ATI NUTRITION PROCTORED 2020/2021 FOCUSED REVIEW GUIDE
Chapter 1:
Carbohydrate, protein and fat 3 main nutrients.
Carbs: 45-65% of daily
... [Show More] calories
function: energy, regulate fat, cardiac and cns system, protein metabolism.
Glycogen: stored carb in the liver and muscle and it release between the meals to regulate the Blood glucose level.
Carbs 4 calories per gram per energy
* Fiber intake 25gr women, for M 38gr per day
* Protein 10-35% daily calories, 0.8 gr per kg body weight, tissue building, immune function, neutral nitrogen balance. Wound healing is important.
▪ Complete protein: all 9 amino acids, animal sources and soy
▪ Incomplete: 2 different one together is complete like rice plus beans.
▪ Protein 4 calories per gram per energy.
▪ Fat lipids: 20-35% of daily calories. Les that 10 sutured fat, ideally 7%
Function: store energy, padding insulation. Hormone, absorption of fat-soluble vitamin
▪ Cholesterol: 200-300 mg/day
▪ Fat provides 9 calories/energy
If you eat 5 gr of fat how many calories: 45 calories.
Vitamins:
Fat soluble: A, D, E, K they have risk for toxicity, don’t overdose, CF, celiac and crohns disease Water soluble: Vitamin C and B complex thiamine, niacin, pardaxin, panthocacid, folic, cobalamin: no risk for toxicity, you will pee it out.
Vitamin c: iron absorption, tissue building Citrus fruits, tomatoes, green veggie.
Deficiency in vitamin C: bleeding, swelling gums and joint pain, during pain and illness take more, during smoking take more
B complex: CNS functioning, meats, milk, whole grains, legumes, green leafy veggies. Pregnancy get folic acid.
Def B12: pernicious anemia.
Vitamin A: vision health, skeletal and soft tissue: orange and yellow fruits, fatty fish, dairy products.
Deficiency: xeropthalmia and vision issue
Vitamin D: absorption of calcium and phosphorus. Sunlight, Milk, fatty fish and eggs. Deficiency: bone loss
Vitamin E: serve as antioxidants: fat containing food, nuts, dark green veggies. Deficiency very rare: muscle pain.
Vitamin K: blood clotting and bone maintenance, dark green veggie, carrots deficiency: increase bleeding time. Antidote for Warfarin
Electrolytes:
Sodium Na: 136-145 normal level.
function: fluid balance and nerve and muscle function. Food high in Na: salt and processed food.
Hyper: hypervolemia and HTN
Hypo: confusion, muscle cramps, headache, fatigue, NV
Potassium K: 3.5-5 normal level.
Function: ICF, nerve function, muscle and heart contraction
FOOD HIGH IN K: bananas, potatoes, tomatoes, oranges, avocadoes, dark green veggies, dried foods
Hyper: dysrhythmias, muscle weakness, NV, confusion Hypo: dysrhythmias, muscle cramps and constipation
Chloride Cl: 98-106 is normal level
Function: Help with digestion, ICF and ECF. Find in salt Hyper: NV
Hypo: muscle cramps, GI upset
Calcium CA: 9-10.5 is normal level
Function: bone, teeth formation, nerve and muscle function, BP Food: dairy, dark green veggie, fruits
Hyper: constipation, decreased DTR, kidney stones, lethargy Hypo: Positive Chvostek and Trousers’, muscle spasm and tingling
Magnesium Mg: 1.3-2.1
Function: Nerve, muscle function, bone formation, biochemical reactions Foods: nuts, veggies, whole grain, milk
Hyper: NV/ hypotension, muscle weakness, lethargy. Respiratory and cardiac arrest Hypo: increased DTR, dysthymias, seizure, tremors
Ph: Phosphorus 3-4.5 is normal level Function: bone and teeth formation
Dairy and cheese, dark green veggies, fish and legumes Inverse relationship with calcium, high Calcium low Ph
Trace Minerals:
1. Iodine: synthesis of thyroxine required level is 100-150mcg. Find in table salt and sea food
2. Iron: make help HH. Meat, fish, legumes, Vitamin C, constipation, increase fiber intake, tooth discoloration. Z track for IM injection. Calcium lower absorption
3. Zinc: important in immune functions, NUTS, cereal and beans
4. Fluoride: help protect cavities, in water
Water: 2-3 L/day .minimum requirement level is 1.5 L I should = O
Sensible fluid loss: can be measured. Urine, vomit
Insensible: fluid loss from lung, water excreted in the feces. Sweat
Older adult and children greater risk for dehydration
S/S: dehydration poor skin turgor, confusion, hypotension, decrease Urine output, dry mucous membrane, increase urine osmolarity. Sunken in babies.
