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Nutrition/Diabetes
Nursing 100 Exam: nutrition and diabetes
| Question | Answer |
|---|---|
| What are the four layers of the intestine from inner layer to outer layer? | Mucosa, Submucosa, Musularis, and Serosa |
| How does the autonomic parasympathetic nervous system effect digestion? | Parasympathetic increases digestive secretions and gastric motility |
| When does the cephalic phase of digestion begin? | as soon as you see or smell food |
| What is the name of the sphincter that goes from the esophagus into the stomach? | Esophageal Sphincter |
| What is the name of the sphincter that goes from the stomach into the small intestine? | Pyloric Sphincter |
| What organ produces insulin? | Beta-cells in the Pancreas |
| What are the two main digestive functions of the pancreas? | Exocrine: secrete enzymes for digestion Endocrine: produce insulin using beta-cells |
| What are the three parts of the small intestine in order? | Duodenum, Jejunum, and Ileum |
| What is the main function of the small intestine? | Nutrient absorption |
| What are the six parts of the large intestine in order? | ascending colon, transverse colon, descending colon, sigmoid, anal canal, and rectum |
| What are the primary functions of the large intestine? | Water absorption and elimination |
| What is the difference between and endoscopy and colonoscopy? | Endoscopy: enter through the mouth; examines esophagus and stomach Colonoscopy: enter through the rectum; examines large and small intestines |
| What four methods should you use to assess a patient's abdomen in order from first to last? | Inspect, Ausculate, Percuss, and Palpate |
| Which essential nutrient is composed of carbon, hydrogen, and oxygen, and can be simple or complex? | Carbohydrates = 4 kcal/g |
| Which essential nutrient is composed of carbon, hydrogen, an oxygen, and is insoluble in water? | Lipids = 9 kcal/g |
| Which essential nutrient is composed of carbon, hydrogen, oxygen, and nitrogen, and is made up of amino acids? | Proteins = 4 kcal/g |
| What enzyme helps break down carbs? | Ptyalin -- present in saliva |
| How are excess carbs stored and where? | Glycogen in the liver |
| What is the name for the process of glycogen formation? | Glycogenesis |
| What is the difference between essential and nonessential amino acids? | Essential amino acids must be consumed by the body; Nonessential amino acids can be manufactered by the body |
| What is the difference between anabolism and catabolism? | anabolism: building protein catabolism: breaking down protein |
| What kind of lipid is solid at room temp? | Fats -- mainly saturated lipids |
| What kind of lipid is liquid at room temp? | Oils -- mainly unsaturated lipids |
| What composes a triglyceride lipid? | Three Fatty Acids |
| Cholesterol is a lipid. Where is cholesterol produced? | Liver |
| Where is bile produced and what is it's purpose? | Produced in the Gall Bladder Helps to digest lipids |
| What is the most basic nutrient for humans? | Water |
| What is the difference between fat soluble and water soluble vitamins? | fat soluble vitamins can be stored by the body water soluble vitamins are needed through diet |
| This vitamin is an antioxidant and promotes healthy vision and skin | Vitamin A |
| This vitamin helps with blood clotting and is found in leafy green veggies | Vitamin K |
| This vitamin helps with calcium and phosphorus absorption and usage | Vitamin D |
| This vitamin is an antioxidant and promotes healing and iron absorption | Vitamin C |
| This vitamin is an antioxidant that protects cell membranes and aids in RBC formation | Vitamin E |
| What is the primary function of B vitamins | metabolism |
| Which B vitamin metabolizes proteins? | B2 Riboflavin |
| Which B vitamin metabolizes carbs? | B1 Thiamine |
| Which B vitamin aids with hemoglobin production? | B12 Cobalamin |
| What is pernicious anemia and what causes it? | low blood oxygen levels due to a vitamin B12 deficiency |
| This mineral is used for bone formation and energy | Calcium |
| This mineral is important for water balance, metabolic reactions, and should NEVER be crushed, chewed, or given IV push | Potassium |
| The rate that the body metabolizes food to maintain body requirements at rest | Basal Metabolic Rate |
| The amount of energy required to maintain basic body function to survive | Resting Energy Expenditure Males: 1 cal/kg/hr Females: 0.9 cal/kg/hr |
| Explain the Rule of 5 | used to predict ideal body weight for females 105 lb for 5 ft tall, add 5 lb for each inch over 5 ft tall |
