EXAM 1

1/2 Normal Saline (1/2 NS) Description Osmolality Use Miscellaneous

0.45% NaCl in water crystalloid solution Hypotonic (154 mOsm) Raises total fluid volume Useful for daily maintenance of body fluid, but is of less value for replacement of NaCl deficit Helpful for establishing renal function Fluid replacement for clients who don't need extra glucose (diabetics)

Normal Saline (NS) Description Osmolality Use Miscellaneous

0.9% NaCl in water crystalloid solution Isotonic (308 mOsm) Increases circulating plasma volume when red cells are adequate Replaces losses without altering fluid concentrations Helpful for Na+ replacement

What is the recommended intake amount for sodium?

1.5 g/day

The Esophagus

A muscular tube through which bolus travels from mouth to stomach Peristalsis Segmentation Cardiac sphincter

Protein as source of energy

Amino acids: deamination Some amino acids converted to pyruvate or to TCA cycle intermediates

Ammonia water

Ammonia gas dissolved in water

List the primary functions of chloride.

Assists with maintaining fluid balance Aids in preparing food for digestion (as HCI) Helps kill bacteria Assists in the transmission of nerve impulses

Fluid & Electrolytes

Balance To maintain fluid balances -- cells control movement of electrolytes Imbalances Fluid Volume Deficit (FVD) Vascular, cellular, or intracellular dehydration Causes include diarrhea, vomiting, high fever, diuretics, sweating, polyuria Most at risk: elderly people and infants

Methods to determine food energy

Bomb calorimeter Proximate composition

Kilocalorie Values of Types of Foods (Nutrient, Kilocalorie/gram)

Carbohydrates: 4 Proteins:4 Alcohol: 7 Lipids (fats): 9

Seltzer

Carbon dioxide in water

Regulation of body fat complex

Changes in body fatness 1 pound of body fat approximately equivalent to 3500 kcal Energy balance determined by relationship of energy intake to energy expenditure

Processes completed by digestive system

Chemical and mechanical digestion

Aerobic pathway (glycolysis): oxygen needed

Creation of acetyl coenzyme A (CoA) For endurance-type exercise Takes place in mitochondria of cell

The primary function of carbohydrates in the body is to provide: Satiety Dietary fiber Sweetness Energy.

Energy

Dietary Reference Intakes: Terms

Estimated Average Requirement (EAR) Recommended Dietary Allowance (RDA) Adequate Intake (AI) Tolerable Upper Intake Level (UL) Acceptable Macronutrient Distribution Range (AMDR)

Organs of the Digestive Tract

Gastrointestinal (GI) tract Digestive system Digestion

Protein & amino acid supplements

If protein needs are met by food, supplements are treated as excess protein. Protein (amino acids) does not increase muscle mass; athlete needs resistance strength training program and diet rich in complex CHO.

As bodies function, chemical energy from food converted to mechanical energy & heat

Kilocalorie (kcal): unit of energy measurement

Type I Diabetes Mellitus

Less common than type II (20% of the people who have diabetes have Type I and 80% have Type II). In Type I diabetes, the pancreas does not have any insulin to release, so even though there is abundant glucose in the bloodstream, it is not able to enter the cell. This is also called insulin-dependent diabetes, because insulin injections have to be taken in order to stimulate the cell membrane to take in the glucose.

A client is asking the nurse in his provider's office about the various well-known weight loss programs. In discussing low-carb diet programs, the nurse should point out that clients report which of the following when using this type of plan? Heart healthy Less hungry Limited availability

Less hungry

Glycemic Index:

Level to which food raises blood glucose levels in comparison with reference food Highest ranking is 100

List some toxicity symptoms of phosphorus.

Muscle spasms Convulsions Low blood calcium levels

What are the deficiency symptoms of chloride?

Muscle weakness Bone pain Dizziness

Complex Carbohydrates:

Polysaccharides ➢composed of many units of monosaccharides held together by different kinds of chemical bonds Starch Fiber

I have difficulty lifting things because my muscles feel weak. I also have felt my heart beating irregularly and have vomited a couple of times. Question 2: What type of electrolyte deficiency or excess is the person dealing with? What is the recommended intake?

Potassium, 4.7 g/day

Minerals

Serve structural purposes in body & found in body fluids 16 essential minerals, categorized as major & trace minerals Found in fruits, vegetables, dairy, meats, & legumes

Set point & body fatness

Set point: natural level (of some characteristic) that body regulates or defends Defending set point of weight & body fatness Food intake adjustments Bodies make adjustments to return to set point. Among adult humans, there is a range of set points for body fatness.

The primary Extracellular electrolytes in body fluids are

Sodium (Na+ /cation) & Chloride (Cl/anion) (35% of body water)

Syrup

Sugar dissolved in water

36. Within the body, water helps to do which? a) dissolve lipids b) avoid dehydration c) insulate nerve fibers d) regulate body temperature

b) avoid dehydration d) regulate body temperature

5. The nutrients that provides the highest number of kcals per gram is: a) protein b) alcohol c) fat d) carbohydrate

c) fat NOTE: Kcals values for carbohydrates (4gr), Protein (4gr), alcohol (7gr), Lipids/fat (9gr)

8. A category of nutrients that assists other nutrients with metabolic functions throughout the body is: a) water b) protein c) vitamin d) minerals

c) vitamin NOTE: Vitamins indirectly assist other nutrients through the complete processes of digestion, absorption, metabolism, and excretion. Water provides a fluid medium and a transport system for body processes. Protein makes up many body structures, enzymes, and components of the immune system. Minerals serve structural purposes and are found in body fluids.

15. The "fruit & veggies - more matters" slogan is part of a campaign designed to increase of fruits & veggies among: a) school-age children b) people living in urban areas c) low-income individual and families d) all Americans NOTE: "Fruits & veggies—more matters" is part of the National Fruit and Vegetable Program, designed to increase intake of fruits and vegetables among all Americans. It is not specifically targeted at any age, demographic, or socioeconomic group.

d) all Americans NOTE: "Fruits & veggies—more matters" is part of the National Fruit and Vegetable Program, designed to increase intake of fruits and vegetables among all Americans. It is not specifically targeted at any age, demographic, or socioeconomic group.

20. Consider the following food label from a frozen meal, and choose the nutrients important for healthy bone and tissue. a) calories b) fat c) cholesterol d) sodium ( e) potassium (muscle) f) sugar g) protein (tissue) h) calcium (bone) i) iron (hemoglobin)

g) protein (tissue) h) calcium (bone)

Glycogenolysis:

glycogen stored in the liver is converted back to glucose

Gluconeogenesis:

is the process of producing glucose from protein & fat

If a client drinks a cup of decaffeinated coffee in the morning, a cup of fruit juice with lunch, 6 cups of water throughout the day, and a cup of tea at bedtime, her fluid intake would be considered: Optimal Dangerously low Too high Below optimal

optimal.

Glycogen:

storage form of CHO in liver and muscles

Glycemic Load:

total glycemic index; effect of mixed meal or dietary plan

What is the recommended intake amount for phosphorus?

2.3 g/day

What is the recommended intake amount for potassium?

4.7 g/day

Acceptable Macronutrient Distribution Range (AMDR) for carbohydrates:

45% to 65% of kcal intake per day as primarily complex carbohydrates.

1. How many total calories does a food with 4 g of protein, 4 g of carbohydrate, and 4 g of fat contain? a. 68 calories b. 48 calories c. 12 calories d. 88 calories

ANS: A Protein and carbohydrates each contain 4 cal/g. Fats contain 9 cal/g. Therefore, this food would contain (4 × 4) + (4 × 4) + (4 × 9), or 68, total kilocalories.

Toward a Positive Nutrition Lifestyle: Contracting

Contract: a specific agreement with yourself or between you and a friend, spouse, or other relative Agreement represents willingness to attempt to change a health-related behavior. Goal or behavior change clearly defined and observable.

