Chapter 14:
• Hepatitis-Causes and Diet:
o Hepatitis A: fecal / oral (poor handwashing)
▪ vaccine
▪ asymptomatic
▪ adequate nutrition needed / NO alcohol
o Hepatitis B: blood, sexual contact, vaginally during deliv
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Chapter 14:
• Hepatitis-Causes and Diet:
o Hepatitis A: fecal / oral (poor handwashing)
▪ vaccine
▪ asymptomatic
▪ adequate nutrition needed / NO alcohol
o Hepatitis B: blood, sexual contact, vaginally during delivery
▪ vaccine
▪ asymptomatic
▪ adequate nutrition needed / NO alcohol
o Hepatitis C: blood, saliva, tears, semen
▪ no dietary recommendations
▪ baby boomers get this the most
o Hepatitis D: only occurs if you already have Hep. B
▪ no dietary recommendations
▪ risk factor: IV drug use
o Hepatitis E: self-limiting, enterically transmitted
▪ risk factors: travel to tropical areas
▪ avoid drinking water and avoid uncooked fruits and veggies
▪ no vaccine
• Fatty Liver at Risk and Diet:
o avoid over nutrition - high fat - high fructose - weight loss w/out skipping meals
o mist common cause: alcohol - obesity - some medications - parenteral nutrition
o liver disease ---> impairs protein synthesis ---> most affected is the immune system
• Liver Failure/Cirrhosis/Esophageal Varices/Ascites:
o Liver Failure:
o Cirrhosis: protein and energy malnutrition common, soft, low-fiber, sodium and fluid restriction
▪ chronic disease
o Esophageal Varices: soft diet
o Ascites: sodium retention -- cannot use actual weight because of the fluid, need to find another way to weigh these pts
• Gall Bladder Risk and Diet:
o occlusion can lead to ---> liver problems / failure or pancreatitis
o risk factors ---> rapid weight loss through low calorie diets, very low fat diet, skipping breakfast
o avoid fatty foods
o IV fluids
Chapter 16:
• When/How to Resume Post-Op Diet:
o assess swallowing ability before transition
o slowly advance diet
o increase oral intake while decreasing tube feedings
o proper assessment of GI tract required before weaning from parenteral nutrition
o presence of bowel sounds
• Calorie Counts:
o done for the malnourished pt.
o best way to evaluate poor appetite
• Burn Injury Diet:
o enteral nutrition needs to start w/in the first 24 hrs. of transmission
• Diabetes:
o diagnosed via blood glucose level > 126 fasting (must be collected two times to determine)
o A1C normal is 4-6% and over 6.5% indicates type II DM
o Type I ---> insulin deficient - have to be on insulin for the rest of their life, early s/s are the 3 P’s
o Type II ---> insulin resistance / intolerance - diet, oral meds, insulin
o tx ---> diet ---> carb counting
o hypoglycemia ---> rule of 15 (pts skin, hot and dry the sugar is high)
• Supplements for Wounds:
o vitamin C
o zinc
Chapter 17:
• Triglycerides:
o At risk: diabetic pts - overweight pts - alcohol abuse pts - sedentary lifestyle - smoking - high carb. intake - genetic factors - meds.
