Heathy Lifestyles Final Exam

Tons

Adding plexiglas to an infusion pump

A scientific discipline that studies human error

Heat illness, sedentary behavior & workplace violence

reduce, reuse, recycle

OARS

Promoting positive behavior change

Brisk walking for 30 minutes, 3 times/ week

Primary, secondary & tertiary

An active state which facilitates well- being

physical, emotional, mental, social, environmental, occupational, and spiritual

Efforts to prevent an injury or illness from ever occurring. Primary prevention includes health promotion, environmental protection, and specific protection against disease or injury. In primary prevention, health promotion includes education in many forms such as nutrition and sex education. Counseling, family planning, and the promotion of physical activity are other forms of health promotion. Environmental protection includes sanitation, air quality control, and food, workplace, and home safety. Specific protection against disease or injury includes preventions such as immunizations, use of seatbelts and infants' car seats, preconception folic acid supplementation, and reduction of human exposure to carcinogenic agents

refers to education that will allow prevention or allow a patient that has a disease to have early diagnosis, which can allow time to cure the disease. Health screenings are at the core of secondary prevention and are very important. Blood pressure screenings, screening for breast can using mammograms for example are secondary forms of prevention. Usually secondary prevention takes place in community settings

includes interventions that limit disability or interventions that enhance rehabilitation from disease, injury, or disability. For example if a patient has elevated blood pressures that were not controlled by diet and exercise then the patient may be referred to a doctor medication and received referrals for other specialist such as a cardiologist. Examples of tertiary prevention are medical treatment, physical and occupational therapy, and rehabilitation

a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity

the "active process of becoming aware of and making choices toward a healthy and fulfilling life. [...] a dynamic process of change and growth."

"any combination of learning experiences designed to help individuals and communities improve their health, by increasing their knowledge or influencing their attitudes".

Nurses promote health, prevent disease and help patients cope with illness. They are an integral part of the health education process. As educators, they help whole communities by teaching individuals and groups how to take steps to improve or maintain their health.

Incorporate a variety of methods. Facilitate active learner involvement. Create a conducive learning environment. Assess learner readiness. Include relevant information which relates to the learner's life experiences. Practice repetition of concepts presented. Promote a positive experience. Arrange material to be presented from simple to complex. Promote learning in a variety of settings. Consider the pace of learning for the target audience.

Bloom's taxonomy is a set of three hierarchical models used to classify educational learning objectives into three levels of learning. Cognitive, affective, and psychomotor domains are summarized below and discussed further in your readings:

is defined as the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions (UNC Health Sciences Library, 2018). The Patient Protection and Affordable Care Act of 2010, Title V, defines health literacy as the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions (CDC.gov).

1. Assess Learning Needs & Readiness 2. Determine Learning Needs 3. Develop Learning Outcomes 4. Develop a Teaching Plan 5. Implement Teaching Plan and Strategies 6. Evaluate Learning

- requires intellectual behaviors and focuses on thinking. It involves knowledge (learning thenew information), comprehension (understanding the new information), application (using the new information in aconcrete way), analysis (organizing the new information), synthesis (using the knowledge for a new outcome), andevaluation (determining the effectiveness of learning the new information).

- involves feelings, beliefs, and values. Hearing the instructor's words, responding verbally and nonverbally, valuing the content or believing that it is worth learning, creating a method for identifying values and resolving differences, and employing values consistently in decision-making.

- gaining skills that require mental and physical activity. Psychomotor learning relies on perception (or sensory awareness), set (readiness to learn), guided response (task performance with an instructor),mechanism (increased confidence allowing for more complex learning), adaptation (the ability to alter performance when problems arise), and origination (use of skills to perform complex tasks that require creating new skills).

- Evaluate whether the learning objectives were met. Determine if your teaching was effective? Would you revise any teaching for future sessions? Revise the plan if learner outcome(s) were not met. Determine follow-up and resources. Document the teaching- learning process.

- Prepare the physical environment, deliver effective communication, secure audiovisual equipment, deliver the information. Be flexible, keep the sessions short, and vary teaching strategies used. Relate the material to the learner's life experiences, plan for evaluation of learning, and assess feedback (verbal and non-verbal). Remember the Acronym TEACH to maximize the effectiveness of patient teaching.

- Select content, content sequencing and appropriate teaching strategies for the selected topic. Health topics can include such areas as promoting health, preventing illness, restoring health, and facilitating coping. Consider the patient's learning style, interests, and resources. Explore time constraints and the physical environment in which the teaching will occur. Consider the SMOG calculator when developing teaching materials. SMOG can be used to assess the readability of text used in educational information. Health literacy will be discussed in greater detail later on in this module. Smog Calculator (Links to an external site.)

- Identify SMART goals ; determine learning domains, prioritize & include the learner. Refer to Bloom's taxonomy to assist you with the level of learning and appropriate "verbs" to use for each. Think about how you will evaluate learning from the goals developed.

- Make sure they are realistic and validated through interactions with the patient/ family.