Elimination

Expulsion of feces or body waste products called defecation Residue may include: Undigested materials such as cellulose and other dietary fibers. Undigested fats may combine with dietary minerals such as calcium and magnesium to form residue. Additional residue may include water, bacteria, pigments, and mucus.

The Mouth

Function of salivary glands Secretes saliva Starts digestive process Function of teeth and tongue Teeth tear & pulverize food Formation and movement of bolus

Structure of minerals

Inorganic substances incorporated into body structures (bones), organs, & fluids

Primary functions of sodium.

Major positively charged electrolyte in extracellular fluid Maintains proper acid-base balance Assists with transmission of nerve signals Aids muscle contraction Assists in the absorption of glucose and other nutrients

Metabolism of minerals

Minerals are not metabolized by the human body Inorganic & do not provide energy Some are cofactors of metabolic processes

What are the deficiency symptoms of sodium?

Muscle cramps Loss of appetite Dizziness Fatigue Nausea Vomiting Mental confusion

Brine

Sodium chloride (table salt) dissolved in water

To maintain fluid balance, cells control the movement of electrolytes. Water will follow

Sodium concentration.

23. A bolus is a ball of: a) masticated food ready to be swallowed b) fat emulsified with bile and intestinal secretions c) mucus that helps move food along the GI tract d) indigestible fiber mixed with the waste products of digestion

a) masticated food ready to be swallowed

1. Which of the following nutrients provides energy to the body? a. Water b. Vitamin C c. Carbohydrates d. Potassium

ANS: C Only carbohydrates, proteins, and lipids release energy for the body to use. Vitamins, minerals, and water, although essential, do not release energy. These non-energy-yielding nutrients have indirect roles as catalysts for the body's use of energy nutrients.

1. According to MyPlate, how much of an individual's "plate" should be filled with fruits and vegetables? a. 1/4 b. 1/3 c. 1/2 d. 2/3

ANS: C MyPlate (www.choosemyplate.gov) is based on the 2010 Dietary Guidelines for Americans and is a visual way for consumers to see what foods they should be eating at any given meal. The recommendation is to make half of the plate fruits and vegetables because these foods are generally low in fats, high in nutrients, and relatively low in calories.

Energy Balance Estimating daily needs

Recommended energy allowances, National Research Council Formulas Components of total energy expenditure: Basal metabolism or basal metabolic rate; physical activity; thermic effect of food Adaptive thermogenesis: Energy used to adjust to changing physical & biologic environmental situations Coldness, changes in kilocalorie intake, physical & emotional trauma

One reason that increasing fruit and vegetable consumption helps decrease dietary fat intake is that fruits and vegetables: Are rich in antioxidants and phytochemicals Are natural appetite suppressants Decrease absorption of fat from foods Replace high-fat foods in the diet

Replace high-fat foods in the diet

What is a blood glucose level of 60 mg/dL is considered to be? Representative of hyperglycemia Representative of hypoglycemia Representative of normoglycemia Inconclusive

Representative of hypoglycemia

1. Which principle of health diet suggest selecting a wide range of foods as represented by the USDA's MyPlate food plan? a) Variety b) Moderation c) Adequacy d) Energy density

a) Variety

39. Serum calcium levels can be affected by which? a) dietary intake of calcium b) vitamin D intake c) time spent outside d) exercise

a) dietary intake of calcium b) vitamin D intake c) time spent outside d) exercise

17. Fish consumption is increasing in the United States as a result of: a) greater availability of fresh & frozen fish b) increased use of fish in processed foods c) dietary emendations to consume lighter colored protein sources d) recognition that protein form fish is superior to other protein sources.

a) greater availability of fresh & frozen fish

27. The esophagus is the: a) muscular tube use for excretion of waste products. b) pathway through which enzymes & hormones travel. c) pathway that blood follows within the body from organ to organ. d) muscular tube along which a food bolus travels from the mouth to the stomach.

d) muscular tube along which a food bolus travels from the mouth to the stomach.

40. If a patient has cancer & is being treated using chemotherapy, his or her greatest food safety concern is: a) avoiding pesticide residues b) potential food-drug interaction c) choosing natural food products d) preventing foodborne illness

d) preventing foodborne illness

30. The person eating a high intake of complex carbohydrates is likely following a ___ diet a) low-fat diet b) lactovegetarian c) vegan d) regular

d) regular

32. Bacteria have a role with ____ in causing_____ a) fiber, diabetes b) fiber, tooth decay c) sugar, diabetes d) sugar, tooth decay

d) sugar, tooth decay

6. As a nurse, you know that health promotion typically, consist of strategies use to increase the level of the health of individuals, their families, groups, and entire communities. Example of health promotion strategies implement by nurse often include: a) Knowledge, power, and community services b) trust, government stipends, and managed care c) knowledge, techniques, and community support d) trust, cultural perception and knowledge

d) trust, cultural perception and knowledge

As a part of a weight-loss workshop in the local community, a nurse is teaching participants how to use anthropometric measurements for self-assessment. Which of the following measurements from participants indicates a healthy waist-to-hip ratio? Male, waist 36 inches, hips 34 inches Female, waist 28 inches, hips 31 inches Male, waist 38 inches, hips 41 inches

male, waist 38 inches, hips 41 inchesTo calculate waist-to-hip ratio, divide the circumference of the waist by the circumference of the hip. This client's ratio is 0.93. A healthy ratio for a man is below 0.95, a healthy ratio for a woman is below 0.8

Electrolytes are: Major electrolytes: Specific functions:

minerals that carry electrical charges or ions (particles) when dissolved in water Major electrolytes: sodium, potassium, & chloride Specific functions: Acid-base balance of body fluids depends on regulated distribution of these minerals, proteins, & other electrolytes. Electrolytes have a role in normal functioning of nerves & muscles. Each mineral serves other specific functions in body.

Somatostatin:

pancreatic and hypothalamus hormone that inhibits insulin and glucagons

Insulin:

pancreatic hormone that regulates blood glucose uptake

Glucagon:

pancreatic hormone that releases glycogen from liver

Glycogenesis:

process of converting glucose to glycogen

Fiber

▪Carbohydrate (polysaccharide) & lignin in plant foods ▪Does not provide kcal or nutrients ▪Cannot be digested by humans Soluble fiber - dissolve in liquids Insoluble fiber Health Effects Obesity Constipation Diverticular disease Colon cancer Heart disease Diabetes control Recommended adequate intake (AI): 25 to 38 g/day Unrefined versus refined grains Whole (unrefined) grains Refined grains Enrichment

Glycogen

A highly branched polysaccharide molecule Short-term storage molecule usually found in the liver or muscle cells. The glycogen is deposited in the liver throughout the day and is used during the night as a fuel source (glucose molecules are cleaved off the glycogen). The glycogen is usually depleted by morning; this is why it is so important to eat breakfast—to get the sugar level back up in your bloodstream and to start storing glucose as glycogen for the next night.

A nurse is giving a presentation at a community center about the health risks of obesity. Which of the following disorders should the nurse include? (select all that apply) A. heart failure B. cancer C. hypothyroidism D. gout E. cardiac dysrhythmias

A. heart failure B. cancer D. gout E. cardiac dysrhythmias Gout-gout stems from excess uric acid production, and when there is more cell turnover and breakdown with obesity, the risk increases.Cancer-obese men at increased risk for colon, rectal, and prostate cancer-obese women at increased risk for breast, uterine, ovarian, and gallbladder cancerHeart failure-added strain on the heart plus the larger volume of blood and many other facotrs greatly increase the risk Cardiac dysrhythmias-atrial fib is common in people who are obese

2. In comparison with the average person, a muscular person with a large amount of lean body mass would have __________ basal metabolic rate. a. a higher b. a lower c. the same

ANS: A Basal metabolic rate (BMR) is the rate at which the body spends energy to keep all life-sustaining processes going. People with more lean body mass have a higher BMR because more energy is needed to maintain muscle mass than to maintain other types of tissues, such as fat.

