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Jean Inman_ Domain II MNT - Questions with Explanations of Answers
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Jean Inman_ Domain II MNT - Questions with Explanations of Answers
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Jean Inman: Domain II MNTUlcer: Definition - ✅✅ -A sore that develops on the lining of the esophagus,
stomach, or small intestine.
Ulcer: Treatment - ✅✅ -- Antibiotics (kill H. pylori bacteria)
- Drug therapy: Cimetidine, Ranitidine - H2 blocker to decrease acid secretion
- Diet as tolerated
- Omit cayenne, black pepper, chili powder, avoid excess alcohol, black pepper
Hiatal Hernia: Definition - ✅✅
-Condition in which part of the stomach pushes up
through the diaphragm muscle
✅✅-small, bland feedings
Hiatal Hernia: MNT -
When does dumping syndrome usually occur? - ✅✅-Follows a gastrectomy
(Billroth I, II), gastic surgery
Dumping Syndrome: Definition - ✅✅
-physiologic response to RAPID GASTRIC
EMPTYING into the jejunum, manifested by nausea, weakness, sweating,
palpitations, syncope, and possibly diarrhea
Billroth I: Definition -✅✅
-Gastroduodenostomy
- Attaches remaining stomach to the duodenum
✅✅
Biliroth II: Definition - -Gastrojejunostomy
- Attaches the remaining stomach to the jejunum
Which 2 Vitamins/Minerals are affected by gastrectomys? - ✅✅-Calcium and Iron
Dumping Syndrome: MNT - ✅✅-Frequent small, DRY FEEDINGS, fluids
before/after meals.
- Protein at each meal
- Moderate fat
- B12 injections maybe
Schilling Test - ✅✅-Diagnoses pernicious anemia
- lack of IF
✅✅
What 2 deficiencies are associated with Dumping Syndome/Gastroectomys? -
-B12 and Folate deficiency
- B12: lack of IF d/t dec HCl
- Folate: needs B12 for transport
,Gastroparesis: Definition - ✅✅ -delayed gastric emptying
- surgery, diabetes, viral infections, obstructions
Gastroparesis: Medications - ✅✅-Prokinetics (erythromycin, metoclopramide)
Gastroparesis: MNT - ✅✅ -- Small, frequent meals
- pureed foods
- avoid high fiber
- avoid high fat (liquid fat may be better tolerated)
✅✅-Chronic GI disease, intestinal lesions
Tropical Sprue: definition -
Tropical Sprue: complications, deficiencies - ✅✅-- diarrhea, malnutrition
- B12 and folate deficiency d/t decreased HCl and IF
Tropical Sprue: Treatment & MNT - ✅✅
-- antibiotics
- high calories, high protein
- B12 injections and Folate supplements
Non-Tropical Sprue (Celiac Disease) -✅✅-Reaction to gluten (gliadin in wheat)
Non-Tropical Sprue (Celiac Disease): Complications - ✅✅-Malabsorption
- macrocytic anemia
- weight loss
- diarrhea
- steatorrhea
- iron deficiency anemia
What to avoid if you have Non-Tropical Sprue: gliadin-free - ✅✅
-No WROB
(Wheat, Rye, Oat, Barley)
No CBBOGMTD (Couscous, Bran, Bulgur, Orzo, Graham, Malt, Thickening agents,
Durum)
Constipation: MNT - ✅✅-High fluid, high fiber, exercise
Diverticulosis: Definition - ✅✅-Presence of diverticula - small mucosal sacs that
protrude through the intestinal wall d/t structural weakness.
Diverticulosis: MNT - ✅✅ -High fiber diet.
This increases volume and weight of residue while providing rapid transit
Diverticulosis: Complications (2) - ✅✅-Constipation, Lifelong intra-colonic
pressures
, Diverticulitis: Definition -✅✅
-When diverticula become inflamed as a result of food
and residue accumulation and bacterial action.
Diverticulitis: MNT - ✅✅-Clear liquids, low residue or elemental gradual return to
high fiber
Gastritis -✅✅ -Inflammation of stomach
- anorexia, N/V, diarrhea
✅✅-clear liquids; advance as tolerated, avoid gastric irritants
Gastritis: MNT -
Crohn's Disease: location in intestine - ✅✅-Inflammatory Bowel Disease that
affects the TERMINAL ILEUM
Crohn's Disease: 2 Deficencies -✅✅-B12 deficiency and Iron Deficiency Anemia
Crohn's Disease: B12 deficiency leads to...? - ✅✅-Megaloblastic Anemia
Crohn's Disease: What causes Fe deficiency anemia? - ✅✅-Blood loss and
decreased absorption
Ulcerative Colitis: location in the intestine - ✅✅-IBD of the COLON, begins in the
rectum
Ulcerative Colitis: Complications (2) - ✅✅-BLOODY DIARRHEA & ELECTROLYTE
DISTURBANCE
Crohn's Disease: Acute Chronic Flare-up MNT - ✅✅-Bowel rest, parenteral
nutrition or minimal residue
Ulcerative Colitis: Acute UC Treatment - ✅✅-Elemental diet may be needed to
minimize fecal volume
When IBD is in remission or under control - MNT - ✅✅-High fiber to stimulate
peristalsis
IBD MNT (4-6) - ✅✅ -- maintain fluid and electrolyte balance
- antidiarrheal agent (sulfasalazine)
- ENERGY NEEDS ACCORDING TO CURRENT BMI
- LIMIT FAT ONLY IF STEATORRHEA
- HIGH FAT MAY IMPROVE ENERGY BALANCE
- ASSESS Ca, Mg, Zn (loss in steatorrhea)
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