NR 228 Nutrition, Health and Wellness Final Exam Latest Update 2023/2024 9 Versions Combined

Nutrition Final Study Guide 2023/2024 1-The nurse is conducting screening at a local clinic to identify clients needing instruction regarding weight management. Which clients body mass index BMI never written normal limits I require no further interventions (SATA) A client who has high blood pressure and has a BMI of 32, A client who was diagnosed anorexia nervosa and has a BMI of 16, A client diagnosed with diabetes and has a BMI of 31, 2-the nurse is instructing a client about protein metabolism in the body and its effect on nitrogen balance. Which of the following condition may result in a negative nitrogen balance? Starvation 3-the nurse in a diabetic clinic is educating a client diagnosed with type I diabetes melittis who has increased his exercise level. Which of the following dietary recommendation is most appropriate for this client? Consume additional carbohydrates 4-the nurse is instructing a group of clients about right amins and minerals. The nurse should include that intestinal absorption of calcium and phosphorus depends on which vitamin? Vitamin D 5-the nurse is conducting a nutrient teaching nutrition teaching session with a group of clients which functions of water in the body should the nurse include in the teaching fashion? Select all that apply helps regulate body temperature shape and rigidity to cells provide a source of trace minerals participates in chemical reactions 6-The nurse is educating a hospitalized client who has diagnosed with acute pancreatitis which nutritional alterations will be observed in the client? There may be alterations in insulin and Glucagon as these hormones are secreted by the pancreas 7The nurse is assessing a client who has diagnosed by a health care provider with chronic malnutrition which of the following diagnosis will nurse expect to find a client with chronic malnutrition? A patient with cancer diagnosed two years ago 8-The nurse is preparing a plan of care for a client who was recently diagnosed with gold battered disease and has symptoms that occur after eating that include mild abdominals pain which is the priority nutritional consideration for this client? Set short term goals to deal with the paint improve nutritional status 9-A client who is healing more slowly from surgery benefits from which interventions? Supplemental zinc and vitamins A and C 10-The nurse is caring for a client that requires a low glucose diet. Which of the following substances should the nurse instruct the client to use as a sweetener? non nutritive sugar substitute 11-The nurse is discussing gastrointestinal disorder with a client who complaints of diarrhea flatulence and abdominal cramping after ingesting dairy. which condition is decline most likely experiencing? Lactose intolerance 12- A middle aged client has begun a very low carbohydrate diet to lose weight. which possible consequences should the nurse be aware of that may occur with prolonged carbohydrate deficiency? Ketosis 13-the nurse is conducting a nutrition class of a local high school. It is important to include which information about the MyPlate food guidance system? Half of my plate visual plate should be fruits and vegetables 14-which organ is responsible for managing bile production and metabolism of carbohydrates lipids protein and vitamins? Liver 15-the nurse is assessing the results of a client total blood cholesterol panel which component of the cholesterol panel aids in reducing the risk of carbo vascular disease? High density lipoprotein HDL 16-The nurse educator is discussing the healthy people initiated with a group of nursing students. Which of the following represents the overall goal of this initiative? Identify nation might have improvement priorities and provide measurable objectives and goals 17- what is the first priority for a client who was experiencing a third degree burns over 30% of the body surface area? Replacement of fluid and electrolytes 18-The nurse is caring for a client who is a vegetarian and needs to select foods that are high in protein. which food should the nurse instruct the client to consume? tofu 19-which dietary teaching will the nurse provide to client who uses sunscreen and wears ultraviolet UV Protective clothing and hats Yeah to prevent the development of skin cancer? Ensure adequate intake of vitamin D from fortified foods and supplements 20-Which dietary selection will be the best source of protein for client with HIV aids who is experiencing diarrhea? peanut butter on toast or as a dip for fruits and vegetables 21-the nurse is teaching a group of parents about the required nutrition for children which of the following minerals should the nurse inform the parents help with bone and teeth formation? Fluoride 22-the nurse is admitting a client to a med surgical floor. The nurse noted that the client is taking St. Johns worth for the depression. During the assessment the nurse notes which signs or symptoms may be associated what do use of St John’s worth? Ginseng and insulin taken together may cause weakness dizziness and hunger 23-the nurse is reviewing a client medication list at discharge. The nurse is providing teaching on the interaction between ginseng and insulin, two items that are listed on the clients list. Which statement best indicates the interactions between ginseng and insulin. Ginseng and insulin taken together may cause weakness dizziness and hunger 24-The nurse is teaching a group of women who's planning to have a baby about vitamins and minerals supplements during pregnancy. which vitamins and minerals should the woman ensure that are supplemented when they become pregnant? (SATA) 25- A client indicates activity level that includes a long hot bike after four hours which will be the primary source of energy? Fatty acid 26- the nurse is teaching a client about the main functions of the large intestine if the large intestine does not carry out its main function the client will produce which type of feces? Liquid 27-the nurse is reviewing the function of the gastrointestinal tract with the client. The client correctly identified which function is being the most important of the small intestine? complete digestion 28-a nurse is reviewing information on health promotion and disease prevention to teach clients. The nurse notes that for most Americans, which is the most significant nutrition concern? excessive intake of saturated fats cholesterol sodium and sugar 29-which amino acid plays an important role in the gastrointestinal tract during stress? Glutamine 30-which statement is true about protein intake for a client with chronic renal failure who begins peritoneal dialysis? Increase protein because protein is most into the dialysate 31-a nurse is teaching a client who has cholecystitis about required dietary medication the nurse should include which of the following foods as appropriate for the client side? Turkey 32-the nurse is instructing a group of clients about consequences of decreased gastrointestinal motility. Which is seen in decrease GI motility? Constipation 33-which instruction will be helpful to a client who has gastroesophageal reflux? Avoid eating for 3 hrs before lying down Avoid trigger food (citrus fruits, juices, spicy foods, carbonate drinks) Elevate the body on pillows Avoid large meals and bedtime snacks Avoid situation that led to increase abdominal pressure 34-which foods would most likely cause symptoms associated with celiac disease? Food containing gluten 35-If a patient needs regular injections of vitamin B12, the most likely explanation is which of the following? The patient stomach does not produce the intrinsic factor 36-the nurse is instructing a client to document