SWM Module 19: Wound Care — Nutritional Considerations Flashcards

Anthropometric Measurements for Screening

Anthropometric Measurements for Screening

Best practices to obtain accurate weight and height measurements include:

BMI

What is BMI?

BMI

Underweight:

BMI

Normal weight:

BMI

Overweight:

BMI

• Obesity:

What does PEM stand for?

What happens when there's a Lean Body Mass Loss of 20%?

What happens in the body when there's a Lean Body Mass Loss of 30%?

If the loss is less than ___ of lean body mass, healing continues, but greater losses divert protein to restore body mass, slowing the healing process.

Biochemical Markers

Not the best indicators of visceral protein due to variability. Hydration, inflammation, and liver function can affect their reliability.

This reflects immune system status. Stress and infection can influence TLC.

Managing ______ is key to improving healing and recovery.

The below are signs of what?

• Thirst
• Cracked Lips
• Sunken Eyes
• Dark or Strong-Smelling Urine
• Poor Skin Turgor
• Confusion

Types of Dehydration

There are three types of dehydration – ___ ___ and ___. Each one affects cell tonicity differently. What are those 3 types?

• Commonly caused by excessive sweating and/or fevers
• More water loss than sodium
• Requires water replacement

• Commonly caused by vomiting and/or diarrhea
• Equal loss of water and sodium
• Requires replacement of both

• Commonly caused by diuretic use and/or kidney disease.
• More sodium lost than water
• Requires both water and electrolyte replacement

_________ damages tissues through increased protein degradation, decreased collagen formation, and slow healing.

The American Diabetes Association (2023) recommends the following ranges for blood sugar: Fasting Blood Sugar

The American Diabetes Association (2023) recommends the following ranges for blood sugar: Non-Fasting Blood Sugar for peak postprandial

Hemoglobin A1c reflects average glucose over the past __ to __ weeks.

Higher values indicate a higher risk of diabetic complications, including ___ _____.

Normal hemoglobin A1c for adults is ___.

The target range for people with diabetes is ___.

What is the primary purpose of nutrition screening in healthcare settings?

To provide detailed dietary plans for the person

To identify those at risk of malnutrition and decide on the best interventions

To measure the exact caloric intake of each person

To ensure everyone receives the same nutritional supplements

True or False

Nutrition is vital for wound healing; nutrient deficiencies can delay or impair normal healing processes.

Aim for __ _ ___kilocalories per kilogram of body weight daily, adjusting for age, comorbidities, activity level, healing stage, wound severity, and the number of wounds. Monitoring and adjusting calorie intake will enhance the healing process.

____ are essential for collagen production, new cells, and blood vessels. Insufficient dietary ____ will delay healing. Proteins also support surgical wound repair, skin health, fluid and electrolyte balance, and immune function.

With a heavily exudating wound, the body can lose up to ___ ___ of protein a day, making it important to adjust protein intake to compensate for protein loss through exudate.

The body breaks down protein into ___ ___, which contain _______.

These amino acids are the building blocks of proteins and are crucial for ____ ___ and ____ ____.

Amino acids like ___ and _____ are particularly important for speeding up the healing process

Neither arginine nor glutamine can be adequately metabolized ___ ___, making supplementation important during the body's healing phases.

Arginine is a building block of protein, supports immune response, and is essential to collagen formation. Its role in healing is:

Glutamine is necessary for building proteins in the body. Its role in healing is:

Achieving a positive nitrogen balance is necessary for new tissue synthesis. This occurs when nitrogen intake exceeds nitrogen excretion, enabling the body to build and repair tissues effectively. Insufficient protein intake leads to a negative nitrogen balance, causing tissue breakdown instead of repair.

For effective wound healing, aim for ____grams of protein per kilogram of body weight.

For effective wound healing, aim for ___ ___ of protein per kilogram of body weight for severe wounds or burns.

Sources of high-quality protein include -

Patients with ___ _____ must be careful about how much protein they take. Always consult the patient’s nephrologist and dietitian to recommend appropriate diets and supplements!

Key Points

__ ___ like arginine and glutamine are vital for _______ __ the healing process.

A person’s daily protein requirements might look like this: Typical adults:

A person’s daily protein requirements might look like this: During wound healing:

A person’s daily protein requirements might look like this: Severe wounds or burns:

Fats and Fatty Acids

Fats and fatty acids normally constitute ___ to ____of total daily calories and should come from healthy sources. Fats and fatty acids play a significant role in wound healing

Fats and fatty acids play a significant role in wound healing by:

• Important for reducing inflammation and supporting cell membrane integrity.
• From sources like fish, nuts, seeds.