Identify knowledge, skills or attitudes needed by the learner. Assess their readiness to learn and factors affecting their ability to grasp the content. Consider the learner's physical maturity, psychosocial development and cognitive ability.

Teaching is directed towards the parents.

If teaching is geared toward young children, material should be presented in a simplistic manner, including only basic facts and concrete examples. Digital games, animations, "hands on" demonstrations are beneficial to relay the information. Consider the shorter attention span and increased need for nurturing, support and creativity when teaching children.

The teaching learning process for school aged children should take into considered the logical reasoning abilities they have. Clear explanations and reasons for care activities can be presented using creative learning activities. Information presented should be presented in a simple and logical manner. Adult reinforcement of information presented is needed.

Teaching is similar to adults so content and strategies resemble those. Such considerations as the adolescent's maturational level, peer group, need for independence and a trusting relationship ] should not be overlooked.

As adults age, teaching is varied according to personalities and and learning abilities. Adults must see the need for learning before being willing to learn new skills, procedures, etc. Motivational skills complement the teaching- learning process when working with adults. As aging occurs, sensory deficits, limited physical mobility, and the inability to comply with a recommended regimen are teaching considerations. Allowing additional time , shorter teaching sessions, and reduction of environmental distractions contribute to successful teaching (Nigolian & Miller, 2011).

cognitive, affective, psychomotor

Specific, Measurable, Attainable, Realistic, Timely

T: Tune in to the patient E: Edit patient information A: Act on every teaching moment C: Clarify often H: Honor the patient as a partner in the process

is a quick method for health care professionals to check how well the learner has understood information presented. This includes having the nurse demonstrate and observing the patient and/ or family repeat back or perform the desired skill (Arkansas State University, 2018).

relates to the traditional method of teaching in surgery characterized by the American surgeon William Stewart Halsted. Medical trainees were expected to be capable of performing a certain procedure after observing one being performed. Subsequently after performing it, they should also be able to teach others. (European Medical Journal, 2014). SODOTO is widely used in health education today.

is prevalent in all ethnicities, sexualities, and genders. A person with health illiteracy cannot follow simple instructions. For example, they cannot read the side effects on a medicine bottle, understand a campaign about the risks of a drug overdose, or vaccination clinics advertised on posters (Worldliteracyfoundation.org).

• Choose • Define • Find • How • Label • List • Match • Name • Omit • Recall • Relate • Select • Show • Spell • Tell • What • When • Where • Which • Who • Why • Classify • Compare • Contrast • Demonstrate • Explain • Extend • Illustrate • Infer • Interpret • Outline • Relate • Rephrase • Show • Summarize • Translate • Apply • Build • Choose • Construct • Develop • Experiment with • Identify • Interview • Make use of • Model • Organize • Plan • Select • Solve • Utilize • Analyze • Assume • Categorize • Classify • Compare • Conclusion • Contrast • Discover • Dissect • Distinguish • Divide • Examine • Function • Inference • Inspect • List • Motive • Relationships • Simplify • Survey • Take part in • Test for • Theme • Agree • Appraise • Assess • Award • Choose • Compare • Conclude • Criteria • Criticize • Decide • Deduct • Defend • Determine • Disprove • Estimate • Evaluate • Explain • Importance • Influence • Interpret • Judge • Justify • Mark • Measure • Opinion • Perceive • Prioritize • Prove • Rate • Recommend • Rule on • Select • Support • Value • Adapt • Build • Change • Choose • Combine • Compile • Compose • Construct • Create • Delete • Design • Develop • Discuss • Elaborate • Estimate • Formulate • Happen • Imagine • Improve • Invent • Make up • Maximize • Minimize • Modify • Original • Originate • Plan • Predict • Propose • Solution • Solve • Suppose • Test • Theory • Maximize

Better overall healthPhysical and psychological healthFlexibility, muscle strength, enduranceLower incidence of coronary heart disease Better brain healthWeight reductionHealthy agingMaintenance of bone massArthritisLower back painImmune Function

WomenLower SES and less educationAfrican AmericansHispanicsPeople with disabilitiesChildren who are less active in early yearsResidents living in Northeastern & Southern states

Body movement carried out by skeletal muscles that requires energy

Planned, structured, repetitive movement intended to improve or maintain physical fitnessPhysical activity is essential to healthExercise is necessary to significantly improve fitness

< 5,000 = Sedentary 5,000- 7,000 = Low Active 7,500-9,999 = Somewhat Active 10,000- 12,4999 = Active *> or = 12, 5000 = Highly Active*

1.Cardio Endurance 2.Muscular Strength & Endurance 3.Flexibility4.Body Composition

Ability of the body to perform prolonged, large-muscle, dynamic exercise at moderate-to-high intensity Central component of health-related fitness Recommendation 20 to 60 minutes/ session Single or multiple sessions10 or more minutes/ session High- intensity exercise may require less time

Client's perception of exercise intensity Subjective Rating sOverall feelings Exertion & Physical Fatigue Not the same for everyone Correlate Heart Rate Oxygen Consumption

