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Nutrition 222 Lecture 17
Terms in this set (63)
What is the stress response?
The body's non specific response to a variety of stressors; this depends on what the stressor is.
What are types of stressors?
Infections, burns, fractures, surgery, etc.
What does the body do in a stress response?
It focuses on immediate survival.
What happens to nutrients during stress response?
Nutrients are mobilized from storage to build up damage tissue.
What happens to heart rate & respiration during stress response?
Heart rate & respiration increase.
What happens to blood pressure in stress response?
Blood pressure rises.
What are catecholamines?
Epinephrine & norepinephrine; fight or flight hormones; these hormones are released in response to danger & stimulate the heart rate, raise blood pressure & raise basal metabolism.
This stimulates glycogen breakdown in the liver so it stimulates glucose production; it releases fatty acids from adipose tissue.
Steroid hormone that induces protein degradation. It enhances glucagon's action on liver glycogen.
This is a hormone that reabsorbs sodium in the kidneys.
What are antidiuretic hormones?
What does inflammation serve to do?
It contains & destroys the potential for infection. To immediately survive, the bacteria on say a splinter must be destroyed.
What is the first step of the inflammatory response?
Arteries dilate (release oxygen) & venules constrict.
Very small blood vessel in the microcirculation that allows blood to return from the capillary beds to drain into the larger blood vessels.
Why does swelling occur in the inflammatory response?
Bc blood plasma is released from the arteries at the site of puncture.
Immune cells that engulf bacteria & disable them with hydrolytic enzymes & reactive forms of oxygen.
Symptoms of Inflammatory Response
3. Heat production
What happens if inflammation becomes chronic?
Phagocytes will begin to damage tissues. Also, plaque formation occurs at inflammatory site.
What are interventions for acute stress?
1. Restore fluids & electrolytes
2. Remove underlying stressor
3. Treat infections
4. Repair wounds
5. Drain abscesses
6. Remove dead tissue
What are the 2 problems that can occur?
1. Hypermetabolism & negative nitrogen balance.
2. Hyperglycemia & insulin resistance
Hypermetabolism & Negative nitrogen balance
Metabolism increases because body draws on nutrient stores to induce healing. However, lots of protein is being lost bc tissue is dying.
Hyperglycemia & Insulin resistance
Glucose is really high in the blood due to insulin resistance; increased risk of infection.
What dietary goals are there?
1. Preserve lean tissue
2. Maintain the immune defense
3. Go on diet that promotes healing
4. Balance overfeeding & underfeeding
Why not overfeed when one has a stressor?
This leads to hyperglycemia; this increases the risk of refeeding syndrome.
Consisting of metabolic disturbances that occur as a result of reinstitution of nutrition to patients who are starved or severely malnourished.
This causes a negative nitrogen balance bc you're already breaking down lean tissue & now that you're underfeeding, MORE lean tissue will be broken down, making you lose nitrogen.
A condition in which an excessive amount of glucose circulates in the blood plasma.
How to calculate energy requirements:
1. Calculate resting metabolic rate & multiplying by stress factor.
Estimating protein requirement?
.8 g/kg of protein/day.
Undergoing stress: 1.2-2 g/kg per day.
50-60% of calories should come from carbs. However, if person has hyperglycemia (high blood glucose) than 50% of calories should come from lipids.
Vitamins & Minerals Requirements
Increased needs for these
Reduced oxygen or increase CO2; leads to labored breathing.
Body changing the breathing pattern in an effort to remove excess CO2; may cause individual to work harder to breathe, thus requiring more energy; can lead to malnutrition & weight loss.
Chronic Obstructive Pulmonary Disease (COPD)
Chronic bronchitis & emphysema; 2 types of respiratory stress
Symptom of chronic bronchitis?
Productive cough that lasts for 3 years
Characterized by gradual destruction of the walls separating alveoli & reduced lung elasticity; your lung stretches out when air comes in, but w/o elasticity, you can't take deep breaths.
Characterized by inflammation, excessive secretion of mucus, & narrowing of the bronchi, these are the factors that reduce normal airflow.
Shortness of breath
What can COPD lead to?
Full respiratory failure & heart failure
Causes of COPD?
2. Chronic respiratory infections
3. Occupation exposure to dust or chemicals that damage lung tissue.
4. Genetic susceptibility
Goals for treating COPD?
1. Improve food intake
2. Maintain healthy weight
3. Prevent muscle loss & improve exercise endurance
Treatment for COPD?
1. Small, frequent meals
2. Adequate fluids
3. Liquid supplements
4. Exercise plan
What is respiratory failure?
Gas exchange between air & blood is greatly impaired.
Causes of Respiratory Failure
1. Aspiration of stomach contents
2. Neuromuscular disorders
3. Smoke inhalation
4. Airway obstruction
5. Physical trauma
Fluid in the lung due to an infection.
Low oxygen in the blood.
Excessive CO2 in the blood
Low oxygen in the body tissue
Acid accumulation in bodily tissues; direct result of hypoxia; this alters functions of CNS.
Blue tint of the skin; has to do with many imbalances in the body.
Consequences of respiratory failure
Acute Respiratory Distress Syndrome
When one must go on a breathing machine to restore normal O2/CO2 levels; leads to multiple organ dysfunction syndrome; lung inflammation.
Treatment of respiratory failure
1. Support lung function
2. Carefully monitor fluid
Nutritional Treatment of Respiratory Failure
Energy: make sure you're not overfeeding
Protein: 1-1.5 g/kg body weight per day (healthy: .8 g per day)
Chronic Obstructive Lung Disease
The condition of altered airflow through the lungs, generally caused by airway obstruction as a result of mucus production; does NOT need a machine to help breathe like ARDS
Fortification for Nutrition Care?
Since reactive oxygen species are formed, antioxidants & omega-3 fatty acids should be introduced into the diet to deal with inflammation.
Multiple Organ Dysfunction Syndrome (MODS)
A failure of 2 or more organ systems.
What organs fail in MODS?
4. GI tract
Causes of MODS?
Once inflammatory response spreads through body, it leads to SIRS or sepsis. This leads to shock & eventually MODS
Symptoms of SIRS & sepsis?
1. Elevated respiratory rate
2. Elevated heart rate
3. Abnormal body temperature
4. Abnormal white blood cell count
Whole body inflammation caused by an infection (type of sepsis).
Systematic Inflammatory Response Syndrome (SIRS)
Clinical response to infection or trauma that leads to systemic inflammation
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