MNT Pt 2

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Across
  1. 6. due to low fiber intake(recommend fiber supplements due to having poor appetite and early satiety) or fatty foods, high-carb & sugar alcohol foods, caffeine, and dairy items (find replacements or add supplements that thicken stool consistency --> banana flakes, apple powder) with fluid balance restoration
  2. 7. inflammation, irritation, and ulceration of the GI tract including the oral cavity and esophagus (causes oral lesions, erythema, xerostomia, or candidiasis, dysphagia, odynophagia)& treated with neasy-to-chew foods.ft, moist, and easy-to-chew foods, avoiding acidic and spicy foods and alcohol, and maintaining good oral care
  3. 9. caused by defect in this kind of branching enzyme which causes this to be stored in abnormal forms in the liver, muscle, and other tissues; symptoms: failure-to-thrive and hepatosplenomegaly(aka Andersen disease)
  4. 11. umbrella term for malnutrition from poor intake of protein/calories
  5. 16. prevent or reduce micronutrient deficiencies, preserve lean body mass and prevent weight loss, minimize effect of nutritional impact symptoms, enhance immune function by decrease risk of infection, maximize quality of life, independence, and ability to perform ADLs through use of food as comfort and improving nutritional status, inform patients regarding alternative and complementary diets using active listening and a nonjudgmental approach
  6. 18. mild-moderate inflammation due to this, and may have increased energy/nutrient needs with/out reduced intake
  7. 20. autosomal recessive disorder resulting from a defect from the branched chain α-ketoacid dehydrogenase enzyme complex which leads to acidosis, seizure, coma, and death and is treated with PD and hydration(aka branched-chain ketoaciduria)
  8. 22. distressing and persistent (may be physical, emotional, and/or cognitive) and interferes with usual functioning; recommend nutrition interventions that include ready-to-serve items or foods with minimal preparation, energy dense foods that are easy to chew, and small frequent meals and snacks; *largest meal should be eaten when both energy and appetite are at the best with snacks and beverages should be easily accessible
  9. 23. taste alterations that are either poor/little or metallic taste; treated with sour sauces, salt, lemon juice (for too sweet tastes), eating with chopsticks or plastic utensils (for metallic tastes), marinating meat in sweet juice or eating other types of meat like poultry, fish, or vegetarian protein (for bitter tastes)
  10. 24. smell alterations that sauses food aversions and treated with cold foods or drinking from a covered cup with a straw to mask beverage smells
  11. 26. mucositis of the mouth and lips
  12. 27. blood condition resulting from insufficient healthy RBC (due to size, number, or amount of hemoglobin)
  13. 28. characterized by high levels or organic acids in the urine and high plasma ammonia levels mostly caused by a defect in methylmalonyl-CoA mutase apoenzyme treated with specialty formulas and pharmacological doses of vitamin B12 --> cofactor of methylmalonyl-CoA mutase (common in infants)
  14. 31. ageusia, anemias, anorexia, capillary leak syndrome, constipation, dehydration, diarrhea, dysgeusia, dysosmia, dysphagia, early satiety, electrolyte imbalances, esophagitis, fatigue, fluid retention, headache, hepatic toxicity, leukopenia, malabsorption, mucositis, myalgia, nausea/vomiting, neuropathy, neutropenia, pain, renal toxicity, stomatitis, thrombocytopenia, weight loss, xerostomia
  15. 34. viral infection that leads to immune system dysfunction
  16. 36. fatty acid oxidation disorder which can be presented with hypoglycemia but no urinary ketones, symptoms: episodic vomiting, hypotonia, failure to thrive; treatment is avoidance of fasting and low-fat diet
  17. 39. protein metabolism disorder resulting in increase of PHE in the blood due to this hydroxylase gene that catalyzes PHE to tyrosine; MNT goals: daily PHE restriction through use of medical PHE-free formula, low-PHE foods, and ensuring adequate energy, protein, and micronutrient intake; nutrition therapy: total energy and protein intake and percentages of them, tyrosine, calcium, and iron iontake from formula and medical foods
  18. 44. deficiency of both protein and energy with wasted appearance and depresses somatic and visceral protein stores, leads to growth retardation, low BMI/body weight, treated through stabilization and resuscitation (common in adults & children)
  19. 46. caused by defect in glycogen debranching enzyme; symptoms: similar to GSD1 with ketonemia if fasting; treatment: small frequent feedings of complex carbohydrates and protein to prevent fasting or continuous enteral feeds for overnight(aka Cori/Forbes disease)
  20. 47. used to advance evidence-based malnutrition care across the US (collaboration between AND, Avelere Health, and other stakeholders
  21. 48. no inflammation, caused by environmental or knowledge and beliefs
Down
  1. 1. chemotherapy, hormonal therapy, biotherapies, radiation therapy, stem cell transplant, surgery
  2. 2. restoration and maintenance of nutritional stores, achieve healthy body weight and body composition, support medication treatment goals while controlling/reducing symptoms, prevent or delay advancement of HIV disease and onset of comorbidities(e.g. cardiovascular disease, diabetes), provide nutrition education related to food and water safety particularly those with low CD4 cell counts, assess barriers to adequate and appropriate food intake and refer to relevant resources (e.g. food banks, meal delivery)
  3. 3. negative iron balance (that affects the body from making hemoglobin), treated with ferrous iron (ferrous sulfate) and education on dietary sources of iron and ways to increase iron absorption