A technique used to express or validate how hard a client feels he or she is working during exercise. 6= No exertion at al l7 8 9= Very light 10 11= Light 12 13 Somewhat hard (*) 14 15= Hard (Heavy) 16 17= Very Hard 18 19= Extremely hard 20= Maximal exertion*= Feeling your exertion at a manageable level

Maximize your cardiorespiratory benefits 65-90% of your maximum heart rate Can be adjusted (percentage range) for clients beginning exercise and/or unfit individuals

(MHR)220 - client's age = MHR

Multiply the MHR by 65% and 90% Example19-year-old MHR = 220 - 19 = 201 65% training intensity 0.65 X 201 = 131bpm 90% training intensity 0.90 X 201 = 181 bpm Heart Rate Range= 131-181 bpm

difference between maximum heart rate and resting heart rate Requires an accurate resting HR Client must know how to take pulse

Helpful for Unusually high or low resting heart rates Possible causes Medications, illnesses, chronic conditions, fitness level

25 year old with a Resting Heart Rate of 65 bpm Plans to exercise 50-85% exercise intensity Example:220-25 = 195 (maximum predicted heart rate) 195 - 65 = 130 (heart rate reserve) 130 (HRR) 130 X 0.50= 65 + 65 =130 bpm 130 X 0.85= 110.5 + 65= 175.5 round to 176 Target Zone 130-176 bpm

StrengthForce a muscle produces with single maximum effort Greater muscle mass means higher rate of metabolism. Beneficial for weight loss & maintenance

Ability of muscle to remain contracted or to contract repeatedly for a long period of time.

Sum of the vital processes by which food energy and nutrients are made available to and used by the body

Ability to move joints through their full ranges of motion As we age, the importance increases rapidly Essential for good back healthAffects our overall fitness level

Frequency, Intensity, Time, Type

Proportion of fat and fat-free massAmount of muscle, bone, and water in a body

Body-type classification system that describes people Can influence fitness Muscular (mesomorph) Tall and thin (ectomorph) Round and heavy (endomorph)

Evaluate current fitness level and health statusMost likely safe if Male and under 40 yearsFemale and under 50 years Never hurts to consult provider Higher RiskMen 40 years and aboveFemale 50 years and above Preexisting health problemsHypertension, heart disease, muscle/ joint conditions, obesity, diabetes, etc.Visit health care provider Consider gender, age, health history, present health condition, illnesses, medications May need further testing prior to startingDetermined by providerTypes: Exercise stress testAnalysis of changes in electrical activity in the heart from an electrocardiogram (EKG or ECG) taken during exercise.Used to determine if any heart disease is present and to assess current fitness level Graded exercise test (GXT)Exercise test that starts at an easy intensity and progresses to maximum capacity.

Assess current level of fitness for each of the five fitness components.What am I doing right now?

Think carefully about overall goals, and be clear why you are starting a program.Health vs. Body Image?

Train regularly & the way you want to change Start slowly, and get in shape graduallyBeginning phase Progress phase Maintenance phase Increase duration and frequency before increasing intensity.

Warming up can decrease your chances of injury. Cooling down after exercise restores circulation to its normal resting level. Exercise safely Avoid overloading muscles & joints Less pain, more gain Listen to your body, and get adequate rest Quality of sleep critical Cycle the volume and intensity of your workouts2-23 Vary your training activitiesMix it up so it's not monotonous Try training with a partner Buddy system Train your mind Prepare to be successful! Fuel your activity appropriately Have FUN! Choose what you LIKE to do! Track Your progress Keep your exercise program in perspective

Hydration Current Average Recommendations½ to 1 oz. of water for each lb. of weight Example An individual who weighs 150 lb. would need75 to 150 oz. of water daily Consider activity, climate (hot/ cold), physical exertion, age, gender, healthConditionMonitor urine color & amount

Develop tools to monitor progress Track daily progress to remind you of your ongoing commitment to your program and to gain a sense of accomplishment The results of different fitness tests vary Compare results over time Make a commitment Signing an agreement or contractKeep it visible to remind you

Physical activity throughout the day Active play encouraged

Provide opportunities to exercise every day Need at least 60 minutes per day Variety is Key Activity 3 days a week Vigorous- running, soccer Strengthens muscles- climbing or push-ups Strengthens bones- gymnastics, jump rope Children need to be developmentally capable of participating in an activity Make sure children get plenty of water when exercising in the heat

Improves overall health and wellness Healthy adults Should perform at least 150 minutes (2 hr. 30 minutes) of moderate intensity aerobic exercise or at least 75 minutes (1 hr. 15 minutes) of vigorous intensity exercise per week .Brisk walking

65 years and ove rAdd in activities to improve balance For strength training Use a lighter weight; perform more (10 to 15) repetitions Perform flexibility exercises at least 2 days per week for at least 10 minutes Drink plenty of water Avoid exercising in extreme temperatures Warm up slowly and carefully Cool down slowly, continuing very light exercise until the heart rate is below 100.

