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Terms in this set (113)
Mechanically altered diets
This diet contains foods that are modified in texture. Pureed diets include only pureed foods. Mechanically soft diets may include solid foods that are mashed, minced, grounded or soft.
Blenderized liquid diets
This diet contains fluids and foods that are blenderized to liquid form. This is for people who can not chew, swallow easily or tolerate solid foods.
Clear liquid diet
This diet contains clear fluids or foods that are liquid at room temperature and leave minimal residue in the colon. This is used for preparation for bowel surgery or colonoscopy, for acute GI disturbances.
limits dietary fat to low. For people who have certain malabsorptive disorders or symptoms of diarrhea, flatulence, or steatorrhea.
[<50g/day] or very low
Limites dietary fiber; degree of restriction depends on the patients condition and reason for restriction. This is used for acute phases of intestinal disorders or to reduce fecal output before surgery.
Limits dietary sodium; degree of restriction depends on symptoms and disease severity. This is to help lower blood pressure of prevent fluid retention; used in hypertension, congestive heart failure, renal disease and liver disease.
High-kcalorie/high protein site
This diet contains foods that are calorie and protein dense. This is used for patients with high calorie and protein requirements; also used to reverse malnutrition, improve nutritional status, or promote weight gain
nasogastric (TF routes)
tube is places into the stomach via nose
nasoenteric (TF routes)
tube is places into the GI tract via the nose
Nasoduodenal (TF routes)
tube is placed into the duodenum via the nose
nasojejunal (TF routes)
tube is placed into the jejunum via the nose
transnasal (TF routes)
a transnasal feeding tube is one that inserted through the nose
enterostomy (TF routes)
an opening into the GI tract through the abdominal wall
gastrostomy (TF routes)
an opening in the stomach through which a feeding tube can be passed. a nonsurgical technique for creating a gastrostomy under local anesthesia is called percutameous endoscopic gastrstomy (PEG)
Jejunostomy (TF routes)
an opening in the jejunum through which a feeding tube can be passed a nonsurgical technique for creating a jejunostomy is called percutameous endoscopic jejunostomy (PEI). The tube can either be guided into the jejunum via a gastrostomy or passed directly into the jejunum.
orogastric (TF routes)
tube is inserted into the stomach through the mouth. This method is often used to feed infants because a nasogastric tube may hinder the infants breathing.
drawing in by suction or breathing; a common complication of enteral feedings in which foreign material enters the lungs, often from GI secretions or the reflux of stomach contents
a lung disease resulting from the abnormal entry of foreign material; caused by either bacterial infection or irritation of the lower airways.
a person with a functioning GI tract who cannot meet nutrient needs with conventional foods alone may be a candidate for eternal nutrition support.
Oral use of enteral formulas
enteral formulas can fully meet a persons nutritional needs. Patients drink enteral formulas to supplement their diets when they are unable to consume enough food to meet their needs.
Candidates for tube feeding (definition)
Tube feeding are typically recommended for patients at risk of developing protein-energy malnutrition who are unable to consume adequate food or formula for at least seven days.
Who are candidates for tube feeding?
-severe swallowing disorders
-impaired motility in the upper GI tract
- Gastrointestinal obstructions and fistulas that can be bypassed with a feeding tube
-certain types of intestinal surgeries
-extremely high nutrient requirements
-little or no appetite for extended periods, especially if the patient is malnourished
-mental incapacitation due to confusion, neurological disorders, or coma.
When working with patients nurses should be alert to possible interactions between diet and dietary substances. These interactions can raise health care costs and result in serious and sometimes fatal complications.
Drugs may alter: (3)
Drugs and nutrients may?: (1)
interact and alter metabolism
Some medications bind to nutrients in the GI tract, preventing their absorption.
Diet Drug interactions generally fall into the following categories
-Drugs may alter food intake by reducing the appetite or by causing complications that make food consumption difficult or unpleasant. Other drugs may increase appetite and cause weight gain.
-Drugs may alter the absorption metabolism or excretion of nutrients. Nutrients and other food components may alter the absorption metabolism and excretion of drugs
-Some interactions between dietary components and drugs can be toxic.
chronic obstructive pulmonary disease (COPD)
refers to a group of conditions characterized by the persistent obstruction of airflow through the lungs
Causes of COPD
cigarette smoking is the primary risk factor in 90 percent of COPD cases and is especially damaging when combined with a respiratory inceptions or an occupational exposure of dust or chemicals
Treatment of COPD
The primary objectives of COPD treatment are to prevent the disease from progressing and relieve major symptoms. Individuals with COPD are encourage to quit smoking to prevent disease progression and to get vaccinated against influenza and pneumonia to avoid complications People with severe COPD will need supplemental oxygen therapy
Nutrition therapy for COPD
-The main goals of nutrition therapy for COPD are to correct malnutrition (which affects up to 60% of patients with COPD)
-encouraging adequate food intake is generally the main focus of the nutrition care plan.
