Chapter 63- Care of Patients with Malnutrition and Obesity
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slchildress Plus on September 25, 2011
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Terms | Definitions |
|---|---|
 Dietary Guidelines for Americans | Recommendations made by the USDA and U.S. Department of Health and Human Services to help people maintain nutritional health; updated every 5 years |
| Food Guide Pyramid | Food recommendations of the U.S. Department of Agriculture presented in a graphic pyramid design format to communicate the key dietary principle of variety, moderation, and proportionality. In the pyramid design, the diet is built on a base of grains, fruits, and vegetables, with moderate quantities of lean meats, protein sources, and dairy products and limited intake of fats and sweets. In 2005, this pyramid was redesigned into the MyPyramid to help people better understand these principles. MyPyramid also stresses the importance of physical activity to promote health. |
| Lacto-vegetarian | A vegetarian diet pattern in which milk, cheese, and dairy foods are eaten but meat, fish, poultry, and eggs are avoided |
| Lacto-ovo-vegetarian | a vegetarian diet pattern in which milk, cheese, eggs, and dairy foods are eaten but meat, fish, and poultry are avoided |
| Vegetarian Food Pyramid | a food pyramid to assist vegetarians with daily food choices |
| Atkins Pyramid | A food pyramid based on the Atkins diet that emphasizes building the diet on protein sources and vegetables rather than on grains, fruits, and vegetables, such as in the pyramid approved by the U.S. Department of Agriculture |
| Nutritional status | reflects the balance between nutrient requirements and intake |
| Nutritional Screening | a screening by the health care provider that includes visual inspection, measured height and weight, weight history, usual eating habits, ability to chew and swallow, and any recent changes in appetite or food intake. The screening is a way to determine which patients need more extensive nutritional assessment |
| Knee Height Caliper | device that uses the distance between the patella and heel to estimate height |
| Body Mass Index (BMI) | a measure of nutritional status that does not depend on frame size; indirectly estimates total fat stores within the body by the relationship of weight to height |
| Skin-Fold Measurements | measurement that estimates body fat |
| Protein-energy Malnutrition (PEM) | see protein-calorie malnutrition: a disorder of nutrition that may present in three forms marasmus, kwashiorkor, and marasmic-kwashiorkor; also called "protein-energy malnutrition." |
| Protein-Calorie Malnutrition (PCM) | a disorder of nutrition that may present in three forms marasmus, kwashiorkor, and marasmic-kwashiorkor; also called "protein-energy malnutrition." |
| Marasmus | a calorie malnutrition in which body fat and protein are wasted but serum proteins are often preserved |
| Kwashiorkor | lack of protein quantity and quality in the presence of adequate calories. Body weight is somewhat normal and serum proteins are low |
| Marasmic-Kwashiorkor | a combined protein and energy malnutrition that often presents clinically when metabolic stress is imposed on a chronically starved patient |
| hypoproteinemia | inadequate levels of phosphate in the blood (below 3.0 mEq/L). |
| cachexia | Extreme body wasting and malnutrition that develops from an imbalance between food intake and energy use |
| Anorexia | the loss of appetite for food |
| Anorexia Nervosa | an eating disorder of self-induced starvation resulting from a a fear of fatness, even though the patient is underweight |
| Bulimia Nervosa | an eating disorder that is characterized by episodes of eating in which the patients ingests a large amount of food in a a short time, followed by a purging behavior such as self-induced vomiting or excessive use of laxatives |
| Visceral Proteins | proteins such as albumin that circulate in the bloodstream and may be produced by the liver |
| Prealbumin (PAB) | a protein secreted by the liver that binds thyroxine |
| Transferrin | an iron-transport protein that can be measured directly or calculated as an indirect measurement of total ironbinding capacity |
| Edentulous | toothless |
| medical nutritional supplements (MNS) | enteral products taken by patients who cannot consume enough nutrients in their usual diet (e.g., Ensure, Boost). |
| Specialized Nutrition Support (SNS) | total nutritional intake orally or intravenously with commercially prepared products (either total enteral nutrition or total parenteral nutrition). |
| Nasoenteric Tube (NET) | any feeding tube that is inserted nasally and then advanced into the gastrointestinal tract |