Physician Visit Maintain moderate level Increase intensity gradually Consider heart rate range Limitations, medications Warm up and cool down gradually Session lasting at least 10 minutes Monitor heart rate during exercise Stop if symptoms present Nitroglycerin (meds). available if ordered Use Borg Scale RPE to monitor workload

Physician May recommend Stress Test Diabetes well controlled Exercise with a buddy Wear health bracelet Adjust insulin amount/ timing Monitor blood sugar closely Keep record of diet, insulin & activity

Low-to-moderate activities Increase intensity slow Weight increases their efforts Exercise 60 min. or more each day Single or multiple sessions Non- or low weight bearing exercises GO SLOW!!Monitor for heat intoleranceRecognize signs/ symptoms

Keep regimen regular Allows body to adjust Carry medications as prescribed Eg. InhalersWarm up & cool down slowly Self-paced endurance activities Beginning until body can tolerate Education about those circumstances that can trigger attacks

Help individuals develop an exercise plan What to consider? Referral Identify at-risk individuals Resources Community, family support, health providers

1. Place the tips of your index, second, and third fingers on the palm side of your other wrist, below the base of the thumb. Or, place the tips of your index and second fingers on your lower neck, on either side of your windpipe. (See the illustrations to the right.) 2. Press lightly with your fingers until you feel the blood pulsing beneath your fingers. You might need to move your fingers around slightly up or down until you feel the pulsing. 3. Use a watch or stopwatch for accuracy. 4. Count the beats you feel for 10 seconds then multiply this number by six to get your heart rate (beats per minute or bpm). Check your pulse -x 6 = (beats in 10 seconds) (heart rate in bpm)

ACSM stands for American College of Sports Medicine.

The ACCM's mission is "ACSM is a community of the best and the brightest. Diverse in many ways, yet united in our vision to create a better life for individuals, families and communities". Reference: http://www.acsm.org/acsm-membership

Study of food intake How food nourishes the body Nutrients Substances within our body; majority work together Activity, reproduction, growth/ development, maintaining health, recovery from illness.

o Essential component of our food o Required in large amounts o Help our body in proper functioning, growth/ development, metabolism o Body obtains calories from o Protein, carbohydrates, fat and fiber

Nutrient Kcal Value per Gram Carbohydrates 4 Proteins 4 Lipids (Fats) 9

Major source of energy 45-65% of our daily energy needs Provide glucose- efficient more of energy Easily used by the body Keeps CNS functioning Stored in major organs and used later on Primarily starchy food Regulate protein & fat metabolism

Simplest sugar Carbon, hydrogen & oxygen Basic Energy; Building blocks Glucose Molasses, Carrots, Corn, Dates, Grapes, Oranges Fructose Cherries, Fruits, Honey Galactose Yogurt

Simple; double sugar Made of 2 monosaccharides Energy Calcium & phosphorous absorption Sucrose Table Sugar Glucose & Fructose Apricots, granulated table sugar, honeydew and cantaloupe, molasses, peaches, peas, corn, plums Lactose Milk sugar Maltose Malt or beer sugar

Complex Carbohydrates 45-60% of total calories Body digests 95% of starch within 1- 4 hrs of eating Refined Tend to be much lower in fiber, vitamins, minerals Unrefined Take longer to chew and digest Enter bloodstream more slowly Whole grains linked to reduced risk of heart disease, diabetes, and cancer Important role in GI health and body weight management

starches found in grains, potatoes, and vegetables

SIMPLE COMPLEX Choose LESS often White bread, pasta, rice, Regular crackers White potatoes Soda, Juice Candy, Sweets Sugar, Honey, Jelly, Jam Choose MORE often Whole wheat, whole grain Brown rice, whole wheat pasta Starchy vegetables Sweet potato Winter squash, Corn/ Peas Whole milk Other whole grains Quinoa, oats

Non-digestible carbohydrate Plant foods contain some dietary fiber Fruits, legumes, oats (oat bran), & barley Help regulate blood glucose & cholesterol levels Total Fiber Women: 25 grams/ day Men: 38 grams/ day

(viscous) fiber Dissolves in water and is fermented by the intestinal bacteria. Gel develops Found in fruits/ vegetables Helps with diarrhea & constipation Lowers cholesterol Regulates blood sugar

• Isn't dissolved in water or fermented by intestinal bacteria. Fiber not broken down by bacteria Skin of fruit, celery strings Passes through in bulk Helps with constipation Removes waste from body quickly Lowers Colon Cancer risk

10-35% of calories Growth, Tissue Repair, Immune Function, Energy Preserve lean muscle mass Foods Meats, poultry, fish, cheese, milk, nuts, legumes, some starchy foods/ vegetables Made up of smaller amino acids

: Fish, beef, chicken, fish, poultry, egg and dairy

Plant based Grains, fruits Vegetables

Provides the protective layers around our organs and energy reserve Important- brain and nerves Used to make our hormones You are what you eat so choose your fats wisely Texture and flavor Dietary Guidelines for Americans (2015-2020) Limit intake of saturated fats and trans fats Less than 10 % of calories per day f

