ATI Nutrition Exam Questions and Answers Graded A

ATI Nutrition Exam Questions and Answers Graded A Function of iron it is responsible for hemoglobin formation/function, cellular oxidation of glucose, antibody production, and collagen synthesis Iron food sources what increased the absorption of iron? lean red meats, organ meat, egg yolks, whole grains, green leafy vegetables, beans, raisins, peanut butter Vit C increases absorption of iron (OJ, tomatoes) What factors influence the body's need for protein tissue growth needs quality of the dietary protein added needs due to illness pregnancy/lactation What is the difference between complete and incomplete proteins? complete: generally from animals sources and contains all 9 essential amino acids incomplete: generally from plants (grains, nuts, legumes, fruits, vegetables) and do not contain all of the essential amino acids What is B12 and why is it important? What causes a deficiency? water soluble vitamin AKA Cobalamin - necessary for the production of RBC - deficiency is causes pernicious anemia and is seen mosly in strict vegetarians and those with the absence of intrinsic factor needed for absorption of b12 Sources of B12 food of animal origin: beef liver, shell fish, fortified grains Function of Vitamin C water soluble vitamin aka "ascorbic acid" iron absportion, antioxidant, tissue building -deficiency can cause scurvy, decreased iron absorption, and bleeding gums Sources of Vitamin C citrus fruits, tomatoes, peppers, green leafy vegetables, strawberries, Fiber carbohydrate that does not yield energy to the body -impt for bowel elimination; adds bulk to the feces and stimulates peristalsis to ease elimination -part of fruits, vegetables, and grains that is not broken down by your body: pectin, gum, cellulose, mucilage What are some foods high in fiber content prunes, rasberries, blackberrries, artichokes, legumes, high fiber cereal, whole grains Fat soluble vitamins A,D,E,K - have potential for toxicity due to ability to be stored in body for long periods of time -stored in the liver and fatty tissues, and are eliminated much more slowly than water-soluble vitamins A: vision D: bone development E: protects cells from oxidation K: normal blood clotting Water soluble vitamins Vitamin C and B-complex -your body metabolizes what it can and flushes out the excess through pee C: iron absorption, antioxidant, tissue building B: cell metabolism, energy, neurological function (Thiamin, Riboflavin, Niacin, Pantothenic acid, Pyridoxine, Folate, Cobalamin) Vitamin D function: maintain serum calcium and phosphorus, aid in bone development sources: fish, fortified dairy products, SUNLIGHT deficiency: low serun calcium, fragile bones, rickets B1 water soluble vitamin aka "thamin" function: muscle energy, GI support, CV support sources: meats, grains, legumes deficiency: Beriberi, altered digestion, CNS and CV problems CHO carbohydrate: organic compounds composed of carbon, hydrogen, and oxygen types: monosaccharides (glucose, fructose, galactose), disaccharides (sucrose, lactose, maltose), polysaccharides (starches, fiber) fuction: to provide ENERGY for the body *130 g/day needed to fuel the brain Low cholesterol diet avoid saturated and trans fats (red meat, full fat dairy) -limit saturated fat to 10% of calories and cholesterol to 300 mg/day -increase monounsaturated fats and soluble fiber include: oatmeal, oat bran (High fiber foods), fish and omega-3 fatty acids, walnuts/almonds/other nuts, olive oil, plant sterols clear liquid diet Foods that are clear and liquid at room temperature -water, tea, coffee, fat-free broth, carbonated beverages, clear juices, ginger ale, gelatin full liquid diet Foods that are liquid at room temperature -all foods on CL diet, all forms of milk, soups, strained fruits and vegetables, vegetable and fruit juices, egg nog, plain icecream and sherbert, refined or strained cereals, and puddings blenderized liquid (Pureed) diet liquids and foods that ar pureed to liquid form, separately to preserve individual flavor indications: clients who have chewing or swallowing difficulties, oral or facial surgery, wired jaws soft (Bland, Low-Fiber) diet whole foods that are low in fiber, lightly seasoned, and easily digested -High fiber gas forming foods are excluded (fruits, veggies, beans, coarse breads/cereals) Indications: clints transitioning between full liquid and regular diet, acute infections, chewing difficulties, or GI disorder Mechanical Soft diet modified in texture to include foods that require minimal chewing before swallowing (ground meats, canned fruits, softly cooked vegetables) indications: limited chewing ability; dysphagia, porrly fitting dentures, edentulous (w/out teeth), surgery to head/neck/mouth, strictures of the intestinal tract Lactulose or