Nutrition Exam 2

Pataasin ang iyong marka sa homework at exams ngayon gamit ang Quizwiz!

What are the six things that can alter someone's fluid requirements? Be able to describe each to the level covered in the lecture.

-Surrounding environment like temperature and altitudes -activity level -functional losses -age and metabolic need -caffeine/ medication

calcium metabolic functions

-absorption of b12 -activation of lipase activation of protein-splitting enzymes -secretion of insulin -regulation of cell membrane permeability

how does potassium effect metabolic reactions

-converts glucose into glycogen -store nitrogen -released insulin

What are the tips provided for helping to relieve nausea and vomiting during pregnancy (used to be called morning sickness)?

-eat small frequent meals/snacks -Fluid intake between meals also prevent an empty stomach -Avoid strong odors and foods that trigger nausea -Try ginger or vitamin B6 supplements -Hyperemesis gravidarum-Report to clinician

sx of water intoxication

-low Na+ -Edema -lung congestion -muscle weakness -Decreased mental alertness -sleepiness -loss of appetite -Poor motor coordination -Confusion

ACE inhibitors

-pril; prevents ace enzymes, reverses the process of the RAA and ADH system and lowers BP

which role does magnesium have in the body

-secretion on thyroxine -nerve impulses -cofactor in activating amino acids -essential constituent of cell proteins

WHO growth charts cover what ages

0-2 years

water requirements of 0-6months

0.7l

How much protein do adults younger than 65 years old need?

0.8 per kg/day

water requirements of 1-12 month

0.8l

How much protein do adults ≥ 65 years old need daily

1-1.5 per kg/day

average wt gain recommended during 1st trimester

1-5lbs

failure to thrive usually affects those ages:

1-5yrs

vegetarians need ____ more iron due to lower bioavailability of iron form plant sources

1.8x

UI of fluoride

10mg/day to avoid fluorosis

average wt gain recommended during 2nd and 3rd trimester based on obese bmi

11-20 lbs

Premature infants have energy needs between

110 and 130 kcal/kg/day.

UL iodine

1100mcg

RDI for zinc

11mg/day for men 8mg/day for women

How long is recommended to exclusively breastfeed?

12 months

women between 50-70 require how much calcium

1200mg

An absolute minimum requirement of _____ of carbs per day for children and adults is recommended and necessary for normal brain function.

130g

average wt gain recommended during 2nd and 3rd trimester based on overweight bmi

15-25 lbs

What are the recommended U.S. physical activity guidelines for reducing risk of chronic disease later in life?

150-300 mins moderate activity/week or 75-150 mins vigorous activity/week

DRI for vit d for lactating mothers

15mcg/day

iron rda increases during pregnancy from

18 to 27mg/day

RDI of sodum

19-50 years: 1.5 g 51-70 years: 1.3 g 71+ years: 1.2 g

how many pounds per week should you gain in 2-3 trimesters

1lb/week

outpatient wt recommended wt gain for anorexia

1lb/week

inpatient wt recommended wt gain for anorexia

2-3lbs/week

What are the average daily water requirements for sedentary women

2.7L(91oz)

How much of peak bone mass is deposited as a fetus and depends on the mother's diet?

20-40%

DRI chloride

2300 mg or 2.3 g

Sodium UL

2300 mg/day

When does gestational diabetes get screened

24-28 wks, second trimester or symptomatically

average wt gain for healthy bmi

25-35lbs

how many elements are essential minerals in human life

25/118

average wt gain recommended during 2nd and 3rd trimester based on underweight bmi

28-40 lbs

What are the average daily water requirements for sedentary men

3.7L(125oz)

According to MyPlate.gov, __ % of a child's plate should be vegetables.

30

At what age does a gradual loss of functioning cells result in body composition changes such as increased muscle mass loss?

30

calorie prescription for treating anorexia

30-40 kcal/kg/day

What percentage of daily calories are recommended to come from fat for 1-3 years olds?

30-40% cals from fat

what is the additional daily calorie needs during the second trimester

340 kcal/day

extracellular water comprises

35%

what is the daily fluid requirement for a woman who is breastfeeding

3L/day

when is the last day gestational age can be determined for neonates over the age of 26 weeks

4 days of birth

when should you start introducing solid foods

4-6 months

RDI potassium

4.7 g/day

what percentage of ault peak bone mineral density is depostied during adolescene

40

upper limit of zinc

40 mg/day

When does a more rapid decline in basal metabolic rate start in life for men?

40 yrs

how much of peak bone mass is deposited as an adolescent

40%

1. When should you start providing an infant with Vitamin D supplementation and when can you stop giving the Vitamin D supplementation?

400 IU vit D daily at hospital discharge until drinking 16oz of vit d fortified milk

magnesium requirements

400-420 mg/d for males, 310-320 mg/d for females

UI for vitamin d

4000 IU/day

how much daily folic acid should women take who are capable of becoming pregnant

400mcg/day

when does menopause occur

45-55

what is the additional daily calorie needs during the third trimester

450 kcal/day

the national standards for nutrition needs for older adults are based on which estimated percentage decrease in metabolic activity during the middle and older years

5%

How much fluid do athletes need to hydrate with prior to exercise?

5-10ml/kg of body wt 2 hours prior

How much fluid do athletes need to hydrate with after exercise

5-7mL water/kg body wt at least 4 hours before working out

When does a more rapid decline in basal metabolic rate start in life for women?