• Anti-inflammatory
• Support tissue regeneration
• Found in fish, flaxseeds, chia seeds, walnuts, and hemp seeds

• Omega Six Fatty Acids Omega-6 fatty acids are another type of healthy fat necessary for cellular function. Important to note:

Both omega-3 and omega-6 are essential, but maintaining a proper balance is crucial. The typical Western diet is often too high in ____and too low in ___, which can lead to excessive inflammation.

Aim for a balanced intake to support optimal wound healing and overall health.

T/F

By burning carbohydrates for energy, the body preserves protein for its role in healing

Glucose, a form of carbohydrate, is used for __production and is needed in phagocytosis and collagen development.

What is needed for Phagocytosis and collagen development in wound care?

Vitamins and minerals

Hemostasis, inflammation, proliferation, and remodeling are what in wound healing?

Hemostasis

Primary Hemostasis (Stopping the Flow)

Inflmmation

Inflammation begins within ___ of injury and lasts between 2 to 5 days.

Because of increased blood flow and chemical activity at the injury site, the inflammatory phase is characterized by four distinct physical symptoms:

Fat-Soluble Vitamins

Fat-soluble vitamins are stored in the ____ and play crucial roles in collagen formation, immune response, and blood coagulation. Ensure adequate intake from dietary sources for wound healing.

Vitamins A, D, E, K

Function / Source: Vitamin A

Function / Source: Vitamin D

Function / Source: Vitamin E

Function / Source: Vitamin K

Two key water-soluble vitamins vital for wound healing are:

Vitamin _____

• Antioxidant
• Supports the immune system
• Key for collagen synthesis required for new connective tissue formation
• 500 mg or more daily to support wound healing
• Found in citrus fruits, strawberries, and bell peppers

B Complex

• B1:

B Complex

• B2:

B Complex

B3:

B Complex

B5:

B Complex

B6:

B Complex

B7:

B Complex

B9:

B Complex

B12:

Name that vitamin:

Folate for DNA repair and red blood cell production

Name that vitamin:

Pantothenic acid key for energy production and fatty acid metabolism

Name that vitamin:

Niacin for DNA repair and skin health

Conditions like pernicious anemia, gastric or ileal resections, Crohn's disease, and low stomach acid can___ vitamin B12 absorption, sometimes necessitating B vitamin injections.

_____ are vital for DNA synthesis, oxygen transport, and inflammation reduction. Adequate intake from sources like meat, beans, shellfish, and fortified cereals is crucial for wound healing.

Name the mineral:

• Tissue Repair
• Immune function
• Anti-inflammatory properties
• Liberates vitamin A from storage in the liver
• Depleted with wound drainage, excessive gastrointestinal fluid loss, or poor long-term dietary intake
• No supplement recommendations unless true deficiency
• High serum zinc levels may inhibit healing and interfere with copper metabolism

Name that mineral:

• Oxygen transport to healing tissues
• Energy production
• Immune response

Name that mineral:

• Preserves strength of skin, blood vessels, epithelial and connective tissue
• The balance between copper and zinc levels is more clinically significant than their concentrations alone.

• Aids in hydration of wound sites and oxygen perfusion
• Solvent for minerals, vitamins, amino acids, glucose, and other small molecules
• Transports vital nutrients to cells and removes wastes from them

Patients with excessive wound drainage are at a higher risk of dehydration. Additional risk factors for dehydration and conditions requiring extra fluids include:

Prioritize ___ over other beverages, as some can negatively affect nutritional balance.

• Heart Failure
• Edema
• Fluid Overload
• Severe Renal Failure

Amino acids play a significant role in tissue repair, what are amino acids considered the building block of?

Proteins

Vitamins

Fats

Carbohydrates

Protein breaks down into ___ ___ , considered the building blocks of protein, which are needed for tissue repair and collagen synthesis. Amino acids are not considered the building blocks of vitamins, fats, and carbohydrates.

Amino acids are needed for the following:

Proteins are crucial for collagen production and tissue repair; 1.2 to 2 grams per kilogram of body weight is the recommended amount of protein for wound healing.

Which strategy effectively enhances nutrition in a person with a reduced appetite?