Rita Marie Concannon NURS 405A ATI Nutritional Form A Flash Cards

LDL low density lipoprotein

"Bad" cholesterol because it transports cholesterol out of the liver and into the circulatory system, where it can form plaques on the coronary artery walls. The optimal range for LDL is less than 130 mg/dL. ●Optimal total cholesterol level is less than 200 mg/dL.

HDL high density lipoprotein

"Good" cholesterol because it removes cholesterol from the serum and takes it to the liver. Levels greater than or equal to 60 mg/dL provide some protection against heart disease.

GDM increases risks for

- Preeclampsia ●Cesarean delivery ●Large newborn birth weight ●Infant hyperglycemia ●Infant death ●Maternal hypertension and diabetes mellitus after pregnancy

Fluid

2,000 to 3,000 mL fluids daily from food and drinks. Preferred fluids include water, fruit juice, and milk. Carbonated beverages and fruit drinks provide little or nonutrients

Sleeve gastrectomy

A longitudinal portion of the stomach is removed to create a "sleeve" effect. Reduces the hormone ghrelin which decreases hunger. ●Bariatric surgery works best in combination with diet and lifestyle changes. Nutritional counseling is essential. ●Instruct client that dramatic changes in food intake and regular physical activity will be necessary for successful long‑term weight control

Bolus feed

A variation of intermittent feeding using a large syringe attached to the feeding tube. A large volume of formula (700 mL maximum, usual volume is 250 to 400 mL) is administered over a short period of time, usually in 15 to 30 min, four to six times daily. ●The rate of administration for a premature or small infant should be no greater than 5 mL every 10 min, and 10 mL/min in older infants and children. ●Bolus feedings are delivered directly into the stomach; they are contraindicated for tubes placed into the jejunum or duodenum. They can be poorly tolerated and can cause dumping syndrome.

Norovirus

A viral infection caused by consuming contaminated fruits and vegetables, salads prepared by someone who is infected, oysters, and contaminated water. Norovirus is very contagious, and has an onset of 24 to 48 hr. Manifestations include projectile vomiting, fever, myalgia, watery diarrhea, and headache

GERD

Abnormal reflux of gastric secretions up the esophagus. This leads to indigestion and heartburn. ●Factors that contribute to GERD include hiatal hernia, obesity, pregnancy, smoking, some medications, and genetics. ●Long‑term GERD can cause serious complications, including adenocarcinoma of the esophagus and Barrett's esophagus. ●Manifestations include heartburn, retrosternal burning, painful swallowing, dyspepsia, regurgitation, coughing, hoarseness, and epigastric pain. Pain can be mistaken for a myocardial infarction

Adjustable gastric banding:

Adjustable gastric banding: restricts stomach capacity to 15‑30mL with an inflatable band that encircles the uppermost portion of the stomach, similar to a "belt" to create an outlet that can be adjusted as needed. ◯Instruct client that diet will gradually increase from liquids to pureed to soft foods. ◯Instruct client on the importance of chewing foods thoroughly, slowly and in small amounts. ◯Micronutrient deficiencies are common long term.

Type 2 DM Risk Factors

Age older than 45 years, Hypertension, Hyperlipidemia, African American, Latino, Native American, Asian American, and Pacific Islander ethnic groups, Obesity and sedentary lifestyle, Relative who has diabetes mellitus

Dysphagia

Alteration in the client's ability to sw allow. ●Causes include obstruction, inflammation, and certain neurological disorders. ●Modifying the texture of foods and the consistency of liquids can enable the client to achieve proper nutrition. ●Dry mouth can contribute to dysphagia. Evaluate medications being taken to determine if this is a potential adverse effect. ●Clients who have dysphagia are at an increased risk of aspiration. Place the client in an upright or high‑Fowler's position to facilitate swallowing. ●Provide oral care prior to eating to enhance the client's sense of taste. ●Clients who have dysphagia should be referred to a speech therapist for evaluation. ●Dietary modifications are based on the specific swallowing limitations experienced by the client. ●Allow adequate time for eating, use adaptive eating devices, and encourage small bites and thorough chewing. ●Pills should be taken with at least 8 oz of fluid (can be thickened) to prevent medication from remaining in the esophagus. ●Avoid thin liquids and sticky foods. ●Nutritional supplements are beneficial if nutritional intake is deemed inadequate

Type 1 DM

Autoimmune disease triggered by genetic links or a viral infection. ●Damage to or destruction of beta cells of the pancreas results in an absence of insulin production. ●Usually occurs in individuals under the age of 30 whose weight is within ideal healthy body weight.

