Nutrition Study Guide Exam 2 Outlined Review, Study Guides, Projects, Research of Nursing

Download Nutrition Study Guide Exam 2 Outlined Review and more Study Guides, Projects, Research Nursing in PDF only on Docsity! Nutrition Study Guide Exam 2 Outlined review Satisfactions Guaranteed Chapter One – Nutrition and Health 1. Government Agencies: charged with reducing chronic disease and containing health care costs; giving attention to what people eat Roles & Responsibilities: USDA (United States Department of Agriculture): federal agency concerned w/food Maintains the NEL (Nutrition Evidence Library) Developed 7 messages summarizing concepts of 2010 Dietary Guidelines Issued first food guide in 1980; Food Guide Pyramid in 2005; MyPlate in 2010 FDA (Food and Drug Administration): Ensuring safety of food supply; food labeling Regulation of tobacco products Advancement of public health CDC (Centers for Disease Control and Prevention) Community Health Monitors infectious diseases/outbreaks 2. Evidence based practice (EBP) see page 14 Three Step Process: Identify problem: What question needs to be answered? Review the evidence: Search for professional studies relevant to your question/issue being addressed Implement findings: Develop/implement plan for clients; include evaluation component; share results with other professionals 3. Review Key Terms page 8 Nutrigenomics: study of effects of nutrients/other bioactive substances found in food on genes, body proteins, and metabolites Nutrigenetics: study of effect of individual’s particular genetic makeup on metabolic/physiologic functions, including nutrient requirements, risk of certain diseases Homeostasis: state of dynamic equilibrium within body’s internal environment; balance achieved through control of various interrelated physiologic mechanisms Nutrition: sum of processes involved in food intake, releasing contained nutrients, assimilating/using nutrients to provide energy, maintain body tissue Nutrition Science: body of scientific knowledge developed through controlled research, relates to all aspects of nutrition (national, international, community, clinical Dietetics: science related to nutritional planning/preparation of foods and diets Registered Dietician (RD) or Registered Dietician Nutritionist (RDN): accredited health professional w/minimum of 1200 hrs of post-baccalaureate supervised practice, passed National Registration exam Public Health Nutritionist: health professional w/graduate degree (MPH or DrPH) in school of Public Health accredited by Council on Education for Public Health; supervises nutrition component of public health programs in country, state, national, or international community settings Nutrients: substances in food essential for energy, growth, normal body function, maintenance of life Essential Nutrients: substances that cannot be made by body; must be supplied in food; include essential fatty acids, essential amino acids for making protein, vitamins and minerals Macronutrients: 3 energy-yielding nutrients = carbohydrates, fat and protein Carbohydrate: includes starch, sugar and fiber; starch should be major source of energy in diet; sugar and starch have fuel factor of 4 kcal/g; fiber is indigestible form of carbohydrate Fat: provides concentrated form of energy yielding 9 kcal/g; stored in body as adipose for energy reserve; supplies essential fatty acids in diet Protein: contains nitrogen, essential amino acids; amino acids are building blocks for forming body tissues, enzymes and hormones; yields 4 kcal/g Micronutrients: 2 classes of non-energy yielding elements and compounds = minerals and Food Sources: vegetable oils, peanut butter, nuts, certain fruits/veggies, tomatoes, spinach, fortified ready-to-eat cereals Clinical Applications: Vit E therapy to reverse hemolytic anemia; needed for cystic fibrosis patients and those w/malabsorption syndromes Vitamin K: Function: blood clotting, bone metabolism Deficiencies: bleeding, easily bruising Food Sources: dark, leafy greens, some cheeses Clinical Applications: prophylactic dose to newborns; patients w/bile duct obstruction before surgery; children w/cystic fibrosis to