the number of calories consumed each meal. How many calories are contained in a food that has 15 grams of carbohydrates, 6 grams of protein, and 10 grams of fat? 174 (Fat 10 x 9) = 90 now add 90 + 24 + 60 =174 (Protein 4 x 6) = 24 (carbs 15 x 4) = 60 Which is the best salad choice for a client who is implanting therapeutic lifestyle changes to reduce the risk for coronary heart disease? Mix greens with olive oil vinaigrette and walnut 38-a nurse is caring for a client with type 2 diabetes. The nurse teaches the client which technique to maintain constant glycemic control? Space snacks and meals evenly 39-Which diet is recommended for a client with chronic cholecystitis inflamed gall bladder? Low fat diet 40-which replacement will a client receive who has chronic renal failure and develops anemia? Erythropoietin 41-sets are divided into a number of groups which groups are fats? (SATA) triglycerides phospholipids steroids 42-some nutrients cannot be made by the body but are needed for growth and development. Which group of nutrients are these? Essential 43-which dietary change may have decreased the risk of hypertension? Drinking skim milk instead of soda 44-which action by the mother would be greatest concern for an infant with cystic fibrosis? Breastfeed without using enzyme supplements 45-Which vitamin is involved in blood clotting and health the platelets healthy? Vitamin K 46-which statement best describes potassium in diet? It controls fluid levels inside the cell 47-which is the best food selection for a client whose plan of care include a renal quiet? Baked chicken with rice and green beans 48-which recommendation best meets the dietary recommendation by the National Cancer Institute to help prevent cancer? Eating five or more daily servings of fruits and vegetables 49-A client that must obtain the greatest percentage of daily carbohydrates from complex carbohyd rates most likely has which disease process? Diabetes 50-a nurse is caring for a client whose partner is requesting to bring the client food from home that is not allowed in the client’s dietary plan which of the following responses should the nurse make? Everyone likes food from home, but it can delay your partner's recover Powered by TCPDF () NR 228 Nutrition, Health and Wellness Ch. 1 (Wellness Nutrition) Which of the following shows a possible relationship between intellectual and social health? A. A child with iron deficiency and poor attention span in school B. A teenager overeating after a break-up of a relationship and skipping family dinner time because she isn't hungry C. A mother on a tight budget spending twice as much money on fresh produce at a nearby convenience store rather than at a distant grocery store and experiencing repeated headaches at night D. A college student binge drinking on the weekend with friends and earning poor grades as a result of a lack of studying A recently diagnosed patient with diabetes is taught that vegetables are a low-carbohydrate food and all but a few can be eaten without restriction. He is encouraged to buy more vegetables at his nutrition consultation. However, he lives in an apartment complex that is over a mile away from any grocery store, and his only mode of transportation is his electric wheelchair. This living environment is an example of which of the following? A. Nutrient disparity B. Poor socioeconomic status C. Food desert D. Health illiteracy A 65-year-old patient who is diagnosed with type 2 diabetes mellitus walks briskly for 30 minutes each day. This exercise helps control blood glucose levels and decreases the need for medication. This disease prevention would best fit into which one of the following classifications? A. Primary B. Secondary C. Tertiary D. Quaternary Establishing priorities, setting realistic and measurable outcomes, and choosing interventions are all part of which step in the nursing process? A. Assessment B. Diagnosis C. Planning D. Implementation E. Evaluation Both carbohydrates and proteins provide approximately ___4_____ kilocalories per gram. Ch. 2 (Personal & Community Nutrition) During your nursing assessment of a patient who is pregnant, you find she has low folate levels. Upon further inquiry, you also find she has little income and eats few fresh fruits and vegetables because of their cost. To which government-funded program(s) could you refer her? A. Supplemental Nutrition Assistance Program (SNAP) B. Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) C. School Lunch Program D. Medicare E. Both a and b F. Both b and d The Nutrition Facts label is based on a 2000-calorie diet. For which age group is it most appropriate? A. 2 to 12 years of age B. 13 to 18 years of age C. 40 to 60 years of age D. 75 to 90 years of age The U.S. Food and Drug Administration (FDA) regulates food labeling, as well as dietary supplement labeling. However, a difference exists between how the two labels are regulated. What is this difference? A. Dietary supplement labels can contain claims concerning the prevention of a disease, whereas food labels cannot. B. Dietary supplement labels can contain claims concerning the treatment of a disease, whereas food labels cannot. C. Dietary supplements must be proven unsafe before they can be removed from the market. D. Dietary supplements must be proven safe before they can be sold on the market. What is the definition of "light" when found on a food label? A. Contains no more than 3 grams of fat per serving. B. Contains 25% less of a nutrient or calories. C. Contains no more than 10 grams of fat per serving. D. Contains one third fewer calories or one half the fat of the original product. Using the exchange group nutrient values, the following meal would contain approximately ___52_____ grams of carbohydrates: one serving of fat-free milk, two servings of a vegetable, one serving of a lean meat, and two servings of fruit. Ch. 3 (Digestion, Absorption, Metabolism) Once a gallbladder has been removed, what organ is then solely responsible for releasing the bile needed for fat digestion? A. Liver B. Pancreas C. Stomach D. Duodenum A patient tells you that he has intense heartburn on a regular basis. As he is describing what it feels like, you realize he is most likely experiencing gastroesophageal reflux disease (GERD). Which muscle in his digestive tract is most likely weakened and releasing stomach acid into his esophagus? A. Parotid gland B. Hepatic muscularis C. Diaphragm D. Cardiac sphincter What approximate percentage of carbohydrate, protein, and fat does a healthy human gastrointestinal tract absorb during the process of digestion and absorption? A. 65% B. 75% C. 85% D. 95% During the process of metabolism, which nutrients directly enter the lymphatic system from the gastrointestinal tract? A. Carbohydrates and fat-soluble vitamins B. Carbohydrates and small parts of broken-down lipids C. Proteins and fat-soluble vitamins D. Fat-soluble vitamins and large lipids Ch. 9 (Energy, Weight, & Fitness) Adequate stores of muscle glycogen would be most important for which athlete? A. Marathon runner B. 100-meter sprinter C. 400-meter sprinter D. High jumper Given that each individual is in a healthy mental and physical state, who will most likely have the highest basal metabolic rate (BMR)? A. 25-year-old professional male athlete B. 22-year-old female distance runner C. 77-year-old male farmer D. 45-year-old female construction worker A female dancer, 19, enters a clinic with a small bone fracture in her foot. The following preliminary information is collected: body mass index (BMI): 17, 12% body fat. What other symptom is she probably experiencing? A. Muscle hypertrophy B. Amenorrhea C. Hyperlipidemia D. Sleep apnea Ch. 4 (Carbohydrates) A 29-year-old patient with