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pathopharm exam 4

CHAPTER 81

QuestionAnswer
Vitamins? Organic compoundsRequired in minute amounts for growth and maintenance of healthAre not a source of energy
VITAMINS ARE? Essential for energy transformation and regulation of metabolic processesSeveral vitamins are inactive in native form and must be converted to active compounds in the body
Intake of Vitamins? Recommended dietary allowances (RDAs) for vitamins are set by the Food and Nutrition Board of the National Academy of Sciences RDAs represent the average daily dietary intake sufficient to meet the nutrient requirements of nearly all healthy individuals (97% to 98%) in a particular life stage or gender group
Intake of Vitamins he Tolerable Upper Intake Level (UL) for a vitamin is the highest average daily intake that can be consumed by nearly everyone without significant risk of adverse effects
Intake of Vitamins The UL is an index of safety; it is not a recommendation to exceed the RDA The estimated average requirement (EAR) is the level of intake that meets nutritional requirements for 50% of the healthy individuals in any life stage or gender group
ntake of Vitamins? The acceptable macronutrient distribution range (AMDR) is a range of macronutrients (eg, proteins, carbohydrates, fats) associated with optimal health. INTAKE BELOW AMDR=IncREAS. risk of malnourishment. INTAKE ABOVE=iNCREAS. risk of chronic diseases.
Vitamins6 ARE? Fat soluble •Vitamins A, D, E, K Water soluble •Vitamin C •Vitamin B complex: Thiamin, riboflavin, niacin, pyridoxine, pantothenic acid, biotin, folic acid, cyanocobalamin
Vitamin A (Retinol) Multiple functions in the eyes Toxicity Teratogenic, birth defects, hypervitaminosis liver injury, bone-related disorders Deficiency results in: Night blindnessXerophthalmia Keratomalacia Blindness
Vitamins D and E may help protect against breast cancer, colorectal cancer, type 1 diabetes, and overall mortality. Vitamin D Regulates calcium and phosphorus Deficiency causes rickets or osteomalacia Vitamin E Antioxidant properties Dietary sources: Fresh greens, seeds, oils Toxicity may increase risk for bleeding Increased risk of hemorrhagic stroke
Vitamin K Action required for synthesis of prothrombin and other clotting factors-Deficiency produces bleeding ADR=Hypersensitivity reaction,Hyperbilirubinemia in parenteral administration to newborns Correction or prevention of hypoprothrombinemia and bleeding caused by vitamin K deficiency Control of hemorrhage caused by warfarinVitamin K9
Water-Soluble Vitamins- Vitamin C Members of the vitamin B complex: Thiamin, riboflavin, niacin, pyridoxine, pantothenic acid, biotin, folic acid, and cyanocobalaminWater
Vitamin C Action required for production of collagen and other compounds that bind cells together Part of the biochemical reaction for the synthesis of adrenal steroids
Vitamin C SourcesCitrus fruits/juices, tomatoes, potatoes, strawberries, melons, spinach, broccoliHas antioxidant propertiesFacilitates iron absorptionDeficiency can lead to scurvyVitamin C11
Vitamin B Complex Niacin (nicotinic acid) Riboflavin (vitamin B2) Thiamin (vitamin B1) Pyridoxine (vitamin B6) Cyanocobalamin (vitamin B12) Folic acid
Niacin (Nicotinic Acid) Deficiency Pellagra: Dermatitis characterized by scaling and cracking of the skin in areas exposed to the sun GI disturbancesCentral nervous system (CNS)•Irritability, insomnia, memory loss, anxiety, dementiaNiacin
ADVRSE EFFECTS Niacin (Nicotinic Acid) Small doses devoid of adverse effects Large doses•Vasodilation with flushing, dizziness, nausea Therapeutic uses As a vitamin, used only as treatment for niacin deficiencyIf given in large doses, can decrease cholestero
Riboflavin (Vitamin B2) Involved in numerous enzymatic reactionsFirst, must be changed to flavin adenine dinucleotide (FAD) or flavin mononucleotide (FMN) ADRNone for humans, no UL Therapeutic usesRiboflavin deficiency Migraine headaches Riboflavin (Vitamin B2)15
Thiamine (Vitamin B1) ActionsCoenzyme for carbohydrate metabolismRequirements increased slightly during pregnancy and breast-feedingDeficiencyBeriberiWernicke-Korsakoff syndrome
Thiamine (Vitamin B1) Wet beriberi Fluid accumulation in the legsCardiovascular complications (palpitations, electrocardiograph [ECG] abnormalities, high-output heart failure)May progress to circulatory collapse and deathRecovery is dramatic with replacement therapy
Wet beriberi Cardiovascular complications (palpitations, electrocardiograph [ECG] abnormalities, high-output heart failure)May progress to circulatory collapse and deathRecovery is dramatic with replacement therapy Dry beriberiNeurologic and motor deficits, no edema or cardiovascular symptomsRecovery is slow Fluid accumulation in the legs
Thiamine (Vitamin B1) Wernicke-Korsakoff syndrome (caused by alcoholism) Alcoholism is the most common cause of thiamin deficiency in the United States Serious CNS disorder (neurologic and psychologic)•Nystagmus, diplopia, ataxia, inability to remember recent past
Pyridoxine (Vitamin B6 Coenzyme in the metabolism of amino acids and proteinsMust first be converted to its active form, pyridoxal phosphate Sources Fortified breakfast cereals, meat, fish, poultry, white potatoes, other starchy vegetables, noncitrus fruits
Pyridoxine (Vitamin B6) Dietary deficiency of vitamin B6 is rare in the United States except in alcoholics DeficiencY May result from poor diet, isoniazid use, inborn errors of metabolism Symptoms Seborrheic dermatitis, microcytic anemia, peripheral neuritis, convulsions, depression, confusion
Vitamin B Complex resless leg syndrome may not be absorbed PO COULD BE INJECTION OR SUBLINGUAL Cyanocobalamin (vitamin B12) and folic acidBoth essential factors in the synthesis of DNA Deficiency of either manifests as megaloblastic anemia Cyanocobalamin deficiency also results in neurologic damage
Folic Acid Food folate versus synthetic folate Synthetic form is more stable U.S. Food and Drug Administration (FDA) ordered synthetic folate to be added to all enriched grain products
Folic Acid Deficiency of folic acid during pregnancy can impair CNS development Can result in neural tube defects, anencephaly, spina bifida Important for any patient who may become pregnant to take additional folic acid
Pantothenic Acid Essential component of two biologically important molecules: Coenzyme A and acyl carrier protein
Biotin Essential cofactor for several reactions involved in the metabolism of carbohydrates and fats
A nurse is preparing a class on vitamin supplementation. What statement will be included in the class content? Vitamin K is required to prevent bleeding. Vitamin K is required for the synthesis of prothrombin and other clotting factors.
In which patient will the nurse suspect a thiamin deficiency? A 42-year-old with alcoholism who has diplopia, ataxia, and memory loss with symptoms of neurologic and motor deficits.
A deficiency of which vitamin is most likely to result in visual disturbances? Vitamin A-night blindness, xerophthalmia (a dry, thickened condition of the conjunctiva), and keratomalacia (degeneration of the cornea with keratinization of the corneal epithelium).
A patient who is in the early stages of Wernicke-Korsakoff syndrome has been admitted to the healthcare facility. Upon assessment of the patient, the nurse expects to find all but which manifestation? Fixed, dilated pupils associated with severe neurologic damage or opiate drug overdose
Created by: Seka_nurse
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