Suggested recommendations of food at developmental stages:

Birth to 4 months: Breast milk (until 6 months) or formula (at 4 months) ●4 to 6 months: Iron‑fortified rice cereal ●6 to 8 months: Vegetables, fruits or strained meats ●8 to 10 months: Fish, poultry ●9 to 12 months: Table foods (cooked, chopped, and unseasoned) ●12 months: Cow's milk, eggs, chees

Manifestations hyperglycemia

Blood glucose greater than 200 mg/dL, ketones in urine, polydipsia (excessive thirst), polyuria (excessive urination), polyphagia (excess hunger and eating), hyperventilation (Kussmaul respirations), dehydration, fruity odor to the breath, headache, inability to concentrate, decreased levels of consciousness, and seizures leading to coma.

Hyperglycemia

Blood glucose level above the expected reference range. It results from an imbalance with food, medication, and activity, combined with an inadequate amount of insulin production or cells that are insulin‑resistant. ●Infection, other illness, and stress can cause a rise in blood glucose.

Hypoglycemia

Blood glucose level below the expected reference range. It results from taking too much insulin, inadequate food intake, delayed or skipped meals, extra physical activity, or consumption of alcohol without food. ●Blood glucose of 70 mg/dL or less requires immediate action. ●Manifestations include mild shakiness, mental confusion, sweating, palpitations, headache, lack of coordination, blurred vision, seizures, and coma

Caffeine

Caffeine crosses the placenta and can affect the movement and heart rate of the fetus. However, moderate use (less than 300 mg/day) does not appear to be harmful

Food poisoning

Can result due to bacterial contamination of formula

Cholecystitis

Characterized by inflammation of the gallbladder

Heart failure

Characterized by the inability of the heart to maintain adequate blood flow throughout the circulatory system. It results in excess sodium and fluid retention, and edema

Eternal Feeding Formulas

Commercial products are preferred over home‑blended ingredients because the nutrient composition, consistency and safety can be better insured. ●Standard and hydrolyzed formulas are the two primary types of enteral feeding formulas available. They are categorized by the complexity of the proteins included.

Nausea and vomiting

Common during pregnancy. ●For nausea, eat dry crackers or toast. Avoid alcohol, caffeine, fats, and spices. Avoid drinking fluids with meals, and do not take medications to control nausea without checking with the provider. ●For constipation, increase fluid consumption (at least 8cups per day) and include extra fiber in the diet. Fruits, vegetables, and whole grains contain fiber

Hydralized formula/Elemental

Composed of partially digested protein peptides and free amino acids. ●These formulas are used for clients who have a partially functioning gastrointestinal tract, or those who have an impaired ability to digest and absorb foods (inflammatory bowel disease, liver failure, cystic fibrosis, pancreatic disorders, and for clients who have an impaired immune system). ●Most provide 1.0 to 1.5 cal/mL. High‑calorie formulas provide 1.5 to 2.0 cal/mL. Partially hydrolyzed formulas provide other nutrients in simpler forms that require little or no digestion.

Standard formulas/Polymeric/Intact

Composed of whole proteins (milk, meat, eggs) or protein isolates. ●These formulas require a functioning gastrointestinal tract. ●Most provide 1.0 to 1.2 cal/mL, but are available in high‑protein, high‑calorie, fiber‑enriched, and disease‑specific formulas

Diverticulosis

Condition characterized by the presence of diverticula. high‑fiber diet can prevent diverticulosis and diverticulitis by producing stools that are easily passed, thus decreasing pressure within the colon

Inflammatory bowel disease

Crohn's disease (regional enteritis) and ulcerative colitis are chronic, inflammatory bowel diseases characterized by periods of exacerbation and remission.

Osmolarity

Determined by the concentration of sugars, amino acids, and electrolytes. ●Osmolality is increased if the formula contains more digested protein. ●Hydrolyzed or partially hydrolyzed (predigested) formulas are higher in osmolality than standard formulas. They are also lactose‑free.

