NUR 111 Unit 5 Health, Wellness & Illness Module 20
Lipoproteins
Soluble compounds made up of various lipids and a protein.
Nitrogen is the element that distinguishes __________ from ________ and ______________.
protein from lipids and carbs which is why nitrogen balance reflects the status of protein nutrition in the body.
Vit. C
red pepper, broccoli, oranges, salad, POTATO
**Anabolism:
Building tissues: all body cells synthesize proteins from amino acids, types depend on characteristics of cell & are controlled by its genes.
How can nurse help families deal with the effects of illness?
Connect the individual along with the family to help achieve best outcomes.
Cholesterol
dairy/milk, beef
Na Restriction
CHF, nephrotic syndrome, ascites, meneires disease
**Most animal proteins are:
Complete proteins.
curanderos
men
**Fiber
Complex carb from plants, supplies roughage or bulk to the diet
Two main Theoretical Frameworks discussed in this topic?
*Needs Theories* -Maslow - Hierarchy of Needs -Kalish - Maslow's + more *Developmental Stage Theories* -Erikson's Eight Stages of Development
Assessing and planning Health Care can be enhanced when nurses understand what 3 things?
*Individuality*- Unique being, Total care context and Individualized care context *Holism*- Individuals as whole not just parts, Interventions toward overall harmony not just the biological systems. *Homeostasis*-Bodies ability to maintain state of balance while continually changing. Human needs
Difference between Health Promotion and Health Protection (Disease prevention)?
*Motivation is the difference.* Health Promotion is behavior motivated by desire to be healthy overall. Health Protection is behavior motivated by desire to avoid an illness, detect it early, or function with it.
Qi =
"chee"
Manual Healing Methods
"manipulate" the body to improve health
Name two(2) health belief models?
*Health Locus of Control (self-learning model)* -Internals - Health self determined: "I have control of what I do". -Externals - Health in control of others: fate, Dr., God, someone else. *Rosenstock's and Becker's health belief model* -Individual's perception -Modifying factors -Likelihood of action
Explain Rosenstock's and Becker's Health Model in detail.
*Individual Perception* -Perceived susceptibility: do i feel susceptible? -Perceived seriousness: how serious -Perceived threat: strength of first 2 items will increase threat perception. *Modifying factors* -Demographic variables: race, gender -Sociopsychological variables: 4 of 5 friends doing it may motivate you. -Structural variables: prior exp. -Cues to action:internal feeling of being unhealthy, ie: can't play with kids, or walk up stairs w/o breathing hard. *Likelihood of action* -Perceived benefits of action -Perceived barriers to action
What individual characteristics and experiences effect how a client will carry out a Health Promotion Model?
*Personal* Biologic -age, strength, balance Psychological- self-esteem, self- motivation Sociocultural (race, ethnicity, education, socioeconomic status) *Prior related behaviors* Previous knowledge Knowledge Skill in health promoting actions
Name some External variables that influence health status, beliefs and practices.
*Physical Environment* polution *Family/cultural beliefs* *Social support systems*
Homeostasis has two main categories?
*Physiological:* Internal environment of the body. Relatively stable Made of Matter (Body), Energy (Chemical & Thermal), Comm system (Nervous system) *Psychological:* -State of mental well-being -Needs love, security, self-esteem to maintain balance. -Stable physiological and psychological environments where one feels safe, secure, & loved.
Stages of Health Behavior Change?
*Precontemplation*- Think about change, no desire in near future. *Contemplation*- Think, research support groups, want to change in near future *Preparation*-Taking action in immediate future. "Diet starts monday" *Action*-doing phase, on the diet *Maintenance*- after goal reached, months/years down the road. May never leave this phase if temptation still a problem. *Termination*- No time frame, when urge is gone, eating bad foods not an issue.
What are the 3 levels of Prevention?
*Primary*-protection against health problems. *Secondary*-early identification of health problems. *Tertiary*-restoration & rehabilitation
What are Parson's Four Aspects of the Sick Role?
*Rights* -Client are not held responsible for their condition. -Clients excused from certain social roles and tasks. *Obligations* -Client obligated to try to get well quickly. -Client or family obligated to seek competent help.
What are Suchman's Stages of Illness?
*Stage1:Symptom experience.* believe something wrong *Stage2:Assumption of sick role* seek confirmation *Stage3:Medical care contact* seek HCP *Stage4:Dependent client role* dependent of Prof. help *Stage5:Recover or Rehab* Resume former roles and responsibilities
Explain Role Performance Model.
-Ability to fulfill roles even if clinical ill or have disease. -Roles such as mother, teacher, student, nurse etc. -Very individual, illness make affect some differently than others.
What is the Health Promotion Model (HPM)?
-Approach oriented model -Motivational source for behavior change, based on individuals value of the change.
What are the factors influencing adherence?
-Client motivation -Degree of lifestyle change ie:diet -Perceived severity of HC problem -Value placed on reducing threat of illness -Complexity, side effects, duration of proposed therapy. -Overall cost of therapy.
What does Developmental Stage Theory express?
-Describes typical behaviors within age groups. -Predict behaviors in given situation. -Rationale to control behavior manifestations. -Used in parental/client counseling/guidance.
Explain Adaptive Model.
-Function by adapting -Amputation? cope and adapt to this. -Treatment aimed at restoring ability to adapt or cope.
What are the variables of HPM?
-Individual Characteristics. -Nursing interventions focus on modifiable factors. -Behavior specific cognitions and affect. -Commitment to a plan of action. -Immediate competing demands & preferences. -Behavioral outcome.
Explain Illness Behaviors
-One's behavior once sick -Coping mechanism -Individualized -Multiple factors influence behavior
There are 4 Main Characteristics for Physiological Homeostasis?
-Self Regulatory -Compensatory -Mostly regulated by neg feedback systems -May require several feedback mechanisms
Explain Clinical Model.
-State of not being "sick". -Cannot be sick in this model. -Health defined by absence of symptoms of disease or injury.
The REE of healthy persons is generally about:
1 cal/kg of body wt/hr for men and 0.9 cal/kg/hr for women w/great variations.
Botanical Healing Interventions
1) Dietary therapy: hot/cold foods, unprocessed food, macrobiotic diet (whole grains; avoid meat/ poultry). 2) Aromatherapy, Herbs, & Vitamins
cal/d women cal/d men
1,200-1,500 1,500-1,800
#1: Systematized Health Care Practices:
1. . Ayurveda ( Ancient India ), 2. Traditional Chinese Medicine (TCM), 3. Native American Healing, 4. Curanderismo (Latin America)
**Caloric value in: 1. Carbs, 2. Protein, 3. Fat 4. Alcohol
1. 4 calories/gram 2. 4 calories/gram 3. 9 calories/gram 4. 7 calories/gram
The only "universally" accepted guidelines for food/nutrition intake are:
1. Eat a wide variety of foods to furnish adequate nutrients and 2. Eat moderately to maintain correct body weight.
**Body breaks carbs inot glucose to:
1. Maintain blood levels 2. Provide readily available source of energy 3. Remainder used as energy or stored.
Healing Modalities Six Categories:
1. Systemized Health Care Practices, 2. Botanical Healing, 3. Manual Healing Methods, 4. Mind-Body Therapies, 5. Spiritual Therapy, 6. Misc. Therapies
Reasons, aside from nutrition, for nasogastric tubes:
1. To prevent nausea, vomiting, & gastric distention following surgery. In this case, tube is attached to suction source. 2. To remove stomach contents for laboratory analysis. 3. To lavage (wash) the stomach in cases of poisoning or overdose of medications.