1. Which organ is responsible for the majority of nutrient absorption? a. Stomach b. Small intestine c. Liver d. Large intestine

ANS: B Although absorption also occurs in the large intestine, the small intestine does the majority of nutrient absorption. The stomach prepares food for digestion by releasing chemicals and forming chyme. The liver is the first organ to receive digested nutrients from the circulatory system.

2. Which organ is responsible for producing insulin in sufficient amounts to keep blood glucose level within normal ranges? a. Liver b. Pancreas c. Spleen d. Adrenal glands

ANS: B The pancreas produces insulin, which helps regulate blood glucose levels each time an individual eats a meal containing carbohydrate. Insulin helps lower blood glucose levels to within the normal range. Glucagon is a hormone also released from the pancreas that signals an opposite action: when glucagon is released, the liver converts stored glycogen into glucose for the body to use as energy, particularly during the night time or times of fasting.

2. This Dietary Reference Intake (DRI) is used when there is not sufficient research or evidence to determine a Recommended Daily Allowance (RDA). It is an approximate level that appears to maintain good health: a. Estimated Average Requirement (EAR) b. Acceptable Macronutrient Range (AMR) c. Adequate Intake (AI) d. Tolerable Upper Level (UL)

ANS: C Dietary Reference Intakes are set using the latest research and experimentation. Some have RDAs while others have AIs, depending on the amount and quality of data available. RDAs are more precise and intake of a nutrient at that level would cover needs of most of the population. AIs are approximate averages.

Oxidative phosphorylation

Creation of phosphate bond to form ATP

What are the deficiency symptoms of phosphorus?

Dangerous changes in pH Irregular heartbeat

D5 1/2 NS Description Osmolality Use Miscellaneous

Dextrose 5% in 0.45% saline Hypertonic (406 mOsm) Useful for daily maintenance of body fluids and nutrition, and for rehydrationMost common postoperative fluid

D5NS Description Osmolality Use Miscellaneous

Dextrose 5% in 0.9% saline Hypertonic (560 mOsm) Replaces fluid sodium, chloride, and calories Watch for fluid volume overload

D5LR Description Osmolality Use Miscellaneous

Dextrose 5% in Lactated Ringer's Hypertonic (575 mOsm)Same as LR plus provides about 180 calories per 1000ccsWatch for fluid volume overload

D5W Description Osmolality Use Miscellaneous

Dextrose 5% in water crystalloid solution Isotonic (in the bag) *Physiologically hypotonic (260 mOsm) Raises total fluid volume Helpful in rehydrating and excretory purposes Provides 170-200 calories/1,000cc for energy Physiologically hypotonic—the dextrose is metabolized quickly so that only water remains a hypotonic fluid

Diffusion

Diffusion Diffusion is process consists of a random movement of molecules that will move from a higher concentration (more solutes) to an area with a lower concentration until it is equally distributed between both areas. Think of opening a perfume bottle; after a while, the entire room smells like the perfume. This is often considered a form of passive transport.

Digestive Process Across Life Span

Digestive process across the life span Immature GI tract of young infants Allergies Middle years include gallbladder disease and peptic ulcers Age-related lactose intolerance Older years associated with constipation and diverticulosis

CarbohydrateDigestion

Digestive process begins in mouth Breakdown to monosaccharides Mechanical digestion Chemical digestion function of enzymes Lactose intolerance

Digestion & absorption of minerals

During digestion, minerals are separated from foods. Bioavailability affects levels of minerals absorbed. Risk exists for deficiencies of iron, calcium, & zinc.

A nurse is teaching a client who is trying to lose weight about reading food labels. Which of the following instructions should the nurse include? The "% Daily Value" refers to a 1,500 calorie dietServing quantities represent their weigh tin ounces "Amount per serving" is the amount in the size portion the label specifies

"Amount per serving" is the amount in the size portion the label specifies

A client has heard that nutrients can be converted to other nutrients in the body. He takes high-dose vitamin C supplements because he believes this will supply his body's need for other vitamins. What is the nurse's best response to him? "You should switch to a multivitamin supplement instead of just vitamin C." "Each vitamin has a specific function and needs to be supplied through a variety of foods." "Vitamin C can provide only water-soluble vitamins, and you still need to consume fat-soluble vitamins." "Vitamin C supplements should be taken only when you have symptoms of a cold or influenza."

"Each vitamin has a specific function and needs to be supplied through a variety of foods."

A cup of frozen yogurt contains 24 g of carbohydrate, 2 g of fat, and 4 g of protein. The total number of kilocalories in the frozen yogurt is: 110 130 162 140

130 (4x24)+(4x2)+(9x4)

Dietary Reference Intake (DRI) for carbohydrates for adults between 19 and 30 years of age:

130 g/day

Mineral categories

16 essential minerals divided into 2 categories: Major and trace minerals Based on amount of mineral in body Major minerals Required daily: 100 mg or more Trace minerals Required daily: 20 mg or less

A nurse is counseling a client about maintaining his weight. He is 5 feet and 10 inches tall and has a sedentary lifestyle. How many calories should the client consume in a day?

2,158

What is the recommended intake amount for chloride?

2.3 g/day

2. What is overall transit time from food to move from the plate to the body cells? a. 2 to 6 hours b. 9 to 16 hours c. 16 to 27 hours d. >36 hours

ANS: C The overall transit time ranges from 16 to 27 hours. It takes seconds for food to be swallowed, or pass from the mouth through the esophagus. Once food is in the stomach, it takes from 2 to 6 hours to pass into the small intestine. After approximately 5 hours in the small intestine, the remaining food passes into the large intestine for final absorption. It moves through the large intestine at a slower rate, taking 9 to 16 hours. Any remaining food, fiber, or nutrients, along with bacteria, are then excreted via the anus.

2. How have food expenditures changed since the 1970s? a. More money is spent on foods prepared in the home. b. Less money is spent on fast food. c. Less money is spent at restaurants. d. More money is spent on away-from-home foods.

ANS: D Americans are cooking less at home and buying more prepared meals every year. Usually these prepared meals, whether fast food or from a restaurant, are higher in calories. Factors influencing this change from the 1970s include cost, availability, knowledge, and time.

1. Which monosaccharide is found in the bloodstream and is responsible for producing energy in individual cells? a. Fructose b. Galactose c. Maltose d. Glucose

ANS: D Glucose is the monosaccharide found in the bloodstream and is often referred to by medical personnel as "blood sugar." It is the primary source of energy for cells. Although it can be synthesized by fat or protein when needed, it is obtained most efficiently from a diet with at least 45% to 65% carbohydrate in order to meet dietary needs.

1. In addition to fluids consumed from foods, the Adequate Intake for water each day is set at how many cups for men and for women, respectively? a. 4 and 4 b. 10 and 4 c. 10 and 8 d. 13 and 9

ANS: D The Adequate Intake for water is 13 cups for men, 9 cups for women each day. This is in addition to whatever fluids they are consuming through foods.

2. Which food contains the highest amount of sodium per serving? a. Baked potato b. Boiled potato c. French fries d. Au gratin potatoes from dry mix

ANS: D The more processed a food, the more likely it will contain higher amounts of sodium. Sodium is a preserving agent and is found in many processed foods. Au gratin potatoes from a dry mix would contain the most sodium because they are the most processed of the foods listed. Of course, the answer would depend on the amount of salt added to French fries or a baked potato, but usually these contain less salt than prepackaged boxed products.

