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NBCD > Chapter 24: MNT in Surgical Conditions and Burns > Flashcards

Chapter 24: MNT in Surgical Conditions and Burns Flashcards

1
Q

is the anatomic alteration of the human organism that is designed to arrest or alleviate a pathologic process

A

surgery

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2
Q

characteristics of this conditions

-insulin resistance
-hormonal changes
-peristalsis is inhibited
-electrolyte losses
-increased utilization of nutrients

A

surgery

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3
Q

hormonal changes during surgery

increased secretion of _____ (3)

A

Antidiuretic hormone (adh/vasopressin), catecholamines, adlosterone

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4
Q

surgery - dietary mgmt (pre-op)

case: elective surgery

diet: ?

rationale: to prevent vomitus aspiration

A

npo at least 6 hrs before surgery

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5
Q

surgery - dietary mgmt (pre-op)

case: elective surgery

diet: ?

rationale: promote glycogen storage and facilitate safe and faster recovery

A

high calorie

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6
Q

surgery - dietary mgmt (pre-op)

case: elective surgery

diet: ?

rationale: if obese, to facilitate safe and faster recovery

A

low calori

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7
Q

surgery - dietary mgmt (pre-op)

case: elective surgery

diet: ?

rationale: build-up nitrogen reserves, increase resistance to infection, wound healing, regeneration of hemoglobin

A

high protein

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8
Q

surgery - dietary mgmt (pre-op)

case: elective surgery

diet: ?

rationale: regulates fluid and electrolyte balance, promoted blood building and clotting

A

vitamin and mineral supplementation

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9
Q

surgery - dietary mgmt (pre-op)

case: emergency surgery

diet: ?

rationale: fastest method of nourishing patient prior to operation; to prevent shock

A

parenteral feeding

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10
Q

surgery - dietary mgmt (post-op)

case: -

diet: ?

rationale: to prevent aspiration

A

NPO

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11
Q

surgery - dietary mgmt (post-op)

case: -

diet: ?

rationale: to adjust to the ability of the patient to digest food

A

progress to clear liquid to regular diet

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12
Q

surgery - dietary mgmt (post-op)

case: -

diet: ?

rationale: to prevent ketosis; for increased metabolism; to spare protein

A

high calorie

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13
Q

surgery - dietary mgmt (post-op)

case: -

diet: ?

rationale: replace protein losses; promotes wound healing; helps prevent infection; promoted blood building

A

high protein

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14
Q

surgery - dietary mgmt (post-op)

case: -

diet: ?

rationale: promotes wound healing; replace losses; prevents dehydration and shock; promotes blood building and clotting

A

vitamin and mineral supplementation

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15
Q

surgery - dietary mgmt (post-op)

case: -

diet: ?

rationale: to meet nutrient requirements

A

tube feeding or TPN when necessary

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16
Q

specific surgical conditions

a surgical procedure that creates an opening from the colon through the abdominal wall to the surface of the skin for defecation when the feces cannot pass through the rectum and anus

A

colostomy

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17
Q

specific surgical conditions

refers to a surgical procedure that creates an opening from the ileum to the surface of the abdominal wall to permit drainage of the contents of the small intestine

A

ileostomy

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18
Q

specific surgical conditions

short segment of the jejunum is joined to the terminal ileum; effectively 90% of the small bowel

A

jejunoileostomy

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19
Q

specific surgical conditions

refers to the surgical removal of the gallbladder

A

cholecystectomy

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20
Q

specific surgical conditions

refers to the surgical removal of tonsilitis

A

tonsilectomy

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21
Q

specific surgical conditions

surgical removal of hemorrhoids

A

hemmorhoidectomy

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22
Q

specific surgical conditions

procedure when the entire colon is bypassed, and opening ic created from the oleum that is attached directly to the anus

A

ileorectal anastomosis

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23
Q

the decrease in plasma volume because of increased peristaltic movement

hypertonic, hyperosmotic food in the jejunum causes rapid emptying time resulting to hypoglycemia, diarrhea, dizziness, and pallor

A

dumping syndrome

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24
Q

nut. absorption and consequences of intestinal surgeries

a. 90-95% of nutrient absorption takes place in the first half of the _____

after a resection, nutrient absorption may be reduced

A

small intestine

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25
Q

Surgery to remove tissue or part or all of an organ

A

resection

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26
Q

nut. absorption and consequences of intestinal surgeries

b. there are certain dietary and growth factors that promote intestinal adaptation, like _____ (for glucose source)

A

glutamine

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27
Q

nut. absorption and consequences of intestinal surgeries

b. there are certain dietary and growth factors that promote intestinal adaptation, like _____ (for energy)

A

short-chain fatty acids

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28
Q

nut. absorption and consequences of intestinal surgeries

b. there are certain dietary and growth factors that promote intestinal adaptation, like _____ (for increased nutrient uptake and utilization)

