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AH Lewis Ch. 40

Nutritional Problems

The lower the socioeconomic status? the poorer the nutritional state
What is nutrition? the process by which the body uses food for energy, gowth, and maintenance and repair of body tissues
What are the essential components of the basic food groups? carbohydrates, fat, proteins, vitamines, and minerals
What is the body's primary source of energy? Carbohydrates
Carbs are either? simple or complex
What are two forms of simple carbs? monosaccharides and disaccharides
What are polysaccharides? Starch, fiber
One gram of fat yields how many calories? 9 calories
The daily caloric requirements of a person are influenced by? body build, age, gender, and physical activity
1 gram of protein = 4 calories
What are the units of structure for protein? amino acids
How many amino acids are there? 22essential and nonessential
The amino acids can be classified as? essential and nonessential
How many essential amino acids are there? 9
What are protein sources containing all the essential amino acids called? complete proteins
Protiens that lack one or more of the essential amino acids are called? incomplete proteins
Protiens are essential for? tissue growth, repair and maintenance, regulatory functions and energy productions
Vitamins are? organic coupounds required in small amounts by the body for normal metabolism
Vitamins do what? metabolize amino acids, fats, and carbs
What are the 2 categories of vitamins? water soluble and fat soluble
What are water soluble vitamins? Vit c, and B
What are fat soluble vitamins? A D E K
What are minderal salts? magnesium, iron and calcium
When minerals are present in little amounts they are called? trace elements
Minerals required in greated amounts are called? major minerals
Minerals are needed for the body to? build tissues, regulate body fluids and assist in various body functions
Minimal amount of minerals are called? trace
Large amounts of minerals are called? Major
What do vegetarioans exclude? red meat
What are vegans? eat only plant food
What is a lacto ovo vegatarians? eat meat and dairy
What is the primary deficincy in vegens? Cobalamin (B12)
B12 can only be obtained how? animals
What does not enough B12 cause? megloblastic anemia
Vegans may also be at risk for? iron deficiency
When assessing a pt diet history a nurse should include? cultural and ethnic considerations
A nurse should not do what when assess cultural considerations? cultural stereotyping
What is malnutrition? a deficit, exess, or imbalance of the essential componenets of a balanced diet
What terms are used to describe malnutrition? overnutrition, undernutrition
What is undernutrition? state of poor nourishment as a result of inadequate diet
What is overnutrition? ingestion of more food than is required for body needs
What is caused by not enough Vit D? rickets
What is scurvy? condition caused by not enough Vit. C, causes weakness, anemia, and oral ulcerations
Malnutrition is common in? hospitalized pt
What is protein calorie malnutrition? most common form of undernutrition and can result from primary or secondary factors
What is Primary protein calorie malnutrition? where the nutritional needs are not met as a result of poor eating habits
What is secondary protien calorie malnutrition? caused by an alteration or defect in ingestion, digestion, absorption or metabolism
Secondary malnutrition may occur because of? GI obstruction, surgery, cancer, malabsorption syndromes, and drugs
What is marasmus? deficiency of both caloric and protein intake leading to generalized loss of body fat and muscle
What is kwashiorkor? caused by a deficiency of protien intake that is superimposed on a catabolic stress event
What does the body use to meet metabolic needs? carbs
During early phase of starvation what is used for metabolic processes? protein
Once carbs are gone what is depleted to glucose for energy? protein
What are the first two amino acids to be used by the liver for the formation of glucose is gluconeogeneses? alanin and glutamine
In prolonged starvation what provides calories? fat
How long till fat is gone? 4-6 weeks
After fat is gone what is used for the increased energy needs? protein
What is the job of albumin? the maintenance of the osmotic pressure of the blood
As total blood volume is reduced the skin appears? dry and wrinkled
What is the body organ that loses the most mass during protein deprivation? liver
What contributes to malnutrition? socioeconomic statues, cultural influences, psychologic disorders, medical conditions and medical treatments
What is malabsorption syndrome? impaired absorption of nutrients from the GI tract
What contributes to malabsorption? illness, major surgery, sepsis, wounds, burns, hemorrhage, fractures, and immoblization
Who does vitamin and mineral imbalances occur? alcohol drug abuse, ill, and ppl who follow poor dietary prectices
Vitamin imbalances that cause CNS problems are usually who? growing child
Vitmain imbalances that causes PNS problems are usually who? adults
The rate that malnutrition develops depends on? the quality and quantity of protein intake, caloric value, illess and age of the person
Malnutrition in a hopital pt usually occurs because of? prolonged hospital stay and delayed recovery
Many malnourished persons are? anemic
Anemia occurs because of? lack of iron and folic acid (RBC)