**BMI 25.0-40.0 at risk for:
1. Type 2 diabetes, 2. hypertension, 3. cardiovascular disease.
**BMI (body mass index) is indicator of what 3 things?
1. indicator of changes in body fat stores, 2. whether weight is appropriate for height 3. estimate of malnutrition.
Hypoglycemic and conscious: __-__ oz ___ or ___ milk
15 g CHO: Drink 1/2 cup fruit juice followed by peanutbutter crackers drink 4-6 oz OJ/ LOW-fat milk
iron/d women men pregnant
18 mg/d W 10 mg/d M 30 mg/d preg
Hypoglycemia unconscious and cant swallow
1mg glucagon SQ/IM (SE: nausea) 25-50 mL 50% dextrose IV (se: HA, pain at site, ensure patency of IV line)
A pound of fat is ____________ kilocalories
3, 500
Hypoglycemia 15 g CHO
3-4 glucose tablets 4 to 6 oz juice or regular soda (not diet) (ie 125 mL of apple juice) 2-3 tsp sugar/honey 6-10 hard candies 1/2 cup plain pasta 1/2 cup of canned fruit NOT.... 2 tsp of sugar= 8.5 g of CHO 1 cup of whole milk= 11 g of CHO 8 ounces of regular soda= 26 g of CHO retest in 15 min, retreat if <70 or if sx persist >10-15 min. Provide snack with protein and CHO unless plan to eat a meal (give milk and crackers or ifOJ/ simple sugar is given, should be followed w/ a meal/ protein)
To prevent spoilage or bacterial contamination, what should be the time limit on allowing feeding solution to hang?
4-8 hours.
One Calorie (Kcal) equals __________ kilojoules.
4.18
Many agencies w/hold tube feedings if more than ___________ to _______ mL of feeding is aspirated.
75-100
Botanical Healing is used by
80% of the world's population
CHF <___ L/d fluid restriction
<2L/d fluid restriction (include ivf)
protein restriction
A client who is on hemodialysis three times per week and has a creatinine level of 2.8 mg/dL (247.52 µmol/L)...kidney failure impairs the kidney's ability to excrete the nitrogenous byproducts that come from proteins A client whose urinalysis is positive for proteinuria and hematuria, but negative for white blood cells and bacteria....indicates glomerulonephritis, which can compromise kidney function; negative WBC and bacteria in urine differentiate UTI from glomerulonephritis A client with hepatitis and who is experiencing mild confusion and difficulty concentrating...proteins are deaminated by the liver and converted to urea for excretion; when liver does not function properly to convert deaminated protein, ammonia builds up, can lead to hepatic encephalopathy
Explain Health-Illness Model
A continuum of how people perceive themselves. Death<------Below Avg-------AVG------Above Avg------->Wellness
Examples of Fat-soluble vitamins
A,D,E, & K
gout prevent recurrent attacks: avoid high __ foods: drink __-__ml/d __ carb diet alch? calcium? if overweight lose __ to __ lb/wk
AVOID high purine foods: RED AND ORGAN MEATS ie liver, SHELLFISH, oily fish with bones, sardines, seafood, meat soups, gravy, anchovies, spinach, peas, dried legumes, wild game drink at least 2,000-3,000mL/d fluid, increase urinary uric acid excretion HIGH carb diet enhances uric acid excretion (low carb causes formation of ketones that decr excretion) eliminate alcohol intake calcium NOT limited with gout lose 0.5 to 1 lb/ week, excessive weight loss may precipitate gouty arthritis (ie lose 3lb/wk)
In the _________________ stage, the person actively implements behavioral and cognitive strategies of the action plan to interrupt risky behaviors and adopt new ones. Greatest commitment of time and energy
Action
Nephrotic syndrome ____ protein ___ sodium fluid restriction?? make foods fun and attractive (LOA with ascites)
Adequate protein, unless cannot tolerate protein, and LOW sodium, fluid restriction with severe edema make foods fun and attractive (LOA with ascites)
**Saturated fatty acids: page 1251
All carbon atoms are filled to capacity w/hydrogen. I.E. butyric acid found in butter.
**Proteins:
Amino acids, organic molecules contained in every body cell. About 3/4 of body solids are proteins.
Large calorie (Calorie, kilocalorie [Kcal]) page 1253
Amount of heat energy required to raise temp of 1 gram of water 15 to 16 degrees Celsius & is the unit used in nutrition.
Small calorie (c, cal)
Amount of heat required to raise the temp of 1 gram of water 1 degree Celsius. Used in chemistry & physics.
Kilojoule (kJ)
Amount of work energy required when a force of 1 newton (N) moves 1 kg of weight 1 m distance.
**Macrominerals:
Those that people require daily in amounts over 100 mg.
**Vitamins Page 1252
An organic compound that cannot be manufactured by the body & is needed in small quantities to catalyze metabolic processes. When vitamins are lacking, metabolic deficits result.
**3 activities of protein metabolism page 1251
Anabolism, catabolism, nitrogen balance
**Carbs can be stored in what 2 ways:
As glycogen or as fat.
**Catabolism: page 1251
Breaking down tissue: Cell can have only limited amount of protein so excess amino acids are degraded for energy or converted to fat. occurs primarily in liver.
**Other indirect body mass measures:
BIA: bioelectrical impedance anyalysis: Speed electrical signal passes through body influenced by H2O in body. More muscle = more water + easier current. More fat = more resistance.
Traditional Chinese Medicine (TCM)
Balance of yin-yang energies, Body's vital energy (qi) circulates via meridians or channels.
Native American Healing
Balance or harmony of mind and body; Medicine women and men; Use medicine objects and ceremonial treatments.
Explain Agent-Host-Environment Model.
Balance=Health No Balance=Disease Agent-Cold Host-Your body Environment-Compromised immune system Disease occurs. All three in balance, no disease.
**BMR: page 1253
Basal metabolic rate: rate at which body metabolizes food to maintain energy requirements of a person who is awake & at rest.
**Fatty Acids
Basic structural units of most lipids, made up of carbon chains & hydrogen.
Why should particular attention be given to monitoring fluid status & circulating volume in nocturnal continuous feeding?
Because nocturnal feedings may use higher nutrient densities & higher infusion rates than standard continuous feeding.
What is tertiary prevention?
Begins after illness. Focuses on help rehabilitate and restore individual to optimum level of functioning(return to health): teaching a client about managing diabetes long term care/rehab
According to Pender's HPM, health promoting behavior is the desired ________________________ which should result in improved health, enhanced functional ability and better quality of life.
Behavior outcome
According to Pender's HPM, the set of variables for ________________________ have important motivational significance. Can be modified through nursing actions.
Behavior specific knowledge and affect (how the individual perceives benefits and feels about change)
Effects of Illness on Individual
Behavioral/Emotional changes Self-concept/Body image changes Lifestyle changes
Holistic health care:
Belief that disease results from multiple factors such as social support, health practices, personality traits, genetics
. Homeopathy:
Body is self-healing, assisted with small doses of remedies, Symptoms reflect body's attempt to heal itself. Law of similar and law of minimum dose
How is BMR calculated?
By measuring the REE in the early morning, 12 hours after eating.
Examples of Water soluble vitamins
C & B complex vitamins: B1 (thiamine), B2 (riboflaving), B3 (niacin or nicotinic acid), B6 (pyridoxine), B9 (folic acid), B12 (cobalimin), pantothenic acid & biotin.
