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27 Cards in this Set
- Front
- Back
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Reactive Hypoglycemia
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Due to rapid digestion and absorption of CHO following gastrectomy.
Insulin overproduction |
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Anemia in Dumping Syndrome
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Iron deficiency - impaired due to loss of acid
B12 deficiency - Lack of intrinsic factor & bacterial overgrowth in in loop of intestine Folate deficiency - Needs B12 cofactor |
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Differences between Billroth I & II
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Billroth I - attaches stomach to the duodenum
Billroth II - attaches stomach to the jejunum |
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Pancreatic secreation in Gastrectomy
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Typically the pancreas is stimulated via passage through the duodenum.
Therefore in Gastrectomy patients are prone to steatorhea |
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Nutritional Implications/MNT for Dumping Syndrome
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6 small feedings
Dry feedings; water before or after Restricted hypertonic concentrated sweets Restrict simple sugars Moderate fat B12 injections (Lactose may be poorly tolerated) |
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Tropical Sprue VS. Non-Tropical Sprue
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Tropical
-Intestinal lesions -Can affect stomach -Deficiency in B12 and Folate -High Calorie/Protein -IM B12 & oral folate Non-Tropical -Gluten-induced enteropathy -Affects jejnum and ileum -Malabsorption (fat soluble), macrocytic and iron deficiency anemia, weight loss steatorrhea, diarrhea. |
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Difference between MNT for Diverticulosis & Diverticulitis
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Diverticulosis - high fiber diet
Diverticulitis - clear liquids, low residue with gradual return to fiber |
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Fiber
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Binds water, increases fecal buik
soluble fibers delay gastric emptying, absorb water form gel in intestine Oat bran (insoluble) and soluble fibers decreas secrum cholesterol |
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Gastirtis
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Clear liquids, avoid gastric irritants
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Inflammatory Bowel Disease
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Regional enteritis (crohn's)
Chronic ulcerative colitis |
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Crohn's disease
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Inflammation of the Ileum,
-B12 deficiency -Megaloblastic anemia -Iron deficiency anemia |
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Ulcerative Colitis
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Ulcerative disease of the colon
-affects H20 and electrolytes -anemia, negative nitrogen balance, bloody diarrhea |
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Nutrition for Inflammatory Bowel Disease
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Acute Crohn's
-Bowel Rest, PN or minimal residue Acute UC -Elemental diet Both -High cal, High Protein, Low Fat, Fat soluble vitamins, Remission/under control -high fiber for peristalsis |
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Inflammatory Bowel Disease
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Regional enteritis (crohn's)
Chronic ulcerative colitis |
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Lactose intolerance
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Calcium and riboflavin supplements recommended
Yogurt and small amounts of aged cheese is okay Whey has lactose |
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Crohn's disease
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Inflammation of the Ileum,
-B12 deficiency -Megaloblastic anemia -Iron deficiency anemia |
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Ulcerative Colitis
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Ulcerative disease of the colon
-affects H20 and electrolytes -anemia, negative nitrogen balance, bloody diarrhea |
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Nutrition for Inflammatory Bowel Disease
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Acute Crohn's
-Bowel Rest, PN or minimal residue Acute UC -Elemental diet Both -High cal, high protein, low fat vitamins, Remission/under control -high fiber for peristalsis |
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Lactose intolerance
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Calcium and riboflavin supplements recommended
Yogurt and small amounts of aged cheese is okay Whey has lactose |
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Diarrhea in Infants & Children
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Acute
-aggressively and immediately rehydrate -replace fluids and electrolytes -Glucose electrolytes solutions Chronic -no significant malabsorption -Consider Fat to CHO calories -40% calories as fat |
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Adult diarrhea
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Replace lost fluids and electrolytes
-after diarrhea begin with low fiber foods then protein, don't need to limit fat -avoid lactose |
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Normal Stool Fat
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2 - 5 g; >6g indicative of malabsorption
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Nutrition for Steatorrhea
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High protein
High Complex CHO Fat as tolerated Vitamins/Minerals MCT |
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Ileal Resection
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Distal - absorption of B12, bile salts, intrinsic factor
Ileum absorbs major portion of fluid in GI tract Malabsorption of Bile Salts |
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Malabsorption of Bile Salts (Ileal Resection)
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leads to malabsorption of fat-soluble vitamins
-Colonic reabsorptionof oxolate (kidney stones) Increased fluid and electrolyte secretionn |
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Nutrition Care for Short Bowel Syndrome (Jejunal Resection)
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-Normal balance of macronutrients
-6 small feedings -Avoid lactose and Large concentrated sweets -vitamin Mineral supplements |
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Nutrition Care for Short Bowel Syndrome (Ileal Resection)
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Limit FAT!
-Use MCT -Supplement fat-soluble vitamins Parenteal B12 |
