Test #2 review

risks associated with Peripheral artery disease

can lead to a heart attack or stroke, common after age 60 and is found in 12% to 20% of older individuals

Level Three of Dysphagia Diet

hard, dry sticky and crunchy foods are not allowed.

constipation

having fewer than 3 stools per week; in addition, afflicted people strain to pass hard, dry stools

ingredient list

labels help you understand the composition of your food; vitamins, minerals, calories, fats etc.

chronic diarrhea

longer than 4 weeks; result of GI irritation or malabsorption

nutritional therapy for diverticulitis

1. A high-fiber diet is recommended to reduce straining during defecation (increase fiber-rich foods by including fruits, vegetables, legumes whole grain breads, and cereals) 2. Stool softeners may be needed to avoid straining

nutritional therapy for Gastroesophageal Reflux Disease (Heartburn)

1. Avoid large or high-fat meals 2. Foods such as chocolate, alcohol, peppermint, spearmint, liqueurs, and caffeine, and high-acid foods (tomatoes, vinegar-based foods, citrus fruits, and juices) may irritate the esophagus and cause heartburn 3. Avoid overeating

nutritional therapy with peripheral artery disease

1. Include unsaturated fats like fish, nuts, and seeds and excludes saturated fats (red meat, butter, and whole milk) 2. Because sodium is another concern, cut back on intake of processed meats, fast food, and convenience foods like frozen dinners, canned soup, and processed cheese

nutritional therapy with Hepatitis

1. Initially liquid diet: then progressing to small, frequent feedings high in calories and high-quality protein as tolerated 2. Carbohydrates at least 40% of calories 3. Fats: limited if steatorrhea is present 4. High fluid intake: 2,500 to 3,000 mL/day 5.Vitamins/minerals: multivitamin that includes B complex (especially thiamine, vitamin B12 6. Abstinence from alcohol

nutritional therapy with IBS

1. Lactose, gluten, or sugar may be eliminated 2. Low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polysaccharides) is now accepted as a strategy

nutritional therapy with cirrhosis

1. Protein: minimum of 0.8 g/kg of body weight 2. Branched-chain amino acid-based formula with restricted aromatic amino acids if protein sensitive (encephalopathy) 3. Kilocalories to prevent catabolism (the breakdown of complex molecules in living organisms to form simpler ones, together with the release of energy; destructive metabolism) 25 to 35 kcal/kg dry weight 4. Sodium: restricted to 2,000 mg if edema or ascites is present 5. Fluids: in relation to intake and output records; may need to restrict to 1,500 mL/day or 1,000 to 1,200 mL/day 6. Vitamins: water soluble, with emphasis on folate, B12, and thiamine; fat-soluble vitamins in water-soluble form if steatorrhea is present

Nutritional therapy for celiac disease

1. Removal of gluten from the diet 2. Lifelong avoidance of gluten 3. Reading food labels: gluten-containing grains are used extensively in the American diet 4. Alternative foods (e.g., rice, potato, buckwheat)

nutritional therapy with vomiting

1. Small cold meals instead of large hot meals (e.g., crackers and cheese, gelatin, fruit or lemonade) 2. Avoid mixing hot and cold foods, which may aggravate the problem 3. Hot, fried, spicy, and strong-smelling foods should also be avoided 4. Some patients find relief with broth-based soups, warm tea with mint, and ginger ale or other carbonated beverages

Causes of vomiting

1. When an intruding virus or toxin has entered the GI tract, vomiting removes the offending substance. 2. An altered sense of equilibrium during air or sea travel can result in motion sickness with nausea and vomiting 3. During pregnancy, hormonal shifts often cause vomiting, especially during the first trimester. 4. Cancer treatment such as chemotherapy, radiation therapy, or use of medicines such as opioids may cause vomiting.

nutritional therapy for diarrhea

1.Enteral or parenteral fluids: may be necessary 2. Oral therapy: oral rehydration solutions; progress to low-fat, low-fiber, low-lactose diet. 3. Small, frequent meals; progress to regular diet

reasons a nurse would contact a Registered Dietician.