50 yrs

normal milestones of growth length by one year

50%

What was the reference population used to develop the WHO charts specifically

6 different countries

solid food introduction

6 months

which infant would require vit d supplementation

6 months being breastfed

Commodity Supplemental Food Program

60+ for socioeconomically disadvantaged, provides food packages to supplement a diet with foods that are high in nutrition

what is the recommended dietary allowance for vitamin d

600 IU/day but we really are only consuming 188IU

dri of vit d for <80yrs

600IU

intracellular water comprises

65%

What does the pH of a body fluid tell us? What is the blood pH compatible with life?

7 .35-7.45 (blood) is neutral

how does iron contribute to hemoglobin synthesis

70% of iron is found in hemoglobin in RBCs also found in myoglobin in muscles

children need between ______________ to ensure normal growth and development.

80 and 120 kcal/kg per day

During the first 3 years of life, the child's energy needs are between

80 and 120 kcal/kg/day.

dri of vit d for >80yrs

800IU

rda for copper

900mcg/day, found in meat

what is considered low vit d

<30 nmol/l

food sources of sulfur

Animal protein foods such as meat, eggs, milk, and cheese, also found in legumes and nuts.

Hemachromatosis

Autosomal recessive disorder that results in iron overload, even though iron intake is within the normal range

why does an infant need iron-fortified foods introduced at ~ 6 months of age

Because they need more iron after six months, breast milk doesn't cover it

what medical conditions result in failure to thrive

CNS disorders Endocrine disorders Congenital defects Partial intestinal obstructions

chemical name for vitamin d

Calciferol

nutrition requirements for adolescents female

Calories: 2200 kcal/day Protein: 45 grams/day Calcium: 1300 mg/day

nutrition requirements for adolescents male

Calories: 2500-2900 kcal/day Protein: 45-59 grams/day Calcium: 1300 mg/day

functions of magnesium

Cofactor for over 300 enzyme systems (catalysis of reactions that produce energy) protein synthesis (nutrient transport) muscle action basal energy expenditure

What are four social programs that exist in the U.S. to help older adults have access to nutritious foods?

Congregate nutrition services home delivered nutrition SNAP seniors farmers market program

What type of fat specifically are children and adolescents under consuming?

EPA and DHA

functions of copperzinc

Energy production Hemoglobin synthesis Iron absorption and transport Nerve and immune system function

clinical manifestations of IDA

Fatigue Cool extremities Dyspnea Activity intolerance Cold intolerance Tachycardia Tachypnea Pallor

eating attitudes

Food aversions Safe, risky, and forbidden foods "Magical thinking" (i.e., irrational thoughts and beliefs) Binge trigger foods Ideas about portion sizes Refusal to eat a food lacking a nutrition label

molybdenum

Functional catalytic component in several cell enzymes Involved in oxidation-reduction reactions

why are infants susceptible to water loss

Greater fluid requirements (due to high metabolic rate) Higher evaporative losses (due to a higher ratio of surface area to volume) Inability to communicate thirst or seek fluid

selenium toxicity sx

Hair loss Joint pain Nail discoloration GI upset

risk factors of BED

Hypothalamic dysfunction Genetic mutation causing food addiction Low levels of serotonin sexual abuse in childhood, frequent comments about wt

Decrease in HGH alone can result in:

Increased fat mass (especially centrally located) Decreased lean muscle mass Diminished muscle strength Decrease physical energy and stamina

eating habits

Intake pattern: the number of meals and snacks eaten and how they are consumed (sitting, standing, in front of a computer, etc.), time of day when eating or restricting intake, duration of meals and snacks, eating environment and company Food group avoidance, especially foods with higher energy density Diet variety from all food groups Fluid consumption: restricted versus excessive, types (caloric, noncaloric, water as beverage)

how does magnesium contribute to protein synthesis

Magnesium is a cofactor for enzymes that activate amino acids for protein synthesis. It also assists in the synthesis and maintenance of DNA

what are the defining characteristics of vitamins

Must be a vital, organic substance (that is not a macronutrient) and is necessary to perform a specific metabolic function or prevent a deficiency disease. 2. The body cannot manufacture it insufficient quantities to sustain life, so the diet must provide it.

food sources of molybdenum

Organ meats Milk Whole grains Leafy vegetables Legumes

what protects a tocopherol

PUFAs

Neuromotor Problems associated with failure to thrive

Poor sucking reflex Abnormal muscle tone Eating, chewing, and swallowing problems

night eating syndrome

Recurrent episodes of night eating, as manifested by eating after awakening from sleep or by excessive food consumption after the evening meal. causes significant distress and/or impairment in functioning.

Vitamin A aka

Retinol

active form of vitamin a

Retinol

eating behaviors

Ritualistic behaviors Unusual food combinations Atypical use of condiments and seasonings Atypical use of utensils or use of utensils to consume a finger food Excessive use of artificial sweeteners

clinical signs of bulimia

Scars and calluses on hands/knuckles Dental enamel erosion Peripheral edema palpitations edema gerd

primary extracellular cation; regulated nutrient transport

Sodium

disulfide bonds

Strong chemical side bonds that are essential to collagen and connective tissue formation

vitamin E chemical name

Tocopherol

ballard scale

Used to determine gestational age POSTNATALLY(after birth)

ergocalciferol is

Vitamin D2

Cholecalciferol is

Vitamin D3

if the solute concentration outside the cell increases, what will happen to the movement of water between the compartments

Water will move from the cell into the extracellular space.

chromium food sources

Whole grains Cereal products Brewer's yeast

how does phosphorous contribute to acid-base balance

a chemical buffer that helps maintain ph homeostasis of body fluids

wilson disease

a congenital disorder that causes a person to retain excess copper. can result in liver and nerve damage that leads to death, if not treated.

