PUD

Assessment

The assessment for PUD is symptoms of abdominal discomfort between the navel and breastbone that is dull and occurs when the stomach is empty. Being bloated, burping, vomiting, poor appetite, and weight loss are also symptoms that will be assessed. Some symptoms such as sharp, sudden, stomach pain, melena, and bloody vomit are emergency symptoms that require immediate attention.  As much information as possible about diet and weight changes should be recorded. An endoscopy plus a tissue biopsy that would allow a professional to see the ulcer would also confirm. A few other ways to test include C-urea breath test, stool antigen test, and serum testing for antibodies. Lastly, H Pylori can be tested for, but many people with H. Pylori do not develop symptoms. 

 

Drugs

Carafate, AlternaGel, Pepcid, PPI

 

 Abbreviations

EGD: esophagogastroduodenoscopy

GER: gastroesophageal reflux 

GERD: gastroesophageal reflux 

UES: upper esophageal sphincter

 

Disease-specific nutrient and dietary requirements

Vitamin B-12 should be tested and patients should eat foods high in vitamin B-12. 

Iron, calcium and other nutrients might also experience malabsorption.  For some patients, acidic food should be avoided.  Large amounts of alcohol should not be consumed. Coffee and cream could cause issues too. Spices increase acid secretion and should be avoided. Green tea, broccoli, sprouts, and kimchi help with eradicating H. Pylori. 

 

DKA

Assessment 

Infections, inadequate insulin, pump malfunction, drug abuse, pregnancy, acute illness, and stress are precipitating factors.  Medication, blood glucose, food, nutrition history, physical activity history, biochemical and anthropometric data should be evaluated. 

 

Drugs 

Tagamet, insulin,  electrolyze supplements, alkalinizing agents,  Biguanide, Sulfonylureas, Meglitinides, Thiazolidinediones, GLP-1 Receptor Agonists, DPP-4 inhibitors, Alpha-glucosidase inhibitors. 

 

 Abbreviations

CGM: continuous glucose monitoring

CF: correction factor

DKA: diabetic ketoacidosis

GI: glycemic index

GL: glycemic load

IFG: impaired fasting glucose

IGT:  impaired glucose tolerance

SMBG: self-monitoring blood glucose

 

Disease-specific nutrient and dietary requirements

CHO counting is used to determine how much insulin is needed. The amount of insulin required by the patient is determined by how many carbohydrates they eat. In order to know the proper dose of insulin, they must count and calculate their carbohydrate intake. The most important part about diet for DKA is managing insulin and making sure it does not get to low. This means eating an equal amount of carbohydrates in small meals throughout the day. 

 

Drug-Nutrient/Depression

Assessment

A patient has depression if they have been depressed for more than 2 weeks, impaired function, irritability, decreased interest or pleasure, loss of concentration, suicidal thoughts, fatigue, change in sleep, weight change, or feeling sad or empty. A decrease in fish oils and omega-3 in diet can contribute to depression because this will cause a hormone imbalance. 

 

Drugs

SSRIs, serotonin-norepinephrine reuptake inhibitors, norepinephrine-dopamine reuptake inhibitor,

 

Abbreviations

AD: Alzheimer’s disease

CFS: chronic fatigue syndrome

DSM-5: Diagnostic and Statistical Manual of Mental Disorders 

EPA: eicosapentaenoic acid

ENS: enteric nervous system

MDD: major depressive disorder

MCI: mild cognitive disorder

 

Disease-specific nutrient and dietary requirements

Fish oil supplements, curcumin, and foods high in EPA and DHA are important. Vitamin B and magnesium deficiencies have been linked to depression. Besides these nutrients, a balanced diet with lots of fruit, vegetables, natural fat sources, and lean protein sources is the main nutrition treatment. 

 

Hematology

Assessment

Symptoms of iron deficiency anemia are leg cramps, craving ice, sore tongue, tachycardia, pale gums and nail beds, and swollen tongue. A diagnosis requires serum ferritin, iron, and transferrin evaluation. TIBC and STFR are other biochemical evaluations. 

 

Drugs

Inorganic iron in the ferrous form, a chelated form of iron is more bioavailable, parenteral iron-dextran is used if iron supplements fail.

 

Abbreviations

IF: intrinsic factor

MFP factor: meat-fish-poultry factor

RLS: restless leg syndrome

SCA: sickle cell anemia

STFRs: soluble serum transferrin receptors

TIBC: total iron-binding capacity

 

Disease-specific nutrient and dietary requirements

Eating foods high in iron, especially heme iron, is important. Heme iron is in meat, fish, and poultry. Some foods inhibit iron absorption and some enhance its absorption. Foods that enhance its absorption are foods high in vitamin C.