MNT Pt 4

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Across
  1. 2. increase caloric and fat intake through high-calorie and high-fat foods and nutrition supplements, supplement oral intake with enteral nutrition if BMI <19 kg/m2or <10th percentile [calorically dense formula >1kcal/mL with pancreatic enzyme replacement, or semi-elemental formula], provide patient education on meeting increased nutritional requirements, correcting or preventing nutritional deficiencies, and compensating for increased losses of fat and salt
  2. 4. energy: estimate with Mifflin-St. Jeor using dry weight + 20% (some patients may require 30 –35 kcal/kg), protein: 1–1.2 g/kg, end-stage liver disease may require food restrictions
  3. 5. cerebrovascular accidents (hemorrhagic, ischemic, TIA --> "mini-_____")
  4. 8. energy: use indirect calorimetry when possible, particularly for patients with obesity, shock, multiple organ failure, and/or mechanical ventilation, increased energy and protein needs with moderate–severe pancreatitis; energy: 25 –35 kcal/kg, protein: 1.2 –1.5 g/kg, early enteral nutrition (within 48 hrs) for severe acute pancreatitis or those with significant malnutrition or with inadequate oral intake for 5-7 days
  5. 10. poor appetite, jaundice, ascites, edema, nausea, weight loss
  6. 15. defined by eGFR in 5 stages (I = ≥90, II = 60-89, IIIa = 45-59, IIIb = 30-44, IV = 15-29, V = <15); symptoms: cachexia due to uremia and/or malnutrition, sarcopenic obesity, bone pain or injuries, cardiovascular abnormalities (dyspnea, bradypnea or tachypnea, bradycardia or tachycardia, fluid retention --> heart failure), poor appetite, early satiety, diarrhea, constipation, abdominal pain and/or bloating, heartburn, nausea, and vomiting; treatment: EPO-stimulating agents, oral or IV iron, iron-based phosphate binders, other iron-related medications, low-potassium and low-phosphorus diet, vitamin D supplementation, restriction of protein during CKD stage 3+, higher if on dialysis
  7. 19. lack of blood flow to the brain due to embolus/thrombus; risk factors: same as risk factors for cardiovascular disease, including hypertension, diabetes, smoking, and dyslipidemia; special attention to patients taking warfarin (education on vitamin K)
  8. 24. liver function deteriorates as scarring increases, liver shrinks and hardens leading to portal hypertension
  9. 26. assess for conditional contraindications to a ketogenic diet and discuss with interdisciplinary team, provide detailed nutrition education on a classic or modified ketogenic diet if agreed to by team and patient, provide nutrition education on the risks of ketogenic diet therapy and how to reduce risks, use self-monitoring data to monitor blood glucose readings and hunger levels, monitor weight gain and linear growth in children and adolescents, discuss micronutrient supplementation regimen
  10. 28. caused by alcohol toxicity, infection (hepatitis A, B, C, D, E), medications, fatty ____; symptoms: loss of appetite, early satiety (particularly with ascites), fatigue, nausea, vomiting, abdominal pain, food restrictions; treated with 4-6 small frequent feedings including a bedtime snack (promote adequate energy and protein intake and minimize loss of lean body mass), <2000 mg sodium, <30% energy as fat (steatorrhea), food and fluid restrictions
  11. 30. presence of calculi in the urinary tract; risk factors: high sodium intake, high oxalate intake, high animal protein intake, low calcium intake, low fluid intake, history of UTIs, gout, obesity, bowel disease, sedentary lifestyle, restricted eating patterns or eating disorders, chronic diarrhea due to malabsorption or short bowel syndrome, excessive vitamin C consumption, and history of these; treated with nutrition education of both _____ and other nutrition diseases (aka urolithiasis)
  12. 31. treatment for patients with AKI who are hemodynamically unstable (bedside dialysis)
  13. 33. when BMI is ≥ 30 and waist circumference is ≥35 --> women and ≥40 --> men; BMI only doesn't define _____, since fat mass and lean mass is indistinguishable when calculating BMI; treating with reduced calorie diet, individualized physical activity goals, meal substitutes, food label reading, and bariatric surgery (last resort)
  14. 34. comprehensive weight management program including diet, physical activity, and behavior therapy, MNT for at least 6 months or until weight loss goals are achieved with weight maintenance program afterwards
  15. 35. injury to normal liver results in chronic inflammation; injury can include damage from alcohol, infection (like ________ viruses), nonalcoholic fatty liver disease, or metabolic disorders (genetic disorders, or autoimmune disorders)
  16. 36. lung inflammation caused by bacteria or viruses; symptoms: cough, chest pain, fever, dyspnea, poor appetite, nausea/vomiting; treated with oral antibiotics, rest, fluids, small, frequent meals/snacks and foods that are easy-to-chew, swallow, and digest, EN (if patient's respiratory function is deteriorating/on mechanical intubation or ventilation)
  17. 37. most common treatment for CKD, using machines with pumps, special membranes, and built-in safeguards to protect the patient from air bubbles, blood removed from body --> "cleaned" in dialyzer --> returned to body
  18. 38. acute or chronic; risk factors: acute--> gallbladder disease, alcoholism, obesity, chronic --> cystic fibrosis, hypertriglyceridemia, hypercalcemia, renal failure, and infection; treatment: prevent weight loss and maintain nutritional status (acute), replenish any nutritional deficiencies and encouraging avoidance of exacerbating factors --> alcohol and excessive fat intake (recovery); mild to moderate should be NPO then progress to a tolerated oral diet, early EN if patient have inadequate oral intake for 5-7 days
  19. 39. energy: for weight maintenance or weight loss if overweight or obese, fat: healthful, unsaturated fat sources
  20. 41. address preoperative and postoperative nutrition needs, provide nutrition education related to postoperative bariatric diet, prevent or correct micronutrient deficiencies