a body mass index (BMI) of 36 (Category II Obese) wants to start a lowcarbohydrate diet. Which recommendation would ensure the patient follows the dietary reference intakes (DRIs) and acceptable macronutrient distribution ranges (AMDRs) for carbohydrate intake? A. Carbohydrate consumption needs to account for at least 35% of the total kilocalorie intake. B. Consuming 80 g of carbohydrates each day will meet metabolic needs. C. Carbohydrate consumption needs to account for at least 45% of the total kilocalorie intake. D. Consuming 130 g of carbohydrates each day will meet metabolic needs. E. Both a and b F. Both c and d A patient asks whether blood sugar is the same type of sugar that he added to his cereal earlier that morning. You respond by telling him that table sugar is actually called which of the following? A. Glucose B. Maltose C. Starch D. Sucrose What are possible outcomes for dietary glucose once it has been absorbed? A. Used directly for energy in cells. B. Converted to protein, and then stored in muscle. C. Converted to fat, and then stored in lipocytes. D. Converted to glycogen, and then stored in the liver. E. a, c, and d F. b, c, and d A mother is concerned her daughter with phenylketonuria (PKU) is consuming phenylalanine, an amino acid that causes serious side effects in patients with PKU. The mother provides a list of the beverages her daughter consumes on a regular basis. Which of the following drinks contains phenylalanine and should be immediately excluded from her daughter's diet? A. Orange juice sweetened with fructose B. Pepsi sweetened with Splenda C. Herbal tea sweetened with Equal D. Sprite sweetened with saccharin Which of the following health problems is directly related to an overconsumption of sugars, specifically table sugar? A. Dental caries B. Obesity C. Type 2 diabetes mellitus D. Attention deficit/hyperactivity disorder (ADHD) Ch. 8 (Water & Minerals) A sprinter on a track-and-field team loses body water through insensible perspiration after a 400meter race. Through which organ(s) does the majority of this water loss, or output, occur? A. Kidney B. Skin C. Large intestine D. Lungs E. a, c, and d F. b and d If the hypothalamus is not functioning normally and releases too little antidiuretic hormone, the individual is suffering from what? A. Hypothermia B. Dehydration C. Edema D. Homeostasis A person diagnosed with osteoporosis needs adequate amounts of which vitamin for calcium absorption from the small intestine? A. Vitamin D B. Biotin C. Vitamin C D. Vitamin B12 A pregnant patient from a rural part of the state tells you at her first check-up (16 weeks' gestation) that the cornstarch she uses to make gravy looks delicious to her. She has eaten tablespoons of it mixed with small amounts of water several times. She asks you if this is normal. You explain she is actually deficient in which of the following? A. Selenium B. Magnesium C. Iron D. Phosphorous The adequate intake of water for women is ___9______ cups per day. Ch. 5 (Fats) A patient at a long-term care facility has been receiving long-term total parenteral nutrition (TPN) because of gut immobility. He has developed skin lesions on his neck, underarms, and groin. You are asked to review his TPN solution. The label does not list linoleic or linolenic acid; however, all of the other macronutrients are listed in adequate quantities. What is one possible diagnosis for the development of these lesions? A. Diet deficient in essential amino acids B. Diet deficient in carbohydrates C. Diet deficient in essential fatty acids D. Diet deficient in triglycerides A patient wants to decrease the amount of saturated fat in her diet while increasing the amount of omega-6 or linoleic acid. She is currently using butter as her fat of choice. Which oil would you recommend she start using for baking and sautéing? A. Canola oil B. Palm oil C. Olive oil D. Coconut oil Which of the following foods will most likely contribute to increased blood cholesterol levels? A. Eggs B. Shrimp C. Bacon D. Oysters A food label lists "partially hydrogenated fat" in the ingredient list. This wording indicates that the food product contains which one of the following? A. Trans fat B. Saturated fat C. Monounsaturated fat D. Polyunsaturated fat A patient needs 2000 kilocalories per day; 25% of these calories should come from fat. Approximately how many total grams of fat should the patient eat? A. 42 B. 52 C. 55 D. 65 Ch. 6 (Protein) Which enzyme found in the stomach of infants aids in milk coagulation, allowing for a longer absorption or transit time? A. Pepsin B. Pepsinogen C. Rennin D. Trypsin A patient recently started following a high-protein, low-carbohydrate diet. The first week he lost 5 pounds, but currently in the fourth week, he has only lost 1 pound. He is confused about why this is happening since he has not changed eating or exercise habits. What is one probable reason as it related to protein metabolism? A. During the first week, he lost the majority of weight from water, attributable to excess urea excretion. B. During the first week, he lost the majority of weight from fat, attributable to protein catabolism. C. During the fourth week, the majority of the weight he lost was from glycogen excretion, attributable to lipid catabolism. D. During the fourth week, the majority of the weight he lost was from fat, attributable to protein anabolism. Which patient would most likely be in positive nitrogen balance? A. A patient 5 months along in her pregnancy B. An adult patient in the psychiatry ward C. A patient visiting the outpatient clinic for weight loss education D. A patient with Type 2 diabetes mellitus Which nutrients would most likely be deficient in a person following a vegan diet, given no supplementation? A. Vitamin D, vitamin C, and iron B. Vitamin E, iron, and vitamin B12 C. Vitamin B12, iron, and calcium D. Vitamin E, calcium, and zinc A 150-pound athlete should eat no more than __116_____ grams of protein per day (rounded to the nearest whole number). Ch. 7 (Vitamins) Which vitamin would be directly absorbed into the lymphatic system? A. Vitamin C B. Vitamin B12 C. Choline D. Vitamin E A patient with leukemia undergoing cancer treatment is most likely to become deficient in which vitamin? A. Folate B. Vitamin K C. Vitamin C D. Iron Which of the following foods would you recommend to a pregnant woman in her first trimester to ensure that she consume adequate amounts of folate? A. Dry breakfast cereal B. Cheddar cheese C. Chili with beans D. Pineapple E. a and c F. b and d Warfarin has been prescribed to a patient recovering from a triple bypass surgery of the heart. A specific dose has been recommended, based on his present food consumption pattern that needs to remain constant to ensure that the warfarin will work as intended. Which of the following foods should he regulate and eat in moderation as a result of this medication? A. Apples B. Oranges C. Spinach D. Sweet potato Ch. 10 (Nutrition Across the Lifespan) A pregnant patient is experiencing constipation and asks if this is normal. Constipation is normal and leads to increased absorption of nutrients, particularly iron and calcium, and is caused by an increased production of what hormone? A. Thyroxine B. Human placental lactogen C. Progesterone D. Estrogen An 18-year old African-American patient enters the clinic. She is 21 weeks pregnant. She has been experiencing dizziness, headaches, severe nausea, and small amounts of blood in her urine. Her hands, face, and feet look puffy. What is a possible diagnosis for these symptoms? A. Diabetes mellitus B. Foodborne illness C. Maternal phenylketonuria D. Preeclampsia The hormones progesterone, estrogen, and human chorionic gonadotropin all signal what to occur during