Nutrition Study Guide: Essential Vitamins and Minerals, Exams of Nursing

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NR 228 Exam 2 Study Guide Thiamin (B1) - Correct answer Water-soluble vitamin Coenzyme energy metabolism; muscle nerve action § Part of an enzyme needed for energy metabolism § Important to nerve function Where do we get Thiamin (B1) - Correct answer pork, whole-grain or enriched breads and cereals, legumes, nuts and seeds Thiamin (B1) deficiency - Correct answer Beriberi!!, neuritis, edema, cardiac failure Riboflavin (B2) - Correct answer water soluble Coenzyme energy metabolism normal vision and skin health Where do we get Riboflavin (B2) - Correct answer Milk and milk products; leafy green vegetables; whole-grain, enriched breads and cereals Riboflavin (B2) deficiency - Correct answer Photophobia, cheilosis, glossitis, corneal vascularization, poor growth Niacin (B3) - Correct answer water soluble Cofactor to enzymes involved in energy metabolism; glycolysis and tricarboxylic acid (TCA) cycle synthesis important for nervous system, digestive system, and skin health Where do we get Niacin (B3)? - Correct answer Meat, poultry, fish, whole- grain or enriched breads and cereals, vegetables (especially mushrooms, asparagus, and leafy green vegetables), peanut butter Niacin (B3) deficiency - Correct answer Pellegra: dermatitis, diarrhea, dementia Niacin (B3) toxicity - Correct answer Flushing, gastrointestinal effects, liver damage "niacin flush" Pyridoxine (B6) - Correct answer Water soluble vitamin Hemoglobin synthesis and other functions Part of an enzyme needed for energy metabolism Where do we get Pyridoxine (B6)? - Correct answer widespread in foods Pyridoxine (B6) toxicity - Correct answer Sensory neuropathy with progressive ataxia; photosensitivity Pyridoxine (B6) deficiency - Correct answer Microcytic anemia; convulsions; irritability Folate/Folic acid (B9) - Correct answer water soluble Coenzyme metabolism (synthesis of amino acid, heme, DNA, RNA) Part of an enzyme needed for making DNA and new cells, especially red blood cells Where do we get Folate/Folic acid (B9)? - Correct answer Leafy green vegetables and legumes, seeds, orange juice, and liver; now added to most refined grains Folate/Folic acid (B9) toxicity - Correct answer Masking of B12 deficiency symptoms in those with pernicious anemia not receiving cyanocobalamin Folate/Folic acid (B9) deficiency - Correct answer Poor growth; megaloblastic anemia (concurrent deficiency of vitamin B12 should be suspected); impaired cellular immunity Cofactor in synthesis of blood clotting factors; protein formation Where do we get Vitamin K? - Correct answer Leafy green vegetables such as kale, collard greens, and spinach; green vegetables such as broccoli, brussels sprouts, and asparagus; also produced in intestinal tract by bacteria Vitamin K deficiency - Correct answer Prolonged bleeding and prothrombin time; hemorrhagic manifestations (especially in newborns) Vitamin K toxicity - Correct answer Possible hemolytic anemia; hyperbilirubinemia (jaundice) what essential nutrients not provided in a vegan diet? - Correct answer o vitamins D and B12 , calcium, and omega-3 fatty acids. These will need to be consumed through carefully selected fortified foods or consumption of supplements as needed Calcium - Correct answer Bone and tooth formation Builds and maintains bones and teeth; essential in clotting of blood; influences transmission of ions across cell membranes; required in nerve transmission Where do we get Calcium? - Correct answer Breast milk, infant formula, yogurt, cheese, fortified or enriched grain products, some green leafy vegetables (such as collards, kale mustard greens, and turnip greens), tofu (if made with calcium sulfate), sardines, salmon Calcium toxicity - Correct answer Excessive calcification of bone; calcification of soft tissue; hypercalcemia; vomiting; lethargy Calcium deficiency - Correct answer Rickets - abnormal development of bones. Chloride - Correct answer Helps regulate acid-base equilibrium and osmotic pressure of body fluids; component of gastric juices Acid-base balance Where do we get Chloride? - Correct answer Breast milk; infant formula; whole-grain breads, cereals, and other grain products; tofu; legumes; green vegetables Chloride deficiency - Correct answer Signs of Sodium depletion- Nausea; cramps; vomiting; dizziness; apathy; exhaustion; possible respiratory failure Magnesium - Correct answer Bone structure Where do we get Magnesium - Correct answer Breast milk; infant formula; whole-grain breads, cereals, and other grain products; tofu; legumes; green vegetables Magnesium toxicity - Correct answer Diarrhea; transient hypocalcemia Magnesium deficiency - Correct answer Muscle tremors; convulsions; irritability; tetany; hyper-or hypoflexia Phosphorus - Correct