| Nasogatric (NG) Tube | a tube that is inserted through a nostril and into the stomach for liquid feeding or for withdrawing gastric contents |
| Nasoduodenal Tube (NDT) | a tube that is inserted through a nostril and into the small instestine |
| Enterostomal Feeding Tubes | a tube used for patients who need long-term enteral feeding; the physician directly accesses the gastrointestinal tract using surgical, endoscopic, and laparoscopic techniques |
| Gastrostomy | a stoma created from the abdominal wall into the stomach |
| Percutaneous Endoscopic Gastrostomy (PEG) | A stoma created from the abdominal wall into the stomach for insertion of a short feeding tube |
| Low-Profile Gastrostomy Device (LPGD) | a gastrostomy device that is uses a firm or balloon-style internal bumper or retention disk; an antireflux valve keeps gastric contents from leaking onto the skin |
| Residuals | the amount of feeding that remains in the stomach |
| jejunostomy | the surgical creation of an opening between the jejunum and the surface of the abdominal wall |
| Bolus feeding | a method of tube feeding that involves intermittent feeding of a specified amount of enteral product at specified times during a 24-hour period, typically every 4 hours |
| Continuous feeding | a method of tube feeding in which small amounts of enteral product are continuously infused (by gravity drip or by a pump or controller) over a specified time |
| Cyclic Feeding | a method of tube feeding similar to continuous feeding except the infusion is stopped for a specified time in each 24-hour period ("down time"); the down time typically occurs in the morning to allow bathing , treatments, and other activities |
| Refeeding Syndrome | Life-threatening metabolic complication that can occur when nutrition s restarted for a patient who is in a starvation state |
| Initial | first or, in phases of shock, early |
| Total Parenteral Nutrition (TPN) | provision of intensive nutritional support for an extended time; delivered to the patient through access to central veins, usually the subclavian or internal jugular veins |
| Overweight | an increase in body weight for height compared with a reference standard(e.g., the Metropolitan Life height and weight tables) or 10% greater than ideal body weight. However, this weight may not reflect excess body fat, which in adult is a body mass index of 25 to 30 |
| Obesity | an increase in body weight to least 20% above the upper limit of the normal range for ideal body weight, with an excess amount of body fat; in an adult, a body mass index greater than 30 |
| Morbid Obesity | a weight that has a severely negative effect on health; usually more than 100% ideal body weight or body mass index greater than 40. |
| Leptin | a hormone released by fat cells and possible by gastric cells; it also acts on the hypothalamus to control appetite |
| Adiponectin | an anti-inflammatory and insulin sensitizing hormone |
| Resistin | a hormone produced by fat cells that creates resistance to insulin activity |
| Inflammatory cytokines | such as inflammatory interleukins and tumor necrosis factor-alpha |
| Apolipoprotein E | one of several regulators of lipoprotein metabolism |
| Cholecystokinin | a hormone that stimulates digestive juices and may work with leptin to increase or decrease appetite |
| Orexins | neuropeptide that is an appetite stimulate |
| Anorexins | Neuropeptide that decreases appetite |
| Panniculus | a layer of membrane; also used to refer to skinfold areas in the obese patient |
| Panniculitis | infection of the panniculus |
| Anorectic Drugs | drugs that suppress appetite, which reduces food intake and many may result in weight loss; may be prescribed for obese patients in comprehensive weight reduction programs |
| Liposuciton | a cosmetic procedure to reduce the amount of adipose tissue in selected areas of the body |
| Bariatrics | a branch of medicine that manages obesity and it related disease |
| Gastric Bypass | a type of gastric restriction surgery in which gastric resection is combined with malabsortion surgery. The patient's stomach, duodenum and part of the jejunum are bypassed so that fewer calories can be absorbed |
| Dumping Syndrome | a constellation of vasomotor symptoms that typically occur within 30 minutes of eating; believed to occur as a result of the rapid emptying of gastric contents into the small intestine, which shifts fluid into the gut and causes abdominal distention. Early manifestions include vertigo, tachycardia, syncope, sweating, pallor, and palpitations |
| Panniculectomy | the surgical removal of an panniculus, most often the abdominal apron; usually done as a follow-up to barriatric surgery in an obese patient |
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