pregnancy? A. Increased glucose circulation and increased immune response B. Increased glucose circulation and decreased immune response C. Decreased glucose circulation and increased immune response D. Decreased glucose circulation and decreased immune response Which of the following foods is/are a choking hazard to a young child? A. Grapes B. Hot dog C. Applesauce D. Peanut butter and jelly sandwich E. b and d F. a and b Ch. 11 (Nutrition Assessment & Patient Care) Which patient would be at high risk for developing malnutrition in a hospitalized setting? A .Patient on intravenous feedings that contain only glucose and saline B. Patient receiving food through a nasogastric tube for longer than 24 hours C. Patient on a clear-liquid diet for longer than 24 hours D. Patient on a soft-food diet for longer than 3 days E. a and c F. b and c Measuring recumbent bed height falls under which key area of patient assessment? A. Anthropometrics B. Biochemical tests C. Clinical observations D. Diet evaluation E. a and c F. b and c Upon admission to the hospital, a patient weighs 145 pounds. His usual weight is 165 pounds; he has lost 20 pounds in the last 3 months. What is this patient's risk category for malnutrition? A. No risk B. Low risk C. Moderate risk D. High risk A female patient fs laboratory report shows a creatinine level of 1.6 mg/dL. This level is indicative of which disease? A. Diabetes mellitus B. Liver failure C. Hypokalemia D. Renal disease A patient has been taking naproxen twice a day to relieve pain associated with arthritis for the past 5 years. To avoid liver toxicity or stomach bleeding, the patient is advised to limit the intake of: A. Dairy products B. Grapefruit juice C. Alcohol D. Foods high in vitamin K Ch. 14 (Nutrition for Disorders of the Liver, Gallbladder, & Pancreas) A homeless person living in a crowded outdoor colony with no access to bathrooms is exhibiting diarrhea, vomiting, jaundice, and dark urine. Which type of hepatitis is most likely responsible for these symptoms? A. A B. B or C C. D D. A or E Limiting fruit intake follows appropriate nutrition therapy for a patient with which condition? A. Hepatitis A B. Cirrhosis C. Nonalcoholic steatohepatitis D. Pancreatitis A patient with cirrhosis has a swollen distended abdomen. Which nutrition therapy is most appropriate for this condition? A. Limit fat intake. B. Increase probiotics intake. C. Limit protein intake. D. Restrict sodium to less than 2000 mg per day. Which of the following is a risk factor for the development of gallstones? A. Age 30 years and older B. High-carbohydrate diet C. After a very low-calorie diet D. Male gender Ch. 15 (Nutrition for Diabetes Mellitus) When blood glucose levels are low, the pancreas releases: A. Insulin; fat cells then take in glucose from the blood. B. Insulin; the liver then releases glucose into the blood. C. Glucagon; fat cells then take in glucose from the blood. D. Glucagon; the liver then releases glucose into the blood. A patient's laboratory work shows a hemoglobin A1C level of 5.9%. After an oral glucose tolerance test, his blood glucose is recorded at 178 mg/dL. This patient is diagnosed with which condition? A. Gestational diabetes B. Prediabetes C. Type 1 diabetes (T1DM) D. Type 2 diabetes (T2DM) A high-school student with T1DM boluses before his lunchtime meal with short-acting insulin. How long should he wait before joining his gym class in a 1-mile run? A. Strenuous exercise is not recommended for those with T1DM. B. Waiting for any amount of time is not needed because this student bolused with short-acting insulin. C. This student should wait 30 to 60 minutes before exercising. D. This student should wait 2 or more hours before exercising. A diabetic patient presents with vomiting and abdominal pain. She has also had heartburn for the last two days and feels like she is losing weight. You look at her medical history and find she has taken the drug Reglan in the past. What is a probable diagnosis for this patient? A. Metabolic Syndrome B. Gastroparesis C. Acanthosis nigricans D. Poly cystic ovary syndrome Ch. 16 (Nutrition in Metabolic Stress: Burns, Trauma, & Surgery) Which stress-altering hormone stimulates the use of fat for energy? A. Antidiuretic hormone B. Adrenocorticotropic hormone C. Norepinephrine D. Aldosterone A patient recovering from trauma is a devout member of a faith that practices fasting on a routine basis. The usual fasting time is 24 hours, once a month. If he decides to fast during recovery, where will the majority of his energy come from during the first 24 hours of fasting? A. Liver glycogen stores are the prime source of glucose. B. Fatty stores are the prime source of glucose. C. Protein stores are the prime source of glucose. D. Muscle glycogen stores are the prime source of glucose. A patient with a stage IV pressure ulcer in a nursing home is in need of special nutrition care. Which vitamins and minerals are of particular importance for healing? A. Vitamin B12, zinc, and calcium B. Vitamin C, zinc, and calcium C. Vitamin C, vitamin A, and zinc D. Vitamin A, zinc, and calcium Ch. 17 (Nutrition for Cardiopulmonary Diseases) Lovastatin is used to treat which condition? A. Cardiovascular disease B. Hypertension C. Dyslipidemia D. Chronic obstructive pulmonary disease As part of the Therapeutic Lifestyle Changes (TLC) diet, it is advised that butter be replaced with which of the following fats? A. Olive oil B. Almond butter C. Lard D. Cream E. Both a and b F. Both a and d A woman with a total cholesterol level of __________, an LDL level of __________, and an HDL level of _________ has optimal cholesterol levels. A. 188; 98; 38 B. 219; 122; 45 C. 150; 109; 25 D. 172; 79; 51 Ch. 20 (Nutrition in Cancer & HIV/AIDS) The process of cancer spreading from one organ, such as the colon, to another organ, such as the lungs, is called _______________. A. Metastasis B. Cachexia C. Carcinogenesis D. Mucositis Which cells in the body have a rapid turnover rate, particularly of concern during chemotherapy? A. Muscle cells B. Bone marrow cells C. Cells of the intestinal tract D. Cells of the mouth E. a, c and d F. b, c, and d Which food would best be tolerated by a patient with cancer who is experiencing nausea and vomiting? A. Freezer pop B. Banana C. Potato chips D. White bread Which of the following is a high-risk food for the patient with an immunosuppressed system? A. Store-bought cookie dough B. Peanut butter and jelly sandwich C. Greek salad with feta cheese D. Shrimp scampi A 150-pound person with human immunodeficiency virus (HIV) who involuntarily loses 25 pounds over 6 months has lost __17_____% of usual weight and is at nutritional risk. NR 228 final Simple refined sugars - Correct answer-honey, pear, milk Complex sugars - Correct answer-wheat rice, sweet potatoes, oatmeal, alfalfa Exchange Lists for Meal Planning - Correct answer-Lists: carbohydrates (CHO), meat and meat substitutes, and fats CHO list subdivided into starch, fruit, milk, other CHO, and vegetables Encourages variety and helps control kilocalories and grams of CHO, protein, and fats Adjust to individual metabolic nutrition and lifestyle requirements Who created MyPlate - Correct answer-U.S. Department of Agriculture (USDA) Advantages of my plate - Correct answer-Portion control, wide range of foods, Promotes adequacy, balance, calorie control, moderation, and variety. As we age changes that affects the digestive system - Correct answer-diverticulitis and constipation Importance in infant (baby) GI track - Correct answer-immature GI track Importance Middle age GI - Correct answer-gallbladder disease and peptic ulcer (lactose intolerance) Importance of Allergies - Correct answer-can develop at any stage in life Water and fat