Caloric density

Determines the volume of the formula necessary to meet the caloric needs of a client (1.0 to 1.2cal/mL

Constipation

Difficult or infrequent passage of stools, which can be hard and dry. ●Causes include irregular bowel habits, psychogenic factors, inactivity, chronic laxative use, obstruction, medications, GI disorders such as irritable bowel syndrome (IBS), pregnancy, or secondary to genital/rectal trauma such as sexual abuse or childbirth, and inadequate consumption of fiber and fluid. ●Encourage exercise and a diet high in fiber (25 g/day for women and 38 g/day for men), and promote adequate fluid intake to help alleviate constipation. ●If caused by medication, a change in the medication might be necessary

Peptic Ulcer Disease

Erosion of the mucosal layer of the stomach or duodenum. ●This can be caused by a bacterial infection with H. pylorior the chronic use of NSAIDs (aspirin, ibuprofen). ●Some clients who have PUD do not experience manifestations. Others report dull, gnawing pain, burning sensation in the back or low midepigastric area, heartburn, constipation or diarrhea, sour taste in mouth, burping, nausea, vomiting, bloating, urea present in breath, and tarry stools.

Vitamin C

Facilitates the absorption of iron (promote consumption)

Manifestations of iron deficiency anemia

Fatigue ●Lethargy ●Pallor of nail beds ●Intolerance to cold ●Headache ●Tachycardia

Recommended weights according to BMI

First TRIMESTER: recommended weight gain is 1.1 to 4.4 lb. SECOND AND THIRD TRIMESTERS: recommended weight gain is 2 to 4 lb/month. ●Normal weight client (BMI 18.5‑24.9):1 lb/week for a total of 25 to 35 lb. ●Underweight client (BMI < 18.5): just more than 1 lb/week for a total of 28 to 40 lb. ●Overweight client (BMI 25‑29.9):0.66 lb/week for a total of 15 to 25 lb. ●Obese client (BMI > 30): 0.5 lb/week for a total of 11 to 20 lb

NATURAL SOURCES OF VITAMIN B12

Fish, Meat, Poultry, Eggs, Milk

APA Citation:

Focused Review:RN Nutrition Online Practice 2016 A. (n.d.). Retrieved October 05, 2017, from https://student.atitesting.com/FocusedReview/119242793/true/Home

Confusion infusion method

Formula is administered at a continuous rate over a 12‑ to 24‑hr period. ●Infusion pumps help ensure consistent flow rates. ●This method is recommended for critically ill clients because of its association with smaller residual volumes, and a lower risk of aspiration and diarrhea. ●Residual volumes should be measured every 4 to 6 hr. ●Feeding tubes should be flushed with water every 4 hr to maintain tube patency and provide hydration. ●If the client's gastric residual volume exceeds 250 mL for each of two consecutive assessments or the amount stated in hospital policy or provider's prescription, the continuous feeding should be held and the client's tolerance should be re‑assessed. In children, residual volumes should be measured and feedings held if the amount is equal to or greater than ¼ the prescribed feeding amount. The residual should be returned and then the amount rechecked in 30 min. to 1 hr

Cyclic feeding

Formula is administered at a continuous rate over an 8‑ to 12‑hr time period, often during sleeping hours. ●Often used for transition from total EN to oral intake

Intermittent tube feeding

Formula is administered every 4 to 6 hr in equal portions of 250 to 400 mL over a 30‑ to 60‑min time frame, usually by gravity drip or an electronic pump. ●Often used for noncritical clients, home tube feedings, and clients in rehabilitation. ●Resembles normal pattern of nutrient intake. ●Residual volumes should be measured prior to initiating the feeding and held if the amount is greater than the amount stated in hospital policy or prescription

Water content

Formulas with 1.0 cal/mL should be 850mL water per 1 L formula. Higher‑calorie formulas have lower water content. The client can need additional free water to meet hydration needs

Food Storage Guidelines

Fresh meat: Maintain refrigerator temperature at 40° F (4°C) or colder. ●Bacon: 7 days ●Sausage (pork/chicken/beef/turkey): 1 to 2 days ●Summer sausage: 3 months (unopened); 3 weeks opened) ●Steaks, chops, roasts (beef, veal, lamb, or pork): 3 to 5days ●Chicken or turkey (whole/parts): 1 to 2 days ●Fish: Maintain refrigerator temperature at 40° F (4° C) or colder. ◯Lean or fatty: 1 to 2 days ◯Smoked: 14 days ◯Fresh shellfish: 1 to 2 days ◯Canned: 3 to 4 days (after opening); 5 years (pantry)Eggs: Store in the refrigerator for 4 to 5 weeks in shell, and 1 week if hard‑boiled.Fruits and vegetables: Refrigerate perishable fruits and vegetables at 40° F (4° C). All pre‑cut and pre‑peeled fruits and vegetables should also be refrigerated.Perishables: Do not leave at room temperature for more than 2 hr (1 hr if the temperature is 90° F [32° C] or above).Canned goods: Check for rusting, crushing, and denting. Observe for stickiness on the outside of can, which may indicate leakage. Do not use any canned foods that are damaged.