Chapter 2:
Catabolism: breaking down of substance to release energy Anabolism uses energy to repair
BMR: energy required for involuntary activities within 24hrs. heart function, respiration INCREASE BMMR: Male gender, more muscle mass, periods of growth such as puberty, stress, exposure to cold, disease and illness, hyperthyroidism, seizure, surgery, pregnancy and lactation
Decrease: female gender, shorter height, less muscle mass, starvation, older age and hypothyroidism.
Nitrogen balance: component amino acids: nitrogen intake-nitrogen excretion For the Adults this nitrogen balance should be neutral.
Negative nitrogen: insufficient protein intake, malnutrition or aging, illness. Positive nitrogen balance: growth, pregnancy and lactation
Chapter 3:
S/s of malnutrition: poor wound healing, hair loss, brittle hair, weakness, poor LOC and look for pre albumin (15-36) albumin (3.5-5)
▪ Increase protein and calories: add milk powder to milk, whole milk, high calories
food, cheese, peanut butter, use of supplement and collaborate with dietitian.
▪ Calculations weight change: usual weight- current weight/ usual weight *100
▪ 2% weight loss in 1 wk. or 7.5% weight loss in 3 months indicate weight loss. when to weight them? early in the morning
BMI: kg/m (WEIGHT (kg)/ Height (m))
BMI ranges include:
Under 18.5 is underweight 18.5-24.9 healthy
25-29.9 overweight 30 or more is obese
300 calories equal 1 pound.
Decrease 500 calories a week lose 1 lb. in 1 wk. 1lb =2.2 kg
Pt teaching: monitor hunger 1-10 scale before eating. Certain food should not be forbidden. Moderation is good. Weight loss is not consistent. Don’t weight daily for fluctuations.
Eat meal free of distraction, not in front of TV
Chapter 4:
5 or more serving of veggie, fruits daily is recommended for everyone. Monosaturated fat. Less than 7% of calories from saturated fat
Salt: 2300mg /day intake
Alcohol: women 1 drink a day and Men 2 drinks a day or less. Exercise rec: 2.5 hrs. /wk. vigorous or 1.25/wk.
SWIMMING IS NOT HELPING TO PREVENT OSTEOPOROSIS ,NOT WEIGHT BARING
Children: 16 minutes/day of physical activities. Vegan diet no animal products at all
Lacto-vegetarian: dairy is ok Lacto-ovo: dairy and eggs are ok
Vegan diet not get enough vitamin D, B12, Omega 3 fatty acid.
Food labels: calories, calories from fat, sutured fat, trans fat, Na, carbs, dietary fiber, sugar, protein, Calcium and Iron. NO Mg IN THE LIST.
Chapter 5:
Food born illness:
• frequent wash hands, refrigerate perishable 2 hrs. or 1 hr if it is hot.
• Prevent cross contaminations.
• Cooks food to recommended temperature.
• Raw and undercooked meats, sprouts, unpasteurized fruit juice, raw milk high risk
food
• Salmonella, E. Choli, Listeria, Norovirus
Foods that affect med: grapefruits juice is a NO, affects statins
High in vitamin K: interfere with Warfarin
Foods high in protein affects Levodopa/ Carvedopa for Parkinson disease
Tyramine: smoked meats, chees, avocados, wine, peanuts, chocolates MAOI’s inhibitors will cause hypertensive crisis.
Potassium rich food: hyperkalemia for pt. who are taking Ace inhibitors or potassium sparing, Lisinopril cause hyperkalemia.
Allergy to egg for vaccination of flu.
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