-Energy needs of COPD patients are usually raised due to hyper metabolism, which results from chronic inflammation and the increased workload of respiratory muscles.
Food intake does what when COPD progresses?
How does COPD medications affect patients appetite?
The appetite may be reduced by medications, depression or anxiety, or altered taste perception.
Pulmonary Formulas for COPD
Enteral formulas designed for use in COPD provide more calories from fat an fewer carbohydrate than standard formulas. This formula should lower respiratory requirements.
Gastroesphageal reflux disease (GERD)
is a condition in which the stomachs acidic contents back up into the esophagus, causing discomfort and, sometimes, tissue damage.
GERD have symptoms like..
heartburn or acid indigestion
Causes of GERD
The lower esophageal sphincter is the main barrier to gastric reflux, so GERD can result if the sphincter muscle is weak or relaxes inappropriately.
Conditions associated with high rates of GERD include
Consequences of GERD
If gastric acid remains in the esophagus long enough to damage the esophageal lining, the resulting inflammation is called reflux esophagitis. Severe and chronic inflammation may lead to esophageal ulcers, with consequent bleeding, healing and scarring of ulcerated tissue may narrow the inner diameter of the esophagus, causing esophageal stricture.
Treatment of GERD
Treatment objectives are to alleviate symptoms and facilitate the healing of damages tissue. Severe ulcerative disease may require immediate acid-suppressing medication, whereas a mild case may be managed with dietary and lifestyle modifications.
Chronic gastritis definition
The extensive tissue damage that sometimes develops in chronic gastritis can disrupt gastric secretory functions.
This may be caused by long-term infections or autoimmune disease and can progress to widespread gastric inflammation and tissue atrophy
Inflammatory bowel diseases
Inflammatory bowel diseases are chronic inflammatory illnesses characterized by abnormal immune responses in the GI tract. Although both genetic and environmental factors contribute to the development of these disease, the exact triggers are unknown.
Two major forms of inflammatory bowel disease
1. Crohn's disease
2. ulcerative colitis
This usually involved the small intestine and can lead to nutrient malabsorption. This inflammatory bowel disease that usually occurs in the lower portion of the small intestine and the colon. Inflammation may pervade the entire intestinal wall
affects the large intestine, where little nutrient absorption occurs. This inflammatory bowel disease that involves the colon. Inflammation affects the mucosa and submucosa of the intestinal wall
Drug treatment of inflammatory bowel disease
Medications help to reduce inflammation, control symptoms and minimize complications.
Nutrition therapy for Crohns Disease
Crohn's disease often requires aggressive dietary management because it can lead to protein-energy malnutrition. During disease exacerbations, a low-residue, low-fat diet provided in small, frequent feedings can minimize stool output and reduce symptoms of malabsorption . Vitamin and mineral supplements are usually necessary, especially if nutrient malabsorption is present.
Nutrition therapy for ulcerative colitis
In most cases, the diet for ulcerative colitis requires few adjustments.Dietary adjustments are based on the extent of bleeding and diarrhea output. A low-fiber diet may reduce irritation by minimizing fecal volume.
This refers to the presence of pebble-sized herniation in the intestinal wall, know as diverticula. This prevalence of diverticulosis increases with age, occurring in 50-65% of 80 year old individuals. Most people are symptom free and remain unaware of the condition until a complication develops.
Diverticula is strongly influenced by..
the amount of dietary fiber a person comes. By increasing stool weight and bulk, high-fiber diets reduce the workload of the circular muscles that move wastes through the colon.
Inflammation or infection sometimes develops in the area around a diverticulum. This is the most common complications of diverticulosis, affecting 10-25% of individuals with the condition. It is thought from the erosion of the diverticular wall due to high pressure within the lumen, causing inflammation and eventually a microperation that leads to subsequent infection.
Treatment for Diverticular disease
Treatment for diverticulosis is necessary only if symptoms develop. Because a high-fiber diet may prevent disease progression and the development of intestinal symptoms, patients are advised to increase fiber intake.
