitor glucose, electrolytes, and fluid balance

what are common complications of TPN

hyperglycemia, hypoglycemia, central-line infection, fluid overload, electrolyte imbalances, and refeeding syndrome

why must blood glucose be monitored during TPN

TPN contains concentrated dextrose that can cause hyperglycemia

unexpected interruption may also cause glucose changes

what is refeeding syndrome

a potentially life-threatening shift in fluids and electrolytes, particularly phosphate, potassium, and magnesium, after nutrition is restarted in a severely malnourished patient

what should the nurse do if TPN is unexpectedly interrupted

assess blood glucose, notify the appropriate provider, and follow the prescribed interruption protocol, which may include a temporary dextrose infusion