Type 2 DM

Genetic and environmental factors ●Characterized by altered patterns of insulin secretion and decreased cellular uptake of glucose (insulin resistance)

Gestational Diabetes (GDM)

Glucose intolerance that is recognized during pregnancy. ●Usually occurs during the second and third trimesters. ●Occurs only during pregnancy and typically resolves after delivery. ●Characterized by increased insulin resistance caused by secretion of placental hormones, and increased insulin antagonists. ●Many women who have GDM develop type 2 diabetes mellitus later in life. ●Blood glucose control is important in preventing damage to the fetus of women who are pregnant and who have GDM or pre‑existing diabetes mellitus.

Celiac disease

Gluten‑sensitive enteropathy, celiac sprue, and gluten intolerance. ●It is a chronic, inherited, genetic disorder with autoimmune characteristics.

Folic acid sources

Green leafy vegetables -Dried peas and beans -Seeds -Orange juice - Cereals and breads fortified with folic acid

Risk factors: modifable

High LDL cholesterol, low HDL cholesterol, consuming a diet high in saturated fat, hypertension, diabetes mellitus, obesity, sedentary lifestyle, nicotine use disorder

Coronary Artery Disease

Hypercholesterolemia is a major risk factor for developing CHD. CHD is caused by atherosclerosis, a process of damage and cholesterol deposits on the blood vessels of the heart

Lactose intolerance

Inadequate supply of lactase in the intestine, the enzyme that digests lactose.

Myocardial infarction

Inadequate supply of oxygen to the myocardium. Frequently, an MI occurs because of atherosclerosis. ●After an MI, it is necessary to reduce the myocardial oxygen demands related to metabolic activity. ●Risk factors for MI are the same as for CHD

Food can alter medications

Increased absorption: Improves the peak effects of some drugs when taken with food. ●Decreased absorption: Food can decrease the rate and extent of absorption. ◯Reducing the rate of absorption delays the onset of peak effects. ◯Reducing the extent of absorption reduces the intended effect of the medication.

Risk factors: non-modifable

Increasing age, male gender, and family history of early CHD

Acute and chronic gastritis

Inflammation of the gastric mucosa. The gastric mucosa is congested with blood and fluid, becoming inflamed. There is a decrease in acid produced and an overabundance of mucus. Superficial ulcers occur, sometimes leading to hemorrhages. ●Acute gastritis occurs with excessive use of NSAIDs, bile reflux, ingestion of a strong acid or alkali substance, as a complication of radiation therapy, or as a complication of trauma (burns; food poisoning; severe infection; liver, kidney, or respiratory failure; major surgery).

Pancreatitis

Inflammation of the pancreas. ●The pancreas is responsible for secreting enzymes needed to digest fats, carbohydrates, and proteins. ●Nutritional therapy for acute pancreatitis involves reducing pancreatic stimulation. The client is prescribed nothing by mouth (NPO), and a nasogastric tube is inserted to suction gastric contents

Diverticulitis

Inflammation that occurs when fecal matter becomes trapped in the diverticula manifestations: abdominal pain, nausea, vomiting, constipation or diarrhea, and fever, accompanied by chills and tachycardia

Roux‑en‑Y gastric bypass:

Ingested food bypasses 95% of the stomach, the duodenum, and a small portion of the proximal jejunum. Weight loss is achieved through malabsorption and dumping syndrome and the altering of the hormone ghrelin which decreases hunger.

Anorexia

Lack of appetite. It is a common finding for numerous physical conditions and is an adverse effect of certain medications. It is not the same as anorexia nervosa. ●Anorexia can lead to decreased nutritional intake and subsequent protein and calorie deficits

Vitamin B deficiency

Lack of meat or dairy consumption, small bowel resection, chronic diarrhea, diverticula, tapeworm, excess of intestinal bacteria MANIFESTATIONS: ●Pallor ●Jaundice ●Weakness ●Fatigue GASTROINTESTINAL FINDINGS: ●Glossitis (inflamed tongue) ●Anorexia ●Indigestion ●Weight loss ●Frequent diarrhea and/or constipation NEUROLOGICAL FINDINGS: Decreased concentration ●Paresthesia (numbness) of hands and feet ●Decreased proprioception (sense of body position) ●Poor muscle coordination ●Increasing irritability ●Delirium