menkes disease

a genetic disorder of copper transport that creates a copper deficiency and results in brittle hair, poor muscle tone, poor feeding, low temp

which factors increase intestinal absorption of minerals

a healthy GI tract eating foods from animal sources

how are fat-soluble vitamins transported and absorbed

absorbed by intestinal cells, along with dietary fat, as micelles. Incorporated into chylomicrons inside intestinal cells. Chylomicrons then enter the lymphatic system, and eventually the bloodstream.

how does calcium contribute to metabolic reactions

absorption of b12 and secretion fo insulin by pancreas

what will kidneys do if blood pH is too acidic

accept more hydrogen ions from blood in exchange for a sodium ion (which are more basic) to balance high acidity

in which metabolic process in phosphorus involved

acid base balance energy metabolism tooth formation

which effect on health is caused by a very low calorie diet

acidosis and electrolyte imbalance

calcitriol

active form of vitamin d; maintains calcium balance in the body

carbonic acid buffer system

adds or removes H+ compensating for either excess or shortage of H (h20 or co2)

the renin-angiotensin-aldosterone system causes what hormone to be released from the pituitary gland

adh

signs/symptoms of vitamin b2 riboflavin deficiency

affects areas of rapid cell generation cracked lips and corners of mouth swollen tongue burning and itchy eyes scaly greasy dermatitis

what are the recommendations for preventing food allergies when introducing solid foods?

after age two, slowly incorporate foods one at a time, every 3-5 days

when do sx of water dehydration become apparent

after loss of 1-2% of normal body wt

factors that influence water content

age (greater in infancy) gender M>F ratio of muscle to fat (muscle contains more water than fat

active form of vitamin e

alpha-tocopherol

How much additional protein is needed during pregnancy?

an additional 25 g, equals about 71g/day

when would you recommend someone rehydrates with both fluid and electrolytes (sodium and chloride) versus with only plain water?

an endurance athlete who is exercising longer than 90 minutes, especially in hot weather

iron deficiency

anemia; 33% of world population

food sources of phosphorus

animal foods, meat, fish, poultry, eggs, milk, plants (decreased ability to be absorbed due to oxalic acid)

phylloquinone

antidote used for excessive anticoagulant drug doses

selenium functions

antioxidant enzyme fucntion protects the lipids in the cell membrane

two main functions of vitamin e

antioxidant action and collagen formation

potential roles of phytochemicals

antioxidant, anti-inflammatory, hormonal actions, interactions w/ enzymes, dna replication, antibacterial effects

in which forms do minerals exist in the body

as part of vitamins, as charged molecules, and molecularly bound to other minerals

chemical name of vitamin c

ascorbic acid

how does calcium help blood clotting

assist in the formation of fibrin, which forms the protein matrix of blood blots

Acrodermatitis enteropathica

autosomal recessive zinc absorption impaired diarrhea, dermatitis, alopecia in infants

what two vitamins need to be increased during pregnancy

b9(folate) and vitamin D

why do infants receive a vitamin k injection at birth

because they don't have the hut bacteria that helps produce vit k

signs/symptoms of vitamin b1 thiamin deficiency

beri beri( i cant, i cant), wernike encephalopathy (alcohol induces deficiency causes debilitating brain disorder

during chloride shift, which ions move out of RBC and into the plasma as chloride moves into RBC

bicarb

what does transferrin do

binds and carries iron throughout the body

phytochemicals

bioactive organic molecules found in plants

Inadequate zinc intake leads to

birth defects, poor cognitive development after birth, poor wound healing, compromised immune system, dermal and epidermal tissue breakdown

Vitamin A deficiency can cause

blindness/ocular diseases risk factor for death from measles and diarrhea

vitamin k functions

blood clotting and bone development

four key functions of calcium

bone and tooth formation blood clotting muscle and nerve action metabolic reactions

Phosphoruous functions

bone and tooth formation energy metabolism acid-base balance

hypophosphatemia results in

bone loss, which is characterized by muscle weakness, loss of appetite, fatigue and pain

Vitamin A toxicity

bone pain, dry kin, fatigue, anorexia, hair loss

what does phosphorus toxicity cause

bone reabsorption

selenium food sources

brazil nuts, fish, meat, eggs, whole wheat bread

which food has the highest water content

broccoli

which substance directly controls calciums intestinal absorption and its use

calcitonin, vit d and parathyroid hormone

active form of vitamin D

calcitriol

which mineral supplement is recommended for mothers expecting multiple births

calcium

what two minerals need to be increased during pregnancy

calcium and iron

functions of vitamin d

calcium and phosphorous homeostasis and bone mineralization

examples of functional foods

calcium fortified orange juice, folate enriched bread, soy based foods

muscle contraction and relaxation require what for stimulation

calcium ions

How does vitamin a cause liver injury

can cause liver injury due to portal hypertension and ascites

what does the body do to b carotene

can convert half of it to active form, retinol.

what is the preferred energy source for infants, children, and adolescents?

carbohydrates

what happens if iron toxicity is left untreated

causes free radical damage that cannot be adequately neutralized by antioxidants

menopause results in

cessation of estrogen and progesterone

water is required for which actives in the body

chemical reactions distribution of heat transportation of solutes

risk factors of bulimia

childhood sexual abuse, childhood physical abuse, or post-traumatic stress, recent sexual assault childhood obesity

sodium deficiency can also lead to

chloride deficiency

name the anions

chloride, bicarbonate, phosphorus and sulfate

When teaching patients with diabetes, which trace mineral should the nurse include as being important for its effect on insulin?

