NUTRITION Sum of all interactions between an organism and the food it consumes Study of nutrients A degree Caloric deficiency

ncy Marasmus (Malala) Calories Old mans face No edema No changes in hair 1st born child: kwashiorkor 2nd born child: marasmus Carbohydrates Energy Easiest to digest Flour, rice, plant based Low-carb diet: STOMACH *Dumping syndrome low carb 3Ds D-iaphoresis D-izzines D-iarrhea Fiber Cannot be digested o cholesterol heart disease o blood sugar levels DM o cancer polyps/constipation Fats Insulation warm Absorption of vitamins Hormones Hardest to digest Plant and animal based Low-fat diet: GALLBLADDER, PANCREAS Bile o Produced by liver

Stored by gallbladder

Nutrients Substances that keep our bodys healthy Ingested o Water o Carbs, fats and protein (macronutrients) calories o Vitamins and mineral (micronutrients) Anatomy Hypothalamus o Regulation of nutrition Thirst 2% water loss = 2% blood loss Hunger hypoglycemia Appetite personal taste Satiety gastric distention o *stomach to dilate: 20-30 mins GIT system o Processing of nutrition Mouth aspiration Stomach intrinsic factor, Vit B12 pernicious anemia SI vitamin deficiency LI DHN colostomy, ileostomy Calories *1 cup of rice 200cal Beer 7cal/gm Carbohydra tes Fats Protein 4 9 4 C02 Ketones Urea ammonia and Energy Energy Energy

Kwashiorkor (Matanda) Falsely healthy looking Protein Round full face Edema lack of albumin Flags sign lack of melanin

Protein Building blocks o Muscles o Albumin o RBC o WBC Low-protein diet: kidney failure, liver failure Protein > ammonia -> liver -> urea -> kidney *azotemia blood toxicity, increase in ammonia and urea Urea/ammonia o Complete Animal product With amino acids Ex. Eggs (best source of protein) o Incomplete Plant product Without amino acids Ex. Lentil soup (monggo)

Vitamins 2 classifications Fat soluble (toxic) o Stored in the liver o ADEK Water soluble (non-toxic) o Excreted o BC Vitamin A Vegetables green/yellow, dairy, liver Mucous membrane integrity Vitamin A deficiency Xerophthalmia dryness of eyes Nyctolopia night blindness Bitots spots spots on eyes

LIVER

AND

Vitamin D Vegetables green/yellow, dairy, liver, sunlight Bone integrity Calcium and phosphorus Vitamin D deficiency Osteomalacia adult o Normal looking o Coma place near the window o Prisoner o Burns Rickets children o Abnormal looking Pigeon chest deep breathing Bone rosary no ribs Bow legs curving Vitamin E Cellular membrane - hemolysis Toxicity: unknown Nuts, oil Vitamin K Green leafy vegetables, colon Clotting factor synthesis Vitamin K deficiency Bleeding Hemorrhagic disease of the newborn Vitamin c, calcium, vitamin K prevents you from bleeding Vitamin C Citrus fruits, guard, vegetables Capillary membrane integrity Increase absorption of IRON -> never take with milk

Vitamin C deficiency Scurvy o Sailors disease o Bleeding

DRY HUMAN PARALYSIS

Petechiae pinpoint Ecchymosis coin size Purpura V/S kalat kalat Hematoma bukol Stool Upper GI: black melena Ulcer s/sx Gastric CA s/sx Esopharigeal varices Swallowing of blood dental, oral, TB Hemorrhoids Colon CA Anal trauma Gunshot wound Guiac stool exam

Wernicke-Korsakoff Syndrome may pera Alcohol A-mnesia N-ystagmus O-pthalmoplegia Priority: Nutrition DOC: IV thiamine Wernicke-Korsakoff Psychosis ANO with hallucinations Priority: safety DOC: anti-psychotic Mouth stomatitis Lips cheilosis Ariboflavinosis vitamin deficiency Brain dementia Skin dermatitis GI diarrhea 3Ds pellagria Nerve integrity Peripheral neuritis Numbness Cramps Tingling sensation Given with TB drugs - IHN when taking Levodopa Given during pregnancy RBC maturation Nervous system development

Vitamin B2 RIBOFLAVIN

Lower GI: hematochezia Occult bleeding

red

B2

Vitamin B3 NIACIN

48 before exam False (+) Iron, dark red, NSAID, ASA, steroids False (-) Vitamin C Vitamin B Complex TA RA NA PLEASE FOLLOW CYAN 1 2 3 6 9 12 Grains, meat, dairy and legumes (nuts) Energy production Brain and heart Beri-beri (walang kinain) WET HEART EDEMA

Vitamin B6 PYRIDOXINE

Vitamin B9 FOLIC ACID

Vitamin B1 THIAMINE

Vitamin B12 CYANOCOBALA

Megaloblastic Anemia large cell of RBC Neural tube defect Meningomyelocoele Meningitis -> Pus in CSF -> Hydrocephalus -> Mental retardation RBC maturation - brain fxn

MIN

Pernicious anemia Psychosis Schillings test 24 hour urine collection Beefy red tongue/glossitis Gastronomy: life-time Monthly injection on IM

in K Pinapples Grapes Iron Hemoglobin synthesis Liver Vitamin C enhances absorption CA decreases absorption Iron deficiency anemia Mothers pregnant Infants Oral supplement o After meals straw if cannot swallow (causes to stain, dikit sa CA) o Most common side effect constipation OFI/fiber IM o Gluteal muscles o G18 length 2 inches o Z-track method prevents staining on skin 0.2-0.5 mL of air to the patient for airlock Change the needle Dont massage the site Warm compress faster absorption Personnel/Delegation 1. Nurse a. Health teaching b. Assessment 2. Doctor a. General guidelines i. NPO ii. Clear liquid diet iii. Full liquid diet 3. Dietician a. Specific diet i. Low-sodium ii. 2,300kcal diet b. With treatment

4. Nutritionist a. Promotion of health b. Food 5. Pharmacist a. Formulate TPN Assess Nutritional Status A-nthropometric measurement B-iochemical data C-linical s/sx D-iet hx

Minerals Inorganic Calcium Bone, muscle, clotting Dairy and broccoli calcium phosphorus Tetany Rapid loss of CA Trossueaus sign Chvosteks sign notify physician; give CA gluconate STAT Post-Thyroidectomy -> PTG -> hypocalcemia -> tetany -> diaphragm (paralyzed) Risk factors 1. Menopause - estrogen a. Osteoporosis chronic loss of CA 2. Coffee diuretic: CA 3. Softdrinks - phosphoric acid 4. Immobile sedentary lifestyle - 48 in bed *best exercise: walking/weight bearing exercise (active lifestyle) Sodium and Potassium (PISO) NA K Extracellular Intracellular Canned cured Vegetables and fruits condiments in K - ABC A-vocado/apricot addisons B-anana C-antalopue cushings