Treatment for diverticultitis
patients may need antibiotics to treat infections and, possibly, pain control medications. In mild cases, a clear liquid diet may be advised initially with progression to solid foods as symptoms resolves, In severe cases, bowel rest is necessary, and fluids are given intravenously.
Irritable bowel syndrome (IBS)
People with irritable bowel syndrome experience chronic and recurring intestinal symptoms that cannot be explained by specific physical abnormalities.
Symptoms of IBS
Causes of IBS
The causes of IBS remain elusive, people with this disorder tend to have excessive colonic responses to meals, GI hormones, and stress.
Treatment of IBS
Medical treatment of IBS often includes dietary adjustments, stress management, and behavioral therapies. Medications may be prescribed to manage symptoms, but they are not always helpful.
Nutrition therapy for IBS
Although dietary adjustments may be useful measures that help one symptom can sometimes make another worse. The most common dietary recommendation is to gradually increase fiber intake to relieve constipation and improve stool bulk, although clinical studies suggest that additional fiber has limited effectiveness in improving symptoms and may worsen flatulence.
Foods that make IBS worse
-fried or fatty foods
-gas producing foods
Kidney stones develop..
when stone constituents become concentrated in urine, allowing crystals to form and grow. About 70% of kidney stones are made up primarily of calcium oxalate. Less commonly, stones are composed of uric acid, the amino acid cystine, calcium phosphate, or magnesium ammonium phosphate.
Factors that predispose an individual to stone information include the following: (Kidney stones)
-dehydration or low urine volume
The nephrotic syndrome can sometimes progress to_______________
Acute Kidney injury is also know as?
acute renal failure
Restrict sodium to 2-3grams/day if fluid retention and hypertension are present
Hypertension is a result from?
Chronic kidney disease causes gradual loss of kidney function and often results from long-standing diabetes mellitus or hypertension
What is cancer?
Cancer is the growth of malignant tissue, is the second most common cause of death in the US
The development of cancer is called?
carcinogenesis, often proceeds slowly and continues for several decades.
An abnormal mass of cells is called?
a tumor. Grows, blood vessels form to supply the tumor with the nutrients it needs to support its growth.
A tumor can disrupt the functioning of the normal tissue around it.
Some tumor cells may?
metasize. spreading to another region in the body
cancer that affects the white blood cells. The abnormal cells do not form a tumor but rather accumulate in the blood and other tissues.
Ways to get cancer.
-Inherited, born with a genetic defect
-Certain metabolic processes may initiate carcinogensis
-persons genes and environmental agents
-exposure to cancer-causing substances
May alter induce genetic mutations that lead to cancer or promote the proliferation of cancerous cells.
Obesity is a risk factor for a number of different?
Obesity increases cancer risk because?
it alters levels of hormones that influence cell growth, such as sex hormones, insulin, and several kinds of growth factors.
Fruits and vegetables help reduce?
Fiber-rich diet helps with?
protecting against colon cancer.
A wasting syndrome associated with cancer that is characterized by anorexia, muscle wasting, weight loss and fatigue.
Metabolic changes in Cancer
Elaborate the wasting patients will have increase of protein turn over and reduced protein synthesis. which depletes the body supply of protein.
Anorexia associated with cancer. What are the factors?
-Chronic nauseas and early satiety
-fatigue: Cancer patients feel a lack of energy to prepare and eat meals
-pain: people in pain may have little interest in eating, particularly if eating makes the pain worse.
-mental stress: cancer can cause distress, anxiety and depression
-Effects of cancer therapy: Therapies for cancer can reduce food
Medical nutrition therapy for cancer
The objectives of MNT for cancer patients are to minimize loss of weight and muscle tissue, correct nutrient deficiencies and provide a diet that the patient can tolerate and enjoy.
Appropriate nutrition care for cancer patients
helps patients preserve their strength and improves recovery after stressful cancer treatments.
Malnourished cancer patients..
Develop more complications and have shorter survival times than patients who maintain good nutrition status.
Patients at risk of weight loss and wasting need to focus their nutrition care by making sure what is in their diet?
Protein and energy
Nutrition support is used in limited situations during cancer treatment. Is generally what?
tube feedings and parenteral nutrition are prodded to patients who have long-term or permanent GI impairment or are experiencing complications that interfere with food intake.
Chronic Kidney disease
A kidney disease characterized by gradual, irreversible deterioration of the kidneys.
