HEAL 2045- In Class Study Guide

Anorexia

Lack of appetite; common in cancer patients or patients with heart failure

Cachexia

Loss of body weight; lean muscle, weakness

Sarcopenia

Muscle wasting disorder; worsens with age

What do healthy meals look like?

Lean protein, fresh fruits, veggies, low sodium, low in added sugars, low in saturated fats, whole grains

BRAT diet

Bananas, Rice, Applesauce, Toast

PUD most common risk factor

H.Pylori

How to get rid of PUD

Take all antibiotics to treat to fully get rid of H.Pylori

Is coffee ok for patients with PUD?

It is ok for PUD if they can tolerate it, should stop drinking if they cannot tolerate

Dumping Syndrome focuses

Low lactose, low fiber, and low volume of food

Who is more at risk for Dumping Syndrome?

Patients who have undergone gastric bypass surgery

Things to help with Dumping Syndrome

Drink between meals, small frequent meals, lean meats, and grains are okay to eat

Things to Avoid for GERD

Avoid laying down for 30 minutes after meals, late night snacking, peppermint, chocolate, spicy foods, acidic food

What can help with GERD?

Weight loss

What can GERD cause ?

Acid reflux

If GERD is left untreated what can happen?

Adenocarcinoma (Cancer)

Nausea and vomiting that does not improve indicates?

Intestinal Obstruction

What should someone with Celiac Disease avoid?

Wheat, barley, rice, soy sauce, some oats

What should a patient with Cholecystitis eat?

A low fat diet

Nutritional treatment for Gallstones?

A low fat diet to help with buildup of sludge, and discomfort in stool

What is happening when a patient presents with Gallstones?

They are not getting enough bile where they need to

Nutritional treatment for Colostomy?

Small frequent meals, liberal fluid, salt and protein

How much fluid does a patient who underwent a Colostomy need?

80 oz of fluid a day

What is the purpose of small frequent meals for a Colostomy?

They help to regulate the patient's new bowel pattern

Purpose of high fiber diets

Reduce the rick of colon cancer, start the diet slowly then gradually increase intake

What phase should patients with IBD intake low fiber?

During the acute phase

People with Dumping Syndrome need...

Low fiber

When do patients with Crohn's disease need low fiber?

During a flare up

If someone is instructed to have a low fiber diet what foods should they avoid?

Popcorn, nuts, seeds

What are some foods someone instructed to have a low fiber diet can eat?

Bananas, cantaloupe, melon

What else besides fiber can also help?

Yogurt, because is pre/probiotics and live cultures

What diseases cause Secretory diarrhea diarrhea?

Crohn diseases and Celiac disease

What is Secretory diarrhea?

Excessive secretion into gastric space

Lactose Intolerance

Lack of lactase enzyme; causes cramping, pain, and causes osmotic diarrhea

What is Osmotic diarrhea?

lactose intolerance: extra lactose
Dumping syndrome: extra sugar

Meal options for a low fat diet for Gallbladder dz

Avoid things higher in fat, such as salad dressings, mayonnaise, and avoid fat coming out in stool

Underlying risk factors of NAFLD

Obesity, Diabetes, hyperlipidemia

How can one reduce the risk factors of NAFLD?

Weight loss and exercise

What is the adequate protein intake for Cirrhosis?

1.2-1.5 g/kg

What interventions help with Cirrhosis?

Frequent meals

What can lead someone to Cirrhosis?

History of alcohol abuse

Head/neck radiation-what concern do you have?

Dysphagia, anything in that area can be affected, raw irritated esophagus, mouth sores

Recommendations for Chemo patients

Eat a large breakfast (feel best when they wake up in the morning), small frequent meals, nutrient density (not a big appetite so what they eat should be nutrient dense)

How can you help Chemo patients during eating and experiencing a metal taste?

Use plastic utensils

Why should you recommend Chemo patients brush their teeth before eating foods?

Can help decrease nausea

Why are cold foods better for cancer patients than hot foods?

Hot foods have more flavor and can be harder to digest

Recommendations for a patient with Stomatitis

Room temp food, glutamine swishes, soft, east chewable food, because their whole mouth hurts

Why do recommend patients with Stomatitis to do glutamine swishes?

Can help numb the mouth

What kind of diet do patients with HIV/AIDS need?

Individualized diet based on lifestyle and medications; not necessarily high in calories

Diet for patients with a surgical resection

High protein diet for tissue repair

End of life diet

Liberalize the diet: whatever patients want to eat, as long as it is safe and tolerable

Nutritional practices that lower the risk of cancer

Fruits, veggies, phytonutrients

What Carcinogenic foods should someone avoid to help lower the risk of cancer?

Processed meats, nitrites, spam, sausage, bacon, foods that are grilled over charcoal

Recommendations for cancer patients experiencing nausea

Cold foods, do not eat for 1-2 hours before chemo, low-fat, easy to digest foods (crackers, carbohydrates), small frequent meals

Neutropenic diet

Refrigerate foods after purchase, avoid buffets, thaw food in the fridge

What do worry about for patients on a Neutropenic diet?

Foodborne illnesses

Diarrhea with Chemo

Increase fluids, use the BRAT diet (Bananas, Rice, Applesauce, Toast)

Diet for Nephrotic Syndrome

Low fat, low cholesterol, moderate protein 0.8 g/kg protein sparing

What is being loss in a patient with Nephrotic syndrome?

Urinary losses of albumin

How to calculate fluid allotment for patients with kidney disorders

Urine output + 1000mL

When should Urimic patients eat?

In the AM; they feel best in the morning so get calories in early

Chronic Kidney Disease (CKD) patients protein intake

cut back to 0.8 g/kg

Recommendations for patients with kidney stones

Limit sugar sweetened beverages, adequate calcium, low sodium/adequate protein, at least 2L /day fluid

What to watch for in Acute Kidney Injury (AKI)

K+ levels rising

What is the best way for kidney patients to receive an iron supplement?

Best done via IV for dialysis patients

When can a normal diet be resumed for patients who underwent a kidney transplant?

1-3 months post op

What is needed at the beginning of post op for kidney transplant patients?

Extra protein intake for healing

Fluid requiremnets post kidney transplant

No restrictions

Mediterranean diet

High in unsaturated fat (40%), fish oils, nuts, avocado oil, helpful in lowering LDL

Processed foods are highest in...

Sodium

Example of processed foods

Processed cheese, canned soup

Recommendations for a patient trying to avoid processed foods

Stick to the perimeter of the grocery store, because the center of the grocery store has food very high in sodium

What does saturated fat increase?

LDL

Examples of food high in saturated fats

Red meat, butter, fried foods, things from fast food restaurants

Heart healthy protein

Fish

Main Difference between DASH and Mediterranean?

Mediterranean is high in fat, but that fat in unsaturated

DASH diet is high in potassium to help...

Lower blood pressure

When there is higher potassium there is lower sodium in the body; this helps what?

Lower blood pressure

How can a patient nutritionally prevent CVD?

Avoid red meats/processed meats