o most common fat found in the bloodstream
• Cholesterol:
o high cholesterol ---> over 200
o sterols = cholesterol
o bile, vitamin D, sex hormones, cells in the brain and nerve tissue
o food sources: meats - fish - dairy (plants don’t contain cholesterol)
o LDL = amt. of cholesterol brought to the cells that has the potential to be dropped off along the way to clog vessels (puts cholesterol on the walls)
▪ should be evaluated every 6 weeks after changing diet
• Heart Healthy Foods:
o DASH diet ---> low sodium
▪ increasing fruits and veggies
▪ decreasing dairy - red meat - soup - sauce - spices - sauerkraut - snacks - sodium processed meats
o Mediterranean diet ---> low cholesterol (consume a lot of olive oil)
▪ fruits, veggies, grains and only source of protein comes from fish
▪ 40% of calories from fat
o Basic diet ---> low sodium and low cholesterol - fluid restriction
• HTN Treatment:
o weight loss
o reduce sodium
o usually results are seen w/in 2 weeks
o increase fruit and veggie intake
o decrease dairy intake
o decrease red meat
o decreasing soup - sauce - spices - sauerkraut - snacks - sodium processed meats
• COPD Diet:
o feeding has to balance CO2 production ---> more CO2 is made from carbs
▪ 50% of non-protein calories needs to be from fats and carbs
▪ protein stays the same
▪ carbs and fats are going to be 50/50
▪ need to decrease calories consumed from carbs in order to decrease the amt. of carbon dioxide they have in their system
▪ fat and carbs are supposed to be 50% of non-protein
• Heart Failure Diet:
o decrease sodium (1500 mg) and decrease fluid (1-2 L per day)
o want to increase kcals but not increase the amt. of food being consumed
o low sodium - low cholesterol - fluid restriction
• CF:
o need pancreatic enzyme replacement
o malabsorption for almost all nutrients
o exceed DRIs for all nutrients by 1.2-2 times kcals and ALL nutrients
o need multivitamin
Chapter 18:
• Nephrotic Syndrome:
o increased protein in the urine (increase urinary excreting protein - proteinuria)
o nutrition ---> control HTN - minimize edema - muscle catabolism - high carb diet - protein restriction - Na+ restriction
• Most Common Cause of Acute Renal Failure:
o nephrotoxicity (Ibuprofen)
• Foods High in Potassium:
o kale - bananas - oranges - legumes - tomatoes - yogurt - avocados
• Renal Failure:
o supplements ---> iron - nephrocaps - vitamin D
o avoid phosphorus ---> competes w/ calcium for receptors and increases risk for bone loss
• Types of Diets:
o Clear Liquid: 24 hrs. only
o Full Liquid: complete nutrition
▪ same as clear diet but w/ milk products and all juices
o Level 1 Dysphagia Pureed Diet: completely blended, pudding consistency
o Level 2 Dysphagia Mechanically Altered: food is moistened, meat is ground up, served w/ gravy
o Level 3 Dysphagia Advanced: hard, sticky, crunchy foods are omitted
o Level 4 Dysphagia: return to normal diet
o Mechanically Altered Diet: chopped, ground, mashed, pureed
o Soft Diet: transition from liquid to regular diet
Chapter 20:
• Diets for Radiation and Mucositis:
o decrease risk of surgical complications
o able to meet energy and protein requirements
o neutropenic diet ---> no raw or undercooked meats - pasteurized milk, juice, eggs
- wall washed fruits and veggies
o increase kcals
o mechanically soft diet
• Cachexia: complex syndrome wasting of lean body mass / weight loss
o affects 50% of cancer pts.
o take Megace ---> appetite stimulant
o NSAIDs ---> omega-3 fatty acids
Miscellaneous Questions:
• Dysphagia:
o s/s: coughing - drooling - eating slowly
o stroke - esophageal varices - Parkinson’s
o sit the pt. upright and give them a lot of time to eat
o foods that are not consistent in structure are the most difficult to eat
• Lactose Intolerance:
o lactose enzyme to help tolerate dairy products
• Vitamin K Deficiency:
o blood coagulation
o interacts w/ Warfarin (Coumadin)
o foods ---> leafy greens (kale - broccoli)
• B12: pernicious anemia
o intrinsic factor is needed to increase absorption of B12
• Proteins Complete / Incomplete:
o Complete: has all 9 essential amino acids (breast milk - soy - eggs)
o Incomplete: cannot live off of
o Sources: legumes - soy beans - animal products
• Extra Info:
o Primary Deficiency: not enough being consumed
o Secondary Deficiency: eating enough but the body is responding properly
o vitamin D is the only vitamin created in the body
o needs 2 cups of fruits and 2 ½ cups of veggies per day
o need B6 to absorb amino acids
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