MNT weeks five and six notes
MNT weeks five and six notes NUTR 342-31
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This 3 page Class Notes was uploaded by Olivia Notetaker on Sunday February 28, 2016. The Class Notes belongs to NUTR 342-31 at La Salle University taught by Professor Danowski in Fall 2016. Since its upload, it has received 25 views. For similar materials see Medical Nutrition Therapy in Nutrition and Food Sciences at La Salle University.
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Date Created: 02/28/16
MNT weeks five and six notes - Hematology- diagnostic tool; study of blood - Albumin is in the plasma - Erythrocytes= RBC and hemoglobin - Hemoglobin carries O2 - RDA for iron is different between males and females (due to menstruation) - Ferritin= storage from of iron - Iron deficiency anemia is the most common deficiency - RBC amounts remain normal until full deficiency - False levels of high ferritin when there’s actually not a lot of iron o Positive acute phase reactant= indicator of inflammation - Transferrin carries iron in blood o Saturated means bound with - Heme is absorbed better - Chelates- minerals chemically bound to help with absorption; so iron bound with amino acids to help with absorption - People complain with constipation with iron supplements - Menke’s syndrome- sparse kinky hair; affects nervous system; infants don’t live past 3 - Homocysteine metabolism- breaking down homocysteine (an amino acid) o Indicator of heart disease - Glossitis- inflammation of tongue - Folate has to be activated to work - If B12 not available to take away the methyl group, folate becomes trapped in its inactive form - Pernicious anemia= most severe kind of anemia - EEG= brain function - Hypochromic- pale - PUFA= polyunsaturated fatty acids - MCHC= mean corpuscular hemoglobin concentration - MCV= mean corpuscular volume - Hypochromic microcytic= small and pale - Normochromic normocytic- normal color and size but MCV is low and MCHC is high o Kidneys aren’t functioning properly and kidneys help make RBC, so if not functioning properly then RBC not being made - With hemochromatosis, fatigue is also a symptom of general anemia - Chelation- remove iron by letting it bind to a molecule (in IV fluid) - Thalassemia= inherited; hypoxia= lack of O2 of brain Liver - Dialysis starts in stage 5 - 2 kidneys the size of your fist - Renal pelvis brings blood into kidney - Nephrons- functioning unit of the kidney - Blood goes through glomerulus and gets filtered - Blood going through kidney to get completely cleaned (goes through semi-permeable membrane. Waste goes out and clean blood comes back) - Kidneys control how much sodium and water is excreted - SMA-7: chem 7 (Na, K, Cl, bicarbonate, BUN, Creatinine, glucose) - GFR is number one looked at with KD o How well kidney is being cleared - Creatinine can be high but that doesn’t mean malnutrition - Azotemia= large waste amounts - Hyperparathyroidism= parathyroid becomes enlarged and high PTH since it’s not working - Renal osteodystrophy= wasting of bone due to renal failure - CKD is nonreversible; Px will die if no tx o First couple of stages are asymptomatic o Can slow progression if catch it early (with diet, exercise, meds) o Glomerulonephritis= inflammation of nephrons around glomerulus from lack of O and nutrients to kidney o 1 in 10 ppl have it o EPO replacement necessary because no RBC being made o Restrict protein in stage 2 because kidneys can’t process it and don’t want to push px to next stage o Dialysis- giving a temporary kidney (hooked up to it) Two types: Hemodialysis and peritoneal dialysis First is to weigh px (because fluid buildup because they can’t excrete urine). Then hooked up to dialysis with 2 needles, 1 giving clean blood to px and the other taking dirty blood to dialysis machine which passes through membrane and dialistate (removes excess waste) and urine comes at bottom of tube and clean blood goes back to px AVF- arterial venous fistula; AVG- arterial venous graft PD: there’s a risk for infection but not as high because it’s not hooked to a major artery High risk for peritonitis MHC antigens determine if kidney is compatible to persons blood Transplant is the least worrisome of them all Would need to get another one or go back on dialysis 5-10 years after first transplant Malnutrition because px feels nausea, vomiting, etc. before dialysis o HBV- high biological value o Protein is very important, especially in stage 5 because temporary kidney takes away protein (50g up to) Stages 3 and 4 need low protein Phosphorus is looked at because it’s added to a lot of food, kidneys can’t clear it out, no immediate affect but can lead to bone disease; Phosphorus binder helps bind and excrete phosphorus o With PD, you can eat a little more protein/phosphorus than HD o Dialysate- 300-500 cals o In beginning, albumin is low so focus on protein and K; later focus on phosphorus