Elderly diet calcium __ -__ mg/day vit D __ -____ min __-__ x/wk ___ cho, ___ fiber
CALCIUM: 1000-1500 mg/daily vit D: 15-20 min of exposure to the sun 3-4 x/wk complex cho, fiber >65 influenza yearly pneumococcal q5 hr
Which 2 minerals make up 80% of all mineral elements in the body?
Calcium and phosphorus.
Example of how nutrients can affect drug utilization: Milk
Calcium in mild hinders absorption of tetracycline antibiotic but enhances absorption of antibiotic erythromycin.
Examples of macrominerals:
Calcium, phosphorus, sodium, potassium, magnesium, chloride & sulfur.
**Unsaturated fatty acids:
Can accommodate more Hydrogen atoms than it currently does. Has at least 2 carbon atoms not attached to hydrogen atom but, instead, has double bond between 2 carbon atoms. Can be monounsaturated or polyunsaturated fatty acids.
What 3 elements make up lipids (same as carbs)?
Carbon, hydrogen and oxygen but, unlike carbs, lipids have higher proportion of hydrogen.
Proteins are composed of:
Carbon, hydrogen, oxygen & nitrogen
What are the energy providing nutrients?
Carbs, fats & proteins.
**Carbohydrate composition page 1250
Composed of the elements carbon (C), hydrogen (H) & oxygen (O)
According to Pender's HPM, each person has unique ____________________ that affect subsequent actions.
Characteristics and experiences
Manual Healing Methods interventions
Chiropractic; Massage, Acupressure; acupuncture, & reflexology; Hand-Mediated Biofield Therapies; Therapeutic Touch ; & Reiki
Models of Health (6)
Clinical Model Role Performance Model Adaptive Model Eudemonistic Model Agent-Host-Environment Model Health-Illness Continuum
**Complementary proteins
Combinations of 2 or more proteins to make a complete protein. I.E.: corn and beans. One way to take full advantge of vegetable proteins is to eat w/animal protein: spaghetti w/cheese, rice w/pork, noodles w/tuna, cereal w/milk.
Proteins may be either ___________ or _____________.
Complete or incomplete.
Complete proteins:
Contain all of the essential amino acids plus many nonessential ones.
In the _____________________stage, the person acknowledges having a problem and seriously considers changing a specific behavior, actively gathers information and verbalizes plan to change in near future(next 6 months).
Contemplation
Cyclic feedings
Continuous feedings that are administered in less than 24 hours (i.e. 12-16 hrs). Often done at night & allow client to attempt regular meals during day.
contraindications for colonics
Contraindications include people in a weakened state and those having ulcerative colitis, diverticulitis, Crohn's disease, severe hemorrhoids, or tumors of the large intestine or rectum.
Integrative health care =
Coordination of care that includes all types of practitioners, treatments & health practices a client uses; combines conventional medicine and CAM
**Examples of Incomplete proteins
Corn (low in tryptophan & lysine, beans (low in methionine)
**cholesterol is needed to:
Create bile acids & to synthesize steroid hormones.
Phosphorous
DAIRY products (milk, yogurt, cheese, pudding), organ meats, nuts, fish, poultry, whole grains, cola, peanut butter
Signs of clients being at risk for aspiration:
Decreased level of consciousness, poor cough or gag reflexes, inability ot participate in the procedure, restlessness or agitation.
**End products of carb digestion:
Desired end products are monosaccharides.
Factors affecting nutrition
Development, sex, ethnicity and culture, beliefs about food, personal preferences, religious practices, lifestyle, economics, medications and therapy, health, alcohol consumption, advertising, psychological factors.
Glucose that cannot be stored as glycogen is converted to ________.
Fat
prevent odor with colostomy
Drink cranberry juice and buttermilk, eating parsley and yogurt is also helpful Eat crackers, toast, and yogurt. (prevent gas) chewing gum, skipping meals, drinking beer, and smoking contribute to the production of flatus Use a commercially prepared deodorizer inside the pouch (eliminate odor)
Prevent dumping syndrome eat high __ and high __ foods, and ___ cho avoid high __ foods, ___ sugars, and___ drink fluids __ meals
EAT HIGH PROTEIN HIGHT FAT FOODS (remain in stomach longer), low carb and sugar-free AVOID HIGH CHO foods, simple sugars, AVOID FIBER??? drink fluids in between meals (1 hr before/ after) smaller frequent meals
What is secondary prevention?
Emphasizes early detection of disease, prompt intervention and health maintenance(detect illness early): screening surveys and procedures ie BSE regular check ups assessing growth and development of children
What two systems maintain homeostasis?
Endocrine and Autonomic nervous system
**Micronutrients
Energy providing nutrients (vitamins and minerals) that are required in small amounts (e.g. milligrams or micrograms) to metabolize the energy-providing nutrients.
2 classifications of amino acids: page 1250
Essential & Nonessential
How does the nurse view the individual?
Every person is unique and health is highly individual
Spiritual Therapy
Faith & Prayer
**Cholesterol page 1251
Fatlike substance both produced by boy & found in foods of animal origin. Along w/phospholipids, large quantities are presnet in cell membranes & other cell structures.
Monounsaturated fatty acids:
Fatty acids w/one double bond
When are nasoenteric tubes used?
For clients who are at risk for aspiration.
When are nasogastric tubes not advisable?
For feeding clients w/out intact gag and cough reflexes since the risk of accidental placement of the tube into the lungs is much higher in these clients.
When are nasogastric tubes used?
For feeding clients who have adequate gastric emptying & who require short-term feedings.
**Rule of 6
For men: 106 lb for 5', + 6 lbs for each inch over 5', + or - 10% for body-frame size.
**Rule of 5 page 1253
For women: 100 lb for 5', + 5 lb for each inch over 5', + or - 10% for body-frame size.
When is vitamin content highest?
Fresh foods that are consumed asap after harvest.
What is primary prevention?
Generalized health promotion and specific protection against disease(prevent illness): immunizations, family planning services, health education on nutrition
Triglycerides
Have 3 fatty acids & account for more than 90% of lipids in food & in body. May contain saturated or unsaturated fatty acids.
Curanderismo (Latin America)
Healers: men (curanderos) & women (coranderas); Religious rituals, cleansing rites, and prayers
Ayurveda ( Ancient India ) Health & Illness
Health = interdependence of person and quality of social interactions. Illness = imbalance
________________ is behavior motivated by the desire to increase well-being and actualize human health potential.
Health promotion
_______________ is behavior motivated by the desire to avoid illness, detect it early or maintain functioning within constraints of illness.
Health protection
What is Illness?
Highly personal state? SUBJECTIVE Only person can say he/she is ill. Overall ill feeling with no empirical data to validate or refute its existence.
The four main characteristics of the concept ____________________ are: Self-regulation Compensatory Negative Feedback More than one feedback system stimulates change
Homeostasis
Mind-Body Therapies
How mind & emotions affect body functions. Interventions target client's mood and reaction to stress to improve health.
While almost all body cells can store glycogen, most is stored where?
In the liver & skeletal muscles where it is available for conversion back to glucose.
Effects on Illness on Family
Income earner hospitalized? What impact does this have? Single parent get sick Role Changes Task Reassignments Cultural and social customs of family
Pender's Health Promotion Model focuses on what three areas?
Individual Characteristics and Experiences Behavior Specific Cognition and Affect Behavioral Outcome
**Minerals are:
Inorganic compounds or free ions found in organic compounds.
Nasogastric tube
Inserted through one of the nostrils, down the nasopharynx & into the alimentary tract.