  21. 42. ketogenic diet if indicated (have family complete a 3-day diet record before starting ketogenic diet therapy and use to determine daily calorie requirements along with RDAs for age and weight)
  22. 43. energy: 25 –35 kcal/kg, protein: 1–1.5g pro/kg(1.6–2 g/kg if septic), monitor UUN levels, avoid overfeeding
Down
  1. 1. flu-like symptoms, fatigue, dark urine, abdominalpain, poor appetite, jaundice, weight loss, acholic stool (pale stool due to lack of bile)
  2. 3. individualize approach with goal of losing up to 10% of initial weight in first 6 months, basing energy needs on indirect calorimetry or Mifflin-St. Jeor using actual weight, provide nutrition education on portion control, food selection, reading labels, recipe modification, and discourage extremes and fad diets
  3. 6. removes 80% of the stomach leaving a “banana-shaped” pouch (restrictive)
  4. 7. infusing dialysate through a patient's _______ through a surgically placed catheter, draws excess fluid and toxins from the body into the dialysate and discarded, can be done manually during the day or with a machine at night
  5. 9. creates a stomach pouch ~ size of an egg and creates a roux limb of the small intestine to bypass a large portion of the small intestine (restrictive & malabsorptive) (aka gastric bypass)
  6. 11. energy and protein: increased (~1.2-2x DRI), fat-soluble vitamins, zinc supplementation, monitor growth in children and adolescents –some CF patients may have normal growth with RDA for calories and protein, energy needs may increase during exacerbation but may be offset by reduced activity level
  7. 12. absolute increase in serum creatinine of at least 0.3 mg/dL, a percentage increase in serum creatinine of 50% or more, or documented oliguria <0.5 mL/kg/h for >6 hours; energy and protein requirements increase with the degree of catabolism and with treatment (hemodialysis or continuous renal replacement therapy)
  8. 13. portal hypertension, esophageal varices, spider angiomas, confusion, jaundice, poor appetite, ascites, edema, nausea, weight loss, gastritis, pancreatitis
  9. 14. removes part of the stomach and attaches the remnant stomach to the ileum, with the rest of the small intestine used to pass pancreatic and bile juices (restrictive & malabsorptive)
  10. 16. most common form of dementia --> death of nerve cells and/or loss of communication between nerve cells (impaired intellectual functioning); symptoms: irreversible decline of memory, language skills, loss of time and space perception, thinking, and behavior
  11. 17. maintain or approach healthful weight while providing adequate balance of macronutrients and micronutrients, address feeding problems, monitor symptoms, lab values, and/or comorbidities that may require changes in the nutrition prescription
  12. 18. occurs when a brain blood vessel bursts; risk factors: High blood pressure, smoking, use of illegal drugs, and medications that cause bleeding
  13. 20. energy: measure with indirect calorimetry or use Mifflin-St. Jeor with actual body weight and activity factors, protein: 1.1-1.5 g pro/kg IBW, micronutrients: tailor to prevent or correct deficiencies using DRIs as baseline
  14. 21. inflammation leads to scarring and nodules, and damaged tissue doesn’t work as well, fibrosis can regress to a health liver or progress to cirrhosis and liver failure
  15. 22. provide adequate nutrition via oral or enteral nutrition to optimize recovery and reduce likelihood of future cardiovascular events, utilize food and/or nutrient delivery interventions that prevent aspiration and compensate for dysphagia, provide nutrition education on foodsources of vitamin K and other foods that may interfere with medications, provide nutrition education on reading nutrition labels, identifying foods high in saturated fat, cholesterol, and sodium, and recipe modification
  16. 23. weight loss surgery that requires the patient to have some of the following criteria --> BMI ≥ 40 or more than 100 pounds overweight, BMI ≥ 35 with ≥1 obesity-related comorbidity (T2DM, hypertension, sleep apnea, nonalcoholic fatty liver disease, osteoarthritis, lipid abnormalities, GI disorders, heart disease), inability to achieve healthy weight loss sustained for a period of time with prior weight loss efforts
  17. 25. provide adequate energy and protein via liberal diet order, small frequent snacks, and foods that are easy to chew, swallow, and digest, promote nutritional status and prevent weight loss, even in overweight patients
  18. 27. places an adjustable band around the top of the stomach, limiting food passage from the stomach into the intestine and increasing feelings of fullness (restrictive)
  19. 29. Acute --> progress from NPO to oral feeds without symptom exacerbation, provide adequate energy and protein to prevent deficiency/maintain or improve nutritional status, prevent weight loss, initiate early enteral nutrition if indicated; Recovery --> replenish nutritional deficiencies that occurred during acute phase, encourage avoidance of alcohol and excessive fat intake to prevent recurrence of symptoms
  20. 32. caused by mutations in the CFTR gene that produces sticky and thick mucus; symptoms: poor oral intake, diarrhea, steatorrhea, change in stool appearance, macronutrient and micronutrient content of the patient’s diet, abdominal pain, weight loss, trouble gaining weight, poor growth, reduced skeletal muscle mass (skin-fold measurements), chlorine levels in sweat; treated with increased calorie and fat intake using energy-dense foods, nutrition education regarding compensation for fat and salt loss, EN only if patient has low weight or poor growth (calorie-dense with pancreatic enzyme replacements or semi-elemental without pancreatic enzyme replacements)
  21. 40. chronic neurologic disorder that causes 2 or more unprovoked seizures at least 24 hrs apart; treated with a ketogenic diet (if needed), vitamin and mineral supplementation with carbohydrate-free fillers