Lipids Chemical group Dark meat, poultry skin, dairy foods Added oils Fat Essential nutrient Provide densest form of energy Hormone production, vital organs protection, body temperature, fat-soluble vitamin absorption

Very- low density lipoprotein (VLDL) Carries triglycerides to cells Low-density lipoprotein (LDL) Blood fat transports cholesterol to organs/ tissues Excess amounts cause accumulation of fatty deposits on artery walls Saturated and trans fat raise levels Unsaturated fats lower levels High-density lipoprotein (HDL) Blood fat that helps transport cholesterol out of the arteries

Improves blood cholesterol and insulin sensitivity Look for Omega-3 fatty acids Heart disease prevention Vision Brain development in infants (DHA/EPA) Reduce symptoms of arthritis Avocado, nuts, seeds, olives, fatty fish

Monounsaturated Healthy, Eat MORE Olives, canola oil, avocado, peanuts & nuts, eggs Polyunsaturated Corn, wheat germ, soybean, safflower, sunflower, fish Fatty Acids Omega- 6 Fatty Acids Both, eat in moderation Omega- 3 Fatty Acids Healthy, Eat More

Make up majority of fat in food Solid- room temperature Primarily animal sources Beef, butter, hard yellow cheeses, luncheon meat

Unhealthy fats that form when vegetable oil hardens Hydrogenation Hydrogens added to unsaturated fats ▪ Turns liquid oil into solids ▪ Produces a mixture of saturated & unsaturated fatty acids Labeling Partially hydrogenated vegetable oils Palm and coconut oils Can read 0 g if less than 0.5 gm/ serving

Can't be synthesized in the body Consumed via Diet/ Supplements Three types Protein Carbohydrates Fats

Required in smaller amounts to regulate and maintain body functioning Not required to be a dietary supplement Synthesized within the body Types Vitamins Minerals Water

A nutrient that regulates many chemical reactions Macro minerals. Greater than 100 mg Calcium, sodium, potassium, magnesium, phosphorus, chloride (chlorine), and sulfur Trace minerals Small amounts Iron and zinc

Helps maintain fluid balance Helps transmit nerve impulses Influences contraction & relaxation of muscles Too much sodium Causes high blood pressure May lead to fluid retention

The body requires 500 mg per day Average American ingest 2,300 - 6,900 mg per day. Recommended range 1,500 - 2400 mg per day

Other Names Monosodium glutamate (MSG) Baking soda Baking powder Disodium phosphate Sodium alginate Sodium nitrate or nitrite

Eat more fresh foods Eat less processed foodsLunch-meat, etc. Look for low-sodium products Avoid/ limit the salt you add to foodsAlways taste FIRST!! Experiment with other seasonings Limit condimentsKetchup, mustard Use salt substitutes with caution

Regulates fluids, heart, muscles, nerves Prevents heart irregularity ToxicityMuscle weakness FoodsOranges, peaches, pears, bananasDates, applesAvocados, raisins

The most abundant mineral in your bodystored in the bones How much do you need? Males 19-50 years old: 1,000 mg / day Females 19-50 years old: 1,000 mg / day Food Sources Broccoli , Carrots, Cheese, Green beans, spinachMilk & Low fat yogurt, Tofu

Bone formation, Nerve/ muscle function, smooth muscle relaxant Deficiency Weakness, vertigo, increased blood pressure, anorexia Excess Diarrhea, nausea, muscle weakness, hypotension, bradycardia, lethargy Food Sources Green leafy vegetables, nuts, whole grains, tuna, halibut, chocolate

Cell health Combines with calcium Releases energy Prevents osteoporosis Toxicity Tissue calcification Foods Avocados, raisins Whole grains Meat, eggs, milk

Check with provider first. High risk groups: Strict vegetariansT hose who do not eat a balanced diet Those who are over 60 yrs. Smokers and those who regularly drink alcohol Chronic dieter s Those who suffer from food allergies, intolerances

Can't live without it of our body weight Carries & helps the body absorb

should come from fluids should come from food should consume ½ of our body weight in ounces of water every day Calculate your body weight in pounds, divide it by 2 and drink that many ounces of water each day .pound man should drink 100 ounces/day women should consume 75 ounces/ day.

Cannot be stored in body - regular supply needed Excess is excreted in urine - No danger of toxic levels Unstable to heat and light, leach into cooking liquids

Vitamin A:Promotes good visionPromotes healthy skinHelps with growth and maintenance of bones, teeth, and cell structure RDA: 900 micrograms for males 700 micrograms for females

ADEK Can be stored in body - regular supply not needed Can accumulate to toxic levels if large amounts ingested -Caution: Liver disease Fairly stable at normal cooking temperatures

Too Much May turn your skin orange Fatigue, weakness, severe headache, blurred vision, hair loss and joint pain. Toxicity: May cause severe liver or brain damage Birth defects Too Little Night blindness Lowered immune system

Foods Only animal products Liver Eggs Milk, butter and cheese Carotenoids Orange/Yellow fruits and vegetables Cantaloupes, carrots, sweet potatoes, winter squash Leafy green vegetables Spinach, broccoli

