Nutrition 3

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Author:
haip50
ID:
182566
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Nutrition 3
Updated:
2012-11-27 18:51:18
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CVD
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Nutrition Exam 3
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  1. The Role of Fats and CVD
    • Saturated and trans fats increase VLDs and LDLs
    • Total Cholesterol < 200 mg/dL
    • HDL > 40 mg/dL
    • LDL < 100 mg/dL
    • Triglycerides < 150 mg/dL
  2. How to Improve Blood Lipid Levels
    • Decrease dietary sat fats
    • Increase omega-3 fatty acids
    • Consume folate everyday
    • Increase intake of whole grains, fruits, veggies
    • Maintain blood glucose
    • Eat smaller more frequent meals
    • No more than 2 alcoholic drinks/day - red wine
    • Stop smoking
    • Get active
    • Maintain healthy weight
  3. TLC Diet
    • Sat Fat: < 7% of energy
    • Monounsat: plant oils, nuts - substitute for sat fats up to 20% energy
    • Polyunsat: sub for sat fats up to 10% energy - veg oils, semiliquid margarines
    • Carbs: 60% energy
    • Fiber: 5-10 g/day
    • Protein: sub plant for animal
    • Other: 2-3 g plant sterol
  4. Nutrition Therapy
    • Measure LDL at 6-week interval
    • If nutrition unsuccessful, try more, then add meds after 3 months
  5. MI Diet
    • Goal: reduce workload
    • Diet
    • - liquid (24 hrs)
    • - smaller, more frequent
    • - restrict caffeine
    • - moderate temp
    • - Na, cholest, fat, calories individual
    • - omega-3 fatty acids
  6. CHF Diet
    • Goal: lessen workload
    • Restrict Sodium
    • Fluid restriction if hyponatremic (1-2 L/day)
    • Give 20-30% above basal needs
    • Nutritional supplements, enteral nutrition, or PPN
  7. ARF, RDS Diet
    • Goal: inhibit tissue destruction
    • Provide extra nutrients for hypermetabolic conditions
  8. COPD Diet
    • Goal: preserve muscle strength and immune system
    • Maximize oral intake
    • 25-45 cal/kg
    • Limit salt
    • Increase fiber
    • Increase fluids
  9. Renal Diets
    • Ordered for chronic renal failure, not acute
    • Changes with stages of CKD and dialysis
  10. Acute Renal Failure (ARF)
    • Abrupt loss of renal function
    • Prerenal, intrarenal, or postrenal
    • GFR - 90-110
  11. ARF Nutritional Problems
    • Retention of Na, H2O, Nitrogen
    • Potassium retention leads to cardiac problems
    • Anemia --> fatigue
    • Proteinuria - loss of immunoglobulins and vit D proteins
  12. ARF Nutritional Therapy
    • Protein: 40 g/day
    • Na: 2-3 g/day
    • K - 25-40 mEq/day restrictions
    • TPN may be required
    • Fluid intake: output + 500-700 ml/day
    • I&O
    • Daily weights
  13. Chronic Renal Failure (CRF)
    • Irreversible loss of kidney function
    • Stage 5: GFR < 15
    • Stage 5 is on dialysis
  14. Decreasing GFR
    • Abnormal urine production
    • Poor water excretion
    • Electrolyte imbalance
    • Metabolic abnormalities
    • Dilute urine reduced
    • BUN increase
    • Urine output decreases
  15. CRF Nutritional Problems
    • Proteinuria
    • Na excretion changes, early risk for hyponatremia
    • Late Na retention - hypotension, edema
    • Late K excretion, hyperkalemia
  16. Renal Diet
    • Low:
    • - P, K, protein, Na
    • Exception: dialysis patients need more protein
  17. Potassium Foods
    • Prunes
    • Oranges
    • Bananas
    • Dried fruits
    • Potatoes
    • Tomatoes
    • Brussel sprouts
    • Spinach
    • Beets
    • CKD 4-5: restricted
  18. Phosphorus Foods
    • Milk
    • Cheese
    • Yogurt
    • Dried beans, peas
    • Nuts
    • PB
    • Bran
    • Whole-wheat bread
    • CKD 3-5: restricted 800-1000 mg/day, binders may be needed
  19. Na Foods
    • Processed meats
    • Canned soups
    • Salty snacks
    • Deli meats
  20. Ca Foods
    • Dairy
    • CKD 1-4: 1200-1500 mg/day, may need vit D3
    • CKD 5: < 2 g/day, activated vit D
  21. Renal Nutrition Therapy
    • Foods with essential amino acids
    • Vitamin supplements
    • P restriction avoids osteodystrophy
    • Protein restriction
    • Sufficient calories, high carbs
    • Replace Na and K loss
    • Monitor labs, weight, BP
    • Monitor fluids (FVE)
  22. Hemodialysis
    • Treatments 3-4 hrs, 3x/week
    • Protein increased
    • Fat restricted
    • P restricted
    • Na, K, fluid based on weight
  23. Peritoneal Dialysis
    • Usually performed at home
    • Treatment 20-30 mins over 8-10 hrs
    • 4-5x/week
    • Vitamin supplments, folic acid, Ca
    • Protein increased - loose 20-30 g/day
    • P restricted
    • HTN, edema, CHF between treatments due to Na and fluid
  24. Cachexia
    • Wasting syndrome - 10% loss in 1 month
    • Indicative of cancer/HIV prognosis
    • Abnormalities in metabolism
  25. Malnutrition
    • Risk for dehydration
    • Protein malnutrition most common with cancer
    • Vitamin/Mineral deficiencies
  26. Anorexia
    • Liquids
    • Small portions
  27. Nausea/Vomiting
    • BRAT diet
    • Ginger ale
  28. Diarrhea
    • No lactose
    • Binding foods - bananas, oatmeal, crackers
  29. Constipation
    • Fluids
    • Fiber
    • Movement
  30. Taste Abnormalities
    • Lemon juice
    • Vinegar
  31. Fatigue
    Easy foods
  32. Depression
    Communication
  33. Dehydration
    Fluid replacement
  34. Vitamin and Minerals
    Multivitamin with meals
  35. Opportunistic Infection
    • Client on antibiotics
    • Yogurt
    • Probiotics
    • Thrush - cold beverages
  36. Household Poverty
    Outreach programs
  37. Goals for Cancer/HIV
    • Preserve lean body mass
    • Gut function
    • Prevent malnutrition
    • Minimize symptoms of malabsorption

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