chromium

Kashin-Beck disease

chronic arthritis and joint deformity cause by selenium deficiency

what two conditions lead to vit k deficiency

chrons disease and chronic antibiotic use

food sources of vitamin c

citrus fruits and veggies, pineapples bell pepper oranges lemons

food sources of vitamin b12

clams, eggs, tuna, salmon, milk

foods that impair iron absorption

coffee, tea, dairy, soy, eggs

what are the negative consequences of not consuming enough of EPA and DHA essential fats early in development?

cognitive development and learning delays

which cue is associated with general symptoms used to help diagnose an eating disorder

cold intolerance, fatigue

functions of vitamin c

collagen synthesis and blood vessel wall regulation, iron redutant, antioxidant

how to help sodium deficiency from strenuous exercise

commercial sports drinks which supplement sodium and glucose

which are functions of phosphorus in the body

component of DNA ph balance calcification of bones and teeth stores energy as ATP

iodine

component of thyroxine T4, a hormone made by the thyroid gland that helps control the BMR.

cretinism

condition of congenital hypothyroidism in children that results in a lack of mental development and dwarfed physical stature; the thyroid gland is either congenitally absent or imperfectly developed

how does magnesium contribute to muscle action

conduction of nerve impulse for cardiac and muscle contraction

poor zinc intake in pregnancy can result in

congenital malformations

which meal program is most appropriate for a physically active older adult who is socioeconomically stable

congregate nutrition services

how can you enhance absorption of iron

consuming vitamin c and eating moderate amounts of lean meats, fish, and poultry in the same meal.

how does calcium contribute to bone and tooth formation

contains 99% of the body's calcium

why should you wait until 1 year to introduce cows milk

contains high amounts of calcium which inhibits iron absorption

excessive zinc leads to

copper deficiency

The renin-angiotensin-aldosterone-system

corrects hypovolemia by slowly increasing blood volume by reabsorbing sodium in the kidneys, which leads to water retention and vasoconstriction which increases blood pressure

which medication may increase water intake requirements

corticosteroid, anticholinergic, snri

food sources for riboflavin (b2)

cows milk

hindmilk

creamy, high in fat and other nutrients

what must happen for the active form a vitamin d to be made

d2 and d3 must be activated in two successive hydroxylation reactions

Severe hypomagnesemia can cause

death through cardiac arrhythmia

Why might Vitamin B12 supplementation need to be provided to older adults by subcutaneous injection?

decrease in digestive juices to be able to absorb vitamin d, injections will bypass GI tract for better absorption

Why are older adults at risk for dehydration?

decreased kidney function thirst response is blunted changes in hypothalamus

reduction of thirst in elderly is caused by

decreased production of ADH by the hypothalamus

hypocalcemia

deficient calcium in the blood that can result in muscle spasms, tetany that can progress to seizures and dementia

hypokalemia

deficient potassium in the blood; often due to prolonged diarrhea/vomiting, severe malnutrition, misuse of laxatives or surgery.

what can cause chloride toxicity

dehydration

iodine deficiency in childhood can lead to

delayed growth and onset of puberty

What is the leading cause of unintentional weight loss for older adults?

depression

what is first line treatment for GDM

diet and exercise

which clinical assessment finding leads the nurse to believe that a patient has hypokalemia

difficulty breathing, bloating and irregular heart beat

decreased secretion of digestive juices results in

diminished absorption and bioavailability of nutrients

normal milestones of growth length by 4 years

double birth length

normal milestones of growth weight by 6 months

double birth weight

albumin

draws water inside blood vessels to maintain equilibrium of the solute concentration between the fluid compartments

xerostomia

dry mouth

why do woman require extra iron

due to menstration

why do people who smoke or vape need additional vitamin c

due to oxidative stress from free radicals damage from the smoke, an additional 35mg of vit c is recommended to stabilize free radicals

What are two interventions an individual can do to decrease the amount of skeletal muscle mass loss at this age?

eating an adequate amount of protein, regular exercise

binge eating disorder

eating large amounts of food in a short amount of time. -no food control -secretly eat -guilt and shame The constant dieting and weight gain place these people at risk for alcohol and drug abuse.

food sources of folate

edamame, fortified breakfast cereals

sodium toxicity

edema, acute hypertension

good sources of vitamin a

eggs, milk, carrots, sweet potatoes, cantaloupe (orange foods), spinach, broccoli

who is most at risk for dehydration

elderly due to associated changes in hypothalamus and kidneys

What are the two particles that control water balance in the body?

electrolytes and plasma proteins

decline in insulin production and sensitivity in older age can cause

elevated blood glucose and DM

rhodopsin

enables the eye to adjust to different amounts of available light; retinal is part of this

sulfer makes high energy bonds that make metabolic reactions

energetically favorable

People particularly susceptible to dehydration include those who

engaging in intense exercise, those who have severe cutaneous compromise, infants, and older adults.

manganese functions

enzyme used for CHO amino acid and cholesterol metabolism formation of bone and cartilage as well as wound healing associated with serum ferritin concentrations

sulfur functions

essential element in protein structure

MNA

evaluates risk for malnutrition

hyperkalemia

excessive potassium in the blood due to excessive intake or IV administration of potassium; can lead heart to weaken to the point of cardiac arrest

dietary requirements of vitamin D vary due to

exposure to sunlight, latitude of residency, melanin concentration

where is chloride found in the body

extracellular fluidmagn

anorexia

extreme aversion to food, Severe weight loss Decreased basal metabolic rate. affects girls more than boys