Chronic kidney disease is also know as?
Chronic renal disease
Drug therapy for chronic kidney disease
Drug therapies help to control some of the complications associated with chronic kidney disease.
Treatment of hypertension is critical for?
slowing down chronic kidney disease progression and reducing cardiovascular disease risk.
Dialysis replaces kidney function by removing excess fluid and wastes from the blood.
the blood is circulated through a dialyzer, where it is bathed by a dialysate. This solution selectively removes fluids and wastes.
the dialysate is infused into a persons peritoneal cavity, and blood is filtered by the peritoneum.
MNT for chronic kidney diease
The patients diet strongly influences disease progression, the development of complications, and serum levels of nitrogenous wastes and electrolytes.
MNT for chronic disease
Because the dietary measures for chronic kidney disease are complex and nutrient needs change frequently during the course of illness. Dietitian specialists in renal disease is best suited to provide MNT.
Energy intake for chronic kidney disease
The energy intake should be high enough to allow patients to main a healthy weight and to prevent wasting. Foods and beverages with a high energy density are typically recommended. Malnourished patients may require oral supplements or tube feedings maintain weight.
Protein in chronic kidney disease
a low-protein diet is usually prescribed to help slow the progression of kidney diseases. However their diet must provide enough protein to meet needs and prevent wasting.
Lips and Chronic Kidney disease
Patients with chronic kidney disease are at increased risk of coronary heart disease and are therefore advised to restrict their intakes of saturated fat, trans fat and cholesterol to help control elevated blood lipids.
Sodium and Fluids, chronic kidney disease
As kidney disease progresses, the patient excretes less urine and cannot handle normal intakes of sodium and fluids. Recommendations depend on the total urine output, changes in body weight, BP and serum sodium levels.
Sodium, Chronic kidney disease
Fluids are not restricted until urine output decrease. For a person who is neither dehydrated nor over hydrated, the daily fluid intake should match the daily urine output.
Dialysis with sodium and fluids
Once a person is on dialysis, sodium and fluid intakes should be controlled so that only about 2 pounds of water weight is gained daily- this excess fluid is then removed during the next dialysis treatment.
Potassium, Chronic kidney disease
Before dialysis treatments begin, most renal patients can handle typical intakes of potassium. Potassium restrictions are usually necessary only in patients with elevated potassium levels.
Dialysis and potassium
Dialysis patients must control potassium intakes to prevent hyperkalemia or, more rarely hypokalemia. Restriction is usually necessary for people treated with hemodialysis, where those undergoing peritoneal dialysis can consume potassium more freely.
Potassium and fresh foods
all fresh foods provide potassium, but some fruits and vegetables contain such high amounts that their regular use is discourages in patients at risk of hyperkalemia.
Calcium, phosphorus and vitamin D, Chronic kidney disease
To prevent bone disease, calcium and phosphorus intakes may need adjustment, even during the early stages of kidney disease.
this can develop in response to simultaneous calcium and vitamin D.
Vitamins and minerals, Chronic kidney disease
The restrictive renal diet interferes with vitamin and mineral intakes, increasing the risk of deficiencies.In addition, patients treated with dialysis lose water-soluble vitamins and some trace minerals into the dialysate.
Enteral and parenteral nutrition, chronic kidney disease
Enteral and parenteral nutrition support can provide nutrients to renal patients who cannot consume adequate amounts of food. The eternal formulas suitable for chronic kidney disease are more calorically dense and have lower protein and electrolyte concentration that standard formulas
Intradialytic parenteral nutrition
The infusion of nutrients during hemodialysis, often providing amino acids, dextrose, lipids and some trace minerals.
a preferred alternative to dialysis in patients with end-stage renal disease is kidney transplantation. A successful kidney transplant restores kidney function, allows a more liberal diet, and frees the patient from routine dialysis. Many patients would prefer transplants, but the demand for suitable kidneys for exceeds the supply.
Treatment of acute kidney injury
treatment of acute kidney injury involves a combination of drug therapy, dialysis, and medical nutrition therapy to restore fluid and electrolyte balances and minimize blood concentrations of toxic waste products. Both medical care and dietary recommendations are highly individualized to suit each patients needs.
Drug treatment in acute kidney injury
Because kidney function is required for drug excretion, patients may need to use lower doses of their usual medications to compensate for limited urine output.
Medications when you have acute kidney injury
The medications prescribed for acute kidney injury depend on the underlying cause of illness and the complications that develop.
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