answer Builds and maintains bones and teeth; component of nucleic acids, phospholipids; as coenzyme functions in energy metabolism; buffers intracellular fluid Acid-base balance Where do we get Phosphorus? - Correct answer Breast milk; infant formula; cheese; egg yolk; meat; poultry; fish; whole-grain breads, cereals, and other grain products; legumes Phosphorus toxicity - Correct answer Hypocalcemia (when parathyroid gland not fully functioning Phosphorus deficiency - Correct answer Phosphate depletion unusual - effects renal, neuromuscular, skeletal systems as well as blood chemistries Potassium - Correct answer With sodium and chloride, major intracellular electrolyte for fluid regulation; muscle function (heart is a muscle) Where do we get Potassium? - Correct answer Breast milk; infant formula; fruits especially orange juice, bananas, and dried fruits; yogurt; potatoes; meat; fish; poultry; soy products; vegetables Potassium deficiency - Correct answer Muscle weakness; decreased intestinal tone and distension; cardiac arrhythmias; respiratory failure Sodium - Correct answer Major extracellular electrolyte for fluid regulation; body fluid levels; acid-base balance; nerve impulse and contraction; blood pressure/volume Where do we get Sodium? - Correct answer Table salt- sodium chloride Sodium deficiency - Correct answer Nausea; cramps; vomiting; dizziness; apathy; exhaustion; possible respiratory failure Sulfur - Correct answer Component of protein structures Where do we get sulfur? - Correct answer meat and poultry, fish and seafood, legumes, nuts and seeds, eggs and dairy, dried fruits, Certain vegetables: (asparagus, broccoli, Brussels sprouts, red cabbage, leeks, onion, radishes, turnip tops, and watercress), grains (pearl barley, oats, wheat, and flour made from these grains), beverages (beer, cider, wine, coconut milk, and grape and tomato juice), condiments and spices (horseradish, mustard, marmite, curry powder, and ground ginger) Sulfur deficiency/toxicity - Correct answer do not occur and are not a health issue Chromium - Correct answer Required for normal glucose metabolism; insulin cofactor where do we get Chromium? - Correct answer Meat; whole-grain breads, cereals, and other fortified or enriched grain products; brewer's yeast; corn oil Chromium deficiency - Correct answer Glucose intolerance; impaired growth; peripheral neuropathy; negative nitrogen balance; decreased respiratory quotient Food asphyxiation - Correct answer ◦Toddlers and elderly persons at higher risk ◦Foods associated with choking ◦Prevention and Heimlich maneuver Obesity - Correct answer ◦Increase among children and adolescents ◦Etiology: multifactorial ◦Clinical assessment and intervention ◦Health history ◦Intervention: motivation/weight-associative disorders ◦Physical symptoms such as sleep apnea Type 2 diabetes mellitus - Correct answer ◦Risk factors: overweight during childhood and lack of physical activity ◦Genetics and race: predispose some individuals ◦Prevention approaches: individual and public health Iron-deficiency anemia - Correct answer ◦Poverty: risk factor ◦Lead poisoning and chronic hunger increase risk. ◦Affects ability to learn◦Public health issue ◦Role of nurses-Educate teaching staff about relationship between iron deficiency and learning ability. Expected increase of BMI during pregnancy - Correct answer 15-20% by term Underweight (BMI <18.5): 28-40lbs Normal Weight (BMI 18.5-24.9): 25-35lbs Overweight (BMI 25-29.9): 15-25lbs Obese (BMI >30): 11-20lbs Weight gain during pregnancy - Correct answer three components to maternal weight gain: (1) maternal body composition changes, including increased blood and extracellular fluid volume; (2) the maternal support tissues, such as the greater size of the uterus and breasts (3) the products of conception, including the fetus and the placenta. Role of folic acid before and during pregnancy - Correct answer 600mg and 500mg for lactating mothers -Prevent neural tube defects Role of iron during pregnancy - Correct answer RDA is 27mg/day iron supplement with 30mg of ferrous iron daily Nausea/Vomiting during pregnancy - Correct answer Eat small, frequent meals, to drink liquids between rather than with meals, and to avoid fried and greasy foods. Some find it helpful to reduce coffee intake and to prepare meals near an open window to avoid cooking odors. If nausea upon getting out of bed in the morning is a problem, dry toast or crackers eaten before getting out of bed may provide relief. Snacks to keep handy while working or traveling include dried fruit, crackers, and small cans of juice. heartburn - Correct answer from the amount of progesterone The best dietary remedies are eating small, frequent meals, avoiding foods high in fat, drinking fluids between rather than with meals, limiting spicy foods, and avoiding lying down for 1 