Clinical Nutrition

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Clinical Nutrition
2014-04-16 15:01:05

Exam 4
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  1. Discuss the nutritional side effects of cancer
    • Weight loss, malnutrition, fatigue,
    • nausea & vomiting, oral mucositis, taste alterations, constipation, loss
    • appetite, decrease intake
  2. Describe the effects of vitamins in relationship to food allergies & wound healing.
    Wound healing – vitamin A (deficiency impairs wound healing), vitamin C (impaired collagen cross)
  3. Identify the amino acids that are important for wound healing.
  4. Identify the key components of peptic ulcer disease.
    • Gastric Ulcer – lesion in the lining of the stomach     
    • Duodenal ulcer – lesion in the lining of the duodenum
  5. Describe how to monitor protein needs during wound healing
    Transport Proteins – Albumin (predictor of pressure ulcer) trends have half life almost 21 days; prealbumin has 3 days
  6. Body mass index
    Body Mass Index, is a measurement of body fat calculated from height and weight, applies to women, men and children

    • Formula- weight in KG/ height squard*703
    • Over age of 2, we start looking at BMI

    • Underweight: below the 5th percentile
    • Healthy Weight: 5th percentile up to the 85th percentile
    • Overweight: 85th percentile up to the 95th percentile
    • Obese: 95th percentile or higher

    Good indicator, but can be misleading for those with high muscle volume-shows as being overweight
  7. Disease processes that are often correlated with an underweight BM
    • Anorexia –decrease in appetite      
    • Cachexia –loss of muscle with or without loss of fat muscle     
    • Sarcopenia –loss of muscle mass, strength and performance
  8. Know the dietary, non-pharmological, and pharmological ways for a patient
    to gain weight.
    • Nutritional Supplements – Supplements containing whole protein and lactose
    • Prescription: Megace, Marinol, Remeron 
    • Non-pharmological: maintaining weight, motivational interviewing
  9. Nonmodifiable and modifiable risk factors for obesity.
    • Non-modifiable – genetics, heredity, race
    • Modifiable – diet, etc
  10. Complications of obesity
    Pulmonary disease, nonalcoholic fatty liver disease, gall bladder disease,cancer, idiopathic intracranial hypertension, stroke, cataracts, coronary heart disease, serve pancreatitis
  11. Paleo diet
    • The caveman-inspired Paleo diet has a strong following, and revolves around eating like our Paleolithic ancestors – who lived by hunting and gathering.
    • Creators claim that by following this plan, you can increase athletic performance, become naturally lean and eliminate acne. Additionally, the increased consumption of fruits and vegetables is thought to improve symptoms of diseases like osteoporosis, asthma and high blood pressure. 
    • Pros - Lean meats and plenty of fruits and vegetables are recommended.This plan tends to be low in sodium.Exercise is highly encouraged. 
    • Cons - Entire food groups – such as whole grains and dairy – are eliminated,making it tougher to take in essential nutrients, including calcium and vitamin D. Choosing the wrong types of meat (those that aren't lean) can increase your risk for heart disease.Many folks tend to get stuck on the same foods, which limits overall nutrient intake.Can be dangerous to follow for those with specific diseases (like kidney disease).Purchasing fresh grass-fed and free-range meat, fish and seafood can be pricey.
  12. Blood Type diet
    • Type O blood: A high-protein diet heavy on lean meat,poultry, fish, and vegetables, and light on grains, beans, and dairy
    • Type A blood: A meat-free diet based on fruits and vegetables, beans and legumes, and whole grains 
    • Type B blood: Avoid corn, wheat, buckwheat, lentils,tomatoes, peanuts, and sesame seeds. Chicken is also problematic. It is encouraged to eat green vegetables, eggs, certain meats, and low-fat dairy
    • Type AB blood: Foods to focus on include tofu,seafood, dairy, and green vegetables. Avoid caffeine, alcohol, and smoked or cured meats
  13. Black spots seen on tomatoes found on flowers and fruits of vegetables, cereal grains, and ornamental plants:
    A) Rhizopus
    B) Aspergillus
    C) Alternaria
    D) Fusarium
  14. found in soil as well as cotton, rice barely, wheat and corn 
    A) T.O.E. Mix 
    B) culrvularia
    C) Rhizopus
    D) Alternaria
  15. found in old hay, decaying vegetables & roots, bird droppings, tobacoo, and stored sweet potatoes
    A) Aspergillus 
    B) culrvularia
    C) Rhizopus
    D) Alternaria
  16. occurs regularly on banana roots, other fruits and vegetables (tomatoes, watermelon, etc), low growing:
    A) T.O.E. Mix 
    B) culrvularia
    C) Fusarium 
    D) Alternaria
  17. Velvety colony with blue and green center seen on stale bread, citrius fruits apple and jams:
    A) Helminthosporium 
    B) culrvularia
    C) Penicillium 
    D) Alternaria
  18. Reddish brown and cottony grows a cereal grain:
    A) Helminthosporium 
    B) culrvularia
    C) Penicillium 
    D) Alternaria
  19. Identify characteristics of eating disorders
    • Anorexia Nervosa - restricting type: person does not engage in binge eating; binge-eating/purging: person regular engages
    • Bulimia  Nervosa– purging type: the person regular engages in self-induced vomiting or misuse of laxatives, diuretics. Non-purging type – person regular engages in other inappropriate compensation like fasting or excessive exercise
  20. RULE for motivational interviewing
    • Resist the righting reflex (“roll with resistance”)
    • Understand your patient’s motivation
    • Listen to your patient
    • Empower your patient
  21. We try to do these (4) during motivational interviewing:
    Give them Insight - if you can just make people see, then they will change

    Give them Knowledge - if people just know enough, then they will change

    Give them Skills - if you can just teach people how to change, then they will do it

    • Give them Hell
    • - if you can just make people feel bad or afraid enough, they will change