Building and maintaining bones and teeth Calcium absorption and utilization Other health benefits: Boost immune system; cancer prevention RDA:IU (Teens to Adults)IU/day (Upper Limit for Adults)

Currently in the news Can cause Rickets Softening of developing bone Bow legs Malnutrition Liver & spleen enlargement Deficiency causes Inadequate diet Vegetarianism, lactose intolerance, milk allergy Body unable to absorb needed vitamin D Limited exposure to sunlight

Sun exposure minutes a day Food Sources: Fortified milk Tuna, Salmon May need a supplement Check with doctor first though Dosages vary

Important to RBC's, muscles & tissues Antioxidant Slows down aging, healthy skin & hair Deficiency is rare Toxicity is rare Vitamin E acts as a blood thinner Foods: Vegetable oils, salad dressings, whole grain cereals, green leafy vegetables, nuts, seeds, peanut butter and wheat germ, apricots, peaches

Important for blood clotting Also has a role for bone health Mostly made in the intestines Prevents: Hemorrhaging known TOXICITY Foods: Turnip greens, cauliflower, spinach, liver, broccoli, kale and cabbage

Convert carbohydrates to energy Healthy nerve function and muscle tissue, digestive system, energy metabolism. Deficiency: Fatigue, nausea, depression, nerve damage Beriberi Affects skin, muscles, heart, nerves, and digestive system Crippling "I CAN'T" disease No known TOXICITY Foods: Pork, beef, liver, peas, seeds, legumes, whole-grain

Key to metabolism and red blood cells Growth, nerve function, digestion, works with protein for maintenance, energy metabolism. Deficiency: Dry, scaly skin Premature aging Cheilosis Scaling & fissures at corner of mouth No known TOXICITY Foods: Milk, yogurt, cheese, whole-grain breads, green leafy vegetables, lean meat, and eggs, fish

Also involved with energy production Also helps with skin, nerves and digestive system Deficiency: Rare but causes: diarrhea, dermatitis, dementia and death Pellagra Scaly sores degeneration No known TOXICITY Foods: Meat, poultry, liver, eggs, brown rice, baked potatoes, fish, milk, and whole-grain foods, beans

Involved in chemical reactions of proteins and amino acids Healthy brain function, formation of red blood cells, immune system support. Deficiency: Skin changes, dementia, nervous system disorders and anemia No known TOXICITY. Foods: Lean meats, fish, legumes, green leafy vegetables, raisins, corn, bananas, mangos

Key role in red blood cell formation and cell division Age related memory, vision and hearing loss; promotes healthy red blood cells, maintains body enzymes. Deficiency: Anemia, digestive disorders, Vitiligo, neural tube defect in infants Foods: Leafy, dark green vegetables Also found in liver, beans, peas, asparagus, oranges, avocados, legumes, grapefruit

DNA synthesis Healthy red blood cell & marrow, nervous system function, sperm production, strong immune system. Improves mental energy, memory, protects against allergies and toxins (cyanide in cigarettes) Deficiency: Nervous system disorders, intestinal malabsorption Pernicious Anemia Abnormally large RBC's TOXICITY = slight stomach upset Foods: Only found in animal products Meat, fish, poultry, eggs, milk products, clams, liver

Important to bone health, blood vessel health, cell structure and absorption of iron Deficiency: Scurvy Weakness, anemia, bruising, inflamed pores, bleeding gums and loose teeth. Too much vitamin C Acid sores in soft tissues of mouth Foods: Melons, berries, tomatoes, potatoes, broccoli, fortified juices, kiwi, mangos, yellow peppers and citrus fruits

Estimated Energy Requirements (EER)Reference height and weightConsiderations DemographicsAge, SexAdult Females: 1600-2400 calories/ day Adult Males: 2000-3000 calories/ day Height and weightPhysical activity/ sedentary lifestyleWeightGain, lose or maintain

Key FunctionsPromote healthy flora Allows only broken down proteins to pass Nutrient absorptionToxin elimination Linked to Overall WellnessHealth Conditions Bloating InflammationAcneDiabetesPoor sleepDecreased overall happinessObesity

Self reflect How do you feel most of the timeStatus of physical fitnessBody composition Fat vs. muscle How are your moods Does your energy level fluctuateDo you have food cravings How is your skin, vision, dental healthHealth condition(s) recently diagnosed

Partially undigested proteins allowed inGi DistressConstipation, diarrhea, pain bloating, gasNutrient MalabsorptionWeight loss or resistance toFatty acid, vitamin/ mineral deficiencyImmunity affected Frequent colds, flu, seasonal allergies, inflammatory response

AgeHormonalStressInfectionsMedications, Diet

RemoveDietary irritantsRepairEat, drink, supplementReinoculateFermented foodsProbioticsReintroduceAdd in slowly eliminated foodsMonitor Side effects

Foods with live bacterial cultures Promote Good Gut bacteria Bacteria obtained through fermentation process Instead of eating cabbage, look for sauerkraut Fermented vegetables Shredded carrotsKombuchaFermented tea drink