to 2 hours after eating. should not take antacids without approval of a primary care provider Constipation - Correct answer A generous intake of fiber, such as whole- grain cereals, fresh fruit, and raw vegetables, as well as inclusion of plenty of fluids should alleviate constipation. Moderate exercise such as a daily walk may also help. Benefits of breastfeeding for the mother and infant - Correct answer Provides immunologic protection to the infant against many infections and diseases (especially respiratory and gastrointestinal) Offers uniquely suited nutrient composition with high bioavailability Reduces risk of food allergy in the infant Promotes infant oral motor development Offers convenience: always fresh, available, and at the right temperature • Is generally less expensive than formula feeding May protect infant against some chronic diseases such as type 1 diabetes and childhood leukemia Promotes mother-infant bonding Facilitates uterine contractions and controls postpartum bleeding Promotes return to pre-pregnancy weight Sound nutrition practices during first year of life - Correct answer First 4 to 6 months of life is exclusive use of breast milk, which has the correct balance of all the essential nutrients as well as immunologic factors that protect the infant from acute and chronic diseases. The breast should be offered at least 10 to 12 times per 24 hours in the first several weeks AVOID-Honey (may cause infantile Clostridium botulinum poisoning); hot dogs, grapes, hard candies, raw carrots, popcorn, nuts, peanut butter (choking hazards); skim milk (insufficient calories); cow's milk (potential allergen, may replace breast milk or formula); egg whites (potential allergen) 4-5 months: - Correct answer iron fortified infant cereals 5-6 months - Correct answer strained fruits and vegetables 6-8 months - Correct answer mashed/chopped fruits and vegetables also juice from a cup 9-12 months - Correct answer crackers, toast, cottage cheese, plain meats, egg yolk, finger foods how adequate energy is reflected during infancy - Correct answer reflected in satisfactory gains in length and weight as plotted on a National Center for Health Statistics growth chart To reduce risk of diet-related disorders such as coronary heart disease, some cancers, T2DM, and obesity, consider: - Correct answer Scheduling routine food shopping so staples such as fruits, vegetables, and grains are available for meal preparation. • When shopping, occasionally comparing fat content of commonly purchased foods with that of similar products and purchasing the lower-fat product. Aiming to limit foods that contain visible fat. Reorganizing work and personal priorities if necessary to allow time for meal preparation and consumption; for example, get up earlier for breakfast, pack a lunch or after-noon snack, preplan easy-to-prepare dinner menus. Keeping track of dietary intake using MyPlate or the Fruits & Veggies To reduce osteoporosis risk and strengthen bone health, consider: - Correct answer Focusing on routine dietary habits—for example, drink a glass of milk at lunch each day. A food pattern assessment can assist in creating a practical calcium consumption plan. increasing calcium consumption. To decrease the risk of sodium-sensitive hypertension and CAD, consider - Correct answer Adopting the DASH (Dietary Approach to Stop Hypertension) eating plan, which focuses on increasing intake of fruits and vegetables. Learning the food categories that are generally salty, and either consume them only occasionally or, if available, purchase low-sodium versions. Reducing overall intake of fat, particularly saturated fat, while increasing consumption of health-promoting "good" fats such as monounsaturated and polyunsaturated fats found naturally in whole food Anthropometric measurements - Correct answer Height, weight, head circumference, skinfold thickness, waist measurements Body Mass Index range for healthy adult is 18.5 - 24.9 kg/m2 Biochemical tests - Correct answer Visceral proteins Immune function Visceral proteins - Correct answer Serum albumin 3.5 - 5 g/dL; reflects long term changes Prealbumin 16 - 40 mg/dL; reflects short term changes Immune function - Correct answer Serum levels of vitamins A and D, zinc and omega-3 fatty acids Clinical observations - Correct answer Data from medical history, social history and physical examination Dietary evaluation - Correct answer 24-hour diet recall Food records Calorie counts Factors that can compromise the nutritional status of a patient who is ill - Correct answer Can't eat or drink vomiting and diarrhea constipation glucose intolerance renal dysfunction pain physical disability restricted fluid intake reduced GI motility fasting before procedures Impact of nutrition on recovery of a patient - Correct answer The capacity for recovery from illness or