| Explain the Rule of 6 | used to predict ideal body weight for males 106 lb for 5 ft tall, add 6 lb for each inch over 5 ft tall |
| What is the formula for calculating BMI? | Weight in kg __________________ Height in meters |
| What does a BMI of 32 indicate? | Obesity Range 30.3 - 34.9 |
| What does a BMI of 18 indicate? | Underweight Below 18.5 |
| What does a BMI of 26 indicate? | Overweight Range 25 - 29.9 |
| What does a BMI of 19 indicate? | Normal Range 18.5 - 24.9 |
| What does a BMI of 43 indicate? | Extreme Obesity Over 40 |
| The most common weight loss surgery for obese patients | Adjustable Gastric Band |
| This can be caused by poor eating habits or a malabsorption problem | Malnutrition |
| What are the two types of eating disorders and what are the differences between them? | Anorexia: self-imposed starvation Bulimia: cycles of binge eating and purging |
| What is the normal value for serum albumin? | 3.5 - 5 g/dL this will be low if pt is malnurished |
| What is the normal value for lymphocytes? | 25% - 35% this will be low if pt is malnurished |
| What is the normal for electrolyte potassium? | 3.5 - 5.3 mEq/L this will be low if pt is malnurished |
| What is the normal for pre-albumin? | 17 - 40 mg/dL this will be low if pt is malnurished |
| Describe GERD | inappropriate relaxation of the esophageal sphincter which allows gastric secretions into the esophagus and irritates and damages the tissues |
| List 4 signs and symptoms of GERD | dyspepsia: heart burn regurgitation, hyper-salvation dysphagia: difficulty swallowing Odynophagia: painful swallowing |
| A GERD complication caused by esophageal damage that increases your risk for esophageal cancer | Barrett's Esophagus |
| A GERD complication caused by scar tissue, edema, and spasms and can lead to dysphagia | Esophageal Strictures |
| A GERD complication indicated by red, easily torn tissues with ulcers present | Erosive Esophagitis |
| What are four different types of medication used to treat GERD? | antacids, proton pump inhibitors, histamine2-receptor blockers, promotility agents |
| When part of the stomach protrudes through the esophageal hiatus of the diaphragm into the thorax | Hiatal Hernia |
| What are the differences between a rolling and sliding hiatal hernia? | rolling: heartburn, dysphagia, belching, regurgitation; needs surgical intervention Sliding: SOB after meals, feelings of suffocation, chest pain; cannot be managed surgically |
| The type of diabetes where no insulin is produced and is typically diagnosed during childhood | Type I Diabetes |
| The type of diabetes where cells may be insulin resistant or not enough insulin is being produced, the risk for occurrence increases with age and obesity | Type II Diabetes |
| Where is insulin normally produced? | Pancreas |
| What are the three types of cells in the pancreas and what do they produce? | Aplha: produces glucagon, breaks down glycogen stores in liver Beta: secretes insulin Delta: produces somatostatin |
| What is the function of somatostatin? | controls production of glucagon and insulin; slows intestines for nutrient absorption |
| What are the four major functions of glucagon? | Decrease glucose oxidation to utilize glucose for energy Increase blood glucose levels to keep it from falling below 70 Glycogenolysis: break down glycogen Gluconeogenesis: formation of glucose from fats and proteins |
| All tissues require gluce, but not all tissues require insulin for glucose uptake. Name three tissues that don't require insulin. | brain, intestines, liver, and renal tubules muscles' insulin uptake increases with activity |
| How does stress affect blood glucose levels? | Stress INCREASES blood glucose levels |
| What are the three P's of Type I diabetes? | Polyuria: frequent urination Polydipsia: frequent thirst/ dehydration Polyphagia frequent hunger |
| What is ketosis caused by? | Due to lack of insulin, glucose cannot be utilized in the body. The body begins to break down fats for energy use and releases ketones into the blood. |
| This type of diabetes is slow and progressive and typically causes some damage to small and large blood vessels before it is diagnosed | Type II Diabetes |
| What are some manifestation of Type II diabetes? | polyuria, polypepsia, blurred vision, fatigue, and skin infections |
| Should a patient with a fasting blood glucose of 105 mg/dL be diagnosed with Type II diabetes? | No, a fasting blood glucose over 126 mg/dL may indicate diabetes |
