Editing Nutrition – RN Flashcards (section)

== Macronutrients and Micronutrients ==

;How many calories per gram do carbohydrate, protein, fat, and alcohol supply?
:Carbohydrate 4 kcal/g, protein 4 kcal/g, fat 9 kcal/g, alcohol 7 kcal/g.

;What is the baseline adult protein requirement, and how does it change with major wounds, burns, or sepsis?
:About 0.8 g/kg/day at baseline, rising to roughly 1.2 to 2.0 g/kg/day with major wounds, burns, sepsis, or trauma.

;Which nutrients are most critical for wound healing?
:Protein for collagen synthesis, vitamin C for collagen cross-linking, vitamin A for epithelialization, zinc for cell proliferation, and adequate total calories so protein is not burned for energy.

;Which vitamins are fat soluble, and what is the clinical implication?
:A, D, E, and K. They are stored in liver and adipose tissue, so deficiency develops slowly, toxicity is possible with megadoses, and absorption fails in fat malabsorption, cholestasis, cystic fibrosis, and after bariatric surgery.

;Why must thiamine be given before or with glucose in a client with chronic alcohol use disorder?
:Glucose metabolism consumes thiamine. Administering glucose to a thiamine-depleted client can precipitate acute Wernicke encephalopathy, presenting with confusion, ataxia, and ophthalmoplegia.

;What distinguishes B12 deficiency anemia from folate deficiency anemia?
:Both cause megaloblastic, macrocytic anemia, but only B12 deficiency produces neurologic findings such as paresthesias, ataxia, and loss of proprioception. Treating with folate alone corrects the anemia while neurologic damage progresses.

;Which common medications cause long-term vitamin B12 deficiency?
:Metformin and proton pump inhibitors, along with any condition removing intrinsic factor or the terminal ileum, such as gastrectomy, pernicious anemia, and ileal resection.

;What increases and what decreases non-heme iron absorption?
:Vitamin C increases it. Calcium, dairy, antacids, tea, coffee, and phytates in whole grains decrease it. Heme iron from meat, poultry, and fish is absorbed best overall.