lactose intolerant Lactose intolerance occurs when the body is unable to breakdown all of the lactose (predominant sugar in milk) due inadequate lactase (enzyme that digests lactose into glucose and galactose) Lactose is contained in milk and dairy products such as cheese, yogurt, icecream, sherbert symptoms: abdominal distension, flatus, occasional diarrhea nursing concern: substitute calcium with other sources such as tofu, beans, and vegetables; in infants: substitute soy or casein hydrolysate formulas low sodium diet limit sodium to mg/day -benefits patients with cardiovascular risks including heart failure, hypertension, African-American ethnicity, and all middle aged and older adults. high fiber diet promotes normal bowel functioning and is associated with decreased risk factors for certain ancers My Plate diet: consume a minimum of 5 servings of fiber-rich fruits and vegetables and adequate fluid intake - 25 g/day for women and 38 g/day for men high protein diet Needed to promote tissue growth and during times of illness Foods high in protein: chicken, fish, cheese, pork loin, lean beef, tofu, beans, eggs, yogurt, milk, nuts What is nitrogren balance? the difference between the daily intake and excretion of nitrogen; an indicator of tissue integrity positive nitrogen balance: intake of nitrogen exceeds excretion so the body builds more tissue than it breaks down; seen during infancy, childhood, adolescence, pregnancy, & lactation negative nitrogen balance: exretion of nitrogen exceeds intake; body is breaking down more tissue than it is building; seen in illness, trauma, immobility, and malnutrition ***a healthy adult has a neutral nitrogen balance Strategies to increase protein and caloric intake Add skim milk powder to milk (double strength milk) Substitute whole milk for water in recipes Add cheese, peanute butter, chopper hard-boiled eggs or yogurt to foods Dips meat in eggs or milk and coat with bread crumbs before cooking Nuts and beans Albumin lab values and significance Indicates if body is absorbing enough protein Prealbumin: 17-40 mg/dL -used to assess critically ill clients who are at a higher risk for malnutition; reflects acute changes Albumin: 3.5-5 mg/dL -chronic measurement What does a complete cholesterol test measure? •Total cholesterol: this is the total amount of cholesterol in your blood. (should be 200 mg/dL) •Low-density lipoprotein (LDL) cholesterol: this is referred to as "bad" cholesterol and too much of it can lead to heart attack, stroke, and atherosclerosis. (should be 150 md/dL) •High-density lipoprotein (HDL) cholesterol: this is referred to as "good" cholesterol because it helps remove LDL cholesterol from your blood and tranports it to the liver. (should be 60 md/dL) •Triglycerides: when you eat, your body converts the calories it doesn't need into triglycerides, which are stored in your fat cells. People who are overweight or diabetic or who eat too many sweets or drink too much alcohol can have high triglyceride levels. (should be 150 md/dL) Ca+ sreum calcium blood test: 9.0-10.5 mg/dL All cells need calcium in order to work. Calcium helps build strong bones and teeth. It is important for heart function, and helps with muscle contraction, nerve signaling, and blood clotting Deficiency: osteoporosis, tetany, Chvostek's and Trousseau's signs, ECG changes Excess: constipation, kidney stones Hemoglobin (Hgb) females: 12-16 g/dl males: 14-18 g/dl Hemoglobin is a protein in your red blood cells that carries oxygen to your body's organs and tissues and transports carbon dioxide from your organs and tissues back to your lungs. Deficiency: low red blood cell count (anemia). Anemia can have many different causes, including vitamin deficiencies, bleeding and chronic diseases. Excess: the blood disorder polycythemia vera, living in a high altitude, smoking, dehydration, burns and excessive vomiting. K+ serum potassium blood test: 3.5-5.0 mEg/L Maintains fluid volume inside/outside cell, muscle action, blood pressure, CV support Deficiency: dysrhythmias, muscle cramps, confusion Excess: dysrhythmias Hematocrit (Hct) female: 35-45% male: 42-52% measures the percentage of the volume of whole blood that is made up of red blood cells deficiency: anemia, WBC disorders, recent/long term blood blood excess: dehydration, polycythemia vera, lung/heart disease BMI Body Mass Index normal/healthy weight: 18.5-24.9 overweight: 25-29.9 obese: 30+ morbidly ovese: 40 BMI = weight in lbs/height in inches/height in inches x 703 How many cal/g of energy to carbohydrates provide? Protein? Lipids? Carbohydrates: 4 cal/g Protein: 4 cal/g Lipids 9 cal/g RDA - percentages of major nutrients needed for adults Carbohydrates: 45-65% Protein: 10% Fats: 20-35% (less than 10% from saturated fats) limit cholesterol to 300 mg./day