Liver disease

Liver is involved in the metabolism of most nutrients. ●Disorders affecting the liver include cirrhosis, hepatitis, and cancer. ●Malnutrition is common with liver disease. ●Protein needs are increased to promote a positive nitrogen balance and prevent a breakdown of the body's protein stores

Maternal Phenylketonuria (PKU)

Maternal genetic disease in which high levels of phenylalanine pose danger to the fetus. ●It is important for a client to start the PKU diet at least 3 months prior to pregnancy, and continue the diet throughout pregnancy. ●The diet should include foods low in phenylalanine. Foods high in protein (fish, poultry, meat, eggs, nuts, dairy products) must be avoided due to high phenylalanine levels. ●The client's blood phenylalanine levels should be monitored during pregnancy. ●These interventions will prevent fetal complications (intellectual disability, behavioral problems).

Sources of Iron

Meat ●Fish ●Poultry ●Tofu ●Dried peas and beans ●Whole grains ●Dried fruit ●Iron‑fortified foods ◯Infant formula (acceptable alternative or supplement to breastfeeding) ◯Infant cereal (usually the first food introduced to infants) ◯Ready‑to‑eat cereal

Common Food Allergies

Milk, peanuts, fish, eggs, soy, shellfish, tree nuts and wheat are the most commonly reported food allergies in adults. Some infants my react to cow's milk and/or soy, but typically outgrow this by 4 years of age. ●Common manifestations include nausea, vomiting, diarrhea, abdominal distention, and pain. Some reactions are severe and can cause anaphylaxis

Pernicious anemia

Most common form of vitamin B12 deficiency. It is caused by lack of intrinsic factor, a protein that helps the body absorb vitamin B12

Iron deficiency anemia

Most common nutritional disorder in the world. It affects approximately 10% of the U.S. population, especially older infants, toddlers, adolescent girls, and pregnant women. ●From childhood until adolescence, iron intake tends to be marginal

Nasogastric Tube

NG tube are passed through the nose to the stomach.

Baseline parameters

Obtain height, weight, and body mass index. ●Monitor serum albumin, hemoglobin, hematocrit, glucose, blood urea nitrogen (BUN), and electrolyte levels.

Salmonella

Occurs due to eating undercooked or raw meat, poultry, eggs, fish, fruit, and dairy products. Common manifestations include headache, fever, abdominal cramping, diarrhea, nausea, and vomiting. This condition can be fatal.

Chances are of infections being reduced:

Otitis media (ear infections), type 1 and type 2 diabetes mellitus, obesity, leukemia, lymphoma, and gastrointestinal and respiratory disorders

Nasoduodenal tube

Pass through nose through the stomach and end in duodenum. used in clients who are at risk for aspiration or who have delayed gastric emptying (gastroparesis).

Vitamin B12

People over the age of 50 are urged to consume most of their vitamin B12 requirement from supplements or fortified food.vegans need supplemental B12

Ostomies

Placed for clients requiring long‑term enteral feeding, who are at high risk for aspiration or when a nasal obstruction makes insertion through the nose impossible. An ostomy is a surgically created opening (stoma) made to deliver feedings directly into the stomach or intestines

PEG Tube Percutaneous Esophageal tube

Placed with the aid of an endoscope. ●An alternative to the PEG tube is a skin‑level gastrostomy tube, which is known as a low‑profile gastrostomy device. It is more comfortable, longer‑lasting, and fully immersible in water. Checking for residual is more difficult with this device because of the close proximity of the button on the skin. ●Gastrostomy tube feedings are generally well‑tolerated because the stomach chamber holds and releases feedings in a physiologic manner that promotes effective digestion. As a result, dumping syndrome is usual

Folic acid deficiency

Poor nutritional intake of foods containing folic acid (green leafy vegetables, citrus fruits, dried bean, nuts), malabsorption syndromes such as Crohn's disease, certain medications such as anticonvulsants and oral contraceptives MANIFESTATIONS: - Fatigue ●Pallor ●Glossitis - Irritability ●Diarrhea

Refeeding syndrome

Potentially fatal complication that occurs when a client who is in a starvation state is started on enteral nutrition. This occurs because of electrolyte shifts and altered glucose levels once feeding restarts.

