Nursing Exam 1 Study Guide

Exam 1 Study Guide This study guide was developed to help you prepare for the first exam in this course. It is not meant to be all inclusive of all of the information on the exam. Remember that anything done in class, all assigned readings and the ATI Review Module are considered fair game for inclusion on the exam. Chapter 1 Wellness and Nutrition  Six dimensions of health Environmental Emotional Intellectual Physical Social Spiritual  Levels of prevention and nutrition example of each of them Primary: activities to avert the initial development of disease or poor health. Ex- educate about healthy foods Secondary: early detection to halt or reduce the effects of a disease or illness (screening). Ex- regular bloodwork Tertiary: minimize further complications or to assist in the restoration of health after a disorder develops. Ex- specific diets such as cardiac, renal, low sodium  Purpose and the primary goals of Healthy People 2020 Promote health and reduce chronic disease risk through the consumption of healthful diets and achievement and maintenance of healthy body weights.  Categories of nutrients Carbohydrates Proteins Lipids Vitamins Minerals Water  Components of proteins, carbohydrates and fats Proteins, carbohydrates and fats are made from three basic molecules: carbon, hydrogen and oxygen. However, all proteins contain an element not found in carbohydrates and fats -nitrogen -- and some proteins also contain sulfur.  Kilocalorie values of nutrients Fats: 9 cal/g Carbs: 4 cal/g Proteins: 4 cal/g  Difference between essential and non-essential nutrients Essential= nutrients body cannot not manufacture; absence of these can cause deficiency diseases; must be obtained from food Nonessential= nutrients that can be made by the body and absorbed from food  Review DRIs, EAR, RDA, AI, UL, AMDRs and EER Carbs: DRI/RDA= 130g/day AMDR= 45-65% of cal/day (900-1300 cals total daily intake) Proteins: DRI/RDA= 0.8g/kg (men= 56-65g; women= 46-50g) AMDR= 10-35% Fats: DRI/RDA= 20-35% of cal intake DRI= 10% or less from saturated fats DRI= less than 300mg cholesterol AMDRs= 40-97g total fat; 20-25g saturated fat Sodium: AI= 1500mg/day adults UL= 2300mg/day Chloride: AI= 2300mg/day adults, 2000mg/day for older than 5, 1800 mg/day for older than 70 Potassium: AI= 4300 mg/day Phosphorus: RDA= 700mg/day UL= 4000mg  Review importance of assortment, balance and nutrient density Assortment is important to get a variety of different nutrients. A balanced diet supplies your body with nutrients it needs to work effectively. More nutrient-dense foods, get the beneficial nutrients your body needs without consuming too many calories.  Undernutrition, overnutrition and malnutrition Undernutrition= lack of proper nutrition caused by not having enough food or not eating enough food containing substances necessary for growth and health Overnutrition= a form of malnutrition (imbalanced nutrition) arising from excessive intake of nutrients, leading to accumulation of body fat that impairs health Malnutrition= lack of proper nutrition, caused by not having enough to eat, not eating enough of the right things, or being unable to use the food that one does eat. Chapter 2 Personal and Community Nutrition  Understand the terms associated with food selection o Food preferences- evaluative atÝtudes that people express toward foods. Include the qualitative evaluation of foods, and also how much people like and dislike them. o Food choice- how people decide on what to buy and eat. A complex set of factors that vary from person to person and depend on culture, heritage and up-bringing all influence food choice. o Food liking- the pleasantness of taste of food in the mouth.  Five major dietary guidelines outlined in the 2015-2020 Dietary Guidelines for Americans Follow a healthy eating pattern across the lifespan. Focus on variety, nutrient-dense foods, and amount. Limit calories from added sugars and saturated fats, and reduce sodium intake. Shift to healthier food and beverage choices. Support healthy eating patterns for all.  Review importance of variety, proportionality, moderation and activity in terms of nutrition The key to healthy eating is balance, variety and moderation. In short, this means eating a variety of foods without getÝng too many calories or too much of any one nutrient. This also can mean reducing the amount of sugar and fat in our eating. Make sure to eat a variety of nutrientrich foods.  Understand the various tools for nutrition and meal planning  Review purpose of MyPlate and the expected results when following it Purpose of MyPlate is to guide us through our food selections to meet the goals of the dietary guidelines. The result is a total diet that meets the nutrient needs from foods while limiting dietary components that are often eaten in excess. Increasing intake of vitamins, minerals, dietary fiber, and other essential nutrients. Lowering intake of saturated fats, trans fats, and cholesterol and raising intake of fruits, vegetables, and whole grains, thereby decreasing risk for some chronic diseases. Balancing intake with energy needs, thereby preventing weight gain and/or promoting a healthy weight.  