A registered dietician can conduct the nutrition care process, establish the nutrition diagnosis, provision of nutrition therapies, monitoring and evaluation of outcomes.

ascites

Accumulation of fluid in abdominal cavity, treated by dietary restriction of sodium and sometimes fluid

cause of Gastroesophageal Reflux Disease(heartburn)

Acid refluxes after food has already been passed to the stomach; it may pass back up through the cardiac sphincter into the esophagus

parts of the comprehensive nutritional assessment

Anthropometric, Biochemical, Clinical, and Dietary

causes of cirrhosis

Buildup of fibrous connective tissue as result of alcohol abuse; hepatitis; biliary disorders; chronic autoimmune disease; metabolic disorders; or chronic use of hepatotoxic drugs

Nutritional therapy for CHF

Choose foods that are low in salt,Choose plenty of fresh fruits and vegetables,Season with herbs, spices, herbed vinegar and fruit juices,Read food labels before you buy packaged foods

causes of celiac disease

Chronic disease that damages mucosa of the small intestine. Intestinal damage caused by gliadin, the protein fraction of gluten found in wheat, oats, rye, and barley

risks associated with Cirrhosis

Chronic hepatitis C. Chronic excessive alcohol intake. Fatty liver disease (non-alcoholic steatohepatitis) Autoimmune liver disease (autoimmune hepatitis, primary biliary cirrhosis or primary sclerosing cholangitis)

Pancreatitis causes

Excess alcohol consumption, gallbladder disease, genetics

Causes of Irritable Bowel Syndrome(IBS)

Functional GI disorder involving disturbances between the brain and the gut.

risks associated with enteral feeding(tube feeding)

GI problems include diarrhea, nausea and vomiting, also cramping, distension and constipation. Mechanical complications include tube displacement or obstruction, pulmonary aspiration and mucosal damage.

nutritional therapy with MI

Goal- Include intake of better types of fats, plant-based proteins, and soluble fiber. Weight loss may also be needed. 1. Adopting a Mediterranean diet 2. Substitute monounsaturated fat for saturated fats; choose more almonds, walnuts, pistachios, extra-virgin olive oil, and canola oil 3. Daily intakes of 2 to 3 g of plant stanols or sterol esters (isolated from soybean and tall pine tree oils) e.g., products on the market that contain stanols include some brands of orange juice, cereals, and spreads such as Take Control and Benecol 4. Substitute plant-based proteins for animal proteins. Plant-based protein foods (e.g., legumes, dry beans, nuts, whole grains, and vegetables) contain no saturated fat. Healthy animal proteins include fat-free or low-fat dairy products, egg whites, fish, skinless poultry, and lean cuts of beef and pork

Nutritional therapy for PUD (peptic ulcer disease)

Goal- eradicating H. pylori, reducing stomach acidity, relieving symptoms, healing the ulcer, preventing reoccurrence, and avoiding complications 1. No need for special diet or bland diet; high quality diet will suffice. 2. Elimination of foods that may worsen damage to lining of esophagus, stomach, or duodenum, such as red and black pepper, chili pepper, coffee, caffeine, and alcohol. 3. Smoking cessation

nutritional therapy with Pancreatitis

Goal- minimize pancreatic secretions; enteral or parenteral nutrition may be used; enteral nutrition is associated with better outcomes 1. Fat: less than 50 g per day 2. Medium-chain triglyceride (MCT) oils may be used 3. Protein: at least 1.5 g of protein per day 4. Carbohydrates: remainder of kilocalories 5. Meal planning six small meals per day are recommended 6. Enzyme replacement may be necessary to control malabsorption 7. Abstinence from alcohol is imperative

nutritional therapy for Crohn's disease

Goal- to replace lost nutrients, correct deficits, and achieve energy, nitrogen, fluid, and electrolyte balance 1. A high-calorie, high-protein diet divided into small, frequent meals

nutritional therapy for Diverticulosis

Goal- to rest the bowl, allowing infection to resolve 1. Patients are given nothing by mouth, and then progress to liquids 2. After inflammation subsides, a high-fiber diet is recommended to reduce straining during defecation (increase fiber-rich foods by including fruits, vegetables, legumes, whole grain breads, and cereals) 3. Stool softeners may be needed to avoid straining

Causes of Congestive heart failure (CHF)

Heart failure often develops after other conditions have damaged or weakened the heart. Allergic reactions,Any illness that affects the whole body,Blood clots in the lungs,Severe infections,Use of certain medications,Viruses that attack the heart muscle

Causes of Hypertension

In primary hypertension, the cause is not evident, and genetic factors are involved. For some individuals, an overactive hormonal renin-angiotensin-aldosterone system plays a part. Prematurity, low birth weight, infections, and poor nutrition can lead to inadequate kidney development or kidney diseases. In secondary hypertension, the specific cause of elevated blood pressure can be identified. Examples include Cushing's syndrome, polycystic kidney disease, diabetic nephropathy, thyroid disorders, or primary aldosteronism.