Effects of hypothyroidism

fatigue, depression, weight gain, cold intolerance, infertility, thin and course dry hair and skin, low and husky voice

what is the back up energy source for infants, children, and adolescents?

fats

good food sources for vitamin d

fatty fish, fortified milk, plant milks, mushrooms, margarine

iron is stored as ___________ in the liver, spleen and other tissues

ferritin

foremilk

first breast milk received in a feeding, watery and low in cals.

anorexia risk factors

first degree relative with AN, BN, or depressive disorder, higher rates in monozygotic twins. obsessive traits in childhood

antidiuretic hormone (ADH)

first line of defense against hypovolemia; synthesized by hypothalamus and stores in pituitary gland, conserves water by telling kidneys nephrons to increase absorption of water and constrict blood vessels resulting in normal blood volume and osmotic pressure

chemical buffer system

first line of defense against pH shift; when strong acid added to a buffered solution, the base partner reacts with acid to form a weaker acid (acid+alkalline base)

during which two stages is growth the greatest

first six months and onset of puberty

food sources of fluoride

fish products, tea, crab, shrimp, raisins, grape juice, cream of wheat, grits, oatmeal

What are the best food sources of EPA and DHA

fish, seafood, egg yolks, and algae

What are the best food sources of EPA and DHA?

fish, seafood, egg yolks, and algae

if folate or folic acid found naturally in food

folate

Is folate or folic acid better absorbed?

folic acid

are foods fortified with vitamin b9 (like grains) fortified with folate or folic acid

folic acid

is folate or folic acid more easily absorbed

folic acid

which food should be avoided when taking monoamine oxidase inhibitor

foods containing tyramine like cheese, cured meats, and soy products

where is the active form of vitamin a found

foods of animal origin, eggs

what are functional foods

foods that have some kind of health benefit beyond basic nutrition. For example it might prevent some kind of disease

colloidal osmotic pressure

force for attracting water; low levels lead to water going where it shouldn't ; doesn't get drawn into cells resulting in edema

how does calcium contribute to blood clotting

formation of fibrin, a protein produced in response to bleeding to form blood clots

fluoride

forms strong bonds with calcium so accumulates in calcified body tissues, such as bone and teeth.

Where is intracellular fluid found in the body?

found inside of cells 2/3 total body water

two basic forms of minerals in body

free ions, covalently bound to another mineral or organic substance

how can vitamin d3 be made in the body

from a compound in the epidermis called precursor 7-dehydrocholesterol when it is exposed to ultraviolet light.

food sources of potassium

fruits and vegetables, potatoes, milk products, bananas and oranges

what food group is most important to consume while taking thiazide diuretics

fruits and veggies because diuretics can cause excess loss of minerals including potassium

What is the purpose of diuretic medications?

gets rid of excessive fluid and lowers blood pressure

iron is necessary for

glucose metabolism collagen and purine synthesis conversion of beta carotene to active vitamin a

Iodine deficiency

goiter and brain damage

toxicity of molybdenum can cause symptoms similar to

gout

What blood pH would indicate a state of alkalosis?

greater that 7.45

food sources for pyridoxine (b6)

grilled chicken, pistachios

the nurse knows that sulfur enhances the structure of which body part

hair skin and nails

calcium ions are vital for communication between what kind of cells

heart muscle and neurotransmitters

Sx of Hypokalemia

heart muscle weakness, possible cardiac arrest, respiratory muscle weakness causing sob, poor intestinal muscle tone with bloating

chloride functions

helps maintain water balance (follows sodium) helps with acid base balance and digestion (hydrochloric acid in stomach maintains ph)

how does fluoride protect teeth

helps resist erosion from bacteria

how do we screen iron deficiency

hematocrit, hemoglobin, serum iron, transferrin, ferritin

what are the two forms of iron

heme and nonheme

functions of irons

hemoglobin synthesis and general metabolism

> 98th percentile is _____ wt for length WHO

high

girls who mature earlier are at _______ risk for obesity

higher

potassium toxicity

hyperkalemia

Obesity can lead to gestational diabetes and increase the risk of the baby being born with

hypoglycemia and respiratory distress.

antihypertensive medications can cause

hypokalemia

potassium deficiency

hypokalemia

sodium deficiency

hyponatremia sodium loss due to heavy exercise

Why is hydrating with plain water only after prolonged exercise with significant sweating potentially dangerous?

hyponatremia, not replenishing the loss of sodium from sweat

clinical signs of anorexia

hypotension, bradycardia, cols, fatigue, hypercholesterolemia, hypoglycemia, menstrual irregularities, abdominal pain and bloating

defiency or tocity of iodine can lead to

hypothyroidism; greatly reduces BMR

which foods will provide a good source of calcium

ice cream, collard greens, and calcium fortified orange juice

zinc

immune system mineral

chromium deficiency can result in

impaired glucose metabolism

where can you find b carotene (vit a)

in yellow, orange, and dark green foods

causes of iron deficiency anemia

inadequate intake excessive blood loss loss of HCI which frees iron for GI absorption presence of inhibitors or iron medical conditions that affect GI lining

sx of menopause

increase of body fat, decrease of lean muscle tissue and increases risk of heart disease and osteoporosis

during pregnancy, is iodine needs increased or decreased

increased

midmilk

increased fat content

what happens if you introduce solid foods before four months

increased infant adiposity and childhood obesity

how do fats change during pregnancy

increased requirement of essential fatty acidsfla

hyperventilation balances pH by

increasing the release of CO2 (an acid) combating acidosis

cause of manganese toxicity

industrial occupations inhaling it, and over nutrition in parenteral nutrition

Do children need more or fewer daily calories coming from fat than adults

infants needs higher amounts of fat than adults

who is at risk for water intoxication

infants, athletes, and pateints with polydipsia

which risk is associated with lipectomy procedures

infection, large disfiguring skin depressions, blood clots, circulatory problems

electrolytes

inorganic, single mineral elements that carry electrical charges (cations and anions) that help maintain the body's fluid balance