Similar to sauerkrautSpicy, flavorfulPeppers/ vegetablesRicher antioxidantsPre-packaged & Available

CucumbersSaltWaterOrganic bestAvoid added sugars

CoconutTurmericGingerGarlic and onionOreganoBrussel sprouts, kale, cabbageCloves and cinnamonLemon & limeCoriander; olive oil

•Choose plain full fat yogurt/ kefir •Grass fed milk best •Read label•Dairy; Alternatives•Almond milk •Monitor added ingredients•Sugars•Preservatives•Dyes•Can add•Fresh fruit, Granola•Grain Free•Nuts & Seeds

Listen to your body!Can eliminate probiotics for one-weekAdd in one small serving probiotic foodSee how you feelGI symptoms return; avoid or cut back

Lactose intolerance, Sensitivity or Preference•Plant Based Products•Nut Milk varieties•Almond, Coconut, Cashew•Soy•Benefits/ Risks•Yogurts, Cream Cheese•Almond milk varieties•Creamers (Nut Pods/ Better Half)•Almond, Coconut Cream•Flavored; Unsweetened•Less calories•Eliminate dairy exposure

Refined table sugar High glycemic index No nutritional value Artificial sweeteners No calories or nutrients May still initiate an energy response Without nutrients- Energy deficit Nutrients vs. Toxins Fat cell storage Detoxifying from sugar allows release of toxins from fat cells Produces symptoms of withdrawal

Acesulfame K (Sweet One) Aspartame SaccharinSteviaWhite/ bleachedTruvia, Sun CrystalsSucralose (Splenda)Tagatose

Dates (1 whole)Molasses (1 TBSP)Pure Maple Syrup (1 TBSP)- Grade BCarbohydrates with Nutrients B Vitamins, phosphorous, magnesium, iron, copper, manganese, zinc, chromiumFruit Juice Real/ FreshConcentrateRaw HoneySteviaGreen leaf or extract

Brown sugarDate sugar, syrupCane sugarRaw sugarTurbinadoCane juice, crystalsCoconut nectar, sugar/ crystalsPalm sugar

Bran & germ layers removedPreserves the grain for longer timeLose most of their nutrientsWhite flourHalf of B vitamins, E, folic acid and other minerals are lost.Increases blood glucose rapidly; become hungry quicklyAvoid and/ or minimize anti-nutrient foodsWhole grain, grain-like seeds (wheat, barley, oats, beans)Better than white flourStill refined grains and grain productsWhite rice, flour, bread, cereal, crackers, cookies, pastaNegative health effectsObesity, heart disease, stroke, diabetes

Protein Wheat, rye, oats & barleySourcesBarley, bran, couscous, luncheon meats, lipstick, gloss & lip balms, pasta, soup base, vitamins, wheatProcessed foods carry risk of cross- contaminationGluten exposureBloating, fatigue, skin rashes, diarrhea, weight loss, bowel disorders, depressionDiagnosis/ Management

Germination of grains, seeds, and nutsTriggered to germinate and are eaten before they develop into full-grown plantsRetain natural plant enzymesResponsible for healthy digestionNutrients also present that would be destroyed by cookingStimulate good bacteria growthHigh in protective antioxidantsSprouts Digestible, high in protein/ fiber, vitamins/ minerals

Almond FlourCoconut FlourCassavaTropical root plant used in Asia, Africa & South AmericaLow glycemic indexGluten freeRich in B- Complex VitaminsHealthy Gut BacteriaAlternative for grain-free productsCrackers, cookies, chips, tortillas

Beans known to cause gasConsist of carbohydrates; Not proteinUndigestible carbohydratesMore tolerable if beans made more digestibleSoakingSproutingFermentingBetter nutrient- dense foods available

Laugh at something"Gut Brain" 90% Serotonin located in the gutConnects gut and brain healthStress & anxiety worsen Under/ overgrowth of bacteria, produce wrong typesResearchAtopic dermatitis (gut flora irregularity)After watching funny movies for one week, flora improved

Increase diversity of floraHelps reverse flora changes Overweight/ ObesityBrisk half-hour walk beneficialIncrease intense activity gradualOvertraining can increase inflammation

Make time for bedPoor sleep and bad dietInterfere with gut healthSet a bedtimeMake it a priorityPrepare yourself

Restricts stomach capacity to 15-30 ml.Inflatable band (belt) around upper stomach portionDiet gradually increases from liquids to pureed foodsImportant to chew foods thoroughlyAids with digestion

High-density lipoprotein is good cholesterol Low-density lipoprotein is bad cholesterol Limit fat intakeRemove visible fat from meatSkinless meatsBroil, bake, grillChoose low-fat options but don't compromise with sugarTake a statinIncrease fiber intake

Clinically proven to lower blood pressure1500 mg max daily sodium intakeHigh potassiumFruits and vegetables high in potassiumApricots, Bananas, Tomatoes, PotatoesHigh calciumLow fat diary products

Reduce sodium intake to 2,000 mg or lessLimit fluid intake 2 liters or lessIncrease protein intake from the recommended 0.8 g/kg to 1.12 g/kgPatients with heart failure that increase their protein intake live longer than those who do not.Reason UnknownConsider renal function before recommending; consult with provider.