Causes of PUD (peptic ulcer disease)

Infection with Helicobacter pylori or nonsteroidal anti-inflammatory drugs (NSAIDs).

causes of diarrhea

Infection, maldigestion, inflammation, functional disorders of the bowel

how to prevent risks for parenteral feeding

Most are prevented by following monitoring recommendations, using stringent techniques and careful insertion of the central line.

preventive measures for enteral feeding

Most problems with tube feeding can be prevented by good hand washing skills by all the nursing staff administering the feeding,

different tube feedings

Nasogastric, Nasoduodenal, Nasojejunal, Esophagostomy, Gastrostomy, jejunostomy

causes of myocardial infarction

Occurs as a result of sustained ischemia (an inadequate blood supply to an organ or part of the body, especially the heart muscles) that causes irreversible damage to the heart

Constipation causes

Organic:intestinal obstruction, spasms of sigmoid colon, diverticulitis, tumors,Ignoring urge to defecate,Lack of fluid,Prolonged bed rest or lack of physical activity,Habitual use of laxatives or enemas,Pregnancy

why you would choose one tube feeding over the other

Placing the feeding tube into the stomach, duodenum or jejunum through the nose is the simplest and most commonly used tube feeding technique. Surgical placement is preferred when long term use is anticipated

Enteral feeding

This includes liquid diets, soft and solid food diets and special nutritionally complete formulas administered orally or via tubes.

parenteral feeding

This involves the provision of energy and nutrients intravenously. When nutrients are infused into a large diameter vein such as superior vena cava or subclavian vein.

positioning when feeding a client

The safest eating position for someone who has trouble swallowing is sitting upright; the caregiver should sit opposite to help provide cues and reminders while the patient is eating.

Use of Enteral Feeding

This happens when a patient is not able to eat orally for more than a few days, a nonoral method must be used.

use of parenteral feeding

This is for patients who cannot adequately get nutrition through the GI tract. Factors should be considered before initiating is the nature of the patient's GI dysfunction, severity of malnutrition, degree of hypercatbolism, medical prognosis and wishes.

Peptic Ulcer disease (PUD)

a break or ulceration in the protective mucosal lining of the lower esophagus, stomach and duodenum

causes of diverticulitis

a result of long-term, low-fiber eating habits and increased intracolonic pressure such as that created with straining to have a bowl movement

Risks associated with Irritable Bowel syndrome

abdominal discomfort, changes in bowel habits, and pain

nutritional therapy for constipation

adequate fluids, and ample fiber

BMR response to Starvation

after going without food or nutrients the body extracts stored carbohydrates and fat as well as protein from muscles and organs to meet energy demand. the body's metabolic rate slows becoming Hypo-metabolic.

Crohn's disease (regional enteritis)

an inflammatory disorder that involves all layers of the intestinal wall and may affect the small intestine, large intestine, or both.

Causes of Crohn's Disease

autoimmune condition caused by a genetic predisposition followed by an environmental trigger

causes of Peripheral artery disease

blockages in the lower legs and prevents healthy blood flow back to the heart.

different types of modified diets

clear liquid, full liquid, dysphagia-level 1,2, and 3, vegetarian, and lactose free, soft diets and diet as tolerated

Full liquid diet

consists of foods that are liquid at room or body temperature, used to provide nutrients for patients with wired jaws and those who have difficulty chewing or swallowing solid foods.

risks associated to Diverticulitis

constipation, straining during defecation

risks associated with diverticulosis

constipation, straining during defecation

risks associated with CHF

coronary artery disease, heart attack, heart valve disease, high blood pressure, irregular heartbeats, cogenital heart disease, diabetes, meds associated with diabetes, other meds, alcohol use, sleep apnea, smoking and use of tobacco, obesity and viruses

Risks for constipation

dehydration

risks associated with vomiting

dehydration (causes a loss of fluid and electrolytes - magnesium, potassium, sodium)

risks associated with hepatitis

dehydration, nausea, vomiting, weight loss,

Risks for celiac disease

diarrhea, abdominal distention, fat malabsorption, weight loss, anemia, osteoporosis, infertility, steatorrhea (fat malabsorption), or even lymphoma

Signs of food allergy

diarrhea, nausea, vomiting, cramping, abdominal dissension and pain. a true food allergy is caused by the reals of histamine and serotonin.

risks associated with Crohn's disease

diarrhea, which may be profuse and bloody, abdominal pain, intestinal bleeding, protein loss, and fever

causes of diverticulosis

diverticula become infected and inflamed from trapped fecal material and colon bacteria

kcals from fat

fats are important source of energy they contain twice as much energy per gram as carbohydrate or protein, to much fat can lead to obesity and related health problems

risks associated with diarrhea

fluid and electrolytes may be lost leading to dehydration

risks associated with a myocardial infarction (MI)

increasing age, male gender, genes, family history of premature CHD, hypertension, cigarette smoking, diabetes, obesity, physical inactivity, atherogenic diet, coronary artery calcification (CAC), and vitamin D deficiency

causes of Hepatitis (A,B,C,D and E)

inflammation of the liver caused by infectious mononucleosis, cirrhosis, toxic chemicals, viral infection

vomiting/reverse peristalsis

instead of food moving down the GI tract, the peristalsis muscles move the contents of the stomach back through the esophagus and forcefully out the mouth.