| What are some symptoms of diabetes in elderly patients? | urinary incontinence, decreased thirst and hunger, fatigue, weight loss, hypoglycemia, peripheral neuropathy, peripheral vascular disease, diabetic retinopathy, HTN, pain |
| Should a patient with a casual blood glucose of 340 mg/dL be considered for a diabetic diagnoses? | Yes, a casual blood glucose over 200 mg/dL with symptoms of diabetes indicates diabetes |
| What does the HGB A1C test look at? | The amount of glycosylated HGB (HGB coated with sugar) This test is a good measure of how well blood sugar is being managed over a 2-3 month period |
| A patient's HGB A1C test results came back as 6%, what does this indicate? | This patient is at high risk for developing diabetes Diabetic diagnoses = 6.5% or higher High risk for diabetes = 5.7%-6.49% |
| What are the three things that make up the triangle for diabetic management? | Diet, Medication, and Exercise |
| When are some times that diabetics should monitor their blood glucose? | Before and after meals, in the morning, before bed, during pregnancy, whenever they're sick |
| How does hemocrit affect blood glucose readings? | When HCT is high, blood glucose reads low When HCT is low, blood glucose reads high |
| Which type of diabetes is referred to as insulin-dependent diabetes? | Type I |
| Rapid Acting Insulin | Lispro Insulin Onset: 15 minutes Peak: 1-1.5 hrs Duration: 3-5 hrs |
| Short-Acting Insulin | Regular Insulin Onset: 30-60 minutes Peak: 2-3 hrs Duration: 4-6 hrs |
| Intermediate-Acting Insulin | NPH Insulin Onset: 2 hrs Peak: 6-8 hrs Duration: 12-16 hrs |
| Long-Acting Insulin | Lantus Duration: 24 hrs |
| Combination Insulin | Usually NPH and Regular Insulin Onset: 30 minutes Peak: 3-8 hrs Duration: 24 hrs |
| What concentration does insulin commonly come in? | 100 units/mL |
| What are the routes for insulin administration? | SQ injection IV injection IM injection in emergencies Insulin pumps: continuous SQ infusion |
| Remember that insulin injection sites must be rotated. Insulin can cause tissue damage that leads to insulin malabsorption if you don't rotate sites. What are three types of tissue damage caused by insulin injections? | Lipodystrophy: tissues swell Lipatrophy: tissues start to die Hypersensitivity: rash or skin irritation |
| This diabetic medication increases insulin production and sensitivity in type II diabetics | sulfonylureas eg. Amaryl, Diabeta |
| This diabetic medication stimulates the pancreas in type II diabetics | meglitinides eg. Prandin |
| This medication reduces glucose production in the liver | biguanides eg. metformin |
| This medication slows the digestion of glucose in the small intestine | alpha-glucosidase inhibitors eg. precose, glyset |
| This medication stimulates rapid and short insulin secretion and decreases glucose spikes to lower blood glucose levels | phenylalanine derivative eg. starlix, prandin |
| What should the diet of a diabetic patient consist of? | 45-65% Carbs 15-20% Protein <10% Fats 20-35 g Fiber <3000 mg sodium |
| How does alcohol affect blood glucose? | Alcohol potentiates HYPOglycemia |
| Every ONE serving of fruit, dairy, bread, and starch and Every TWO serving of vegetables has how many grams of carbs? | 10-15 grams of carbs |
| How many units of regular insulin should be given to a patient who has consumed 60 grams of carbs? | 4-6 units 1 unit of regular insulin should be given for every 10-15 grams of carbs consumed |
| What is the Dawn Phenomenon? | Blood glucose spikes between 4am and 8am |
| What is the Somogyi Phenomenon? | Blood glucose drops at night but rebounds in the morning |
| A patient has a blood sugar of 45, what signs and symptoms would you expect to see? | hunger, irritability, shakiness, headache, nausea, tachycardia, restlessness, slurred speech, decreased cognition, risk for seizures, risk for diabetic coma, and risk for death |
| What blood glucose reading would indicate hypoglycemia? | Less than 70 mg/dL |
| What is the most common cause of death among diabetic patients? | Coronary Artery Disease |
| What is a chronic diabetic complication that can lead to amputations? | Peripheral Vascular Disease |
| What is diabetic retinopathy? | eye damage |
| What is diabetic nephropathy? | kidney damage |
| What is diabetic neuropathy? | nerve damage |
| Why are diabetic feet treated with such care? | Due to diabetic neuropathy, diabetics may loose sensation to their feet and may not be able to feel damage to their feet. They should inspect their feet daily, make sure they have proper fitting shoes, and see their physician for foot care. |
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