RD Exam Prep: Nutrition Planning and Intervention (Domain 2C) Questions and Answers 100% Pass

RD Exam Prep: Nutrition Planning and Intervention (Domain 2C) Questions and Answers 100% Pass Hypertension (HTN) - Answer- Medications: diuretics, calcium channel blockers, ACE inhibitors Nutrition Intervention: wt reduction, DASH diet, avoid grapefruit on calcium channel blockers, monitor potassium with diuretic use Key Nutrients: sodium (<2300mg/d), potassium ------------------------------------------------- Defined as BP > 130-139/80-89 Stages includes Normal: <120/80, Elevated: 120-130/80, High BP Stage 1: 130-139/80- 89; High Blood Pressure Stage 2: 140-159/ 90-99. Systolic: pressure when the heart pumps; Diastolic: pressure between beats of rest Risk Factors: age (>55), women are more likely to develop HTN after 55, men are more likely to develop HTN before 55, gender, race (being African American inc risk), overweight/obese, lifestyle habits (stress, lack of physical activity, eating too much sodium, family hx Tx: modify lifestyle factors including diet (limit sodium <2300mg/d; DASH diet), wt loss, maintain a healthy wt, limit alcohol, manage stress. Thiazide diuretics may require potassium supplementation d/t potential for hypokalemia. Hyperlipidemia (HLD) - Answer- Medications: HMG Co-A reductase inhibitor Nutrition Intervention: Mediterranean diet Key Nutrients: fats (increase omega 3, <6% saturated), 25-30 g/fiber (mostly soluble), CoQ10, fish oil ------------------------------------------------- Etiology: plaque buildup inside of the heart arteries. Lears to arterial narrowing (stenosis), which prohibits oxygen from reaching the heart. Atherosclerosis is most directly linked with the LDL cholesterol lab Dyslipidemia: excess LDL, cholesterol in the serum blood. Plant sterols lower LDL cholesterol. Ischemia: blood deficiency caused by the blockage. Risk factors: family hx of CAD, smoking, low HDL, high BP, elevated homocysteine, elevated fibrinogen, insulin resistance, and obesity. BMI alone is not a good predictor. Waist circumference is a suitable predictor of risk. Heart Failure (HF) - Answer- Medications: diuretics, beta-blockers, digoxin Nutrition Intervention: 2g sodium restriction, 1-2L fluid restriction Key Nutrients: water, sodium, thiamin, magnesium ------------------------------------------------- Etiology: caused by lower two heart chambers ineffectively pumping blood resulting in less blood circulation. Symptoms: fatigue, dyspnea (SOB), fluid retention Intervention: High protein, limit fluids <2L/d, low sodium <2g/d. Aim for a serum Na of <130mEq/L. Thiamin and Mg supplementation for those on diuretics. Small, frequent meals. Achieve DRI for folate and B12 from either food or supplements. Weight gain/edema is exacerbated by Thiazolidindione medications. Cardiac Cachexia: significant loss of lean body mass (>10% loss of lean body mass/7.5% body weight loss in 6 months, unintentionally); results in poor prognosis and is considered "end stage". Diet: 2x rec kcal, protein: 1.0-1.5g/kg, small and frequent high kcal meal, sodium 1-2g/d. Dietary Approaches to Stop Hypertension (DASH) Diet - Answer- High in f/v, low fat dairy, whole grains, nuts, fish, beans, vegetable oil, lean meats/dairy, sugar, sodium (2300mg), 2-4 servings of fat per day. High in phosphorus, potassium, calcium, magnesium, and protein. Not appropriate for renal patients Mediterranean Diet (MeD) - Answer- Abundant f/v, whole grains, fatty fish, nuts, legumes, and olive oil (omega 3). Low amounts of red meats, high fat dairy, and sweets. Red wine contains resveratrol. High in antioxidants, vitamin E (sunflower seeds), catechism (green tea, cacao, berries)