Alcohol

Pregnant women should not drink any

Iron deficiency anemia

RISK FACTORS: ●Blood loss, deficient iron intake from diet, alcohol use disorder, malabsorption syndromes, gastrectomy ●Metabolic increase caused by pregnancy, adolescence, infection

Escherichia coli

Raw or under cooked meat, especially ground beef, can cause this food-borne pathogen. Findings include severe abdominal pain and diarrhea.

Folic Acid intake

Recommendation: 600 mcg/day of folic acid be during pregnancy. lactating clients include 500mcg/day folic acid. It is necessary for the neurological development of the fetus and to prevent birth defects. It is essential for maternal red blood cell formation. Food sources include green leafy vegetables, enriched grains, and orange juice.

Breastfeeding

Recommends that infants receive breast milk for the first 6 to 12 months of age (exclusive breast feeding). Even a short period of breastfeeding has physiological benefits

Anemia

Reduction in the number of red blood cells (RBCs) or in hemoglobin, the oxygen‑carrying component of blood. Anemia can result from a decrease in RBC production, an increase in RBC destruction, or a loss of blood. ●The body requires iron, vitamin B12, and folic acid to produce red blood cells

Type 1 DM Risk Factors

Relative who has diabetes mellitus ●History of viral infections, such as cox sackie virus, and mumps

Hypertension

Risk factor for developing CHD, myocardial infarction, and stroke. ●Hypertension is a sustained elevation in blood pressure greater than or equal to 140/90 mm Hg for clients under the age of 60, 150/90 mm Hg for those older than 60

Common Foodborne Illnesses

Salmonella, E Coli, Listeria monocytogenes, and Norovirus.

How many calories additional for pregnancy?

Second trimester: + 340 calories. Third trimester: 452 calories.

Nasoenteric Tubes

Short‑term (less than 3 to 4 weeks. ●For an infant, a feeding tube is inserted from the nares or mouth into the stomach. This flexible tube can remain taped in place for up to 30 days.

Listeria monocytogenes

Soft cheese, raw milk products, undercooked poultry, processed meats, and raw vegetables can cause the illness. Listeria monocytogenes causes significant problems for newborns, pregnant clients, and immunocompromised clients. Onset occurs with the development of a sudden fever, diarrhea, headache, back pain, and abdominal discomfort. It can lead to stillbirth or miscarriage

Dumping syndrome

Stomach controls the rate in which nutrients enter the small intestine. When a portion of the stomach is surgically removed, the contents of the stomach are rapidly emptied into the small intestine. ●Early manifestations typically occur 15 to 30 min after eating. Early manifestations include a sensation of fullness, abdominal cramping, nausea, diarrhea, and vasomotor manifestations (faintness, syncope, diaphoresis, tachycardia, hypotension, flushing). ●Late manifestations occur 1 to 3 hr after eating. Late manifestations include diaphoresis, weakness, tremors, anxiety, nausea, and hunger. ●Manifestations resolve after intestine is emptied. However, there is a rapid rise in blood glucose and increase in insulin levels immediately after the intestine empties. This leads to hypoglycemia

Fish

The FDA has issued advisories regarding fish and shellfish consumption during pregnancy due to the risk of mercury levels. Mercury can be toxic to developing fetal brain tissue

Medicinal iron overdose

The leading cause of accidental poisoning in small children and can lead to acute iron toxicity

Metabolic Syndrome

The presence of three of the five following risk factors. ●Abdominal obesity - MEN: greater than or equal to 40‑inch waist (greater than 35 inches for Asian men) - WOMEN: greater than or equal to 35‑inch waist (greater than 31 inches for Asian women) ●Triglycerides greater than or equal to 150 mg/dL ●Low HDL-MEN: less than or equal to 40 mg/dL ◯WOMEN: less than or equal to 50 mg/dL ●Increased blood pressure ◯Systolic greater than or equal to 130 mm/Hg ◯Diastolic greater than or equal to 85 mm/Hg ●Fasting blood glucose greater than or equal to 100 mg/dL

Gastrostomy

Tubes are endoscopically or surgically inserted into the stomach

Jejunostomy

Tubes are surgically inserted into the jejunal portion of the small intestine (jejunum).

Nasojejunal tube

Tubes pass from the nose through the stomach and end in the jejunum. used in clients who are at risk for aspiration or who have delayed gastric emptying (gastroparesis).

Pregnant Vegetarians

Well‑balanced vegetarian diets that include dairy products can provide all the nutritional requirements of pregnancy