overcome antibiotic interference w/synthesis; Tx for OD of blood thinners, monitor patients on blood thinners WATER SOLUBLE : Vitamin C (ascorbic acid) (SEE TABLE 6-3, pg 119) Function: powerful antioxidant, build/maintain many body tissues/bone matrix/cartilage/dentin/ collagen, support metabolism adrenal/pituitary glands, brain, eyes, WBC (SEE PAGE 117); helps absorption of iron Deficiencies: easy bruising, pinpoint hemorrhages of skin (petechiae), weak bones that fracture easily, poor wound healing, bleeding gums (gingivitis), anemia Scurvy: hemorrhagic disease caused by lack of Vitamin C Food Sources: citrus fruits, tomatoes, broccoli, salad greens, strawberries, watermelon, cabbage, sweet potatoes Clinical Applications: wound healing, fever/infection causes vit C depletion, needed during growth, stress and body response uses vit C stores B Vitamins (SEE TABLE 6-4, pg 131 to 132) Beriberi: paralyzing disease plagued East Asia for centuries; vitamin B deficiencies; extracts of rice polishing used to cure by RR Williams, American chemist Chapter 7 – Minerals and Water 1. How are minerals different from vitamins? (Review Table 7-1 pg.138) Structure, absorption, classification, roles in body, relative amount needed, stability 2. Classification (Box 7-1, pg. 139) 1. Major (Table 7-3 pg. 153-4) Ca, P, Mg, Na, K, Cl, S Potassium (K) found inside the cells Sodium (Na) main food source: sodium chloride added in food processing Calcium (Ca) DRI: youth 9-18 1300mg/day, men/women 19-50 1000mg/day, women 51-70 1200mg/day to offset calcium losses associated with menopause 2. Trace (Table 7-5, pg. 164-5) Fe, I, Zn, Cu, Mn, Cr, Se, F, Mo 3. Functions 1. How do vitamins and minerals work together? Vit D helps transport/absorption of calcium; Vit C helps absorption of iron, to prevent anemia 4. Clinical Applications Important roles in both structure and function; cofactors in enzyme systems, work w/vitamins regulating essential metabolic functions Ca: Tx for tetany, rickets, osteomalacia, resorptive hypercalciuria/renal calculi P: recovery from diabetic acidosis; growth; hypophosphatemia; hyperphosphatemia Na: water balance; acid-base balance; cell permeability; muscle action K: water balance; muscle activity; carb metabolism; protein synthesis; BP control; acid-base balance 5. Water and fluid balance 1. Functions: fluid environment for tissues; medication dissolution; regulating body temperature 2. Clinical Applications: uncontrolled diabetes; cystic fibrosis; high fiber; high protein; intense physical activity; impaired thirst in older adults 3. Water Compartments: (ECF) extracellular fluid – outside cells; (ICF) intracellular fluid – inside cells; interstitial fluid 4. Forces that control water distribution: a. Solutes Electrolytes: free in solution, carry electrical charge; Na major cation in ECF; K major cation in ICF Plasma proteins: albumin/globulin; influence movement of water in/out of capillaries; remain in blood vessels/exert colloidal osmotic pressure (COP) to maintain vascular blood volume b. Membranes: water/solutes move across membranes; osmosis, diffusion, active transport, pinocytosis 5. Hormones and water balance a. Antidiuretic hormone (ADH): controls reabsorption of water by kidneys as body needs, acting as water-conserving mechanism b. Aldosterone: Na+ conserving hormone associated w/renin-angiotensin- aldosterone system; secondary control over body water; acts on kidneys to reabsorb sodium, which also reabsorbs water, restoring normal blood volume c. Prostaglandins: exist in virtually all body tissues; act as local hormones to direct/coordinate biologic functions; influence blood pressure, blood clotting, cardiovascular function d. Insulin: hormone produced in pancreas, lowers blood glucose by enhancing its entry into cells Chapter 8 – Energy Balance Energy 1. Controlled reaction rates Enzymes: proteins produced in cell; enzyme & substrate lock together to produce new reaction product; often act as catalysts Coenzymes/cofactors: partners/another substrate; they are changed/reduced when material is transferred Hormones: messengers to trigger/control enzyme action - Shigella: (causes dysentery) spread