Carbohydrate Absorption

Active transport process of glucose Liver conversion of fructose and galactose to glucose

Energy pathways

Adenosine triphosphate (ATP): fuel for all energy-requiring processes

The fuel for all body processes that traps energy released from food is: Adenosine triphosphate Glucose-6-phosphate Acetyl coenzyme A Electrons.

Adenosine triphosphate. The body catabolizes nutrients, and their energy is trapped in adenosine triphosphate (ATP), the fuel for all processes that require energy in the body. Electrons do not store energy. Acetyl coenzyme A is a substance that is produced in the sequence of reactions as nutrients are metabolized in the mitochondria. Glucose-6-phosphate is a substance that is produced in the sequence of reactions in the metabolism of carbohydrate.

Body fat storage

Adipocytes: cells in which fat is stored Hypertrophy (cells increase in size) and hyperplasia (cells increase in number) New adipocytes can be formed at any stage of life if conditions are right. Bodies seem to monitor size of adipocytes (hypertrophy).

Match the hydration recommendations for adequate fluid replacement related to exercise. Before exercise During exercise After exercise

Before exercise: Hydrating several hours before exercise allows for fluid absorption and urine output to normalize During exercise: Weighing before and after exercise is useful for determining replacement fluid amounts After exercise: Consuming normal meals and beverages restores average hydration

Type II Diabetes Mellitus

Called non-insulin-dependent diabetes, because insulin is present (in large amounts), yet the glucose enters the cells slowly. Watching his or her diet is the best way to avoid low blood sugar if a person has type II diabetes mellitus. Most people who have diabetes have this type. Currently there is a strong trend in the American population linking obesity and diabetes. There are also indications linking childhood obesity and diabetes.

Energy

Carbohydrate as source of energy Converted to carbon dioxide & water via metabolic pathways of glycolysis, tricarboxylic acid (TCA) cycle, & oxidative phosphorylation Glycolysis: ATP & pyruvic acid produced Anaerobic pathway (glycolysis): no oxygen needed Limited: Lactic acid & oxygen debt This type of exertion is limited because oxygen is not available quickly enough to continue its support. For sprinting or speed-type exercise Takes place in cytoplasm

6 Nutrient Categories (Essential Nutrients):

Carbohydrates (CHO) Proteins Lipids (fats) Vitamins Minerals Water

Which of the following guidelines does the National Weight Control Registry endorse as a strategy that worked for people it studied who successfully lost weight and maintained it over time? at plenty of fruits and vegetables throughout the dayParticipate in 45 min of moderate physical activity dailyEat four small, low-fat, high-carbohydrate meals or snacks each day

Eat plenty of fruits and vegetables throughout the dayNational Weight Control Registry participants suggest low-fat eating plus fruits and vegetables, 1 hour of moderate physical activity daily, and eating five small, low-fat, high-carbohydrate meals or snacks each day

Of the following, what is the most important overall dietary modification to help reduce the risk of chronic disease? Eating more animal-based foods Buying mostly locally grown foods Eating more plant-based foods Eating fewer foods that contain preservatives

Eating more plant-based foods

The primary Intracellular electrolyte is

Potassium (K+ /cation) (65% of body water)

I have difficulty paying attention to things you may have just stated. My perception of time is off; I have left-sided weakness, difficulty navigating due to spatial-perceptual deficits, and am impulsive. What could you (the RN) do to care for me? Question1: What type of electrolyte deficiency or excess is the person dealing with? What is the recommended intake?

Chloride, 2.3 g/day

Vitamins

Compounds that indirectly assist other nutrients through processes of digestion, absorption, metabolism, & excretion 13 vitamins needed by the body Each with specific function 2 Classes: Fat-soluble vitamins (A, D, E & K) Water-soluble vitamins (B complex & C) Found in many foods, especially fruits & vegetables

The Large Intestine

Consists of cecum, colon, and rectum. Passage through takes about 9 to 16 hours. Site of final absorption of water and some minerals. Bacteria in colon produce several vitamins. Formation of feces and excretion from colon through anus (sphincter).

The Small Intestine

Consists of duodenum, jejunum, and ileum Passage through takes about 5 hours. Major organ of digestion and most absorption Villi are fingerlike projections that increase the amount of mucosal layer available for nutrient absorption. Microvilli are the hairlike projections on villi that also enhance absorption. Ileocecal valve leads to the large intestine (ascending colon).

The Stomach

Consists of fundus, body, and pylorus Gastric secretions Gastric motility Chyme formation Functions of stomach Pyloric sphincter

Anaerobic & Aerobic Pathways

Constant interchange of energy sources Amount of energy used depends on intensity, length of exercise, fitness level, & foods eaten Factors that influence glycogen storage: carbohydrate intake, fitness level

Regulation of Fluid/Water in theBody

Constitutes 50% to 60% of adult weight Percentages even higher for infants (75% to 80%) Homeostasis: maintained by thirst mechanism and reaction to solute levels Thirst stimulates desire to drink.Thirst mechanism is controlled by hypothalamus. As water level in body gets low, sodium and solute levels in blood increase. This causes water to be drawn from salivary glands to provide more fluid for blood. Mouth then feels dry because less saliva is produced. If thirst mechanism is faulty, hormonal mechanisms conserve water by reducing urine output. This is possible during illness, physical exertion, or aging. Excretion controlled by kidneys, brain, pituitary gland, and adrenal glands Hormones: antidiuretic hormone, aldosterone Renin-angiotensin system

Which is a meal planning guide that would be helpful for clients who need to closely monitor their intake of calories, carbohydrates, protein, and fat? Dietary Guidelines for Americans Exchange Lists for Meal Planning MyPlate food guidance system National Fruit and Vegetable Program

Exchange Lists for Meal Planning

Fat

Fat amount used depends on duration and intensity of exercise, prior training, and diet composition. Aerobic activity promotes fat use as energy source. Aerobic activity increases ability to burn fat as fuel and spares muscle glycogen. According to American College of Sports Medicine, 20% to 25% of energy used is from fat.

Major Minerals: Sulfur Function: Recommended intake and sources: Deficiency: Toxicity:

Function: Component of protein structures Recommended intake and sources: No Dietary Reference Intake (DRI) established Sources: all protein-containing foods Deficiency: Does not occur Toxicity: Not a health issue

Health claims relate a nutrient or food component to risk of a disease or health-related condition. Examples:

Potassium is related to reduced risk of high blood pressure (hypertension). Whole grains are related to reduced risk of heart disease and certain cancers. A diet with enough calcium is related to a lower risk of osteoporosis.

A teenaged client is hungry and goes to the refrigerator for a snack. A holiday has just been celebrated at her home, and many of her favorite foods are available. She selects some slices of roast turkey and a cup of her aunt's special fruit salad. What is this an example of? Bingeing Food preference Food choice Abundance

Food preference

Water

Food sources Fluids, fruits, vegetables Adequate Intake (AI) per day: Approximately 13 cups for men 9 cups for women Water quality Hard water: contains high level of minerals such as calcium and magnesium Soft water: filtered with sodium to reduce mineral levels Health issues Contamination: industrial & bacterial pollution Public health concerns Lead

Health literacy is the ability to understand basic health concepts and apply them to one's own health decisions. Health literacy develops through education on topics related to health promotion and illness. Match the 3 different forms of education with the correct definition. Formal education Non-formal education Informal education

Formal education: Is purposefully planned for implementation in a educational setting Non-formal education: Takes place through organized teaching and learning event in hospitals, clinics and community centers Informal education: Encompasses a variety of educational experiences that occur during daily activities (news, internets, etc)

Major Minerals: Phosphorus Function: Recommended intake & sources: Deficiency: Toxicity:

Function: 85% in bones and teeth as component of hydroxyapatite 15% for energy transfer, genetic material (DNA), acid-base buffer, phospholipids Recommended intake & sources: Recommended Dietary Allowance (RDA): 700 mg Sources: widely available in foods, especially protein-rich foods Deficiency: unknown Toxicity: UL of 4000 mg Excessive phosphorus, usually from supplements, causes calcium excretion