**Starches
Insoluble, nonsweet forms of carbs, polysaccharides composed of branched chains of dozens or hundreds of glucose molecules.
What hormone secreted by the pancreas enhances the transport of glucose into cells?
Insulin
Traditional Chinese Medicine (TCM) interventions
Interventions = acupressure, acupuncture, herbal remedy, massage, heat therapy, qi gong, tai chi, & nutritional lifestyle counseling
**health problems related to minerals: Page 1253
Iron deficiency resulting in anemia; Osteoporosis resulting from loss of bone calcium.
**Examples of microminerals
Iron, zinc, manganese, iodine, fluoride, copper, cobalt, chromium & selenium.
Why test the pH of stomach contents?
It is a reliable way to determine location of a feeding tube. Gatric contents are commonly pH 1 to 5. 6 or greater indicates contents are from lower in intestinal tract or in respiratory tract.
The greater effect of alcohol intake is:
It is convereted to acetate by the liver which is released to the bloodstream & used as energy instead of fat which ends up being stored.
What are the difference between Maslow and Kalish?
Kalish added another layer between the Survival(physiologic) needs and the Safety & Security Needs. He added things like Sex, activity, exploration, novelty, & manipulation.
Vit A
LIVER (avoid in pregnant), sweet potatoes, carrots, and dark leafy greens
Diverticular diseases uncomplicated vs acute
LLQ pain relieved by passing stool/flatus, constipation alt with diarrhea uncomplicated, etiology= constipation so avoid by: HIGH fiber (F/V), AVOID food with seeds (TOMATO/CUCUMBERS), nuts, corn/ popcorn, strawberries, and caraway seeds increase fluids, bulk laxatives, antispasmotics/ anticholinergics (dicyclomine) acute: bedrest, NPO, AVOID fiber if diverticulitis develops, progressing to oral fluids and semi-solids, IVF, NGT, Abx
gastroesophageal reflux disease (GERD) __ fat acidic/non-acidic? water with or in between?
LOW fat and NON-acidic foods (no OJ/tomato juice--apple juice is good alternative) , THICKEN foods sm/ freq meals. sip water WITH meals chewing gum (promotes salivation may neutralize acid) ie Broiled chicken, cream of broccoli soup, rice pudding, and apple juice. foods that exacerbate: BIG meals, FATTY foods, spicy, dairy, hot/cold, MINT/Peppermint, oil dressing (high fat), TOMATO, lemonade, carbonated beverages, chocolate, caffeine, alch, nicotine (Wt loss helps, decr gastric pressure, abdom breathing strengthens LES, elevate HOB)
Phenylketonuria (PKU) ____ phenylalanine diet save level range __-__mg/dL <12 yo infants: children: low __ diet (no ___, __, __, __) ___ blood test obtained no later than __ days after birth
LOW phenylalanine diet (NOT totally eliminated bc essential AA for normal development) safe level range 2-6 mg/dL <12yo infants- special formula with milk substitute (Lofenalac) low-protein diet for children (no meat, dairy, eggs, Nutrasweet) Guthrie blood test obtained after ingestion of protein, no later than 7 days after delivery
lower bowel surgery
LOW residue diet skinless vegetables, canned/cooked/seedless vegetables, refined grains (White bread) ok, ALL meats, poultry, fish must be BOILED OR BAKED NO RAW fruit/veg (sprouts, carrots, celery sticks, cabbage) NO beans/legumes (high fiber) NO WHOLE WHEAT, raisin bran/ whole gains NO fried chicken
Glycogen
Large polymer (compound molecule) of glucose.
What is chronic illness/disease?
Last long time, >6 months Slow onset Not going to go away Symptoms can reduce but don't disappear.
Naturopathy is the
Least invasive intervention is used to support body's healing process
Nasoenteric (nasointestinal) tube
Longer than nasogastric (at least 40 cm for adult). Inserted through one nostril down into upper small intestine.
Vit B12 risk for b12 def
MEAT pernicious anemia, vegan, on metformin, gastrectomy (no stomach to secrete intrinisc factor)
Iron
MEATS (red, beef, lamb, liver/organ meats, chicken giblets vs breast, pork) SHELLFISH/ MOLLUSCKS (oysters/clams/scallops, shrimp) egg yolk, dark leafy green veg (SPINACH, collards), broccoli, dried fruits (Raisins), dried beans (green beans not steamed) fortified cereal and grains (OATMEAL), brown rice limit milk intake in toddlers (16-24 oz/d) to ensure balanced diet
**2 categories of minerals Page 1252
Macrominerals and microminerals.
In the ___________________ stage, the person strives to prevent relapse by integrating newly adopted behaviors into his or her lifestyle. Can last from 6 months to 5 years.
Maintenance
Herbal medicine
Many medicines in US are derived from plants, Herbs can interact with drugs thus caution should be used when combining herbs and OTC or prescribed medications, & Herbs are best for non-crisis situations
**Examples of complete proteins:
Meats, poultry, fish, dairy products & eggs.
What is the nurse's role in health promotion?
Model healthy lifestyle facilitate client involvement teach clients assist individuals to increase health educate clients to be effective health care consumers guide clients reinforce clients' healthy behavior advocate in the community for healthy changes
2 types of sugars:
Monosaccharides (single molecules) or disaccharides (double molecules)
What is Disease?
More objective Alteration in body function Examples: COPD, Diabetes, Pneumonia.
**Sources of cholesterol: page 1251
Most of body's cholesterol synthesized in liver but some from diet: milk, egg yolk & organ meats.
Misc. Therapies
Music Therapy; Humor and laughter;
NCCIH's Role
NCCIH is the Federal Government's lead agency for scientific research on complementary and integrative health approaches
**Sources of starch page 1250
Naturally from plants like grains, legumes & potatoes. Foods Processed from starches: cereals, breads, flour & puddings.
__________________ feedback inhibits change.
Negative
What is the most important nutritional need after water?
Nutrients that provide fuel or energy.
Potassium
OJ, oranges, citrus fruits, bananas, coconut, watermelon, cantaloupe squash, potatoes, tomato, broccoli, spinach, avocado, dried fruits, dried apricots, raisins, prunes, celery (low in Na), salt substitute, caesar salad low K+: alfa sprouts, cabbage, lettuce, grapefruit,
Nutrients
Organic & inorganic substances found in foods that are required for body functioning.
**Lipids (Fats) page 1251
Organic substances that are greasy & insoluble in water but soluble in alcohol or ether. Commonly, lipids & fats terms used interchangeably but fats are lipids that are solid at room temp while oils are lipids that are liquid at room temp.
**Enzymes to digest proteins are secreted by ________ and ________.
Pancreas: proteolytic enzymes trypsin, chymotrypsin, carboxypeptidase; Glands in intestinal wall: aminopeptidase & dipeptidase
Behavior-specific cognitions and affect describes what actions or issues for a client.
Perceived benefits of action Perceived barriers to action Perceived self efficacy Activity-related affect Interpersonal influences Situation influences
What are the 5 levels of Maslow's Hierarchy of Needs?
Physiological Needs Safety and Security Needs Love and Belonging Needs Self-Esteem Needs Self-Actualization
Where are unsaturated lipids found?
Plant products like olive oil & corn oil, usually liquid at room temp.
**Sources of fiber:
Plants: present in outer layer of grains, bran & in skin, seeds & pulp of many vegetables & fruits.
___________________ feedback stimulates change.
Positive
When should enteral feedings be started in surgical clients?
Postoperatively w/out the need to wait for flatus or bowel movement.