by insects, unsanitary food handling - Listeria: (complications include pneumonia, sepsis, meningitis, endocarditis, miscarriage) unpasteurized dairy products, undercooked poultry/deli foods FOOD POISONING - Staphylococcal: unwashed infected hand of food worker, - Clostridial: food held for extended times after cooking (warmers/room temp) c. Prevention: appropriate food storage; raw poultry kept separate; thorough cooking; HAND WASHING is most important CLEAN: wash hands/surfaces often SEPARATE: don’t cross- contaminate COOK: to proper temperature CHILL: refrigerate promptly Chapter 11 – Nutrition during Pregnancy & Lactation A. Healthy Pregnancy: 2 key factors: maternal preconception weight and weight gain during pregnancy Complications: Anemia (iron, folate, hemorrhagic), HTN, gestational DM – glycosuria due to increased circulating blood volume and load on metabolites; GDM is intolerance of carbs such that blood glucose concentration increases during pregnancy 1. Factors determining nutritional needs Age, Gravida, Parity Complex Physiologic Interactions of Gestation: mother, fetus, placenta B. Nutritional Demands of Pregnancy 1. Energy Needs Approximately 340 kcal/day during 2nd trimester; 452 kcal/day during 3rd trimester; based on woman’s nonpregnant estimated requirement plus 15 – 20%; critical to ensure nutrient/energy needs, spare protein for tissue building 2. Macronutrients: protein 71g/day (increase of 25g/day), carb 175g/day, DHA/EPA 500mg/day 3. Fetal nourishment: C. High-Risk Pregnancies 1. Special Counseling Needs: age/parity of mother; use of harmful agents (ETOH, cigarettes, drugs, pica), socioeconomic problems Chapter 12 – Nutrition for Normal Growth & Development A. Measuring Childhood Physical Growth: growth charts/percentile growth; weight/length B. Nutrition for full term infant: breast milk (optimal) or formula, provides all nutrients required for first 6 months of life; breastfeeding adequate for first 12 months; newborns get dose of Vitamin K until develops on own; sometimes Vit D supplement warranted Chapter 13 – Nutrition for Adults: Early, Middle, and Later Years A. Older Adults 1. Nutritional Needs: Energy: intake declines, drops from 1750 kcal at ages 50-59 to 1525 kcal at age 70 and older Carbs: 45-65% of total energy Fats: 20-35% of total kcalories Protein: 1.0 g/kg body weight or more needed to support nutritional well-being, prevent age- related muscle loss 2. Fluids and dehydration (Box 13-2, pg 313) B. Mini-Nutritional Assessment (MNA) Tool to identify at-risk older adults and educate individuals and communities in preventive care 5 question screening, weight, LT calf circumference = screening score Chapter 16 – Nutrition Assessment and Nutrition Therapy in Patient Care A. Nutrition Screening: process of identifying characteristics known to be associated with nutrition problems with purpose of identifying individuals who are malnourished or at nutritional risk B. Nutrition Assessment: systematic approach to collect, record, interpret relevant data from patients, clients, family members, caregivers, other individual/groups; ongoing dynamic process Required w/in 24 hrs in hospital/acute setting; 7 days in ALF/nursing home 1. Measurements a. BMI: weight divided by height; <18.5 underweight, 18.5 – 24.9 normal, 25.0-29.9 overweight, >30 obese, >40 extreme obesity b. RMR: resting metabolic rate Calculate: (women 0.9 kcal/kg/hr, men 1.2 kcal/kg,hr) multiply # by kg body weight x 24 (hrs in a day) = RMR c. Weight Loss d. Waist circumference: assesses abdominal fat content, BMI and waist circumference correlate w/obesity and cardiovascular disease risk e. Length and Stature: most sensitive indicators of growth and development in infants/ children 2. Nutrition Care Process (NCP) (Box 16-2 pg. 361) a. Steps 1: nutritional assessment 2: nutrition diagnosis 3: nutrition intervention 4: nutrition monitoring and evaluation b. Developed by Academy of Nutrition and Dietetics Nutrition C. Role of Nutrition in Clinical Care Essential role in disease management, health care, preventive health care; should be provided by qualified nutrition professional; comprehensive nutritional