disease depends on good nutrition status. Poor nutrition status delays recovery and decreases quality of life Role of the registered dietitian - Correct answer The registered dietitian (RD/RDN) is best qualified to provide in-depth knowledge about nutrition care, to consult individu-ally with patients, and to participate in team meetings. A comprehensive nutrition assessment is conducted by dietitians to determine appropriate nutrition therapy based on identified needs (nutrition diagnoses) of the patient. the Nursing Process - Correct answer can be remembered with the acronym ADPIE: assessment, diagnosis, planning, implementation, and evaluation the Nutrition Care Process - Correct answer serve as a valuable partner with the nursing team. The NCP encompasses detailed nutrition assessments, establishment of a nutrition diagnosis, provision of nutrition therapies, monitoring, and evaluation of out-comes. Major types of potential interactions between food/nutrients and drugs - Correct answer depends on characteristics of the individual, including age, physiologic status, multiple-drug intake, hepatic and renal function, and typical dietary intake. age - Correct answer Older adults are more at risk for drug-nutrient reactions because of the greater variety of medications used and the reduced physiologic functioning, which affects drug absorption and efficacy. Physiological status - Correct answer Impaired ability to absorb, metabolize, or excrete nutrients and medications because of disorders of the GI tract and reduction in hepatic and renal functioning increases the risk of drug-nutrient reactions. Polypharmacy - Correct answer The resulting drug-nutrient reactions may be related to the disease itself or be a reaction to medications Influence of typical dietary intake - Correct answer The basis of a person's nutritional status depends on foods regularly consumed; the nutritional content of these foods affects body functions. soft diet - Correct answer sometimes ordered after surgery or as transition from liquid diets to regular diets. Whole foods that are low in fiber and only lightly seasoned are used. Food supple-ments or between-meals snacks may be used to add extra energy diet as tolerated - Correct answer It is also common for this diet to be ordered postoperatively. It permits the patient's preferences and situation to be taken into consideration. enteral nutrition (EN) - Correct answer Any time the GI tract is used to provide nourishment This includes liquid diets, soft and solid food diets, and special nutritionally complete for-mulas administered orally or via tubes. Enteral tube feedings are much less costly than PN for both the patient and the health care institution. parenteral nutrition (PN) - Correct answer When the GI tract is functional, accessible, and safe to use they are physiologically beneficial in maintaining the integrity and function of the gut. management of enteral nutrition and parenteral nutrition - Correct answer Before initiation of enteral tube feedings, placement of the feeding tube must be confirmed and documented. Tube placement is often confirmed radiologically after initial insertion. The rate of the feedings can be advanced to meet the desired volume, and then concentration can be gradually increased until kcal and protein needs are met. Food allergy - Correct answer causes an immune system reaction that affects numerous organs in the body. It can cause a range of symptoms. In some cases, an allergic food reaction can be severe or life-threatening. food intolerance - Correct answer symptoms are generally less serious and often limited to digestive problems. Basic food safety and sanitation guidelines - Correct answer Clean — Wash hands and surfaces often. Separate — Don't cross-contaminate. Cook — Cook to the right temperature. Chill — Refrigerate promptly. Cultural and religious implications on dietary intake - Correct answer A person's level of commitment to their religion may affect whether they adopt the dietary practices of that religion Complementary medicine - Correct answer refers to non-Western healing approaches used at the same time as conventional medicine (allopathy). For instance, the patient who attempts to lower hypertension takes prescription medications (conventional) but also attends yoga classes (complementary) for physical and psychologic benefits. Naturopathic medicine - Correct answer based on noninvasive, natural healing to recover from disease and to achieve wellness. This system incorporates techniques from Eastern and Western traditions. Techniques include acupuncture, exercise, massage, and dietary alterations. Alternative medicine - Correct answer therapies are used instead of conventional medicine. An example is the use of herbal supplements or shark cartilage to treat cancer instead of chemotherapy or surgery.