Trace Minerals: Iron

Function: Distributes Oxygen: Component of hemoglobin (in red blood cells) & myoglobin (in muscle cells). Assists enzymes in oxygen use by all cells. Recommended intake & sources: RDA: 8 mg for men; 18 mg for women; 27 mg during pregnancy Factors affecting recommended intakes: Iron is recycled & reused Lost through shedding tissue: cells in urine, sweat, bleeding (internal or external) Unusual absorption rate of dietary iron (only 10% to 15% absorbed); higher rate absorbed during deficiency, pregnancy, growth Factors inhibiting iron absorption: binders (oxalates), tannins, excessive antacids, pica Animal (heme) & plant (nonheme) sources: Heme iron (easier to absorb): meat, fish, poultry Non-heme iron: vegetables, legumes, dried fruits, whole & enriched grains Factors favoring iron absorption: Consuming foods containing ascorbic acid (vitamin C) enhances iron absorption. Consuming iron from several sources improves total iron absorption. Absorption of nonheme iron increases in presence of heme iron. Deficiency: US public health problem Common among women of childbearing age, teenage girls, and young children Iron-deficiency anemia: a microcytic anemia Physical activity/work difficulties; reduced cognitive functioning or developmental delays (children); impaired immune system, cold sensitivities Sports anemia Causes: Internal loss of blood (i.e., bleeding ulcers, hemorrhoids, menses) Lack of dietary intake (chronic dieting, poor dietary choices) Pica Toxicity: UL of 45 mg Hemosiderosis; hemochromatosis Symptoms: liver/heart damage, diabetes, arthritis, skin discoloration At risk for iron overload: men; individuals with chronic alcohol consumption; individuals genetically at risk Accidental iron poisoning: children

Chloride: Function: Recommended intake and sources: Deficiency: Toxicity:

Function: Extracellular anion that maintains fluid inside & outside cells Component of hydrochloric acid in gastric juice Recommended intake and sources: AI: 2300 mg for adults Sources: table salt (sodium chloride), foods with sodium Deficiency: Very rare Toxicity: Imbalance cause by dehydration

Trace Minerals: Fluoride

Function: Increases resistance to tooth decay and is part of tooth formation Bone mineralization for skeletal health Recommended intake & sources: AI: 4 mg for men; 3 mg for women Sources: fluoridated water (where available), tea, seafood, seaweed; other sources vary Toothpaste ingestion Deficiency: Increases risk of dental caries & may alter bone health Toxicity: ▪UL of 10 mg/day Fluorosis

Sodium Function: Recommended intake and sources: Deficiency: Toxicity:

Function: Maintenance of blood pressure & volume Transmission of nerve impulses Fluid balance Recommended intake and sources: AI:1500 mg, or about 3/4 tsp salt (NaCl) AI lowers to 1300 mg for adults 51 to 70 years of age Sources: table salt (NaCl) & processed foods; occurs naturally in some foods Deficiency: Caused by dehydration or excessive diarrhea Symptoms: headache, muscle cramps, weakness, reduced ability to concentrate, memory & appetite loss Hyponatremia acute or chronic Toxicity: UL of 2300 mg Sodium-sensitive hypertension & edema

Trace Minerals: Zinc

Function: More than 200 enzymes dependent on zinc Growth process, taste and smell, healing process, immune system, carbohydrate metabolism Recommended intake & sources: RDA: 11 mg for men; 8 mg for woman; 11 to 12 mg during pregnancy and lactation Sources: meat, fish, poultry, whole grains, legumes, eggs Bioavailability reduced in foods high in phytic acid Deficiency: Symptoms: impaired growth & wound healing; reduced appetite, taste (hypogeusia), & smell (hyposmia); immunologic disorders Severe deficiency: may result in dwarfism & hypogonadism (reduced function of gonads) At risk in the United States: "picky" eaters; older adults Toxicity: UL of 40 mg Excess supplementation produces GI distress, leading to vomiting & diarrhea, fever, exhaustion (similar to flu). Continual excessive use decreases iron and copper levels & reduces high-density lipoprotein level.

Trace Minerals: Iodine

Function: Part of hormone thyroxin produced by thyroid gland Recommended intake & sources: RDA: 150 mcg for adults Sources: salt fortified with iodine (check label); seafood; other sources inconsistent Deficiency: Reduces thyroxine production Deficiency during pregnancy causes cretinism of fetus Goiter Lack of dietary iodine or by effects of goitrogens Toxicity: UL of 1100 µg Thyrotoxicosis: iodine-induced goiter

Potassium: Function: Recommended intake and sources: Deficiency: Toxicity:

Function: Primary intercellular cation that maintains fluid levels inside the cells Normal function of nerves & muscles (heart) Recommended intake & sources: AI: 4700 mg Sources: unprocessed foods, potatoes, tomatoes, bananas, oranges, other fruits, vegetables, dairy products, legumes Deficiency: Causes: dehydration from vomiting or diarrhea, diuretics, and misuse of laxatives Symptoms: muscle weakness, confusion, appetite loss, &, in severe cases, cardiac dysrhythmias Toxicity: Caused by dehydration or supplement use Symptoms: muscle weakness, vomiting, &, at excessively high levels, cardiac arrest

Major Minerals: Magnesium Function: Recommended intake & sources: Deficiency: Toxicity:

Function: Structural and storage function in bones Assists enzymes; regulates nerve and muscle function, including Heart Role in blood-clotting process and immune system Recommended intake & sources: RDA: 420 mg for men for 31 years and older; 320 mg for women for 31 years and older Sources: unprocessed foods, whole grains, legumes, leafy green vegetables, broccoli Deficiency: Secondary causes: excessive vomiting & diarrhea, gastrointestinal disorder, kidney disease, alcoholism, malnutrition Symptoms: muscle twitching and weakness, convulsion Toxicity: UL of 350 mg (nonfood sources) Rare but serious

Blood Glucose Regulation

Insulin Glucagon Somatostatin Hormones from adrenal, pituitary, and thyroid glands

Major Minerals: Calcium Function: Regulation: Recommended intake & sources: Absorption factors: Deficiency: Osteoporosis: Toxicity:

Function: Calcium is the most abundant mineral in the body Structure & storage (99% in bones) Other 1% of body calcium is released into body fluids when blood passes through bones Other functions: Central nervous system function (impulses) Muscle contraction/relaxation Blood clotting Blood pressure regulation Regulation: Calcium homeostasis: Bones release calcium Intestines absorb more calcium Kidneys retain more calcium Hormonal regulation: Parathormone Calcitriol Calcitonin Effects of low/high blood calcium levels: calcium rigor (stiff muscles), calcium tetany (muscle spasms) Recommended intake & sources: Intake: AI: 1000 mg for adults to age 50 1200 mg for adults aged 50 and older 1000 mg during pregnancy and lactation Sources: Dairy products (milk and milk-based products) Leafy green vegetables; small fish with small bones Fortified foods (orange juice) Legumes Tofu processed with calcium Calcium strategies for lactose intolerance Absorption factors: Lactose Sufficient vitamin D Acidity of digestive mass Binders Dietary fat High fiber and laxative intake Excessive intake of phosphorus or magnesium Sedentary lifestyle Drugs Deficiency: Affects bone health Reduces bone density Stunts growth Osteoporosis: Unmodifiable risk factors: race, gender, family history Modifiable risk factors: nutrition, calcium intake, alcohol, smoking, caffeine, sedentary lifestyle Toxicity: Upper Limit (UL) of 2500mg Supplement concerns: May cause constipation Urinary stone formation Reduced absorption of iron, zinc, and other minerals Supplements should not exceed calcium AI

Water

Functions as major part of every tissue in body Fluid within which substances can break down & re-form As blood constituent, provides transportation for nutrients Equivalent of 9 to 13 cups water a day consumed from foods & beverages

Regulation of Body Fat Level

Genetic influence on body size & shape Genetic effects on body weight Genetics versus environment Genetics and hormones: leptin and ghrelin Fatness: considered as a multifactorial phenotype Regardless of genetic makeup, fatness is also influenced by nutritional, psychologic, economic, & social factors.