soluble (vitamins) - Correct answer-A, D, E, K What influences people desire for salt and sugar - Correct answer-Genetics Importance to know how many calories in product? - Correct answer-Serving size -Vitamins A and C -Calcium -Iron calories to lose a pound - Correct answer-3500 Time Bolus of food move through the stomach? - Correct answer-2-6 hours Person goes to fridge and chooses fruit over turkey or the other way around. - Correct answer-Food preference Fat, Protein and Carbs - Correct answer-will be absorbed no matter what, it happens in large intestine Where Water is absorbed - Correct answer-In small intestine Expect changes as we age - Correct answer-Nutrient need remains Constance Metabolism across the life span - Correct answer--Lowered metabolic rates -Nutrient needs remain constant -Lifestyle behaviors affect functioning and health of GI tract When BMR increases? - Correct answer-lactation, prolong stress, puberty, changes in temperature. (not malnutrition) % required water that the body can obtain from Food? - Correct answer-20 % Person is vegetarian, drinks milk and but no beans(lacks Proteins) - Correct answer- Best source, peanut butter (high in protein) Vitamin c increases absorption of what mineral? - Correct answer-Iron Mineral associated with cardiac arrhythmia - Correct answer-Magnesium (MG) Vitamines and minerals (all of them) - Correct answer- Vitamin B6 (pyridoxine) - Correct answer-Absorbs in the small intestine, passing into the blood without the need of energy. This process is called passive diffusion. Best source of protein - Correct answer-Chicken Food that enhance the absorption of Non-heme iron? - Correct answer-Tomato Juice Food source with more Thiamine (B1) - Correct answer-whole grain, wheat and fiber Food with more Calcium - Correct answer-Milk Trigger for formation vitamin D - Correct answer-Sunlight exposure Example of NPO diet - Correct answer-Nothing by mouth is a medical instruction meaning to withhold food and fluids. Clear liquid diet - Correct answer-● Consists of foods or fluids that have no residue and are liquid at room temperature. ● Primarily to prevent dehydration and relieve thirst, the diet consists of water and carbohydrates. This diet requires minimal digestion, leaves minimal residue, and is non-gas-forming. It is nutritionally inadequate and should not be used long-term. ● Indications include acute illness, reduction of colon fecal material prior to certain diagnostic tests and procedures, acute gastrointestinal disorders, and some postoperative recovery. ● Acceptable foods are water, tea, coffee, fat-free broth, carbonated beverages, clear juices, ginger ale, and gelatin. ● Limit caffeine consumption, which can lead to increased hydrochloric acid and upset stomach Example of Full liquid diet - Correct answer-● Consists of foods that are liquid at room temperature. ● Offers more variety and nutritional support than a clear liquid diet and can supply adequate amounts of energy and nutrients. ● Acceptable foods include all liquids on a clear liquid diet, all forms of milk, soups, vegetable and fruit juices, eggnog, plain ice cream and sherbet, refined or strained cereals, and puddings. ● Evaluate the need for high-protein and high-calorie supplements if this diet is used more than 2 to 3 days. ● Indications include a transition from liquid to soft diets, postoperative recovery, acute gastritis, febrile conditions, and intolerance of solid foods. ● Provides oral nourishment for clients having difficulty chewing or swallowing solid foods. Use cautiously with clients who have dysphagia (difficulty swallowing) unless liquids are thickened appropriately. ● Contraindicated for clients who have lactose intolerance or hypercholesterolemia. Use lactose-reduced milk and dairy products when possible Example of Blenderized liquid (pureed) diet - Correct answer-● Consists of liquids and foods that are pureed to liquid form. ● The composition and consistency of a pureed diet varies, depending on the client's needs. ● Modify with regard to calories, protein, fat, or other nutrients based on the dietary needs of the client. ● Adding broth, milk, gravy, cream, soup, tomato sauce, or fruit juice to foods in place of water provides additional calories and nutritional value. ● Each food is pureed separately to preserve individual flavor. ● Indications include clients who have chewing or swallowing difficulties, oral or facial surgery, and wired jaws. Soft (bland, low-fiber) diet - Correct answer-● Contains whole foods that are low in fiber, lightly seasoned, and easily digested. ● Food supplements or snacks in between meals add calories. ● Food selections vary and can include smooth, creamy, or crisp textures. Raw fruits and vegetables, coarse breads and cereals, beans, and other potentially gas-forming foods are excluded. ● Indications include clients transitioning between full liquid and regular diets, and those who have acute infections, chewing difficulties, or gastrointestinal disorders. ● Predisposes clients to constipation Mechanical soft diet - Correct answer-● A regular diet that is modified in texture. The diet composition is altered for specific nutrient needs. ● Includes foods that require minimal chewing before swallowing (ground meats, canned fruits, softly cooked vegetables). ● Butter, gravies, sugar, or honey may be added to increase calorie intake. ● Excludes harder foods (dried fruits, most raw fruits and vegetables, foods containing seeds and nuts). ● Indications include limited chewing ability; dysphagia, poorly fitting dentures, and clients who are edentulous (without teeth); surgery to the head, neck, or mouth; and strictures of the intestinal tract. Regular diet (normal or house diet) - Correct answer-● Indicated for clients who do not need dietary restrictions. The diet is adjusted to meet age specific needs throughout the life cycle. ● Many health care facilities offer self-select menus for regular diets. ● Modify the regular diet to accommodate individual preferences, food habits, and ethnic values Dysphagia diet - Correct answer-● Prescribed when swallowing is impaired, such as following a stroke. ● Signs of dysphagia are drooling, pocketing food, choking, or gagging LEVELS OF LIQUID CONSISTENCIES - Correct answer-● Thin: Non-restrictive. Consists of all unthickened beverages and supplements (clear juices, frozen yogurt, ice cream, milk, soda and broth). ● Nectar-like: Consists of liquids that are thin enough to sip through a straw but thicker than water. Consistency of a heavy syrup (nectars, cream soups, buttermilk and thin milkshakes). ● Honey-like: Liquids are pourable but thickened. They can be eaten with a spoon but cannot be sipped through a straw (honey, tomato sauce and yogurt). ● Spoon-thick: Consists of liquids thickened to maintain their shape and need to be eaten with a spoon (pudding, custard, hot cereals). Parenteral Nutrition - Correct answer-Parenteral nutrition is one of the ways people receive nutrition when they cannot eat or use their gut via tube feeding. It is a special liquid mixture given into the blood through an intravenous tube into a vein. Enteral Nutrition - Correct answer-Enteral nutrition is another way people can receive the nutrition they need. Also called "tube feeding. total parenteral nutrition (TPN) - Correct answer-TPN provides a nutritionally complete solution. It can be used when caloric needs are very high, when the anticipated duration of therapy is greater than 7 days, or when the solution to be administered is hypertonic (composed of greater than 10% dextrose). It can only be administered in a central vein peripheral parenteral nutrition (PPN). - Correct answer-PPN can provide a nutritionally complete solution. However, it is administered