  4. 4. anorexia and weight loss of both muscle and fat tissue; most common in patients with solid tumors, GI tract cancers, and advanced cancers; nutrition interventions typically improves appetite, increase intake, and better sense of well-being rather than underlying causes of this condition or curing cancer
  5. 5. energy: 25-30 kcal/kg (non-ambulatory, sedentary), 30-35 kcal/kg (hypermetabolic, weight gain, anabolic, 1st month after stem cell transplant), ≥35 kcal/kg (severely stressed, acute graft-vs-host disease, during head & neck chemoradiation, malabsorption); Protein: 1–1.2 g/kg (non-stressed with cancer), 1.2 –1.5 g/kg (undergoing treatment), 1.5 –2 g/kg (stem cell transplant), 1.5 –2.5 g/kg (increased protein needs [e.g. enteropathy or wasting]
  6. 8. amino acid disorder caused by a defect in the fumarylacetoacetate hydrolase enzyme in infants, symptoms: vomiting, acidosis, failure to thrive; treatment includes low-protein diet and specialty formulas without tyrosine, phenylalanine, and methionine
  7. 10. affects a patient's ability to digest sucrose and maltose; symptoms: stomach cramps, bloating, gas, and/or diarrhea; treatment: diet modification to reduce sucrose & maltose or sacrosidase (oral medication) while monitoring blood glucose levels (common in infants moving from formula/breastmilk to fruits, juices, grains)
  8. 12. autosomal recessive disorder with altered function of glucose-6-phosphatase enzyme which results in excess amounts of glycogen and fat storage in the liver and kidneys; symptoms: poor growth, hypoglycemia (leads to poor growth, muscle weakness, brain dysfunction), hepatomegaly, and downstream effects of poor glycogen metabolism; treatment: diet low in lactose, fructose, sucrose, fat, and high in complex carbohydrates (with cornstarch supplements),and avoid fasting (aka von Gierke)
  9. 13. increased energy/nutrient needs due to high level of systemic inflammatory response, poor intake, and/or altered GI function
  10. 14. urea cycle metabolism with a deficiency in the enzyme argininosuccinic acid synthetase resulting in high levels of citrulline in the blood, symptoms: seizure, coma, poor feeding,
  11. 15. inadequate intake/utilization in infants, children, and elderly
  12. 17. caused by this mineral; symptoms: reduced sense of taste, diarrhea, treated with oral folate (with caution) and consume 1 serving of uncooked fruits or vegetables per day and/or fortified foods
  13. 19. anorexia/cachexia, fatigue, constipation/diarrhea, mucositis/stomatitis, nausea/vomiting, neutropenia, dysgeusia/dysosmia, xerostomia
  14. 21. fewer RBCs due to decrease in oxygenation needs without change in blood volume and low RBC hemoglobin content(aka protein-energy malnutrition/protein deficiency)
  15. 25. vitamin B12 and/or folate deficiency; symptoms: fatigue, pale skin, lethargy, dyspnea, dizziness, headaches, sore/red tongue, palpitations, depression, poor appetite and weight loss, forgetfulness,
  16. 29. increase in blood volume = lower concentration of RBC (check on their typical food intake to ensure increased iron requirements are met
  17. 30. low count of these and classifies patients as a 'vulnerable population' for food safety; increases risk of serious life-threatening infections when coupled with impairment of other protective barriers such as the skin, GI tract, and other aspects of the immune system; educate them on food safety (good handwashing practices, proper cooking and storage, avoiding raw/undercooked/unpasteurized/aged foods
  18. 32. depends on the cause and severity, anti-emetics prescribed by physician, treated with low-fat, non-odorous foods and frequent small amounts of dry food (or transitioning from clear liquid to bland foods if vomiting is controlled)
  19. 33. maintain energy balance, protein dependent on acute infection, fluid dependent on fever, vomiting, and dehydration, some fat, fiber, and exercise to manage hyperlipidemia, lipodystrophy, and promote insulin sensitivity (focused mostly on high-quality complete diet)
  20. 35. mucositis of the esophagus
  21. 37. where patients nearing end of life are placed in comfort care (without curative treatment) to provide comfort and support to patients and families when life-limiting illness no longer responds to cure-oriented treatments
  22. 38. caused by vitamin B12 deficiency; symptoms: paresthesia, poor coordination, disturbed vision, hallucinations, treated with intramuscular or subcutaneous vitamin B12 injection, high protein diet after medical treatment, or vitamin b12 supplement/foritifed cereals for older adults
  23. 40. completion of malnutrition screen within 24 hours of admission, completion of nutrition assessment for patients identified as “at risk” within 24 hours of screening, nutrition care plan for patients identified as “malnourished” after a complete nutrition assessment, appropriate documentation of a malnutrition diagnosis
  24. 41. carbohydrate metabolism disorder in newborns presented as seizures and sepsis, symptoms: vomiting, diarrhea, lethargy, failure-to-thrive, jaundice; treatment: soy formula
  25. 42. protein-deficiency malnutrition when patient consumes sufficiewnt energy, but insufficient protein, symptoms: pitting peripheral edema, abdominal distension, rounded face, anorexia; treated by preventing/reducing electrolyte imbalances using ReSoMal and starting feeding (very common in weaning children)
  26. 43. where patients nearing end of life are placed in comfort care (around the same time as curative treatment)for pain and symptom relief
  27. 45. dry mouth syndrome common in patients with head and neck cancer receiving radiation therapy (symptoms: cheilosis, tongue furrows, halitosis, food debris sticking to oral cavity, candidiasis, erythema, thick/ropy saliva, and dehydration) and treated with increasing fluid intake when eating, alternating eating with sips of liquid, soft and moist foods, limiting coffee, tea, or alcohol, good oral care, adding sauces to moisten foods, chewing sugarless gum or sucking on hard candy to stimulate saliva