Factors affecting Glycemic Index

Glycemic Load Health effects: chronic disease

Health

Health is the merging and balancing of 6 physical & psychologic dimensions of health: Physical - efficient body functioning Intellectual - use of intellectual abilities Emotional - ability to control emotions Social - interactions & relationships with others Spiritual - cultural beliefs about the purpose of life Environmental - external factors that impact living & work settings

Hormones and Enzymes

Hormones begin to send messages that regulate the release of digestive juices once chyme enters the small intestine. Secretions from small intestine, liver, and pancreas include: Secretin Bile Cholecystokinin (CCK)

Fat as a source of energy

Hydrolysis of fats into glycerol & 3 fatty acids Glycerol changed to pyruvic acid; used for energy Fatty acids enter the TCA cycle as two-carbon acetyl CoA units (beta oxidation)

What are some dietary strategies to reduce the risk of cardiovascular disease? Decrease intake of trans fatty acids Increase fiber intake Increase intake of omega-3 fatty acids

Increase intake of omega-3 fatty acids

What is the most effective way to increase energy expenditure? Use thyroid hormones to increase basal metabolic rate Lift weights to increase lean body mass and thereby increase basal metabolism Increase the duration and intensity of daily activities Eat foods that require more energy for digestion, absorption, metabolism, and storage

Increase the duration and intensity of daily activities The most effective way to increase energy expenditure is to exercise more. Lifting weights will provide a smaller increase in energy expenditure. Eating foods that stimulate the thermic effect of food will produce a relatively insignificant increase in energy expenditure. Use of thyroid hormones can have adverse effects unless levels are below normal and need to be restored.

A nurse is teaching a client who has a family history of cardiovascular disease about health promotion and disease prevention. Which of the following dietary strategies specifically reduces the risk of cardiovascular disease? Increasing dietary intake of omega-3 fatty acids Increasing dietary intake of trans fatty acids Decreasing dietary intake fo insoluble fiber

Increasing dietary intake of omega-3 fatty acids

List the primary functions of phosphorus.

List the primary functions of phosphorus. Hide Answer Major negatively charged electrolyte in intracellular fluid Maintains proper fluid balance Plays critical role in bone formation Component of ATP, which provides energy for our bodies Helps regulate biochemical reactions Major part of genetic materials (DNA, RNA) A component in cell membranes, LDL

List the primary functions of potassium.

Major positively charged electrolyte in intracellular fluid Regulates contraction of muscles Regulates transmission of nerve impulse Assists in maintaining healthy blood pressure levels

Carbohydrates

Major source of energy & dietary fiber Simple carbohydrates (often called sugars) Found in fruits, milk, & sweeteners Complex carbohydrates found in cereals, grains, fruits, & vegetables All except dietary fiber broken down to units of glucose Supplies very little energy Glucose: most efficient form of energy for body

Facilitated transport/Facilitated diffusion

Molecules are transported across the plasma membrane from the side of higher concentration to the side of lower concentration. Often this can be passive or active, wherein a molecule is moving against the gradient (from lower to higher). In this type of transport, a protein carrier and the use of energy (breakdown of ATP) must be used. Basically, facilitated diffusion works like a gate. The cell membrane becomes the gate keeper. When something that wants to enter a cell reaches the cell membrane and cannot enter via diffusion, a gate will open and allow the molecule to enter, by passive or active process. An example of facilitated transport would be someone trying to sneak into a movie or a show. The guard will not let the person in, but someone inside comes along and opens the back door to the theater so that the person can gain access to the showing.

Simple Carbohydrates

Monosaccharides Glucose Fructose Galactose Disaccharides Sucrose: glucose + fructose Maltose: glucose + glucose Lactose: glucose + galactose

What are the deficiency symptoms of potassium?

Muscle cramps Muscle weakness Muscle paralysis Mental confusion

List some toxicity symptoms of potassium.

Muscle weakness Vomiting Irregular heartbeat

Lactated Ringer's (LR) Description Osmolality Use Miscellaneous

Normal saline with electrolytes and buffer Isotonic (275 mOsm)Replaces fluid and buffers pH Normal saline with K+, Ca++, and lactate (buffer) Often seen with surgery

Normosol-R Description Osmolality Use Miscellaneous

Normosol Isotonic (295 mOsm) Replaces fluid and buffers pH pH 7.4 Contains sodium, chloride, calcium, potassium, and magnesium Common fluid for OR and PACU

For the efficient functioning and maintenance of the body, a person needs to consume sufficient amounts of: Nutrients. Fiber. Minerals. Supplements.

Nutrients.

Nutrition

Nutrition is the study of essential nutrients & the processes by which nutrients are used by the body.

A nurse has just been assigned to a community health program for older adults. She should check the document Healthy People 2020 to become familiar with: Dietary guidelines recommended for older adults. MyPlate recommendations for older adults. Nutrition priorities and goals for older American adults. Dietary standards for Americans older than 50 years.

Nutrition priorities and goals for older American adults.

The client wants to increase their dietary fiber intake. What is the best breakfast choice to help them achieve this goal? Oatmeal with raisins Scrambled eggs and toast Pancakes and orange juice Blueberry muffin and jam

Oatmeal with raisins

Osmosis

Osmosis is the net movement of water across a semipermeable membrane from an area of higher concentration to lower concentration. The membrane is permeable to waste but it is not permeable to the solutes. The solutes will be elements that are able to bind to water, thus disturbing the free flow of water. A water gradient exists, in part because dissolved substances always lower the concentration of water in a solution. (Pure water has the highest concentration of water. So, when something is placed in pure water, it causes the water molecules to displace, or lower the water content.) The process of osmosis will depend on water concentration differences; therefore, the exact types of solutes do not matter. It boils down to the combined effect on the concentration of the water that counts. In other words, it is not the number of molecules, or the volume, but rather the actual amounts of solutes to water ratio. An example of osmosis would be when a protein pushes an ion against the concentration gradient of the cell; it takes energy to do this and allow the substance to enter the cell. Osmosis often can be referred to as active transport.

A nurse is evaluating a client's need to lose weight. Her body mass index is 28.3. Which BMI classification applies to her?

Overweight

Body fat distribution

Pattern of distribution: genetically determined Upper body fat: apple shape (android) Greater health risks Hip-to-waist ratio (<0.95 to 10 in men; ≤0.8 in women) Waist circumference (>40 inches in men; >35 inches in women) Lower body fat: pear shape (gynoid)

What is the most useful part of the food label for clients who want to make sure they choose foods high in nutrients? Organic seal Percent Daily Value Health claims Amount of nutrients per serving

Percent Daily Value

Healthy Weight

Person can physically move comfortably Maintained without undue restriction of food intake or without excessive exercise Live without experiencing any weight-related associative disorders (DM, HTN, etc.) If associative disorders develop: Lifestyle changes can be initiated to achieve a healthier weight. Healthier weight is weight loss of 10 to 16 pounds accompanied by healthy lifestyle behaviors. Measuring body fatness Bodies are composed of fat in addition to bone, muscle, & other nonfat tissue known as lean body mass. When weight is not body a good measure of fatness Underwater weighing (densitometry) Bioelectric impedance analysis (BIA) Measurement of skinfold thicknesses and body circumference Interpreting body fatness measures Should be individualized Body mass index (BMI) Weight in kilograms divided by height in meters squared Limited usefulness: still assessment of weight, not of body fat Functions of fat Vital functions Essential body fat: 3% to 8% in men; 12% to 14% in women Total fat (includes storage fat): 15% to 20% in men; 25% to 30% in women Low body fat levels may result in amenorrhea with bone loss; fracture risk increased

I know this may sound a little weird, but my bones hurt. Any time I change positions (such as from sitting to standing up), I get dizzy. I've also experienced weakness in my arm muscles; I can hardly lift this tea cup. Question 3: What type of electrolyte deficiency or excess is the person dealing with? What is the recommended intake?