into a peripheral vein, resulting in a limited nutritional value. It is indicated for clients who require short-term nutritional support with fewer calories per day. The solution must be isotonic and contain no more than 10% dextrose and 5% amino acids. FINAL EXAM STUDY GUIDE Chapters 1-11 NR228 CHAPTER 1(2 left to answer) How many calories are provided by protein, carbohydrates, fat and alcohol? Protein/Carbs: 4 kcal/gram Fat: 9 kcal/gram Alcohol: 7 kcal/gram What does “nutrient density” mean?Nutrient density assigns the value to a food on the basis of a comparison of its nutrient content with the kcal the food contains. The more nutrients and the fewer kcal a food provides, the higher its nutrient density. Know the basics of the six categories of nutrients. The six categories of Nutrients; Carbohydrates, Proteins, Lipids (fats), Vitamins, Minerals, Water. (**Pages 9-10 on the book goes into a lot of detail about each one***) CHAPTER 2(1 left to answer) What are the five food groups of MyPlate? Veggies: 2 ½ cups Fruits: 2 cups Grains: 6 oz. Protein: 5 ½ oz. Dairy: 3 cups What is “fortification”? Enrichment of nutrients What nutrients are required on a food label? Calories, calories from fat, total fat, saturated fat, trans fat, cholesterol, sodium, total carbohydrates, dietary fiber, sugars, protein, Vitamin A, Vitamin C, Calcium & Iron Know how to read a food label (Page 30-32, page 32 shows an actual label**) The Daily Values is a system for food labeling composed of two sets of reference values: daily intakes (RDIs) and daily reference values. The percent of Daily Values information (%DV), based on a 2000 kcal diet, is intended to show consumers how much of a day’s ideal intake of a particular nutrient they are eating. DVs for selected nutrients and food components based on a 2500-calorie diet are also given at the bottom of the label. CHAPTER 3 In what order does food pass through the G.I. tract? The mouth the esophagus the stomach small intestine large intestine Know chemical versus mechanical digestion. Mechanical Digestion: Chewing, peristalsis, segmentation, action of sphincter muscles Chemical Digestion: Actual breakdown of substances from the production and/or storage of gastric and digestive secretions. Know the physiological function of the stomach, small intestine, pancreas, liver, gallbladder, and large intestine as it relates to digestion. Stomach:Holding food for partial digestion, producing gastric juice, providing muscular action, secreting the intrinsic factor for Vitamin b12, releasing gastrin, and assisting in the destruction. Small Intestine: Absorption of nutrients. Duodenum jejunum ileum Pancreas:Releases digestive enzymes. Liver: Releases glycogen. Breaks down RBCs. Breaks down fats and produces energy/bile. Gallbladder: Stores bile Large Intestine: Absorption of water. Consists of cecum, colon and rectum. CHAPTER 4 (1 left to answer) What are the three sizes of carbohydrates? Name examples of each size.Carbohydrates are classified according to the number of saccharide units making up their structure. • Monosaccharides: simple carbohydrates (glucose-corn syrup, fructose-fruits, galactose-found in milk) • Disacchardies: simple carbohydrates (sucrose-table sugar, lactose-milk sugar, maltose-malt sugar) • Polysaccharides: complex carbohydrates(starches-grains, legumes, and root vegetables, Fiber-whole grains, fruits, and veggies!) What is the normal blood glucose range? 70-100 What is the function of insulin? Bring down blood sugar. What are the health benefits of a high fiber diet?Prevents obesity, formation of diverticula, prevents cancer, prevents heart disease CHAPTER 5 (2 left to answer) What foods contain cholesterol?The only food sources of cholesterol are animal and include beef, pork (bacon), chicken, luncheon meats, eggs, fish, and dairy products (milk, butter, and cheese); plant foods do NOT contain cholesterol! What are good sources of omega-3 fatty acids? Linolenic Acid. Omega 3s may reduce risk by reducing clotting process. Fish sources for Omega 3: Salmon, mackeral, herring, tuna, trout, sardines. Plant Sources: Canola oil, walnuts/walnut oil, Soybean/soybean oil, flaxseed ground and oil, wheat germ and oat germ, green leafy veggies Which lipoprotein in high levels correlates with low cardiovascular risk? HDL Which lipoprotein in high levels correlates with a high risk of heart disease? LDL Be able to interpret serum cholesterol lab tests (Page 366) HDL Levels:Normal is 35-65 mg/dL for men and 35 to 80 for women. (40 or higher is good!) LDL Levels: less than 100, a reading of 130-159 is borderline high and 160 189 is high What is the difference between a monounsaturated fat, a polyunsaturated fat, and a saturated fat? What are sources of each? Monounsaturated Fatty Acid: Only one unsaturated double bond. Ex Oleic Acid, Olive oil, peanuts, canola oil, peanut butter, peanut oil and avocado. Saturated Fatty Acid: single bonded carbon chain. Ex:Palmitic Acid found in animal-derived foods Food Sources: beef, poultry, pork, lamb, luncheon meats, egg yolks, and dairy products. Palm and coconut oils. Polyunsaturated Fat: Two or more unsaturated double bond. Ex: veggie oils, fish, margarine. CHAPTER 6 What are the major functions of proteins? Provide energy and structure to body. What kinds of food are quality sources of protein?Found in animal and plant sources meat, fish, poultry, and some dairy products, such as milk and cheese. Grains, legumes, peas and beans, seeds, nuts and many veggies. CHAPTER 7 Name the water-soluble vitamins.Vitamin C & B Name the fat-soluble vitamins. A,D,E,K. What are good sources of Vitamin C? Green leafy veggies, bacteria in GI tract, eggs, and carrots What is a sign of Vitamin C deficiency? Scurvy w/ bleeding What is the main function of the B vitamins? Metabolism What are good sources of Vitamin B-12? Animal Products What is the main function of Vitamin D?Necessary for absorption of calcium & phosphorus; affects bone mineralization What is the main function of Vitamin K? Blood clotting CHAPTER 8 What minerals are lost through sweating and bleeding?Zinc, Magnesium, sodium, potassium, and calcium What are the two categories of minerals?Trace& Major Which minerals are in each category? TRACE: Chromium, Copper, Fluoride, Iodine, Iron, Manganese. MAJOR: Caclium, Phosphorus, Magnesium, Sulfur What is the definition of each category? Trace: RDA < 20 mg Major: RDA at least 100 mg a day Name the differences between intracellular, interstitial, and extracellular fluids. Intracellular fluids- in cells Interstitial fluids- in between cells Extracellular fluids- outside of cells What enhances iron absorption? Vitamin C What reduces iron absorption? Milk, phylates, oxylates, teas and coffee CHAPTER 9 (4 left to answer) What is basal metabolic rate?Rate at which the body spends energy to keep all life-sustaining processes going. What percent of daily expenditure is used for basal metabolism? The basal metabolic rate accounts for about 60-75% (Honestly found this one on google ) What factors affect basal metabolic rate? What are the BMI categories? Underweight: Less than 18.5 Normal Weight: 18.5-24.9 Overweight: 25-29.9 Obese: Higher than 30 How do you calculate BMI?Divide your weight in kilograms (kg) by your height in metres (m) then divide the answer by your height again to get your BMI What nutrients yield energy when metabolized?Carbs, protein, and fat CHAPTER 10 (3 left to answer) Ideally, how much weight should a normal woman gain during pregnancy? 25- 35 lbs What nutrients need to be increased during pregnancy? All EXCEPT D,E,K, Phosphorus, fluoride, calcium. What advantages does breastfeeding have over bottle-feeding? Antibodies from mom What nutrient may need to be supplemented in breast-fed infants? Iron, Vitamin D, Fluoride At what age should you introduce solid foods to an infant? 