Advanced Nutrition Flashcards
What causes salmonella
Chicken
What are the S/S of salmonella
HA, fever
What should you know about salmonella
It can be FATAL
What causes E.coli
Hamburger, poor hand hygiene
What are the S/S of E.coli
Bloody diarrhea
What causes shigella
salad
What are the S/S of shigella
Diarrhea
What causes listeria
Soft cheese, deli meats, bagged salads
What should you know about listeria
Bad for PREGNATE women (warm up meats and cheese), survives FRIDGE and FREEZER
What are the four points of the American Diabetic Association (ADA)
Dietitian, non-starchy veggies, added sugars and refined grains, whole unprocessed form
What can you teach your pts about the diabetic diet
Carb counting, READING food labels, high-fiber, miimize SIMPLE carbs
What is one serving of carbs
15 grams
What is a cardiac diet
Low in CHOLESTEROL and SATURATED FATS and high in FIBER
What are some sources of saturated fats
Red meat, bacon, sausage, butter
What are some heart healthy fates
Olive oil, advocado, nuts, seeds
What can you teach your pts about the cardiac diet
Reduce sodium intake like CANNED soups
What is the renal diet
Restricts POTASSIUM, SODIUM, PROTEIN, and PHOSPHORUS (three P’s)
What hsould pts on a renal diet limit
Meat, processed foods, peanut butter, cheese, nuts, dark SODA
What must the pt have to be able to have an enteral route
Some function of the GI tract
Why do you want to use the GI tract
Don’t use it you lose it
How do you decide nasal tubes
Aspiration risk
What is the nasogastric tube (NG tube)
Nose to STOMACH, SHORT-TERM, LOW aspriation risk
What is the nasointestinal tube
nose to INTESTINE, LONGER-TERM, HIGH aspiration risk
What is another name for a gastrostomy tube
Percutaneous endoscopic gastrostomy (PEG tube)
Tell me about the PEG tube
SURGICALLY placed to STOMACH, LONG-TERM
What type of pts need a PEG tube
CVA, cancer, trauma
What is the pediatric PEG tube
MIC-KEY, “button”, COMFORTABLE
What should you use a jejunostomy tube (J-tube) (PEJ)
HIGH aspiration risk, to the jejunum
What is the number of TF bottles
calories per mL
Standard TF
Intact w/whole proteins
Elemental TF
Either parially of fully hydrolyzed to aid in digestion
How long do continuous drip feeding
16-24 hours through a PUMP (Kangaroo)
Should you flush with continuous drip feeding
Flush with water every 4-6 hours
What is cyclic feeding
Done during sleeping hours
When is cyclic feeding used
Pts transitioning to oral intake
Where is bolus feedings done
Usally home
What is bolus feedings
LARGE volume, using GRAVITY, given over 15 mins
How are new enteral tube placement confirmed
X-rays
How do you check tube placement after it’s been confermed
Aspirate gastric contents, check pH
How do you clean PEG tubes
Soap and water
What should you monitor the skin around the PEG tube site for
Skin breakdown or infection
What is a big complication of enteral tubes
Peritonitis
What is peritonitis
EMERGENCY, RIDGID adbomen
What must you verify before med pass or feedings
Bowel sounds
What should the HOB be and for how long
At least semi-Fowler;s (30), during and after feedings for 30-60 min
What temp should TF be
Room temp
How often do you need to replace feeding bag and tubing
Every 24 hours
What is residual colume
The stomach contents remaining from the previous feeding
When do you need to check residuals
Every time before feedings and about 4-6 hours
How do you check residual
Put in 30mL of air then take it all out
When can you proceed with the next feeding
The residual is less than 250mL or half the amount of the last feeding
When do you need to NOT feed the patient and report it to the provider
If residual exceeds 500mL or if two measure ments taken 1 hour apart are greater than 250mL
What do you do with the residuals after you measure them
Return
What tubes do you only check residuals on
GASTRIC, NG or PEG tube
What position do you put your pt in when feeding if they have to stay supine
Reverse trendelenburg
What is the lopez valve
You can change the route of flow to do both feedings and meds
What do meds need to be dissolved in
WATER
How much water do you flush with before and after med
15-30mL
What do you do if you have multiple meds to give
Small flush inbetween each med
What should you consider if your pt has GI upset
FORMULA, decrease flow RATE, TEMP
What is dumping syndrome
Fluid shifts can cause fainting
How do you prevent dumping syndrome
Room temp, slow rate
How do you prevent clogging of tube with continuous feedings
Flush tube with 20-30mL warm water every 4 hours
How long can you refrigerate unused formula for
24 hours
What is total parenteral nutrition (TPN)
Nutritino given through PICC line or central line via IV pump
When do you use TPN
When the GI- tract is non-functioning or they need complete bowel rest
What do you need specially for TPN
FILTERED tubing, GLUCOSE checked every 6 hours, daily WEIGHTS and LABS, STERILE technique
What are the electrolyte balances that can occur with TPN
Hyperkalemia, hypoiphosphatemia/clacemia
What happens with there is an air embolism
EMERGNECY, left lateral, trendelnburgs, 02, help
How can you prevent aspiration
TUCK chin, NO STRAWS, alternate food and fluids
Nursing interventions for constipation
Fluid, fiver, activity
Nursing interventinos for diarrhea
Fluids, fiber, gatorade
What is about one serving of carbs
2-3 tablets, candy, 4ox of jucie or soda, 1 tbsp of honey
When do you test blood sugar and what do you need the level to get too before you give carb+protein food
15 ins, 70