In the ___________________ stage, the person does not think about changing behavior in the next 6 months. May be uninformed about consequences of behavior.
Precontemplation
What are the 6 stages of health behavior change?
Precontemplation Contemplation Preparation Action Maintenance Termination
In the _______________________ stage, the person intends to take action in the immediate future(next month). Started making small changes, ie buying self help book, identifying strategies
Preparation
What are the 3 levels of prevention?
Primary Secondary Tertiary
**Sources of simple sugars page 1250
Produced naturally by plants like fruits, sugar cane, sugar beets & animal sources like lactose (glucose + galactose) from animal milk. Processed or refined sugars (table sugar, molasses, corn syrup)-extracted & concentrated from natural sources.
3 Major functions of nutrients Page 1250
Providing energy for body processes & movement, providing structural material for body tissues & regulating body processes.
**Major enzymes of carb digestion:
Ptyalin (salivary amylase), pancreatic amylas & disaccharidase which are maltase, sacrase & lactase.
Fiber
RAW, fresh, and dried fruits/ vegetables, GREEN BEANS, split pea soup, CELERY, pears (NOT cucumber), raspberries, prunes, sweet corn, SALAD bar, CARROTS whole-grains, WHOLE-WHEAT BREAD, WHEAT BRAN, breakfast cereals, oatmeal eight to ten glasses of fluid daily
Metabolism
Refers to all biochemical & physiological processes by which body grows & maintains itself.
**Nitrogen balance:
Reflects the status of protein nutrition in the body. The measure of degree of protein anabolism & catabolism or net result of intake and loss of nitrogen. When nitrogen intake = output, balance exists.
**REE page 1253
Resting energy expenditure: amount of energy required to maintain basic body functions, i.e. to maintain life
While performing care for the elderly client, the nurse notices that the client has a dry, parched mouth and tongue. The nurse should take which action?
Rinse the client's mouth with room-temperature tap water before and after meals. glycerin swabs/ commercial mouthwash (with alch) will dry mucous membranes
Nonessential amino acids:
Those body can manufacture. Body takes amino acids derived from diet & reconstructs new ones from their basic elements.
ferrous sulfate (Feosol) (iron)
SE: constipation increase intake of fruits, fiber, fluids (10-12 cups/d) ie fresh fruits and whole-grain bread give BETWEEN MEALS, WITH CITRUS JUICE calcium/dairy consumed 2 hrs before or 1 hr after iron supplements (decr absorption) (other SE: gastric irritation, N/V/D, abdominal cramps, anorexia, and dark/black/green/tarry colored stools) place medicine in back of mouth (temporary staining of teeth), use dropper/straw keep no more than 1 mo supply, lethal/toxic
cholestyramine SE:___ and ___ deficiency
SE: constipation, depletes fat soluble vitamines consume milk (vit A, D), and green leafy veg (E and K) and encourage high-fiber and fluids
**Fatty acids can be either_____________ or _________.
Saturated or unsaturated.
Lactose intolerance
Shortage of the enzyme lactase which breaks down sugar in milk. Affects 80% of African Americans, 80-100% of American Indians, 90-100% of Asian Americans.
Lipids are classified, based on their chemical structure as either _________ or ___________.
Simple (glycerides), compound (triglycerides)
**2 Basic types of carbohydrates page 1250
Simple Carbohydrates (sugars) and Complex Carbohydrates (starches & fibers)
Glycerides page 1251
Simple lipids, most common form of lipids consisting of glycerol molecule w/up to 3 fatty acids attached.
What is Health?
Some describe it as: Being free from disease Others think that it is: A state of complete phyiscal, mental, and social well-being, and not merely the absence of disease.
What is Well-Being?
Subjective perception of vitality and feeling well. A component of Health.
Nutrition Page 1250
Sum of all the interactions between an organism & the food it consumes. Nutrition is what a person eats and how the body uses it.
**Functions/Atributes of Fiber:
Supplies roughage/bulk, undigestable by humans, satisfies appetite, maintains digestive tract function, aids elimination of waste.
Native American Healing interventions
Sweat lodge (ceremonial sauna), singing, dancing, vision quests (fasting and solitude), smudging (brushing burned herbs on skin), drumming and chanting, healing touch, acupressure, & herbs
What is an Acute Illness/Disease?
Symptoms of short duration. Symptoms appear abruptly, subside quickly. Examples: Cold, appendicitis.
Naturopathy (naturopathic medicine)
System of medicine & way of life based on healing power of nature and client responsibility
Nurses Role in Health Promotion?
Teaching & Modeling (hard to teach no smoking if you smell like an ashtray) Facilitate client willingness/ participation/involvement. Get family support if possible Teach diet plan to person who cooks.
In the _______________ stage, the individual has complete confidence that the problem is no longer a threat or temptation. Ie, wanting to smoke or gaining back weight.
Termination
Nutritive Value
The nutrient content of a specified amount of food.
Macronutrients Page 1250
Those needed in large amounts (e.g. hundreds of grams) to provide energy. Examples are carbs, fats, protein, minerals, vitamins & water.
Essential Amino acids
Those that cannot be manufactured in the body & must be supplied as part of the protein ingested in teh diet.
**sugars:
The simplest of all carbs, water soluble, produced naturally by both plants & animals.
Partially complete proteins:
Those that contain less than required amount of 1 or more essential amino acids & therefore cannot alone support continued growth. i.e. gelatin which has small amounts of tryptophan & milk protein casein w/a little arginine.
**Microminerals:
Those that people require daily in amounts less than 100 mg.
When should BMI be used w/caution and when can it give misleading results?:
Those w/fluid retention (i.e. ascites or edema), athletes or older adults. Possible misleading results in athletes, frail elderly & children.
Polyunsaturated fatty acids
Those w/more than 1 double bond (or many carbons not bonded to a H atom). I.E.: linoleic acid found in vegetable oil.
What is the purpose of Healthy People 2020?
To be used by individuals, states, communities, professional organizations to help them develop programs to improve health
Purpose of the hormone sensitive enzyme lipase
To convert fat into usable energy.
Calorie
Unit of heat energy.
Aromatherapy
Use of oils of plants, Chemicals from oils are absorbed into the body, Oils may be used in massages, inhalants, placed in baths, used as compress, or mixed into ointments
Botanical Healing
Use substances found in nature such as food, herbs, vitamins, oil essences of plants.
Gastrostomy & Jejunostomy devices:
Used for longterm nutritional support, usually more than 6-8 weeks. tubes placed surgically or by laparoscopy through abdominal wall into stomach (gastrostomy) or into the jejunum (jejunostomy).
Name internal variables that influence health status, beliefs, & practices?
Variables Inside us. *Biologic dimension* genetic makeup, gender, age, developmental level *Psychologic dimension* mind-body interactions, self concept *Cognitive dimension* lifestyle choices, spiritual & religious beliefs
How does the nurse view the client using holism?
Views whole person, not just sign or symptom
The need for what vitamin is increased w/alcohol consumption?
Vit B
**Which vitamins can become toxic if taken in high amounts?
Vitamin A, D, B6, K
**The body's most basic nutrient is
Water
Adequate food intake consists of a balance of what nutrients?
Water, Carbohydrates, proteins, fats, vitamins & minerals.
**2 Classifications of Vitamins Page 1252
Water-soluble: body must get a daily supply because it cannot store these. 2. Fat soluble vitamins: Daily supply not necessary because body can store these (limit ot amounts of Vit E & K that can be stored).
What are the different components to Health?