4-6 months What are the recommendations for fruit juice in infancy? Around 6 months 46 oz a day until 12 months Main nutrition concerns of childhood?Obesity, Type 2 Diabetes pages 213-215 in book), Lead poisoning because they naturally absorb greater amounts of minerals than adults, iron deficiency Main nutrition concerns of infancy? Food asphyxiation for toddlers, avoid peanuts, popcorn, hard candies, grapes, and foods containing bones. Main nutrition concerns of adolescence?Obesity CHAPTER 11 Types of malnutrition? Starvation-Related Malnutrition: Chronic starvation without inflammation Chronic Disease-Related Malnutrition: Chronic Inflammation of mild to moderate degree. Acute Disease-Or injury-Related Malnutrition: Acute inflammation of severe degree Requirement for hospital nutrition screening?Must be done within 48 hours. What are anthropometric measurements? ABCD Anthropometric, biochemical, clinical and dietary assessment Anthropometric: Simple, noninvasive techniques to measure height, weight, head circumference, and skinfold thickness. Biochemical: No single test for nutrition. Important indicators visceral protein status and immune function. Serum albumin; prealbumin; lymphocyte count. BMI. Clinical Assessment: Medical history, physical exam, features associated with deficiencies. Dietary Assessment: 24 hour recall, food diary Powered by TCPDF () NR 228 FINAL Review Glucose is the main source of energy for ___? - Correct answer-the brain and nerves What are the fat soluble vitamins? - Correct answer-A, D, E, K What are some food sources for monounsaturated fatty acids? - Correct answer-olive oil, peanuts, avocado, canola oil What are some food sources for polyunsaturated fatty acids? - Correct answer- vegetable oils, fish, margarine, What type of cholesterol increases risk of CAD when elevated? - Correct answer-LDL Where are nonessential amino acids found? - Correct answer-created in the body When is a positive nitrogen balance common? - Correct answer-growing children, pregnant women, people recovering from illness or injury When is a negative nitrogen balance common? - Correct answer-aging adults, physical illness, extreme stress, starvation, surgery, eating disorders What effect does the acid- base balance have on proteins? - Correct answer-if not balance then proteins become denatured and are not able to perform their usual functions Whats the function of hemoglobin? - Correct answer-transports oxygen in the blood What is a complete protein? - Correct answer-contains all nine essential amino acids What are high quality proteins? - Correct answer-contain best balance of essential amino acids and are easily digested What are food sources for high quality protein? - Correct answer-Eggs, human milk What is an incomplete protein? - Correct answer-lacks one or more EAA and will not support life What are some incomplete proteins? - Correct answer-plant foods What is a vegan? - Correct answer-No animal products at all What is a lacto-vegetarian? - Correct answer-no animal products except dairy Whats an ovo-lacto vegetarian? - Correct answer-no animal products except dairy and egs What is marasmus? - Correct answer-Deficient caloric intake, skin hangs on skin What is Kwashiorkor? - Correct answer-Lack of protein while get adequate caloric intake What are some food sources of B1 Thiamine? - Correct answer-lean pork, whole grains and flours, legumes, seeds and nuts What is Beriberi? - Correct answer-Bi Thiamine deficiency. Ataxia and tachycardia What are some food sources for Folate? - Correct answer-leafy green veggies, legumes, fortified grain cereals What is Scurvy? - Correct answer-Vitamin C deficiency, gingivitis, joint and limb aches, bruising, death What is the cause of Rickets? - Correct answer-Vitamin D deficiency What are some food sources for Vitamin D? - Correct answer-animal related foods (butter, egg, liver) What are some possible complications of Iodine Deficiency? - Correct answer-Cretinism in pregnancy, goiter Diet for Congestive Heart Failure? - Correct answer-Reduce Sodium intake What is the function of Vit B12? - Correct answer-Transport and storage of folate What are some clinical manifestations of vitamin B12 deficiency? - Correct answer- pernicious anemia and CNS damage Who is most at risk for a vitamin B12 deficiency? - Correct answer-Vegans and vegetarians What is a clear liquid diet? - Correct answer-Only foods that are clear liquid at room temperature (should not be used more than 24 hours) What is a full liquid diet? - Correct answer-For patients who have difficulty swallowing, and liquids (juices) Enteral vs Parenteral - Correct answer-Enteral is through GI tract (nasogastric), Parenteral is through central line What happens to the body during starvation? - Correct answer-It uses stored carb, protein and fat to meet energy demands, decline in metabolic rate to prolong survival Whats the difference between stress and starvation related weight loss? - Correct answer-During stress metabolic rate increases, starvation it decreases to prolong life Nutrition therapy for burn victims? - Correct answer-fluid and electrolyte replacement Nutrition therapy for someone with wasting syndrome/HIV/AIDS? - Correct answer- increase kcal and protein without expanding food volume What foods should be avoided with calcium based renal calculi? - Correct answer- chocolate, spinach, rubarb, nuts, strawberries, tea (foods that increase oxalate) What is diverticulitis? - Correct answer-inflammation of the diverticuli in the colon Nutritional Therapy for diverticulitis? - Correct answer-liquid diet may be recommended temporarily, low fiber! What diet is recommended for a patient on dialysis? - Correct answer-low sodium, phosphorus, and potassium Foods that should be avoided for patients with IBS? - Correct answer-Fruits, diary, wheat, legumes, beans Whats the normal range for HDL? - Correct answer-40-59 Whats the normal range for LDL - Correct answer-under 100 is optimal Whats the normal range for cholesterol? - Correct answer-under 200 NR 228 Final Exam Hepatitis A - Correct answer--Transmitted by fecal-oral route; often caused by poor handwashing or stool precautions; common in areas of poor sanitation. -Onset rapid: within 4 to 6 weeks Hepatitis B - Correct answer--Transmitted through contaminated blood and sexual contact; also perinatally -Onset slow: approximately 12 weeks Hepatitis C - Correct answer--Transmitted through blood, saliva, or semen -Onset slow: approximately 8 weeks -Progression from Hep C -> cirrhosis An inflammation of the liver that is typically transmitted through the fecal-oral route - and has a rapid onset (4-6 weeks) - Correct answer-Hepatitis A An inflammation of the liver that is transmitted via blood, semen, vaginal mucus, saliva, and tears. Incubation time is about 12 weeks. - Correct answer-Hepatitis B An inflammation of the liver that is transmitted through contaminated blood, saliva, semen or blood exposure. Can progress to cirrhosis in about 10-40 years. - Correct answer-Hepatitis C An inflammation of the liver that can occur only if a person with Hepatitis B is exposed to this... 90% of people are likely to be asymptomatic. - Correct answer-Hepatitis D Transmitted via oral-fecal route, and is attributed to travel in tropical climates, inadequate sanitation, or poor personal hygiene. - Correct answer-Hepatitis E This is the presence of excess fat in feces. - Correct answer-Steatorrhea This condition is an early form of alcoholic liver disease, but can also be caused by obesity, complications of drug therapy, excessive parenteral nutrition, pregnancy, DM, inadequate intake of protein, infection or