Risk FactorsAge: Older than 45ComorbidityHypertension, hyperlipidemiaRaceBlack, Latino, Native American, Asian American, Pacific Islander, Native HawaiianFamilialPrevious diagnosis of gestational diabetes

FermentableOligosaccharidesFructose & GalactoseDisaccharidesLactoseMonosaccharidesFructoseAnd PolyolsSugar AlcoholsMannitol, Sorbitol, Xylitol

Apples, cherries, coconuts, melons, figs, nutsArtichokes, broccoli, brussel sprouts, cabbage, celery, eggplant.Milk HoneyBranMolasses, onions, radishes, Soybean, wheat, barley, yeastBeans

•Irritable Bowel Syndrome (IBS)•Functional GI Disorder•Autoimmune diseases:•Rheumatoid Arthritis•Multiple Sclerosis•Eczema•Fibromyalgia•Migraines•Triggered by eating certain products

Inherited gluten sensitivity Lack digestive enzyme that allows gluten to be digestedConfirmed with an EGDTreatment includes avoiding glutenThis includes nonfood products (lipstick, communion wafers, vitamins)Price of gluten free foods could be a barrierDifferent Response Some can tolerate certain things. Others can't eat products labeled gluten free.SymptomsDiarrhea, Bloating, Abdominal Pain, Anemia, Steatorrhea & Osteomalacia

Increase fiber to 28 mg a day to decrease risk of colon cancerQuit smoking to decrease risk of lung cancerLimit alcohol consumptionConsume polyunsaturated and monounsaturated fats (fish and olive oil)Avoid heavily processed meatsBacon Eat more on "good" daysIncrease protein/ caloriesBetween meal snacksUse whole milkAdd milk, cheese, ice cream, yogurtUse peanut butter/ fruitsDip meats in coatingEggs, milk, bread crumbs

Calculating and interpreting BMI involves the following steps: Before calculating BMI, obtain accurate height and weight measurements. Calculate the BMI and percentile using the formula: ________(weight in pounds) BMI = (height in inches) (height in inches) X 703 BMI Categories for adults age 20 and over: Underweight = <18.5 Normal weight = 18.5-24.9 Overweight = 25-29.9 Obesity = BMI of 30 or greater

Formula: (weight in pounds) BMI = (height in inches) (height in inches) X 703 Show your work here: My BMI is________________________ BMI WEBSITE

20-30%

healthy eating across the lifespan

Chicken

Smoked sausage

Missing meals because of poor planning or being too busy to eat

Nutrients

My Plate

Glucose, fructose and galactose

Spinach

Vitamin D

9

4

A, D, E and K

Vitamin K

Deadliest Plague of the 20th Century: Flu of 1918, Spanish Flu. 2020 Covid 19

Cannabidiol (CBD) Oil Vaping The Opioid Epidemic

Protection Less risk to self- PPE, supplies Daily Needs Transportation, childcare, food items, household supplies Leadership & Communication Anxiety & alert- self protection a priority Less rationale thinking; less receptive Look, listen, link Mental & Emotional Well-being Open environment to voice concerns Counseling spiritual care, employee assistance programs person, phone support, call- in sessions and support groups Ethical Concerns Support network for difficult decisions, dilemmas Promoting Wellness Empower individuals to foster personal resilience Gratitude Value and appreciation Variety of formats person, white boards

Derived from hemp plant Cousin of marijuana without addictive/ dependence nature WHO reports few health relate problems with use of pure CBD

Evidence Based Epilepsy- childhood Anxiety, insomnia Pain control- musculoskeletal, arthritis, neuropathic

Varying laws among states Government- CBD in same class as marijuana

Side effects: Nausea, fatigue, irritabilityIncrease coumadin & increase medication levels (varying drugs)Currently marketed and sold as a supplementSafety & purity not regulated

Education & awareness Encourage clients to discuss with providersUses, side effects, medication interactions aware of resources which provide pure CBDKnow the source Future roles in Cannabis nursing

Current trends Implications What we need to knowLess harmful than smokingVaping is bad for heart and lungsJust as addictive as traditional cigarettesNot a good smoking cessation toolNew addiction to nicotine

Sharp increase since COVID- 19Not receiving attention and resources necessary Need for increased awareness & education Professional Strategies Using telehealth resources to help treat opioid use disorder (OUD)Allocating resources as cases increase Address opioid- related shortages as supply chain affected Monitoring drug diversion Support community organizations -OUD treatment

Bill Gates

All of the answers below: Social isolation Loss of jobs leading to increased feelings of despair & anxiety

Spanish Flu

E-cigarette users

Hemp

the quality of your relationship to your work

Examines how to make the interaction of people and equipment safe, comfortable, and effective.

the science of extermal factors that cause disease, including elements of the natural, social, cultural and technological worlds in which we live

measure of the impact human activities have on the environment in terms of the amount of greenhouse gases produced, measured in units of carbon dioxide