Well-Being-subjective Physical-Carry out ADLs, fitness, nutrition Emotional-manage stress/express emotions Social-Interact,develop/maintain intimacy, "Cultural competence" Intellectual-Learning, growth, new challenges Spiritual-morals, values, ethics, meaning/purpose to life Occupational-work/leisure balance Environmental-Quality of food, air, water.
Complementary and alternative modalities (CAM)
Wide range of philosophies and treatments that allopathy does not typically use or accept.
Mind-Body Therapies Modalities:
Yoga, Meditation; Hypnotherapy & Guided Imagery; Biofeedback; Qigong (chee gong), T'ai chi, & Pilates
Explain Eudemonistic Model
You feel whole even though you have a disease or illness? Its more about the feeling then adapting to the situation.
**Amino acids are absorbed by ______________ through the samll intestine into the ______________circulation. page 1251
active transport, portal blood
Examples of nonessential amino acids
alanine, aspartic acid, sytine, glutamic acid, glycine, hydroxyproline, proline, serine & tyrosine.
Where are saturated triglycerides found?
animal products like butter. Are usually solid at room temp
Ayurveda ( Ancient India ) lifestyle interventions
diet and exercise; detoxification; yoga; breathing exercises; meditation.
Modality =
any method of treating a disorder such as antibiotics or therapeutic touch
cholecystitis avoid ___ and ___-___
avoid fatty (Avocado, bagel, eggs, chips) / gas-forming foods (broccoli, onions, cucumber, beans) ie barbecue chicken, salad, baked potato, rice,
Calcium
beans, dark green veg (spinach, kale, broccoli), calcium-fortified juices and cereals
Faith:
belief in a Supreme Being
acute pancreatitis between attacks: during acute phase:
between attacks pt needs high protein, high carb, low fat NPO during acute phase because pancreatic secretion is increased by food/fluid intake
Enzymes:
biologic catalysts that speed up chemical reactions.
low HCT, low Hgb
diet for iron def anemia
In a sense, protein is stored as ____________.
body tissue as the body can't actually store excess amino acids for future use but limited amount available in metabolic pool that exists because of constant breakdown & buildup of protein in body tissues.
Gas forming foods (4)
broccoli, onions, CUCUMBER, beans, cabbage, cauliflower BANANA BAGELS
a client who follows a vegan diet. The nurse is aware that the client may become deficient in which nutrients
calcium- dairy products vitamin D -in dairy foods vitamin B12 because they do not eat meat iron is found in muscle meats and in fortified cereals and grains
Aromatherapy is used for
calming, stimulation, improving sleep, change eating habits, or boost immune system
Sodium
canned soup, tomato juice, broth, cold cuts, bread, carbonated beverages, canned foods, baked beans, coleslaw, pickles, creamed sauces, MILK (skim milk too), meat/fish that is smoked, pickled, cured, canned, Chinese food/ MSG/ soy sauce, fast food, ceasar salad instant oatmeal has added Na, quick breads, biscuits lemonade= low good choice if restricted
Vit B1, Thiamine
cereals, nuts, beans, and many other vegetables
Child with gastroenteritis once rehydration has occurred/ dehydration is not evident
child's normal diet should be resumed; continued feeding or early reintroduction of nutrients as in a normal diet is without adverse effects, decreases the duration and severity of the illness, and improves weight gain compared to gradually reintroducing foods
morning sickness: ___, __, __ beverages ___ meals high-___ snack before bedtime/ in morning foods/drinks with ____ high in vit. ___ (__,__,___)
clear, cold, carbonated beverages BETWEEN meals high-protein snack before bedtime/ in morning foods/drinks with GINGER and high in vit. B6 (nuts, seeds, legumes)
Prayer:
communication with creator
Bioelectromagnetics:
controversial energy therapy; contraindicated in pregnancy, pacemakers; avoid with anticoagulants, wounds, bleeding, or torn muscles
Allopathic medicine =
conventional medicine; biomedicine; scientific view ; Western medical practices
Pt takes phenytoin (Dilantin)... when providing nutritional counseling, the nurse should include which of the following foods in the patient's diet?
diet high in folic acid, calcium, vit. D anticonvulsants can cause folate and vitamin D deficiencies (se= osteoporosis) folate are green leafy vegetables, legumes, tomatoes, and various fruits such as oranges and cantaloupe; good sources of vitamin D include milk
Prevention for renal calculi fluids ___-___ml/d avoid foods high in ___ (__, __, __) limit __, __ ,__ if calcium calculi: ___ sodium
diet, medications, fluids: 3,000 to 4,000 ml/day, incr fluids in warm/hot enviro to prevent dehydration avoid high in oxalates (spinach, asparagus, and cabbage) limit coffee, cola, tea dietary changes only helpful if you know composition of stones calcium calculi: (ie reduce the amount of dairy products and eggs in your diet) eat diet LOW SODIUM, high sodium will incr calcium excretion
Menieres disease ___sodium avoid __, __, __ meds: ___,__, __, ___ __ body movements
disease of inner ear from accumulation of endolymphatic fluid- incapacitation vertigo, tinnitus, sensorineural loss LOW sodium diet (2,000mg/d) AVOID caffeine, nicotine, alcohol meds: diuretics, antiemetics, antihistamines, antivertigo meds (also SLOW down body movements bc jerky mvmnt precipitates attack, LIE down during attack)
Cirrhosis
early: high protein, high carb, vit. B complex supp advanced stated: fiber, protein, fat, sodium RESTRICTIONS, protein of HIGH biological value, high cal, sm freq feeds fluid restriction avoid alch high cal (malnutrition serious complication): 3,000 calories/day
Abdominal Aortic Aneurysm (AAA)
encourage fluid intake and dietary fiber... prevents constipation and the need for straining with bowel movements that may cause increased intra-abdominal pressure and risk of rupture (dont wear seatbelt, dont lift heavy object, dont elevate feet above heart level-inr abdominal pressure)
**Energy balance is the relationship between: page 1253
energy derived from food & energy used by the body.
**Maintaining a healthy or ideal body weight requires balance between:
expenditure of energy & intake of nutrients.
**Fasting person will obtain most calories from ___________ as lipase breaks down triglycerides in the ___________. page 1252
fat metabolism, adipose cells.
National Center for Complementary & Alternative Medicine (CAM) =
federal agency for research and accurate public information on effectiveness of these modalities.
Pregnant balanced diet, esp containing (6)
folic acid (B9), iron, protein, calcium, whole grains, omega 3-FA AVOID: unpasteurized milk, unwashed F/V, undercooked meat, Deli meat (risk Listeria), hot dogs (unless steaming hot), raw fish/meat, and fish high in mercury (swordfish, king mackerel, shark, tilefish) and excessive vit A (in liver).... avoid Listeria and toxoplasmosis
Water-soluble vitmains can be affected by:
food processing, storage and preparation.
CROSS REACTIVE FOODS WITH LATEX ALLERGY
foods to avoid include apple, apricot, AVOCADO, BANANA, carrot, celery, cherry, CHESTNUT, fig, GRAPE, KIWI, melon, nectarine, passion fruit, papaya, PEACHES, pear, pineapple, plum, POTATO, and TOMATO also lips swell with balloons, hands itch/burn after gloves greatest latex allergy RF: long-term multiple exposures, 93% pt spina bifida
Bipolar
frequently undernourished/dehydrated. give "on the run" foods ie sandwiches, smoothies, milkshakes, ice cream bars, fresh fruit, chips, pizza slices, burritos, fruit juices, granola bars with high nutritional density
lactose intolerance
fresh yogurt can be used in situations of lactose intolerance because it has a lactase enzyme
Horticultural therapy:
gardening- stimulates the five senses, provides leisure activities, improves motor function, provides a sense of achievement, and improves self-esteem
child with adrenoleukodystrophy (ALD) give...
give Lorenzo's Oil treatments.