malignancy. - Correct answer-Fatty Liver This condition is an overly exuberant wound healing in which excessive connective tissue builds up in the liver. It causes no symptoms but can lead to portal hypertension. - Correct answer- Hepatic Fibrosis Condition where the liver cells are replaced by fibrous connective tissue and fat infiltration. - Correct answer-Cirrhosis Can result due to portal hypertension. Patients with this condition should eat soft, low- fiber foods. If ruptured, may be fatal. - Correct answer-Esophageal Varices Stores bile until being released into the duodenum to expedite absorption of fats, fat- soluble vitamins, and certain minerals. - Correct answer-Gallbladder Occurs when gallstones block the cystic duct or when is becomes infected or it becomes ischemic - Correct answer-Cholecystitis Inflammatory process characterized by decreased production of digestive enzymes and bicarbonate. Caused by excess alcohol consumption, gallbladder disease, genetics. - Correct answer-Pancreatitis Secretes enzymes necessary for protein, carbohydrate, and fat digestion. It also secretes sodium bicarbonate to neutralize acidic gastric contents as they enter the duodenum. Known for secreting insulin and glucagon for glucose homeostasis. - Correct answer-Pancreas Is an autoimmune disease resulting in beta-cell destruction. It usually occurs before age 30. - Correct answer-Diabetes Type 1 Multiple daily injections of short or rapid-acting insulins before meals, as well as intermediate-acting insulin one or twice daily. - Correct answer-Flexible or intensive insulin A gradual onset of this disease. People experience polyuria, polydipsia, are easily fatigues, and have frequent infections - especially of the urinary tract. - Correct answer-Diabetes Type 2 This reflects blood glucose control for 100-120 days. As RBC's circulate in the bloodstream, hgb combines with glucose. It is not affected by short-term factors such as food intake, exercise, or stress, so blood samples can be drawn at any time. - Correct answer-Glycosylated hemoglobin A1c Symptoms include cool, clammy, pale skin, confusion, erratic behavior, hunger, trembling/shaking. - Correct answer-Hypoglycemia A life-threatening condition caused by insulin deficiency. Precipitating factors include insufficient or interrupted insulin therapy, too much food, infection, other stresses. - Correct answerDiabetic Ketoacidosis (DKA) A hard ball of hair and vegetable fiber that may develop within the intestines. May be more common with intake of oranges, coconuts, green beans, apples, figs, potato skins, Brussel sprouts, sauerkraut. - Correct answer-Bezoar This is characterized by delayed gastric emptying, and occurs as a result of vagal autonomic neuropathy - happens more often in type 1 DM. - Correct answer-Gastroparesis During pregnancy - this condition develops usually around the 24th week. - Correct answer-Gestational Diabetes A skin condition characterized by areas of dark, velvety discoloration in body folds and creases. Typically occurs in people who are obese or have diabetes. Children who develop this condition are at higher risk of developing type 2 diabetes. - Correct answer-Acanthosis Nigricans Hepatitis D - Correct answer--Occurs only if individual with hepatitis B virus (HBV) is exposed to hepatitis D virus (HDV): coinfection or superinfection Hepatitis E - Correct answer--Enterically transmitted Nutrition Therapy - Correct answer--Initially liquid diet; then progressing to small, frequent feedings high in calories and high-quality protein as tolerated Nonalcoholic Fatty Liver Disease (NAFLD) - Correct answer-In liver, buildup of extra fat that is not caused by alcohol. -Develops in people who are overweight or obese; have diabetes, high cholesterol level, or elevated triglyceride levels; have poor eating habits. Cirrhosis Complications - Correct answer--Portal hypertension: increased pressure in portal vein -Esophageal varices: if ruptured, may be fatal Ascites: - Correct answer-accumulation of fluid in abdominal cavity; treated by dietary restriction of sodium and sometimes fluid Hepatic encephalopathy: - Correct answer-type of brain damage resulting from toxic ammonia buildup; can result in hepatic coma Gallbladder Disorders - Correct answer-Cholelithiasis Cholecystitis Gallbladder Causes and predisposing factors - Correct answer--High-fat diet -Women: multiparity -Oral contraceptive or estrogen use -Obesity -Sedentary lifestyle -Rapid weight loss, very-low-calorie diets -Older age Pancreatitis - Correct answer-Inflammatory process characterized by decreased production of digestive enzymes and bicarbonate Pancreatitis Causes & Consequences - Correct answer--Excess alcohol consumption, gallbladder disease, genetics -chronic pain, diabetes mellitus Nutrition Therapy for Pancreatitis - Correct answer-enteral or parenteral nutrition may be used; enteral nutrition is associated with better outcomes. Meal Planning for Pancreatitis - Correct answer-Six small meals per day are recommended. Enzyme replacement may be necessary to control malabsorption. Abstinence from alcohol is imperative. type 1 diabetes mellitus symptoms - Correct answer-polydipsia, polyuria, polyphagia, weight loss Risk factors of diabetes type 2 - Correct answer-family history, obesity Treatment of Diabetes: (oral glucose) firs tline therapy= - Correct answer-metformin Glycosylated hemoglobin A1c: - Correct answer-reflects blood glucose control for 100 to 120 days Hypoglycemia Causes - Correct answer-too much insulin, skipping meals, too much exercise without food replacement; occurs most commonly during insulin peak and at night during sleep Ketosis: - Correct answer-abnormal accumulation of ketones resulting from metabolism of fatty acids Maternal insulin ______________ cross the placenta, but glucose _________. - Correct answer-Does not; does. Alzheimer's disease - Correct answer-Mediterranean diet, omega-3 fatty acids, light use of alcohol, low amounts of added sugars Coma - Correct answer-The unconscious state in which the patient is unresponsive to verbal or painful stimuli. Guillain-Barré Syndrome - Correct answer-Acute inflammatory demyelinating polyneuropathy Huntington's Disease (HD) - Correct answer-Progressive, fatal neurodegenerative disease Migraine Headache - Correct answer-Brain disorder resulting from altered sensory stimuli and trigeminal nerve dysfunction Multiple Sclerosis (MS) - Correct answer-Diet: lower salt; Vitamin D supplements Myasthenia Gravis - Correct answer-Autoimmune disorder caused by autoantibodies at the neuromuscular junction that attack acetylcholine receptors Parkinson's disease - Correct answer-Diet: Mediterranean diet, antioxidant-rich foods Cerebrovascular accident (CVA) - Correct answer-a.k.a. "Stroke". CVA Risk Factors - Correct answer-hypertension, smoking, diabetes, atrial fibrillation, oral contraceptive use CVA DIet - Correct answer--Fewer red and processed meats, refined grains, sweets, and desserts -More plant-based diet high in fruits, vegetables, fish, and whole grains Left-sided CVA: - Correct answer-Affects sight and hearing, including the ability to see where foods are placed on a plate or tray Right-hemisphere, bilateral, or brainstem CVA: - Correct answer-Causes significant problems with self-feeding, swallowing, and speech. anorexia nervosa - Correct answer-Eating disorder in which the patient severely rejects food, causing extreme weight loss, low basal metabolic rate, and exhaustion Bipolar Affective Disorders - Correct answer-Abnormalities in brain biochemistry and circuits are responsible for the extreme shifts in mood, energy, and functioning. Schizophrenia Diet - Correct answer-antioxidant-rich foods, vitamin D, omega-3 fatty acids, folic acid, and vitam