MNT Pt 5

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Across
  1. 2. onset: 15 minutes-1 hour, peak: 1-3 hours/1-4 hours; duration: depends on the types (e.g: NPH/Regular 70/30, Lispro Protamine/Lispro 50/50)
  2. 6. onset: 1 hour, peak: 9 hours or none, duration: up to 42 hours
  3. 10. onset: 1 hour, peak: 2-4 hours, duration: 5-8 hours; higher risk of hypoglycemia (aka regular)
  4. 11. energy: reduced if overweight or obese; DRIs (protein: 0.8 g/kg/day, fluid: ~1 mL/kcal/day)
  5. 13. DRIs (energy: meet needs, protein: 0.8 g/kg/day, fluid: ~1 mL/kcal/day)
  6. 14. onset: 2.5 minutes, peak: 1 hour, duration: 5-6 hours; taken at beginning of meal or within 20 minutes of eating
  7. 17. provide nutrition education regarding the connection between hydration, diet, and alcohol with acute gout episodes, address comorbidities such as hyperlipidemia, diabetes, renal insufficiency, and hypertension if present, have patient discuss abstaining from alcohol with physician, create a healthful eating plan with the patient considering their culture, SES, and preferences
  8. 20. prioritize energy needsfor weight maintenance or weight lossof up to 10% in first 6 months, provide nutrition counseling to effect behavior change and provide nutrition education related to a comprehensive weight management program
  9. 21. onset: 5-15 minutes, peak: 1 hour, duration: 3-5 hours; taken at beginning of meal or within 20 minutes of eating (aka rapid-acting)
  10. 22. endocrine disorder caused by increased androgens and irregular menstrual cycles due to ovarian cysts; may have insulin resistance with compensatory hyperinsulinemia, increased risk of impaired glucose tolerance, T2DM, kidney and cardiovascular disease; labs: fasting glucose, results of glucose tolerance test, hemoglobin A1C, lipid profile, serum 25(OH)D levels, hemoglobin and hematocrit; treated with lifestyle behavior management for weight
  11. 23. diagnosed in 2nd/3rd trimester (24-28 weeks) of pregnancy (increased insulin-antagonistic hormones --> insulin resistance), fasting blood glucose usually return to normal, but is at risk of T2DM, can lead to neonatal macrosomia, neonatal hypoglycemia, maternal hypertension, preeclampsia, polyhydramnios, estationaldiabetes during a previous pregnancy, history of large birthweight infants, maternal overweight classification, family history of type 2 diabetes, age between 25 and 35 years, maternal PCOS, and pregnancy with twins; treated with motivational interviewing, individualized nutrition goals, food records, self-monitoring of FBG and PPBG, eating regularly throughout the day, <45 g carbohydrate in one sitting, avoid juice/soda, and limiting sweets
  12. 24. co-occurence of abdominal obesity, hyperglycemia, dyslipidemia, hypertension; symptoms (must have 3): elevated fasting glucose(≥100 mg/dL) or diagnosed diabetes/glucose-lowering medication, low HDL-cholesterol(≤40 mg/dL for men and <50 mg/dL for women) or drug treatment, elevated triglycerides(≥ 150 mg/dL) or drug treatment, elevated waist circumference (37-40 in [94-102 cm]for men, 31-35 in [80-88 cm]for women), elevated blood pressure (≥ 130/85 mmHg) or drug treatment; treated with an individualized healthful and cardioprotective eating plan, prioritizing nutrition diagnoses, work with the patient to develop patient-oriented goals, identify necessary resources and knowledge deficits
Down
  1. 1. individualize eating plan to duration of disease, comorbidities, age, culture, SES, and personal preferences, educate on potential food-drug interactions and nutrition-related adverse effects, educate on carbohydrate management strategies and the role of protein intake in diabetes management, educate on blood glucose self-monitoring and use data to adjust therapy, support weight loss (if overweight or obese) using evidence-based guidelines, encourage an individualized physical activity plan
  2. 3. energy: reduced if neededfor weight loss, fluid: 8 –16 cups fluid/day with at least half as water, protein: from low-purine sources, limit meat fish and poultry to 4-6 oz/day
  3. 4. crystal-induced arthritis --> chronic hyperuricemia due to deposition of monosodium urate crystals in the body’s joints and tissues; symptoms: fevers, chills, malaise, joint pain, urinary tract stones, intersitial nephropathy; risk factors: genetic predisposition, older age, hypertension, renal insufficiency, medications that impair uric acid secretion, high alcohol intake, dietary excess (particularly alcohol and purine-rich animal foods), and obesity; treated with limitation of beer, animal organs, red meat, and seafood and increase fluid to reduce dehydration risk
  4. 5. abrupt onset of clinical signs and symptoms of hyperglycemia (left untreated will cause DKA), insulin affects carbohydrate (increases gluconeogenesis and glycogenolysis), protein (increases gluconeogenesis and proteolysis), and lipid (increases ketogenesis and lipolysis) metabolism
  5. 7. energy: reduced for weight loss, cardioprotective diet: increase whole grains and fiber, reduce intake of sugar, saturated fats, and trans fats
  6. 8. onset: 1-4 hours, peak: flat, duration: 12-24 hours
  7. 9. promote a healthful, cardioprotective eating pattern with reduced energy intake for a goal of reducing body weight 7 –10 % in the first year, encourage at least 30 mins of physical activity 5 days a week, provide ongoing support with counseling and nutrition education to address nutrition-related knowledge deficits and treatment goals
  8. 12. onset: 1-2 hours, peak: 8 hours, duration >14 hours; only cloudy insulin (aka NPH)
  9. 13. support medical care plan to achieve regular menstrual function, reduce androgen and insulin levels, improve skin symptoms(follicular keratosis), reduce or maintain weight, and prevent long-term complications
  10. 15. develop eating plan and insulin regimen that fits with patient’s food and physical activity preferences, respect the patient’s wishes, willingness, and motivation to change, ensure adequate energy in eating plan for normal growth and development (youth), optimal outcomes (pregnant and lactating), and appropriate weight (adults), provide self-management education related to hypoglycemia, acute illness, and exercise, prevent and treat chronic complications of diabetes (dyslipidemia, CVD, hypertension, nephropathy, neuropathy)
  11. 16. symptoms caused by low blood sugar; symptoms: sweating, trembling, difficulty concentrating, and dizziness, treated with drinking fruit juice or soft drinks, or consuming foods with carbohydrates like glucose tablets, glucose gel, honey, syrup, or crackers for about 15 –20 g glucose/carbohydrate
  12. 18. diagnosed during acute illness and/or due to a DKA episode, treated with insulin is required to prevent DKA --> eating plan has to be catered around an insulin regimen, carbohydrate counting; glycemic targets for nonpregnant: individualized to age and health status; lab --> HgA1c: <6% or <7.0% to reduce risk of macrovascular and microvascular complications
  13. 19. most common in overweight and obese adults, ; pregnant people can be diagnosed if risk factors show at first prenatal visit; risk factors: having a 1st degree relative with type 2 diabetes, identifying as a race/ethnicity that, as a population, has higher prevalence of type 2 diabetes mellitus (African American, Latinx, Native American, Asian American, Pacific Islander), history of CVD, hypertension or on blood pressure lowering medication, elevated triglycerides, low HDL, physical inactivity, and clinical conditions associated with insulin resistance such as PCOS, severe obesity, and acanthosis nigricans (thickened and dark patches of skin)