What are the 3 monosaccharides & which is the most abundant?
glucose, fructose & galactose w/glucose by far the most abundant simple sugar.
celiac no __, __, __, __ replace __-soluble vit, __, ___ __
gluten-free no BROW: barley, rye, oats, wheat processed foods (chocolate/hot dogs), modified starch, malt, soy sauce = hidden sources deficient vitamins (fat-soluble), iron, folic acid, should be replaced
**End products of lipid digestion are: page 1251
glycerol, fatty acids, cholesterol which are reassembled inot triglycerides & cholesterol esters, eventually becoming lipoproteins.
Folic Acid preg need ___-__mcg/d
green leafy veg, beans, rice, fortified grain products* (cereal, bread, pasta), liver 400-800 mcg/d
Folate
green leafy vegetables, legumes, tomatoes, and various fruits such as oranges and cantaloupe
Magnesium
green veg, nuts bananas oranges, peanut butter and chocolate
Reiki =
hands near the body; client draws energy from practitioner's hands.
Curanderismo (Latin America) specialize as
herbalists, midwives, counselors, spine and joint workers, and massage therapists
Burn victim __ cal __ protein __ cab vit. __, vit. __, ___
high cal, high PROTEIN, high carb, vit B, C, iron (H2 histamin blocker and antacids to prevent curling ulcers, and NGT) Cheeseburger, fruit-flavored yogurt, carrots, and milk. (all contain protein except carrots)
Crohn's/ Ulcerative colitis __ cal ___ protein ___ fat ___ fiber ___ residue diet
high cal, high protein, low-fat, low-fiber, low- residue diet, skinless vegetables, canned/cooked/seedless vegetables, refined grains (White bread) ok, NO RAW fruit/veg (sprouts, carrots, celery sticks), NO beans/legumes (high fiber), NO raisin bran/ whole gains
Cystic Fibrosis __ calorie, __ protein, __ fat diet __ sodium __ fluids supp vit __, __, __, __ oral pancreatic enzymes: __coated so. take with meals. sprinkle on ____, ____, or ___, __, ___/ __-temp foods with pH <____ DONT __/ __ them or take with ___
high calorie, high protein, high fat INCR sodium in diet incr fluid (remove secretions) (impaired intestinal absorption) fat soluble vit supp A D E K oral pancreatic enzyme supplementation: enteric coated. take WITH meals (sprinkle on applesauce, yogurt, acidic, soft, cool/ room-temp foods with <pH 4.5) DONT crush/chew DONT take with milk, enzymes curdle it...excessive intake can cause fibrosing colonopathy
Hepatitis
high carb, high cal fluids 2,500-3000 mL/d sm freq meals, big breakfast (Anorexia lowest in morning) encourage lean meat, F/V, cereals low fat, low protein no alch
Anemia high in __, __, and ___
high in protein, iron, and vitamins
wound healing/ post-op diet
high protein, high cal, iron, vit. C, multivitamins aid in wound healing and RBC formation, B6 and B12 important for collagen synthesis high protein + high cal to remain anabolic state ie Chicken breast, peas, mashed potatoes, orange, and ice cream. Hamburger, boiled potatoes, corn, pudding, and grapefruit juice. Salmon steak, baked potato, lima beans, tangerine, and milk.
Addison syndrome ___ protein, ___ carb, ___ sodium, ___ potassium diet
high protein, high carb, high sodium, low potassium diet
hypothyroidism: __ protein ___ calories ___ fluids ___ fiber
high protein, low cal (overwt), incr fluids, incr fiber/ high-cellulose foods (constipated)
Cushings syndrome ___ protein, ___ carb, ___ sodium, ___ potassium, ___ cal diet, fluid restriction?
high protein, low carb, low sodium, high potassium, low cal diet, fluid restriction
CAPD, continuous ambulatory peritoneal dialysis
high protein, well-balanced diet (fluid and protein loss) may need stool softener and high fiber to prevent constipation (main cause of insufficient dialysate flow)
Renal Failure ___ cal ___ protein
high-cal, low protein diet, as allowed by kidney function
9 essential amino acids:
histidine, isoleucine, leucine, lysine, methionine, phenylalaline, tryptophan, threonine, valine. Necessary for tissue growth & maintenance. (A 10th, arginine, has role in immune system).
Animal-assisted therapies:
horseback riding; resident animals
Ileostomy
ileostomy= small intestine (smaller stoma, 1in or less) follow LOW-residue diet (low fiber) to prevent obstruction of narrow lumen F/V should be pitted, peeled, cooked AVOID: HIGH-FIBER: popcorn, coconut, brown rice, multigrain bread stringy vegetables: celery, broccoli, asparagus seeds or puts: olives, strawberries edible peels: apple slices, cucumber, dried fruit
Traditional Chinese Medicine (TCM) disease =
imbalance or interruption of qi
Contraindications for magnetic therapy (form of bioelectromagnetics)
include pregnancy, pacemakers, implanted defibrillators, aneurysm clips in the brain, cochlear implants, or other implanted electrical devices.
Liver disease
increased carbohydrates, low protein, and low sodium
Critical to health & recovery =
individualize interventions that can combine allopathic and alternative practices in a healing environment
TB diet ___, ___, vit. ___ and vit. __
iron, protein, vitamin B, vit C
biofeedback
is a method by which a person can learn to control certain physiological responses of the body. The technique uses electronic equipment to provide clients with visible or audible evidence that they are controlling their body in the desired manner
pilates
is a method of physical movement and exercise designed to stretch, strengthen, and balance the body, in particular the core or center including the abdominal region
guided imagery
is a state of focused attention, much like hypnosis, that encourages changes in attitudes, behavior, and physiological reactions. Helps us learn how to stop troublesome thoughts and focus on images that help us relax and decrease the negative impact of stressors.
colloquial prayer
is an informal talk with God, as if one were talking to a good friend.
Intercessory prayer
is asking God for things for oneself or others may be called "distant" prayer, if the person being prayed for is remote from the person who is praying
Diet to prevent seizures
ketogenic: high in fat, low in cho, mimics effects of fasting and places body in a constant state of ketosis
Law of minimum dose =
large doses will cause symptom; minute doses stimulate body defenses
radium implant
low residue diet to decrease bowel movements
diarrhea
low residue, high calorie, protein avoid caffeine, roughage (Fresh fruit salad), and DAIRY products avoid honey, high-fructose corn syrup,wheat, spices, hot/cold, fatty, gas-producing (bananas, cabbage, onions, bagels, beans)
Hepatobiliary disease ___ fat ___ protein ___
low-fat hight protein diet vitamins
Massage=
manipulation of soft body tissues
Fat: LOW fat:
marbled meats, cheeseburger, grilled cheese, avocado, milk, bacon, egg yolk, butter, peanut butter, bologna, potato chips bran flakes, skim milk (no fat), canadian bacon, egg whites, COLA (high in cho not fat), water-packed TUNA, backed tortilla chips and salsa
Protein
meat, fish, eggs, dried beans, almond butter milk/dairy (whole milk), milkshakes, fruit smoothies, yogurt, broccoli legumes= economical
**Protein digestion begins in the ___________ w/enzyme ___________. page 1251
mouth, pepsin
Law of similars =
natural substance that causes a symptom in a healthy person will cure the symptom in a sick person
Alcoholic
needs supplementation with all B vitamins, especially thiamine (vitamin B1); thiamine deficiency is the primary cause of alcohol-related changes such as Wernicke's encephalopathy and Korsakoff's syndrome
Fecal occult blood test avoid: food:___ ___, vit. ___ meds: __/___, ___, ___, ___
no red meat, vit. C for 3 days ASA/Ibuprofen, anticoag, iron, corticosteroids interfere
MAOI-s
no tyramine with MAOIs smoked/fermented, alcohol/wine, cheese (Cream cheese ok), chocolate, liver?, BANANAS, AVOCADOS, no yeast/yogurt (brown-rice ok), whole wheat bread likely to have yeast spinach and tuna are ok
Therapeutic Touch =
non invasive, use of hands on or near the body for comfort, pain relief, and healing.