water forms the basis of which type of body fluid that is also composed of sodium and chloride

interstitial fluid

how does potassium contribute to water balance

intracellular electrolyte holds water inside cells and counterbalances osmotic effect of sodium

water forms the basis of which type of body fluid that is also composed of potassium and phosphates

intracellular fluid

hydroxylation

introduces a hydroxyl group into an organic compound

what is the most common deficiency causing preventable brain damage during pregnancy

iodine

how does sodium contribute to maintain water balance

ionized sodium is the major electrolyte in extracellular fluid, variations in sodium control the movement of water across the membrane by osmosis

Why can pregnant women who are otherwise healthy develop a normal physiologic type of anemia related to pregnancy?

iron deficiency

minor minerals

iron, iodine, zinc, fluoride

dietary needs during lactation

kcals/day increase to 330 kcals/day during the first six months and 400 kcals/day in the second six months of lactation Fluid 3L Increased of vit D, b12, and zinc

what usually causes hyperkalemia

kidney dysfunction not appropriately wasting

chronic dehydration results in

kidney infections, kidney stones, gallstones, and constipation

vit d toxicity

kidney stones, calcification of soft tissues, fragile bones

how does the urinary system help balance pH

kidneys can adapt to secrete either more or less hydrogen ions

why is the cleaning your plate method problematic

kids appetites will vary in childhood, they often don't need any many cals as parents think they do. This can lead to bad relationships with food and overeating/binge eating.

iron toxicity

leading cause of poisoning of children in the u.s.

good food sources of vit k

leafy greens

more or less iodine is required for infants and children

less

what do minor minerals mean

less of these in the body than major; less than 100mg/day

What blood pH would indicate a state of acidosis?

less that 7.35

if you have more melanin do you get less or more vitamin d

less; acts as a sunscreen to not absorb ultra violet rays that activate vit d

which food has a water content of 90% or higher

lettuce, cantelope or squash

What are the five lifestyle interventions listed on the lecture slide that can prevent chronic diseases as you get older

limiting/stopping smoking increased intake of fruits/veg lower diet of sat fat and sodium regular exercise limit alcohol intake

What is colostrum, when is it produced, and what are the benefits to the baby?

liquid gold, first lactation, includes nutrients, antibodies, growth factors, proteins, yellow color due to vitamin A, provides first immune boost and laxative to remove meconium. contains about 20% protein

water intake

liquids consumed food consumed end product of cell oxidation

where does the hydroxylation reactions occur for vitamin d production

liver and kidneys

the highest concentration of selenium found in the body are

liver, kidneys, heart and spleen

which medications if fda approved for us in patients who are obese/and or have type 2 diabetes

lorcaserin, phentermine/topiramate

when does dehydration require medical attention

loss of 10-11% body weight

sx of hypophosphatemia

loss of appetite, fatigue, pain

What does sarcopenia mean?

loss of lean muscle mass associated with aging

<2nd percentile is ____ wt for length WHO

low

what are some potential adverse effects of diuretics related to water and electrolyte balance?

low blood pressure, dehydration, and hypernatremia

Hypovolemia

low blood volume

Hyponatrimia

low sodium in the blood causes acid-base imbalances causing muscle cramps, nausea/vomiting, confusion, coma and death

the more hydrogen ions a solution has, the _________ the pH

lower

zinc toxicity can can alter

lymphocyte function and cause nausea, vomiting and epigastric pain

excess calcium interfers with the absorption of

magnesium, zinc, and iron

plasma proteins

mainly albumin and globulin, organic large molecules that are to large to diffuse so they stay in the blood to regulate solute concentration

where is vitamin a stored

mainly liver, found in eyes, lungs, skin, spleen and testes

manganese is mostly found in

mainly plant sources, also cereals tea and whole grains

functions of sodium

maintain water balance muscle action nutrient absorption

MNA less than 7

malnourished

bulimia

manifests as gorging on large quantities of food, followed by compensatory mechanisms to purge. Alternating binging and dieting. Dieting and inappropriately compensating by: -Vomiting what they have eaten -Using laxatives and diuretics -Fasting -Performing extreme exercises

greatest source of zinc

meat such as beef. low fat millk, peanut butter and oysters

RDA for iron

men and woman 8mg/day woman 19-50 18mg/day

intestinal bacteria form of vitamin k

menaquinone

how does magnesium contribute to basal energy expenditure

mgATP involved in the secretion of thyroxine to maintain a normal metabolic rate and adapt to cold temps

food sources of calcium

milk and milk products, calcium fortified soy products, bokchoy, collard greens and kale

What is a commonly used assessment tool to screen for malnutrition in older adults in a clinical setting? Is this used to diagnose malnutrition?

mini nutritional assessment short form; for screening not diagnosis

Does the amount of carbohydrates needed daily stay the same, increase, or decrease during pregnancy?

minimum increases to 175g/day

hemolytic anemia

more blood cells being broken down than are being made

what do major minerals mean

more of these found in the body than trace; more than 100mg/day

heme iron

most efficently absorbed; found in 40% of animal foods, no plant foods

What are the other signs of readiness for solid foods other than age

motor skills, opening mouth in anticipation for food, baby itself is large enough, can actually process swallowing foods(not pooling in front of mouth)

how does calcium contribute to muscle and nerve action

muscle contraction and release of neurotransmitters from neuron synapses

which change in a toddler most requires an adequate dietary supply of protein, minerals and vitamins

muscle development

sx of mag deficiency

muscle weakness tetany Ventricular arrhythmia growth failure (in children)