Phosphorus, 700 mg/day

Food sources of minerals

Plants & animals Inorganic: stable despite cooking Limited bioavailability from some plant sources Binders, soil content Food processing: may result in mineral loss Foods fortified with minerals

Food Sources of Carbohydrate

Primarily plant-based 3 sizes: Monosaccharides Disaccharides Polysaccharides Divided into 2 categories: Simple carbohydrates Complex carbohydrates

Absorption

Process by which substances pass through the intestinal mucosa into the blood or lymph Transport processes Passive diffusion and osmosis Facilitate diffusion Energy-dependent active transport Engulfing pinocytosis Determinants of vitamin and mineral absorption. Nutrients such as fats, carbohydrates, and protein easily absorbed regardless of level of need. Structure of small intestine allows for efficient absorption to occur. Villi and microvilli Factors affecting absorption of nutrients Bioavailability Relationship between food and drug absorption Nutrient transport systems General circulatory (blood) system Lymphatic system Liver

Combinations of amino acids link together to form: Dietary fiber Protein Lipids Carbohydrates

Protein

Protein

Protein requirements for athletes: 1.5 to 2 g/kg body weight (based on animal protein)

Lipids (Fats)

Provide densest form of energy & other functions in the body & in foods 3 categories of lipids: Triglycerides Phospholipids Sterols (cholesterol most common) Relationship between consumption of lipids & risk for diet-related diseases

Proteins

Provide energy & perform extensive functions in body Composed of 20 amino acids 9 essential amino acids found in animal & plant sources Consumption of excess protein

Carbohydrate as a Nutrient in the Body Functions:

Provides energy Dietary fiber Naturally occurring sweeteners (sucrose and fructose) Brain and nerve tissues require CHO (glucose) as fuel. Protein-sparing effect

Food & Athletic Performance

Recommendations Dietary intake pattern: 45% to 65% of carbohydrate (CHO) kilocalories; 20% to 35% of fat kilocalories; 10% to 35% of protein kilocalories Kilocalorie requirements: balance energy expended Negative consequences with inadequate intake: weakness, iron deficiency, stress fractures, amenorrhea, osteoporosis Small meals and snacks: provide needed kilocalories Water: most critical for athletic performance Loss of 2% to 3% of body weight: can impair ability Recommendations for adequate fluid replacement Tests for adequate hydration Sports drinks CHO: energy food CHO loading Delays onset of fatigue Required for maintaining glycogen stores

Metabolism

Set of processes through which absorbed nutrients are used by body for energy and to form and maintain body structures and functions Catabolism Anabolism Functions of nutrients Form new cell structures. Create new substances such as hormones and enzymes. Assist in use of other nutrients in cell. Act as catalysts or coenzymes in transforming and using of carbohydrates, proteins, and lipids. Provides energy. Metabolism waste products Excreted through lungs, kidneys, or large intestine Metabolism across the life span Lowered metabolic rates Nutrient needs remain constant Lifestyle behaviors affect functioning and health of GI tract

Saline

Sodium chloride dissolved in water to reach a specific concentration of 0.15 molar The resultant solution is sterile.

Fluid Volume Excess & Edema Increased fluid retention & edema associated with compromised regulatory mechanism Causes:

Sodium retention Kwashiorkor Water intoxication

I know I should eat, but I'm just not hungry. I have to sit in my wheelchair at times because my leg muscles feel weak and I get dizzy. My daughter stays here with me because I tend to get confused at times. What's going on with me?Question 4: What type of electrolyte deficiency or excess is the person dealing with? What is the recommended intake?

Sodium, 1.5 g/day

Blood glucose

Source of energy to all cells

Starch

Storage form of plant carbohydrate Food sources: Grains Legumes Root vegetables (potatoes)

Function of Water

Structural component of cells Regulation of body temperature Lubricant Shock absorber: cushions body tissues Solvent for transport of nutrients and waste Source of trace minerals Reactant: medium for biochemical reactions (SSSSRRL)

Decisions about Consumption of Sweets Benefits & Risks

Sucrose consumption Alternative sweeteners consumption

3 types of carbs

Sugar (Simple carb) Starch (Complex carb, primary food or energy source) Fiber was (Complex carb)

Other Sweeteners

Sugar alcohols Sorbitol mannitol xylitol Alternative sweeteners (artificial sweeteners) Aspartame Saccharin Acesulfame potassium Sucralose Stevia

The home health care nurse is visiting a 70-year-old client who has just returned home from the hospital after being treated for coronary artery disease (CAD). The medical nutrition therapy developed for him by the hospital dietitian is considered which type of prevention? Tertiary prevention Secondary prevention Primary prevention Palliative care prevention

Tertiary prevention

Role of Nurses for healthy body weight

To consider their attitudes toward their own bodies & level of fitness To consider attitude toward clients who may struggle with weight & fitness issues To remain knowledgeable about lifestyle changes & choices for client success

What is one of the main toxicity symptoms of chloride?

Vomiting

Examples of informal education include: Learning about food safety techniques in a high school economics course. Attending a workshop on coronary artery disease sponsored by the American Heart Association. Watching a television show about diabetes. Joining a support group to help overcome an eating disorder.

Watching a television show about diabetes.

A client is asking the nurse in his provider's office about using a body wrap while exercising to help accelerate her weight loss. The nurse should explain to the client that this type of device effectively promotes the loss of which of the following? Fat Water Amino acids

Water

List some toxicity symptoms of sodium.

Water retention High blood pressure May increase loss of calcium in urine

Wellness

Wellness is a lifestyle that enhances our level of health. Occurs through the development of the 6 dimensions of health

10. If a college student is eating only one small meal per day in an attempt to lose weight and is taking high doses of vitamin and mineral supplements to try make up for the lack of food, he or she would be describe as having: a) malnutrition b) nonnutrition c) overnutrition d) disordered eating

a) malnutrition NOTE: An imbalance of nutrients and/or energy (in this case, high intake of some nutrients and low intake of energy) is called malnutrition. Overnutrition only refers to excessive intake or nutrients and/or energy. Disordered eating refers to unusual eating habits that may or may not lead to some form of malnutrition. Nonnutrition is not a recognized term.

4. Nutrients that DO NOT yield energy include: a) minerals, vitamins and water b) protein, water and vitamins c) water, vitamins, and carbohydrates d) minerals, vitamins, and proteins.

a) minerals, vitamins and water NOTE: Energy-yielding nutrients are organic Carbohydrates, proteins, and lipids

29. Compared with table sugar (sucrose), honey tastes_____ because it contains _____: a) sweeter, fructose b) sweeter, maltose c) less sweet, fructose d) less sweet, maltose

a) sweeter, fructose NOTE: Honey is sweeter than table sugar because it contains fructose, the sweetest of all the sugars. Maltose is less sweet than table sugar and is not found in honey.

24. The villi of the small intestine increase its capacity for: a) digestion b) absorption c) excretion d) elimination

b) absorption NOTE: Villi increase the surface area of the small intestine which makes it possible for it to absorb more nutrients. Digestion occurs in the small intestine, but is not a function of the villi. Excretion and elimination do not occur in the small intestine.