Role and purpose of daily food plans  Required components on the Nutrition Facts label Single serving size, # of servings in package, % of daily values, and amount of each nutrient in one serving.  Purpose of food label descriptors and health claims Food labels descriptors help consumers who try to control their intakes of specific nutrients and food components. Health claims is information that helps consumers select those foods that can keep them healthy and well.  Food descriptor definitions Free= contains only a tiny or insignificant amount of fat, cholesterol, sodium, sugar, and/or calories Low= low in fat, saturated fat, cholesterol, sodium, and/or calories; can be eaten fairly often without exceeding dietary guidelines Lean= contains less than 10g of fat, 4g of saturated fat, and 95mg cholesterol per serving. Extra lean= contains less than 5g of fat, 2g of saturated fat, and 95mg of cholesterol Reduced, less, fewer= contains 25% less of nutrient of calories. Light/Lite= contains one third fewer calories of one half the fat of the original More= contains at least 10% more of the daily value of a vitamin, mineral, or fiber than the usual single serving Good source of= contains 10% to 19% of the daily value for a particular vitamin, mineral, or fiber in a single serving  Factors that affect food buying Budget, consumer diversity, dietary preferences, shopping frequency, location and types of food stores Chapter 3 Digestion, Absorption and Metabolism  Supportive structures and organs of the digestive system Main- mouth, esophagus, stomach, small intestine, large intestine, rectum, anus. Supportive- pancreas, gallbladder, liver.  Types of muscular action in the gastrointestinal tract Peristalsis- involuntary constriction and relaxation of the muscles of the intestine or another canal, creating wave-like movements that push the contents of the canal forward   Role of each organ in digestion and absorption o Salivary glands- make saliva to moisten our food and helps us swallow more easily. Also, contains an enzyme called amylase that breaks down starches. o Small intestine- carries out most of the digestive process by absorbing most of the nutrients you get from foods into the bloodstream. o Large intestine- purpose is to absorb water and salts from the material that has not been digested as food, and get rid of any waste products left over. By the time food mixed with digestive juices reaches the large intestine. Most digestion and absorption has already occurred. o Liver- process nutrients absorbed from the small intestine. o Pancreas- pancreatic juices make enzymes that breakdown sugars, fats, and starches. o Stomach- produces enzymes and acids that mx together and breaks down food so it can pass to your small intestine. o Issues across the lifespan that affect the digestive process  Expected changes in metabolism as a person gets older Slows down  Function of metabolism The three main purposes of metabolism are: the conversion of the energy in food to energy available to run cellular processes; the conversion of food to building blocks for proteins, lipids, nucleic acids, and some carbohydrates; and the elimination of metabolic wastes. Catabolism- breaks down molecules into small units Anabolism- builds molecules from smaller units Chapter 4 Carbohydrates  Understand the difference between simple and complex carbohydrates Complex carbohydrates are present in foods such as bread and pasta. Simple carbohydrates are in foods such as table sugar and syrups. Complex carbohydrates contain longer chains of sugar molecules than simple carbohydrates. The body converts these sugar molecules into glucose, which it uses for energy.  DRI and AMDR for carbohydrates DRI- 130g/day AMDR= 45-65% (900-1300cal)  Functions of carbohydrates Provide energy to body  Difference between soluble and insoluble fiber along with health benefits of each Soluble= dissolves in water to form a gel-like substances. Can lower total and LDL cholesterol and blood glucose. Sources: black beans, apples, oats, barley, brussel sprouts, sunflower seeds, flax. Insoluble= does not dissolve in water; oases through the digestive tract as consumed. Provides stool bulk and promotes regularity. Sources: asparagus, blackberries, chickpeas, dates, lentils, quinoa.  Difference between nutrient content of refined and unrefined grains Refined: wheat, rice, oats, corn, rye. Lose vitamins, minerals, and fiber when processed. Unrefined: whole grains. Contain nutrients and fiber. (better option) Chapter 5 Fats  Major function of triglyceride in food and physiologically in the body Combine with glycerol to supply energy to the body and form adipose tissue to protect internal organs.  Location of digestion of lipids in the body Small intestine  Difference between saturated, monounsaturated and polyunsaturated fats as well as sources Saturated= solid at room temperature and found primarily in animal sources. Ex- butter, coconut oil, fatty meat, cheese. Monounsaturated= unsaturated fatty acid usually from plant sources and help reduce health risks. Ex- olives, canola oil, avocado, peanuts, and other nuts. Polyunsaturated= unsaturated fatty acid usually from plant sources and help reduce health risks. Ex- corn, wheat germ, soybean, safÒower, sunflower, and fish.  