NUR 242 Nutrition SP2020

Study Guide for Chapter 14 Nutrition Intervention, Diet-

Drug Interactions
Be able to give an elevator speech on: foods to avoid (tyramine
sources) for someone on MAO inhibitors

Table 14-1 Ex of Nutr. Interventions—be able to recognize

different interventions that a registered dietitian might use.

Long-term nutr intervention

What facets of the patient need to be taken into account?
What approaches are helpful for long-term dietary changes?

Nutrition education—needs to be tailored to the pt’s

_________________________________
Include an assessment of
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How to evaluate the nutr. intervention?
Dietary Modifications
Be able to give a general description, uses of each of the
following diets. Be able to recognize foods that don’t belong on
each diet. See also ATI, pg 47-48.

Clear Liquid

Full Liquid (see ATI)

Blenderized liquid

Dysphasia Diets and Liquids (will return to this diet in ch 17,

p.491)

(Mechanically altered diets: Pureed, Mechanically altered, Soft)

Fat Restricted

Low-fiber

Low-sodium

High-kcalorie, high-protein

Mediterranean

Diet progression is:

Symptoms of intolerance of food:

NPO is:
Drug-Nutrient Interactions
These are largely from the ATI book. There is a lovely section
on this in the textbook, but in the interest of paring down
content, I’m emphasizing the following:

Ways that drugs affect food intake (see slides)

Diuretics and potassium

Some diuretics can increase losses of potassium, Ca, Mg,
thiamin—they “waste” potassium. These patients need to eat
more potassium in the diet to compensate for this. Ex:
furosemide (Lasix).
(Digoxin (a cardiac glycoside for congestive heart failure) is
often taken with furosemide. Both of these meds increase the
need to eat high potassium foods.)

Other diuretics conserve potassium—they “spare” potassium, so

these pts need to reduce intake. In particular, they must avoid
potassium supplements and potassium salt substitutes. Ex:
spironolactone

Action of grapefruit on enzymes breaking down certain drugs.

What happens if the patient consumes grapefruit while on these
medications?
MAO Inhibitors
What food component do people on these drugs (phenelzine,
selegiline) need to avoid?
What may happen if they don’t avoid it?
What foods is it found in?

Warfarin (Coumadin) and vit K.

What is the interaction between these two? What does pt need
to do?

Warfarin (Coumadin) and vit K—very similar structures.

Warfarin blocks enzyme that activates vit K, thus preventing
several blood clotting factors from being made.
ATI: Consumption of foods high in vitamin K (green leafy
vegetables) can decrease the anticoagulant effects of warfarin
(therefore limit these foods).

(RD plea: Need a steady level of vit K intake to keep warfarin

activity stable. Dark green leafy veggies are critical source of
lutein and zeaxanthin for eyes, to help prevent macular
degeneration. They also are a rich source of potassium,
magnesium, vit A, folate, and fiber, as well as many health-
promoting phytochemicals. Those in the cabbage family (kale,
turnip greens, collard greens, arugula/rocket greens, garden
cress, bok choy, Chinese/napa cabbage…) also have the most
potent cancer-preventing phytochemicals called
isothiocyanates.)
Either way, if the PCP limits or keeps a steady level of dietary
vit K, the patient on warfarin needs to know vit K sources, so
education is a must.

What are some long term nutritional effects of corticosteroids

(ie Prednisone)?

Levadopa and protein.

What is one recommendation for a Parkinson’s pt to manage
protein intake? Why?

Some meds cause gastric irritation, so these need to be taken

with food.
NSAIDS, including ibuprofen (Advil, Motrin)
Some antibiotics—ie amoxicillin (Amoxil)
Some antidepressants—ie bupropion (Wellbutrin)

Meds that reduce stomach acidity can decrease absorption of

B12, folate, iron.
These three are all necessary for red blood cell synthesis, so
watch for anemias.
Ex: antacids (neutralize stomach acid),
proton pump inhibitors,
H2 blockers (decrease acid production)
Methotrexate (anti-cancer) and folate have v similar structures
and compete for the enzyme that converts folate to its active
form. Therefore….