Chapter 11 & 12 - Nutrition In Pt. Care Flashcards
What are the 2 potential risk factors for becoming malnourished?
Primary: inadequate nutrient intake
Secondary: caused by disease or iatrogenic effects
Iatrogenic malnutrition?
Caused by treatment or diagnostic procedures
Screenings and monitoring helps identify patients at risk
Anthropometric Assessment?
- simple noninvasive techniques
- height
- weight
- head circumference
- skinfold thickness - BMI (normal = 18.5-24.9)
Biochemical Assessment?
- Most important indicators
- visceral pain status
- immune function
Clinical assessment?
- Sources of data
- medical history
- social history
- physical exam - features associated with nutritional deficiencies
Dietary intake assessment?
- 24-hour recall
- food records
- kcal counts
Nutritional Assessment involves What?
(A, B, C, D)
- Anthropometric Assessment
- Biochemical Assessment
- Clinical Assessment
- Dietary intake Assessment
What age groups have a moderate Nutritional Risk?
- Adults age 65-75
- children over age 5
What age groups have a high Nutritional Risk?
- 75yrs and older
- children under 5yrs of age
Examples of Basic Hospital Diets?
- Clear liquid diet
- Full liquid diet
- Mechanically altered diet
- Soft diet
- Regular / General diet
What are examples of feeding modalities?
- NPO
- alternate route
- clear liquid diet
What kind of diet is inadequate in energy and almost all nutrients except water?
Clear liquid diet
What kind of diet should not be used for more than 24 hours?
Clear liquid diet
Relationship to hospital malnutrition occurs with what type of diet?
Clear liquid diet
A Full Liquid Diet is what?
Foods that are liquid at room temperature
What kind of diet can supply ADEQUATE energy and nutrients?
Full Liquid Diet
What is a safety concern with a Full Liquid Diet?
Avoid use of raw eggs
What kind of diet is concerned with high saturated fats and cholesterol?
Full Liquid Diet
Mechanically Altered Diets are what?
- chopped
- ground
- mashed
- puréed
Mechanically Altered Diets are used for what types of patients?
Patients with chewing or swallowing difficulties
What is important to remember about Mechanically Altered Diets?
Food consistency altered only to the degree needed
What do soft diets consist of?
Whole Foods low in fiber and lightly seasoned
What kind of diet is considered a “transition diet” ?
Soft diet
What is the typical order of diet progression?
Clear—> soft—> normal
What diet serves as the basis for modified diets?
Regular or general diet
Enteral Nutrition?
Enteral feeding by tube
Enteral feeding by tube is appropriate when what?
When the gut is functioning
What are Enteral feeding routes?
- nasogastric
- nasoduodenal
- nasojejunal
- esophagostomy
- gastrostomy
- jejunostomy
- percutaneous endoscopic gastrostomy (PEG)
Methods of Enteral nutrition administration?
- Continuous
- intermittent (delivering food @ same rate)
- bolus (no pump?)
Feeding tubes used for a short duration are placed how?
Nonsurgical placement
Feeding tubes that are used for a long duration are placed how?
Surgical placement
Enteral feeding tube placement must be confirmed with what?
CXR
Parenteral Nutrition?
Energy and Nutrients delivered via IV (directly into the vein)
Parenteral Nutrition does what?
Provides nutrients to patients who can’t or won’t eat and tube feedings are contraindicated
Parenteral Nutrition doesn’t require what?
DONT need a functioning gut
Bypasses it and goes directly into vein
Components of Parenteral Nutrition solutions?
- carbohydrates
- amino acids
- fats
- total nutrient admixtures: 3 in 1 system
- electrolytes
- vitamins
- trace elements
- bioactive substances
What monitoring should you do for parenteral Nutrition?
- Lab work
- Weight
What is the most common complication of Parenteral Nutrition?
Pneumothorax
What is the most common metabolic complication of Parenteral Nutrition?
Hyperglycemia
What is the most extreme type of nutrition?
Parenteral
What is the order of transitional feedings?
Parenteral —> oral or tube feeding
Long periods of PN without enteral feedings result in what?
Atrophy of the GI tract