Keshan disease

myocardial disease caused from selenium deficiency that primary affects young children and women of child bearing age

food sources of sodium

naturally occurs in food, table salt, processed foods

clinical manifestations of iron toxicity

nausea, irritability, vomiting, diarrhea GI bleeding damage to liver

toxicity of magnesium

nausea, vomiting, diarrhea

how does phosphorous contribute to energy metabolism

necessary for controlled oxidation of carbs, fats, and proteins to release energy

a preterm infant who consumes breast milk from a milk bank is exposed to which risk

necrotizing enterocolitis

how does vitamin k help bone development

needs vit k for osteocalcin to bind to calcium to form bone crystals

anions

negatively charged ions

manganese toxicity

nervous system disorders

signs/symptoms of folate deficiency

neural tube defects

does the fda regulate or recognize functional foods

no

MNA +12

no malnutrition

Can you be diagnosed with gestational diabetes in the first trimester of pregnancy

no, if you are it is most likely undiagnosed type 2 dm

what is the additional daily calorie needs during the first trimester

none

food sources of magnesium

nuts, soybeans, legumes, milk, bananas, cocoa, lots of veggies and unrefined grains, hard water

≥ 95th percentile for BMI-for-age CDC growth chart places individual in the

obesity category

calcium supplements best absorbed in doses ...

of 500mg or less and taken with food

how does the fda recommend supplements

only supplement if you can't meet it in your diet

which food choices are rich sources of potassium

oranges cooked halibut, roasted soybeans

chromium functions

organic complex glucose tolerance factor, which stimulates the action of insulin.

calcitrol maintains bone mineralization which lowers the risk and progression of

osteoporosis

toxicity of phosphorus can result in

osteoporosis

Calcium deficiency

osteoporosis hypocalcemia rickets tetany

Where is extracellular fluid found?

outside of the cells in body water, blood plasma, lymphatic fluid, and interstitial fluid

>= 85th and <95th percentile for BMI-for-age CDC growth chart places individual in the

overweight category

risk factors of GDM

overweight, bmi greater that 26, 30+ years old, pre disposing factors

what prevents the absorption of calcium in plants esp spinach and rheubarb

oxalic acid

what happens when there are too many free radicals

oxidative stress

food sources for niacin (b3)

peanuts, yellowfin tuna

signs/symptoms of vitamin b3 niacin deficiency

pellagra; dermatitis diarrhea dementia death

signs/symptoms of vitamin b12 deficiency

pernicious anemia, peripheral neuropathy, and glossitis

what mineral deficiency can occur from consuming significant amounts of antacids containing aluminum hydroxide

phosphorus deficiency

major form of dietary vitamin k is

phylloquinone

what prevents the absorption of calcium in grains

phytate

Where are phytochemicals found?

plant derived foods

What are the other potential causes of malnutrition in older adults?

poor food habits poor oral hygiene GI problems

decrease of melatonin leads to

poor sleep, insomnia

people with selenium deficiency usually live in geographic areas with

poor soil content of selenium

food sources for thiamin b1

pork, macadamia nuts

cations

positively charged ions

primary intracellular cation; regulated entry of another important electrolyte

potassium

what major mineral stimulates beta cells to release insulin

potassium

how does potassium effect blood pressure

potassium intake increased sodium intake to balance out blood pressure and be normotensive

food jag occurs during

pre school age children

vulnerable population for iron deficiency

pre-school age children, pregnant women

Food preferences come from parents in

preschool-aged children

D vitamins are known as

pro hormones

where is adh produced and stored

produced in the hypothalamus and stored in the pituitary

sulfur deficiency is related to

protein malnutrition

which solutes can influence the movement of water across a membrane

proteins, sodium and glucose

congregate nutrition services

provides adults who are +60 and their spouses nutritionally sound meals in senior centers and other public or private facilities

where is fluoride most commonly found

public water and toothpaste

which water soluble vitamin is involved in protein metabolism

pyridoxine (b6)

What are the symptoms of hyponatremia

rapid pulse, shallow breathing, confusion, headache, seizures, increased urine output, hyperactive bowel.

magnesium deficiency

rare but can be a result of starvation DM kidney disease long term diuretic therapy malnutrition w/ alcoholism

Deficiency of Phosphorus

rare unless using large amounts of antacids containing aluminum hydroxide (binds w/ phosphate which inhibits absorption)

food sources of iron

red meat, organs such as liver, fish and poultry, lentils and other dired beans, dark leafy greens

vitamin d3 niacin toxicity

reddened, flushed skin, itching, burning and tingling

calcitonin

reduces calcium absorption and decreases blood calcium levels

how does calcium act as an iron reductant

reduces iron from ferrous state (3+) back to ferric state (2+)

how does potassium affect muscle action

regulated contraction of cardiac and skeletal muscle cells

how does vitamin k help blood clotting

regulates concentrations of four blood clotting factors.