Functions of phospholipids and cholesterol Phospholipids are important to cell structure and transport of fat soluble substance across the cell membrane. Cholesterol provides material to make bile, vitamin D, sex hormones, and cells in the brain and nerve tissue.  Examples of foods high in cholesterol Full fat dairy, red meat, processed meat, fried foods, baked goods/sweets, eggs (yolk), shellfish.  Function of linolenic and linoleic essential fatty acids Linolenic= decrease the risk of heart disease by helping to maintain normal heart rhythm and pumping. Linoleic= a structural component to maintain a certain level of membrane fluidity of the transdermal water barrier of the epidermis.  Sources of omega-3 fatty acids Oily fish such as salmon, herring, mackerel, sardines. Fish oil and flaxseed oil, flaxseeds, walnuts, and chia seeds. Omega 6- safÒower oil, sunflower oil, corn oil, soybean oil, sunflower seeds, walnuts, pumpkin seeds.  Explain why digestion, absorption and transportation of lipids in the body is important  Different types of lipoproteins and their functions LDL= carry cholesterol to the tissue cells. Bad cholesterol. HDL= remove excess cholesterol from cells and transport to liver for disposal. Good cholesterol. VLDL= carry triglycerides to the cells.  Potential health concerns related to excessive dietary fat intake Build up in tissues, causing congestion and increasing risk for cardiovascular disease. Chapter 6 Proteins  Recommended protein intake for adults RDA= 0.8g/kg AMDR=10-35%  Composition of proteins compared to carbohydrates and lipids Carbohydrates and lipids both contain carbon (C), hydrogen (H), and oxygen (0); proteins contain these three elements plus one or more from nitrogen (N), sulphur (S) and phosphorous (P).  Difference between essential and nonessential amino acids Essential amino acids cannot be made by the body. As a result, they must come from food. The 9 essential amino acids are: histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine. Nonessential means that our bodies can produce the amino acid, even if we do not get it from the food we eat. Nonessential amino acids include: alanine, arginine, asparagine, aspartic acid, cysteine, glutamic acid, glutamine, glycine, proline, serine, and tyrosine.  Difference between complete and incomplete proteins and examples of each Complete proteins, from animal sources and soy, contain sufÏcient amounts of all nine essential amino acids. Ex- Fish, Poultry, Eggs, Beef, Pork, Dairy, Whole sources of soy (tofu, edamame, tempeh, miso). Incomplete proteins, generally from plant sources, can contain an insufÏcient number r quantity of amino acids. Ex- nuts/seeds, whole grains, veggies, legumes.  Digestion and absorption process of protein to be made available to body cells Stomach= pepsinogen turns into pepsin Small intestine= trypsin Absorption= small intestine  Function of proteins in the body Growth/maintenance- collagen Creation of communicator and catalysts- insulin, fibrinogen Immune system response- antibodies Fluid/electrolyte regulation Acid-base balance Transportation- lipoproteins  Distinguish between vegan, ovo-lacto vegetarian and lacto vegetarian in terms of foods eaten Vegan= excludes all meat and animal products Ovo-lacto vegetarian= includes dairy products and eggs Lacto vegetarian= includes dairy products  Identify pros and cons of each type of vegetarian diet Vegetarian= reduced risk for obesity, CVD, DMII, HTN, GI disorders, lung & colorectal cancer. Can be anemic. Vegan= deficient in vitamin D, B12, calcium and amega-3 fatty acids Chapter 8 Water and Minerals  Functions of water in the body Structural, temperature regulation, lubricant, transport, solvent.  Difference in water requirements for males and females M: 15 cups/3.7 L/120oz F: 9cups/2.1 L/ 72oz  Dietary sources of water Fluids Food: fruits and veggies (watermelon, grapes, oranges, lettuce, tomatoes, zucchini)  Foods high in sodium Table salt, processed foods, preserved foods. Chapter 9 Energy, Weight and Fitness  Factors that influence body fat levels Genetics, age, sex, type and amount of activity, nutrition.  Body Mass Index ranges and how to calculate it Underweight= 18.5 Normal= 18.5-24.9 Overweight= 25.0-29.9 Obese= 30+ BMI=( lbs/in^2) x 703  Basal Metabolic Rate and factors that can affect it BMR refers to the amount of energy used in 24 hours for involuntary activizes of the body (maintaining body temp, HR, circulation, and resps). Determined while at rest and following a 12 hr fast. Affected by lean body mass and hormones. Body surface, age, and sex are also factors that contribute to BMR.  Methods a nurse would use to assess body fat composition and body weight Densitometry- underwater weighing Bioelectric impedance analysis (BIA)- uses electrodes place at wrists and ankles to monitor the ease of passage of a mild electrical current BMI  Healthy body fat percentage for males and females Men: 3-8% essential; 15-20% healthy Women: 12-14% essential; 25-30% healthy  Nutritional needs of people who are athletic compared to people who are not  Exercise recommendations Fluids before, during and after exercise