Lithium ____ sodium intake ___ fluid intake (__-__L/d)
normal sodium intake, adequate fluid intake (2-3 L/d) avoid limiting sodium bc lithium is a salt and replace sodium in cells leading to lithium toxicity
Nurses use Maslow's Needs Theory to _____________________ what they're going to do first.
prioritze
**Incomplete proteins lack page 1251
one or more essential amino acids usually lysine, methionine or tryptophan & are usually derived from vegetables. Can mix plant proteins to balance out, ie. corn and beans.
Ideal body weight (IBW)
optimal weight recommended for optimal health.
colonics
or colon therapy, is based on the idea that high-fat, Western diets lead to an accumulation of a substance in the colon, which in turn produces toxins that lead to disease.
Sickle cell crisis
oral and IV fluids high cal high protein FOLIC ACID (help produce new RBC needed due to hemolysis) multivitamin WITHOUT iron (often require blood transfusions and run risk of iron overload if iron is supplemented) IV/oral hydration, narcotics, O2 avoid COLD- promotes sickling
Chronic Kidney Disease (CKD) CHO protein K+ Phosphorous Na Ca Water __-__L/d
pasta/breads--grains are good source of CHO (incr CHO helps pt maintain energy requirements) protein with HIGH biological value is allowed (eggs, LEAN meat ie chicken breast, fish, poultry), protein intake determined on basis of impairment (GFR), too much will incr uric acid CKD causes hyperkalemia... cabbage and apples low in K+ CKD causes hyperphosphatemia CKD causes hypernatremia CKD causes HYPOcalcemia... consume calcium but still AVOID DAIRY bc dairy is high in phosphorous + will bind Ca 1-2 L water/day (maintain fluid balance and avoid retention of excess fluid that cannot be excreted by the compromised kidneys)
bottle-fed infant is allergic to cow's milk
predigested formulas .... formulas that use enzymatic hydrolysis to break down or predigest the casein protein into its amino acids NOT SOY-based formulas (cow's milk allergy due to cross-reactivity to soy) NOT goat's milk (has cross-reactivity with cow's milk protein, is deficient in folic acid, is inadequate as the only caloric source)
Acupressure , acupuncture, & reflexology =
pressure to specific body points to relieve pain and other symptoms.
vit K
produced by bacteria in large intestine GREEN veg, pork, rice, yogurt, cheeses, FISH, EGG
The client is diagnosed with a flaccid bladder following a spinal cord injury. The nurse teaches the client about dietary changes. Which beverage, if selected by the client, indicates to the nurse that teaching is effective? which diet?
promote ACIDIC urine (minimizes risk of UTI and stone formation), 1000 mg vit. C (ascorbic acid) prune juice cranberry juice tomato juice bouillon HIGH fiber, LOW fat diet AVOID alkaline urine... avoid CITRUS juices, OJ, lemonade, excessive amt of milk, and carbonated beverages
Toddler
provide with finger foods no carrots/hot dogs/sticky pb/slippery
Music Therapy:
reduce pain intensity and distress; distraction; induce relaxation; Bioelectromagnetics; Detoxifying Therapies; Animal-assisted therapies; & Horticultural therapy
dental caries cariogenic foods: cariostatic (inhibit caries) foods:
refined simple sugars, sticky, sweet foods, dried fruit/candy milk, dairy, yogurt, F/V/ whole grain, sugar free gum w/ xylitol finish meal with high-protein food
Chiropractic =
relationship between nervous & musculoskeletal system; irritation of nervous system.
Humor and laughter:
relaxation; relieve tension; promote positive emotions
Elevated BUN restrict ___
restrict Protein (decreased production of urea nitrogen can be achieved by restricting protein; metabolic wastes cannot be excreted by the kidneys)
Pro's & con's of herbs =
safety, effectiveness, cost, and convenience (readily available but may delay care)
NCCIH's Mission and Vision is that
scientific evidence will inform decision-making by the public, by health care professionals, and by health policymakers regarding the use and integration of complementary and integrative health approaches.
Hepatitis A. The client complains of fatigue, anorexia, and intolerance to odors.
small and freq feedings. encourage client to eat all meals and snacks; if client has nausea later in the day, offer morning meals that are rich in nutrients should eat protein sources such as milk, meat, and eggs should increase calories to 2,000 to 3,000 calories per day to meet energy needs do not ingest alcohol during episode of hepatitis and for SIX MONTHS after recovery protein restricted if impending hepatic coma
**Most protein digestion occurs in the ______________.
small intestine
**In healthy people, absorption takes place in the:
small intestine where essentially, all monosaccahrides are absorbed (Monosaccacharides don't require digestion).
Stomatitis
soft, bland, nonacidic, and cool liquids and foods will help eating process be more comfortable; spicy foods, hot liquids, and citrus juices cause mucosal irritation commercial mouthwash should be avoided because of high alcohol level that causes a burning feeling in the irritated oral mucosa; warm saline or hydrogen peroxide are mouthwashes that can be used instead nystatin is an antifungal agent in oral suspension; should be swished around in the mouth and then swallowed
**Lipid digestion begins in the _____________ but occurs mainly in the ___________________.
stomach, small intestine.
Vitamin D
sun, dairy foods, vit d fortified juice (OJ), fortified milk, fortified cereal, fish oil, oily/ salt water fish (SARDINES, SALMON, TUNA), egg YOLK,
Isoniazid
supp with vit. B6 (pyridoxine) for peripheral neuropathy/ataxia/dizziness side effects of INH
PUD/ gastric/ duodenal ulcers
taking histamine blocker- small freq feedings are NOT necessary avoid: coffee/caffeine, ASA/NSAIDS/ advil, alcohol, smoking cigs, diet rich in milk/cream, meat extracts -all stimulate acid production
**Caloric value page 1253
the amount of energy that nutrients or foods supply to the body.
Detoxifying Therapies:
the belief that physical impurities and toxins must be cleared from the body to achieve better health. These types of cleansing therapies may be included as a part of Ayurvedic practices.
Hand-Mediated Biofield Therapies=
therapeutic touch, healing touch, and Reiki
What should happend every 4-6 hours with continuous drip feeding?
tubing should be clamped, gastric contents aspirated and measured and then tubing flushed w/30-50 mL of water? This determines adequate absorption & verifies correct placement of the tube.
Qigong (chee gong), T'ai chi, & Pilates=
types of body movement to balance energy
Alternative or complementary medicine =
used in conjunction with traditional medicine (antibiotics & herbs); or instead of traditional medicine (yoga instead of a pill)
coranderas
women
humor
• Establishes relationships relieves anxiety and tension facilitates learning Coping with painful feelings.