consume 2300 mg of salt/day (1 tsp) fiber: 25 g/day women, 38 g/day men what are appropriate drinks for children/adolescents in sports Young athletes need to meet energy, protein, and fluid needs water, low-fat milk, and 100% fruit juices *carbonated beverages may result in deficiencies in vit C, roboflavin, phosphorous, and calcium Suggested introduction of foods from birth-12 months Birth- 4 months: breast milk (until 6 months) or formula (at 4 months) 4-6 mo: iron-fortified cereal 6-8 mo: vegetables, fruits 8-10 mo: strained meats, fish, poultry 9-12 mo: table foods (cooked, chopped,and unseasoned) 12 mo: cow's milk, eggs, cheese Toddler (1-3 yrs old) drink/snack guidelines limit 100% juice to 4-6 oz/day 1-2 yr old requires whole milk to provide adequate fat for the still-growing brain (limit to 24 oz) prefer finger foods because of increasing autonomy and plain foods such as mac n cheese, spaghetti, pizza **Avoid potential choking hazards til 4 years of age (nuts, grapes, hot dogs, peanut butter, raw carrots, tough meats, popcorn) What is the proper temperature for: roasts and steaks chicken/turkey ground beef products that contain egg roasts and steaks: 145 chicken/turkey: 180 ground beef: 160 products that contain egg: 160 *Important to kill unwanted bacteria and avoid foodborne illness How long should you store: fresh meat fish dairy products eggs fruits and vegetables pantry items canned goods fresh meat: 1-2 days at 40 degrees F or colder fish: 1-2 days at 40 degrees F or colder dairy products: cheese 3-4 weeks, milk 5 days eggs: 3 weeks in shell, 1 week hard boilded fruits and vegetables: 3-5 days; citrust fruits/apples, 1 week or longer pantry items: store in dry, dark place at room temp canned goods: 1 year or longer at room temp Salmonella cause; undercooked or raw meat, poultry, eggs, fish, fruit, dairy manifestations: HA, fever, abdominal cramping, diarrhea, N&V --- can be fatal! Escherichia coli 0157:H7 cause: raw or undercooked meat, esp hamburger manifestations: severe abdominal pain and diarrhea Shigella cause: poor personal hygiene and improper hand hygiene food sources: dairy products and salads manifestation: diarrhea Listeria monocytonogenes causes: soft cheese, raw milk products, undercooked poultry, meat, seafood, vegetables manifestations: sudden fever, diarrhea, HA, back pains, abdominal discomfort *Can cause signifacant problems in pregnant clients, immunocompromised clients, and new borns; can lead to stillbirth or misscarriage of pregnant clients How does grapefruit juice interfere with the metabolism/action of medications? causes an increased serum level of the medication When should you advise patients to avoid eating foods rich in Vit K (green leafy veggies, eggs, liver)? when they are taking anti-coagulants such as warfarin (Coumadin) because it decreased their effect by promoting the clotting process Foods high in protein, amino acids, and vitamin B6 can increase the metabolism ______ anti-Parkinson's medication levodopa (L-dopa, Sinemet)by decreasing the duration of its therapeutic effects Hyperkalemia (elevated serum potassium) can be dangerous for clients taking what? What are some foods to avoid? digoxin (Lanoxin), stimulant laxatives, some beta-blockers, ACE inhibitors, calcium channel blockers, MAO inhibitors and spironolactone - avoid: licorice, baked potatoes, bananas, What is tyramine? What can it cause? What are foods high in tyramine? a naturally occuring amine found in many foods that has hypertensive effects may cause clients taking MAO inhibitors to suffer a hypertensive crisis foods high in tyramine: aged cheese, smoked meats, red wines, pickled meats What is recommended weight gain during pregnancy? 1-4 lbs 1st trimester 2-4 lbs/mo 2nd & 3rd trimesters (for a total of 25-35 lb if normal weight client) If a client is breastfeeding, how many extra calories should they consume daily? 330 the 1st 6th months 400 the 2nd 6th months What is the recommended DRI of protein, CHO, and fats during pregnancy/lactation? Why is protein so important? 20% protein (essential for rapid tissue growth of maternal and fetal structures, amniotic fluid, and extra blood volume), 30% fat, 50% carbs the need for which vitamins/mineral increase with pregnancy? Protein, Vit A, Vit C, Thiamin, Vit B6, Folate, Vit B12, Iron additional dietary recommendations during pregnancy 2-3 ml of fluids daily 300 mg/day caffeine 600 mcg/day folic acid - for neurological development of fetus and to prevent birth defects; maternal blood cell formation - consuming foods high in Vit C aids in absorption of iron what is the difference between folate and folic acid? Folate occurs naturally in food, and folic acid is the synthetic form of this vitamin. Sources of folate include liver, grean leafy vegetables, grains, & legumes