What lab test is used for the diagnosis of malnutrition? albumin levels
What is a good test for nutritonal status? prealbumin levels
What decreases during states of protein dificiency? transferrin
What is steatorrhea? fatty stools seen with lowered levels of fat soluble vitamins
What is anthropometric measures? gross measurements of fat and muscle contents
What does nutritional screening do? identifies individuals who are malnourished or at risk for malnutrition
What is the purpose of nutritional screening? to determine if a more detailed nutritional assessment is necessary
When is a minimum data set form used? to obtain info about a person's nutritional status
The outcome and assessment information set is used to? prompt the nurse to cellect info on diet, oral intake, dental health, swallowing difficulties, and any needs for meal assistance
What is a nutrtional assessment? a comprehensive approach to defining nutrtional staus that uses medical, nutrtional, and medication histories
What is an easy way to determine ideal body weight? used rule of thumb method
What is BMI? a measure of weight for height
What BMI is considered overweight? 25-29
What BMI is considered obese? 30
The overall goals are that a pt with malnutrition will? achieve weight gain, consume a number of calories per day, have no adverse consequences
An undernourished pt usually needs to have? between meal supplements
The pt's ability to comple with the dietayr instructions must be examined in light of? past eating habits, religious, and ethnic preferences, age, income, other resources and state of health
What a physiologic changes with the aging that affect the nurtrtional status of older adults? Changes in oral cavity, Changes in digestion, Changes in endocrine system, Changes in musculoskeletal system, Decrease vision and hearing
Retirement or relacation to a nursing home impact? eating habits
What is tube feeding? administration of a nutritionally balanced liquefied food or formule through a tuve inserted into the stomach, duodenum or jejunum
Who may need a tube feeding? anorexic, orofacial fractures, head and neck cancer, neurologic condition that prevent oral intake, extensive burns, and while taking chemo
Enteral nutrtion is used? to provide nutrients by way of the GI tract ethier alone or as a supplement to oral or parenteral nutrition
What are delievery options of tube feedings? infusion by pump, gravity, syringe, and cyclic feeding by infusion pump
What is used for short term feeding? NG tube
What is a transpyloric tube used? physiologic conditions warrant feeding the pt below the pyloric sphincer
What protocol should be used with feeding tubes? pt position, patency of tube, tube postition, formula, administration of feeding, and general nursing considerations
How do you check tube placement? pH
How is the osmolaity of the solution determine? by the number and size of particles in solution
What are the prob associated with gastrostomy or jejunostory feedings? skin irritation and pulling out of the tube
With aging there is decreased ability to handle? glucose loads
What is parenteral nutrtion? administration of nutrients by a route other than the GI tract
What is central parenteral nutrtion? the delivery ofa nurtrtionally adequate hypertonic solution consisting of flucose, crystalline, amino acids, fat emulsion, minerals, and vitamins using a central venous route
What do base solutions of PN include? dextrose and protein in form of amino acids
Calories in PN are supplied by? carbs and fat
Overfeeding can lead to? metabolic complications
The administration of fat emulsion should be used in caution wht pt's who are in? danger of fat embolism and with pt with allergies to eggs
PN is administered by? central or peripheral veins
Central parenteral nutrtion is given though a catheter whose top lies in the? superior vena cava
PICCS are usually placed? into the basilic or caphalic vein and then advanced into the central circulation
Peripheral parenteral nutrition is administered though? a peripherally inserted catheter or vascular access device, which uses large peripheral vein
When is Peripheral Parenteral nutrtion used? when nutritional support is needed for only a short time, protein and caloric requirement are not high and the risk of a central catheter is too great or parenteral nutriton is used to supplement inadequare oral intake
All PN solutions should be prepared by a ? pharmacist or a trained techinician
What should be added after a pharmacist prepares a solution? nothing
A single lumen central catheter should not be used for the? administration of blood or antibiotics, the drawing of blood or the monitoring of central venous pressure
Complication of PN are? infection, metabolic and mechanical
What is the hallmark of refeeding syndrome? hypophasphatemia
Home nutrition therapies are? expensive
Eating disorders are primarily? psychiatric disorders
Anorexia nervosa is? self imposed weight loss, endocrine dysfunction and a distorted psychopathologic attitude toward weight and eating
improved nutrtion is not a cure for? anorexia
What is bulimia nervosa? disorder that has frequent binge eating and self induced vomiting associated with loss of control related to eating an d persistent concern with body image
What disorder includes ppl who laxative, diuretics, exercise and diet drugs? Bulimia nervosa
What is most suseptible to bulimia? women college students
Created by: alicia.rennaker