34. Diets high in cellulose could include which? a) brussels sprouts b) cabbage c) kale d) zucchini e) tomatoes

b) cabbage d) zucchini e) tomatoes

38. intracellular and extracellular electrolytes include which? a) sodium b) calcium (extracellular) c) potassium (intracellular) d) magnesium e) chloride

b) calcium (extracellular) c) potassium (intracellular)

16. One reason that increasing fruit & veggies consumption helps decrease dietary fat intake is because fruit & veggies: a) are natural appetite suppressants b) displace high-fat foods from the diet c) are rich antioxidants and phytochemicals d) decrease absorption of fat from foods

b) displace high-fat foods from the diet NOTE: Fruits and vegetables displace high-fat foods from the diet because they are high in fiber and water; they cause satiety so that clients have less desire for high-fat foods. Fruits and vegetables are not and do not contain natural appetite suppressants and do not hinder absorption of fat from foods. They are rich in antioxidants and phytochemicals, but increased intake of these substances does not affect fat intake.

9. The best source of action to provide adequate amounts of vitamins and minerals is to: a) promote weight loss b) eat a variety of foods c) eat at least three meals per day d) consume a high-fiber, low-fat diet.

b) eat a variety of foods NOTE: Including a variety of foods increases the likelihood of obtaining adequate amounts of vitamins and minerals. Loss of weight will not contribute to adequate nutrient intake. Eating at least 3 meals per day may help increase nutrient intake to some extent, but they could still be meals that provide a limited assortment of foods. Similarly, a high-fiber, low-fat diet could consist of foods that are relatively low in vitamins and minerals.

2. A group of strategies used to increase the level of health of individuals, families, groups and communities is known as: a) Wellness b) health promotion c) tertiary prevention d) nutritional assessment

b) health promotion

7. Water soluble and fat soluble describes the two classes of: a) fiber b) vitamin c) minerals d) carbohydrates

b) vitamin NOTE: Fat soluble vitamins (A, D, E K), Water soluble vitamin (B, C). fat-soluble - absorbed like fats, 1st into the lymph and then into the blood; Usually occur together in fats and oils; Absorbed in the same manner as lipids.water-soluble - absorbed directly into the blood

28. Plants use carbon dioxide, water & the sun's energy in the process of photosynthesis to synthesize: a) fat b) protein c) carbohydrates d) alcohol

c) carbohydrates NOTE: Plants synthesize carbohydrate via photosynthesis. Fat and protein are produced by other metabolic processes in the plants. Living plants do not usually produce alcohol, although stored fruit or grain may ferment and produce some alcohol.

26. The esophagus is a structure that: a) produces & releases digestive enzymes but not hormones b) does not produce digestive enzymes but does release hormones c) does not produces or release digestive enzymes or hormones d) produce only small amount of digestive enzymes or hormones

c) does not produces or release digestive enzymes or hormones NOTE: The esophagus does not produce or release digestive enzymes or hormones. It simply transports food boluses from the mouth to the stomach.

14. Of the following, the most important overall dietary modification to help reduce risk of chronic disease is: a) eating fewer foods that contain preservatives b) buying mostly locally grown foods c) eating more plant-based foods d) eating more animal-based foods

c) eating more plant-based foods NOTE: Scientific evidence from the nutrition evidence library shows that shifting to a more plant-based diet is one of four significant modifications to our dietary intake patterns that will improve the overall health of Americans. Preservatives per se have not been associated with health status (although foods that contain preservatives may be more highly processed and may be higher in fat, sugar, and sodium and lower in nutrients than foods without preservatives). Buying locally grown foods may be a good agricultural and economic practice, but does not affect health status. Eating more animal-based foods would be the opposite of what is recommended.

31. When insufficient carbohydrate are available and the body has to metabolize fat for energy, ____ is/are produced. a) galactose b) fructose c) ketone d) proteins

c) ketone

25. If the large intestine did not carry out its main function, feces would be: a) alkaline b) acidic c) liquid d) very dry

c) liquid NOTE: A major function of the large intestine is absorption of water, so feces would be liquid. Feces would not be dry if they large intestine was not removing water. The large intestine does not have a significant impact on the acidity or alkalinity of feces.

13. Between 1970 and 2000, nutritional concern centered on reducing nutrient excesses. Before 1070, the focus was to reduce: a) consumption of lipids b) low-carbohydrate diets c) nutrient deficiencies d) prevention of infection disease

c) nutrient deficiencies NOTE: Before 1970, most nutritional problems were attributed to nutrient deficiency. Later on, research showed the association between excessive lipid intakes and chronic disease. Low-carbohydrate diets gained popularity for weight loss after 1970. Prevention of infectious disease is not a direct nutritional concern.

21. Valves to control the movement of food in and out of the stomach are called: a) reflux regulators b) peristalsis muscles c) sphincter muscles d) segmentation muscles

c) sphincter muscles NOTE: Sphincter muscles control the movement of food in and out of the stomach. They do help prevent reflux, but this is not their name. They are not involved in peristalsis. Segmentation occurs as circular and longitudinal muscles cause food to move backwards and forwards in the gut.

12. Economics is a significant factor influencing the nutritional status of communities. To overcome economic disadvantage, public health efforts include: a) the MyPyramid food guidance system b) educational program on food safety c) the U.S. government's Food Stamp Program d) public service announcements on heath eating

c) the U.S. government's Food Stamp Program NOTE: The Food Stamp Program provides coupons to buy nutritious foods for individuals and families with incomes below certain levels. This can help improve the nutritional status of economically challenged families. The other public health efforts listed are not specifically aimed at people who have an economic disadvantage.

37. The hormones that causes the kidney to decrease water excretion is called: a) adrenaline b) aldosterone c) alanine d) antidiuretic hormone (ADH)

d) antidiuretic hormone (ADH)

35. Hard water contains high levels of minerals, such as" a) iron & zinc b) lead & sulfur c) sodium & potassium d) calcium & magnesium

d) calcium & magnesium

19. The nutrition facts panel on a food label is useful for: a) determining the ingredients in a product b) determining the ease of preparing a product c) comparing the price value of two of more products d) comparing the nutritional value of two of more products

d) comparing the nutritional value of two of more products NOTE: The Nutrition Facts panel on a food label lists the quantities of specific key nutrients in the food and can therefore be used to compare the nutritional value of two or more products. The ingredients are listed elsewhere on the package, rather than in the Nutrition Facts panel. The Nutrition Facts panel does not indicate how easy the food is to prepare and does not include any information about cost or price.

22. A substance that works only on a specific class of nutrients is called: a) bolus b) chyme c) gastrin d) enzymes

d) enzymes NOTE: Enzymes work on specific classes of nutrients to change them from one form to a simpler form. A bolus is a ball-shaped mass of chewed food that is swallowed. Chyme is the semiliquid mixture of food mass and secretions in the stomach. Gastrin is a hormone secreted by the stomach mucosa.

11. A teenager client is hungry and goes to the refrigerator for a snack. A holiday has just been celebrated at her home, and many of her favorite foods are available. She selects some slices of roast turkey and a cup of her aunt's special fruit salad. This is an example of: a) binging b) abundance c) food choice d) food preference

d) food preference NOTE: This teenager is able to select foods according to her preferences. Food choices are restricted by convenience, but many of her favorite foods are available so her choices are not limited. The food is abundant, and she may choose to binge and overeat, but her selections are made according to her food preference.

18. If a food package has the radura symbol, showing that the food has been irradiated, a consumer can know that the food: a) should not be eaten by pregnant women b) will have a cooked taste & texture c) had to be treated to remove contaminants d) may have an extended shelf life

d) may have an extended shelf life NOTE: Irradiation extends the shelf life of foods by destroying microorganisms, mold, and parasites. Irradiated foods are safe for pregnant women. Irradiation does not give foods a cooked taste and texture. Irradiation is used to destroy normal levels of microorganisms, mold, and parasites in foods, rather than to treat contaminated foods.