IGR (intrauterine growth restriction)

results from malnutrition or poor weight gain. may be caused by the moms chronic disease or infection, or substance use or abuse

hypoventilation balances pH by

retaining more CO2 to alleviate alkalosis (retaining more acid)

chronic vit d deficiency in children

rickets

Vitamin D deficiency symptoms

rickets, muscle weakness, heart disease, tb, obesity, dm, alzheimers, parkinsons

MNA 8-11

risk of malnutrition

extreme vitamin C deficiency disease

scurvy

food sources of iodine

seafood, iodized salt, cranberries, navy beans and peanut butter

what is the criteria for diagnosing hyperemesis gravidarum

sever, prolonged, and persistent nausea/vomiting; usually requiring hospitalization

Vitamin A during pregnancy leads to

severe birth defects and miscarriage

chloride toxicity cause

severe dehydration when the concentration of chloride is too great

<2nd percentile for WHO length-for-age chart places individual in

short stature category

how does phosphorous contribute to bone and tooth formation

skeletal bone mineralization, 1/2 of hydroxyapitate

which major mineral creates a dependent glucose transporter than allows the passage of glucose and galactose from the intestinal lumen into the cell

sodium

which molecule is the primary base used in the chemical buffer system

sodium bicarb

how does sodium contribute to nutrient absoprtion

sodium dependent glucose transporters allow for passage of glucose and galactose from intestinal lumen into the intestinal cells

name the cations

sodium, potassium, calcium, magnesium

major minerals

sodium, potassium, calcium, phosphorus, magnesium, chloride, sulfur (salty potato chips pretty much contain salt

describe the four functions of water

solvent, transportation, thermoregulation, lubricant

antioxidant reaction

stabilizes free radicals so less cell damage occurs ; protects PUFAs

how does the parathyroid hormone control calcium

stimulated vitamin d to increase absorption of calcium in the GI tract and to increase blood calcium levels

Zinc deficiency symptoms

stunted growth hypogeusia hyposmia poor wound healing hair loss diarrhea skin irritation compromised immune function

sources of folic acid

supplements, enriched grains, turkey and chicken liver, greens

do phytochemical work better synergistically or as isolated compounds

synergistically

how do you get chloride in the diet

table salt

which b vitamin is needed for carbohydrate metabolism

thaimin (b1)

which rationale is accurate for reestablishing a normal weight and eating pattern as a priority in the treatment of an eating disorder

the neurochemistry returns to normal

How does the FDA regulate supplements?

they regulate it with foods for safety but not with medications so no clinical trials for efficacy

sulfur is a component of which vitamins which act as coenzymes in cell metabolism

thiamin and bitotin

Boys who mature earlier tend to be

thinner

initial sx of dehydration

thirst, headache, decreased urine output, dry mouth, dizziness, impaired concentration 2% of normal weight is lost

treatment for gestational hypertension with protein >300

three full glasses of milk every day

iodine toxicity

thyrotoxicosis or iodine-induced hyperthyroidism

non heme iron

tightly bound in foods (not as efficiently absorbed) found in 60% of animal foods and all plant foods

signs/symptoms of vitamin c deficiency

tissue bleeding, poor wound healing, bleeding gums, toothloss

Why is it recommended women take folate/folic (Vitamin B9) acid prior to becoming pregnant and during pregnancy?

to decrease neural tube defects, most important in the first 28 days of pregnancy; often too late

In which age group would the child master self-feeding?

toddlers

fluorosis

toxicity of fluoride, yellowing of teeth, white spots on teeth

what is the transport protein of iron

transferrin

normal milestones of growth weight by one year

triple birth weight

infants expected growth rate (wt and ht) by first year

triples birth wt and increases in length by 50%

<5th percentile for BMI-for-age CDC growth chart places individual in the

underweight

CDC chart

used to screen infants/children for potential health or nutrition related problems who fall outside of 5th-95th percentile

WHO charts

used to screen infants/children for potential health or nutrition related problems who fall outside the 2nd-98th percentile

good food sources of vitamin e

vegetable oils, sunflower, safflower and cottonseed oil, hazelnuts and spinach.

function of vitamin a

vision, tissue strength, and immunity

advanced sx of dehydration

visual impairment, hypotension, anorexia, muscle weakness, kidney failure and seizures 10% of body weight is lost

what vitamin deficiency can folate mask

vitamin b12

The intestinal absorption of calcium is controlled by:

vitamin d, parathyroid hormone, calcitonin and estrogen

why are premature infants at risk for hemolytic anemia

vitamin e is normally stored with body fat in the last two months of gestation, without the last two months, vit e cannot provide the antioxidant protect from the rbcs breaking down

what are micronutrients

vitamins and minerals

main cause of chloride deficiency

vomiting up hydrochloric acid, excessive diarrhea or sweating

sodiums main three roles

water balance muscle action nutrient absorption

potassium functions

water balance, metabolic reactions, muscle relaxant, insulin release, blood pressure

water output

water loss through kidneys, skin, lungs, feces metabolic byproducts

electrolytes role in water balance

water(fluid) and electrolyte balances are intimately related; change in one = change in the other

thyroxine affects

weight heartbeat temp muscle contraction

treatment of calcium deficiency

weight bearing exercises medications calcium intake in diet (Mediterranean diet)

two scenarios of vitamin e deficiency

weight-loss medications (orlistat), cystic fibrosis

when do physiological buffer systems establish

when chemical buffers cannot reestablish pH equilibrium the lungs and kidneys help

recommendations for lowering risk of obesity

wide variety of nutrient dense foods fruits and veg lower in fridge limit juice and non-nutrient dense snacks have family meals limit screen time make PA a daily family thing

Can you use the WHO charts to track formula fed infant growth?

yes; although the chart was based on breastfed infants

Vitamin E deficiency is rare unless

you cant absorb or metabolize fat

which mineral plays a role in reproductions, optimal growth hormone activity and successful synptic neurotransmission

zinc


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