Acute Diarrhea

is of short duration and usually the result of medications, changes in dietary habits, or emotional stress.

Diarrhea

is the passing of loose, watery bowel movements that result when the contents of the GI tract move through too quickly to allow water to be reabsorbed in the colon.

risks associated with pancreatitis

malabsorption of fats and proteins, chronic pain, and Diabetes mellitus

Biochemical

many routine blood and urine lab test-useful for objective assessment of nutrition status

Anthropometric

measurements that are simple noninvasive techniques that measure height and weight, head circumference and skin fold thickness

Level Two of dysphagia diet

mechanically altered diet- foods have to moist, soft and easily chewed. meats are ground and served with gravy or sauce.

risks associated with Gastroesophageal Reflux Disease (Heartburn)

severe burning sensation under the sternum; asthma; chronic cough; and other ear, nose, and throat ailment

Nutritional support after surgery

nutrition interventions to help reduce the risk of patient morbidity, mortality and complications, moral support as well.

soft diets

ordered after surgery or a transition from liquid diets to regular diets

food poisoning- preventive measures

personal hygiene and hand washing are most important for prevention , food temps should be maintained.

Hospitalization impact on nutrition

prolong hospitalization was linked to weight loss, also may be affected by medical fasting for testing. 40% of patients are malnourished when admitted.

nutrition's impact on recovery

proper nutrition is vital for proper healing and recovery, poor nutrition may lead to morbidity and mortality, longer length of stay and higher cost of care.

Level one dysphasia diet

pureed diet- no coarse textures are allowed, and foods are totally. blended without lumps, liquids ordered separately and usually pudding consistency.

vegetarian diets

regular diet but does not include meat, poultry, fish or seafood or products containing these foods.

risks associated with Hypertension

stroke, myocardial infarction, vascular disease, and chronic kidney disease

risks associated with parenteral feeding

technical, pneumothorax is the most common, then septic complications, and also metabolic as well and the most common is hyperglycemia.

Dysphagia diet

used with ALS, some forms of stroke, head and neck cancer and other conditions in which swallowing is impaired, thickness can be added to make drinks thicker

BMR Response to stress

the boys metabolic rate rises a lot thus becoming hyperbolic, the response to stress involves most metabolic pathways, with accelerated metabolism of lean body mass, negative nitrogen balance and muscle wasting.

Kcals

the number of calories in food tells us how much potential energy they contain. substance from which the calories are taken is important as well.

Dietary

there are several methods of collecting information regarding actual and habitual dietary intake- most common data collected using dietary recall methods or documented food records.

Percent (%) Daily Value

this doesn't add up to 100% instead it is the percentage of daily value for each nutrient in a serving of food. can tell you if a serving of food is high. or low in nutrient.

diet as tolerated

this happens when a patient is admitted or after an operation, it permits the patients preferences and situation to be taken into consideration

clinical

this includes data from several sources, like medical history, social history and physical exam

Health claims

this includes things that are high in fiber, folic aid and low in sodium, this helps people who need extra of these vitamins.

Lactose - free diet

this is foods that have no lactose or milk products in this, for people who are lactose intolerant.

Clear liquid diet

this was usually ordered when a patient have a gastrointestinal surgery or colonoscopy. diet consists of foods that are clear and liquid at room or body temp, ex: popsicles, plain gelatin, ice chips and apple or grape juices.

risks for PUD (peptic Ulcer disease)

weakens the protective mucosal layer of the stomach and duodenum, allowing gastric acid to damage epithelial tissues, which leads to ulcerogenesis (to cause an ulcer), deep ulcers may penetrate the mucosa and damage blood vessels, causing hemorrhage or perforation of the GI wall

Diverticulitis

when the musculature of the bowel walls weakens, diverticula (pouchlike herniations protruding from the muscular layer of the colon) often develop.

serving size

you should compare the amount of food you normally eat to the serving size listed on the label. the larger portions, the more calories you eat.