Chapter 22: Surgery and Nutrition Support Flashcards
The most common nutrition deficiency related to surgery is
a. vitamin C.
b. iron.
c. protein.
d. essential fatty acids.
c. protein.
Protein deficiencies among surgical patients are the most common. Protein is needed to replace losses during surgery and to supply increased demands of the healing process.
Protein is especially needed in the postoperative recovery period for
a. energy.
b. control of edema.
c. control of hypertension.
d. optimal kidney function.
b. control of edema.
In addition to the protein losses from the body during surgery, other losses of protein from the body occur, including plasma protein loss from hemorrhage, wound bleeding, and various other body fluid losses or exudates. Protein assists in the maintenance of osmotic pressure, which is necessary to maintain normal movement of fluid between the capillaries and surrounding tissue. Without maintenance of osmotic pressure, edema develops.
The vitamin needed to cement new tissues during the healing process is vitamin
a. A.
b. C.
c. B12.
d. K.
b. C.
Vitamin C is necessary to build and maintain strong tissues, especially connective tissues. The major protein involved in fibrous connective tissue is collagen. For the body to synthesis collagen, the amino acid proline must undergo a hydroxylation reaction yielding hydroxyproline. This hydroxylation reaction depends on ascorbic acid. Vitamin C is also necessary for the conversion of other amino acids needed for tissue healing.
Patients who have had surgery of the head, neck, or throat may require
a. a clear liquid diet.
b. a full liquid diet.
c. tube feedings.
d. a low-residue diet.
c. tube feedings.
When regular oral feedings are not tolerated or the patient is severely debilitated or has undergone radical neck or face surgery, feedings by tube may be necessary.
The parts of the gastrointestinal tract that are joined in a total gastrectomy are the
a. stomach and large intestine.
b. esophagus and stomach.
c. esophagus and small intestine.
d. duodenum and colon.
c. esophagus and small intestine.
A total gastrectomy involves joining the esophagus to small intestine. This type of surgical intervention can result in serious nutrition deficits immediately after surgery.
A burn that causes cell damage in both the top layer of skin and some of the dermis is a _____ burn.
a. superficial
b. superficial partial-thickness
c. deep partial-thickness
d. full-thickness
b. superficial partial-thickness
Superficial partial-thickness burns involve cell damage in both the top layer of the skin (epidermis) and some of the second layer of the skin (dermis). A superficial burn involves cell damage in the top layer of skin, a deep partial-thickness burn results in destruction of the epidermis and dermis, and a full-thickness burn results loss of the epidermis, dermis, and frequently the underlying fat layer.
During the initial stage of treatment of a severe burn
a. a dextrose intravenous feeding is started.
b. total parenteral nutrition is initiated.
c. the patient is encouraged to take water orally.
d. an intravenous electrolyte solution is given.
d. an intravenous electrolyte solution is given.
During the initial stage of treatment for a severe burn, referred to as the immediate shock period, massive flooding edema occurs at the burn site. Loss of protective skin leads to immediate losses of water, electrolytes, and protein. Cell dehydration follows. Immediate intravenous fluid therapy with a salt solution replaces water and electrolytes to help prevent shock.
The intravenous solution that is immediately given to a burn patient to prevent hypovolemia is
a. lactated Ringer’s solution.
b. 5% dextrose.
c. normal saline.
d. total parenteral nutrition.
a. lactated Ringer’s solution.
Immediate intravenous fluid therapy with a salt solution replaces water and electrolytes to help prevent shock. Lactated Ringer’s solution is the intravenous fluid given to prevent hypovolemia. This is a salt solution, 6% hetastarch in solution.
An important function of carbohydrates in the postoperative period is to
a. provide substrates for tissue repair.
b. provide a source of vitamins.
c. spare protein for tissue synthesis.
d. protect the adipose reserves.
c. spare protein for tissue synthesis.
Carbohydrates provide the necessary energy for the body to meet increased energy needs while also sparing protein for tissue synthesis.
For a patient who can take an oral diet, an example of a primary source of energy during the postoperative period should be
a. meat.
b. cereals and other grains.
c. lemonade and sodas.
d. fried potatoes.
b. cereals and other grains.
During the postoperative period, the primary source of energy for the body should be carbohydrates.
Two minerals that are lost during tissue catabolism are
a. sodium and chloride.
b. calcium and magnesium.
c. iron and zinc.
d. potassium and phosphorus.
d. potassium and phosphorus.
If a patient requires parenteral nutrition for a prolonged period, the route that should be used is
a. nasogastric.
b. percutaneous endoscopic gastrostomy.
c. total parenteral nutrition.
d. peripheral parenteral nutrition.
c. total parenteral nutrition.
Parenteral nutrition is indicated if the gastrointestinal tract cannot be used for a long period. Total parenteral nutrition, which supplies all the macronutrients and micronutrients along with fluid to meet daily requirements, is necessary for patients who need intravenous nutrition for an extended period.