A

insulin-like growth factors and growth hormone

29
Q

surgery - dietary mgmt

case: tooth extraction and tonsilectomy

diet: ?

rationale: to prevent bleeding

A

cold liquid

30
Q

surgery - dietary mgmt

case: gastronomy when removal of esophagus is necessary

diet: ?

rationale: to rest the organ

A

low fiber, dry meals, cho-restricted

31
Q

surgery - dietary mgmt

case: gastric surgery

diet: ?

rationale: to avoid dumping syndrome

A

high-chon, no simple sugars

32
Q

surgery - dietary mgmt

case: intestinal surgeries

diet: ?

rationale: to avoid motility and supply electrolytes

A

TPN and tube feeding when necessary

33
Q

surgery - dietary mgmt

case: intestinal surgeries

diet: ?

rationale: to adjust to the ability of the body to digest and absorb food

A

gradual progress from npo to normal diet

34
Q

surgery - dietary mgmt

case: ileostomy

diet: ?

rationale: b12 is absorbed in the ileum

A

vitamin b12 supplementation

35
Q

surgery - dietary mgmt

case: ileostomy

diet: ?

rationale: to prevent irritation, gradual introduction of food

A

low fiber, low residue, clear

36
Q

surgery - dietary mgmt

case: ileostomy

diet: ?

rationale: there is fat absorption

A

low fat

37
Q

surgery - dietary mgmt

case: colostomy

diet: ?

rationale: to prevent irritation; gradual introduction of food

A

low fiber, low residue, clear

38
Q

surgery - dietary mgmt

case: colostomy

diet: ?

rationale: there is fat malabsorption

A

low fat

39
Q

surgery - dietary mgmt

case: jejunoileostomy

diet: ?

rationale: to prevent irritation; gradual introduction of food

A

low fiber, low residue, clear

40
Q

surgery - dietary mgmt

case: jejunoileostomy

diet: ?

rationale: there is fat malabsorption

A

low fat

41
Q

surgery - dietary mgmt

case: jejunoileostomy

diet: ?

rationale: to prevent fatty liver; to allow fat transport

A

high chon

42
Q

surgery - dietary mgmt

case: jejunoileostomy

diet: ?

rationale: to prevent fermentation

A

low cho

43
Q

surgery - dietary mgmt

case: hemorrhoidectomy

diet: ?

rationale: to prevent irritation; gradual introduction of food

A

low fiber, low residue, clear

44
Q

surgery - dietary mgmt

case: jejunoileostomy

diet: ?

rationale: to replenish losses

A

supplement of vitamins and minerals

45
Q

surgery - dietary mgmt

case: cholecystectomy

diet: ?

rationale: to adjust to the ability to emulsify fat

A

low fat then normal

46
Q

surgery - dietary mgmt

case: peritonitis and intestinal obstruction

diet: ?

rationale: no peristaltic action

A

NPO, IVF

47
Q

surgery - dietary mgmt

case: peritonitis and intestinal obstruction

diet: ?

rationale: to adjust to the ability to digest and absorb food

A

progressive diets

48
Q

surgery - dietary mgmt

case: peritonitis and intestinal obstruction

diet: ?

rationale: to prevent irritation

A

low residue

49
Q

absorption of vitamins and minerals begins in the _____ and continues throughout the length of the small intestine

A

duodenum

50
Q

possible consequences of resection on nutrient absorption

nutrient absorbed:
-simple cho
-fats
-amino acids
-vitamins
-minerals
-water

A

duodenum/jejunum

51
Q

possible consequences of resection on nutrient absorption

nutrient absorbed:
-bile salts
-vitamin b12
-water

A

ileum

52
Q

possible consequences of resection on nutrient absorption

nutrient absorbed:
-water
-electrolytes
-short-chain fatty acids

A

colon

53
Q

possible consequences of resection on what intestinal part

-minimal consequences if the ileum remains intact
-calcium and iron malabsorption if duodenum resected

A

duodenum/jejunum

54
Q

possible consequences of resection on what intestinal part

-fat malabsorption; protein malabsorption
-cho malabsorption
-calcium, magnesium, and phosphorous malabsorption
-fluid and electrolyte losses
-diarrhea/steatorrhea

A

ileum

55
Q

possible consequences of resection on what intestinal part

-fluid and electrolytes losses
-diarrhea (losses are compounded if ileum is also resected)

A

colon

56
Q

are the injured tissue caused by heat, flame, chemicals, electricity, or radiation characterized by decrease of blood volume, plasma loss, edema, damage to blood vessel walls, increased metabolic rate, weight losses, nitrogen and nutrient losses, and hyperglycemia

A

burns

57
Q

burns - medical mgmt

fluid and electrolyte replacement timeframe

A

in the first 24 to 48 hrs treatment

58
Q

burns - medical mgmt

mgmt: ?

rationale: for epithelial regeneration

A

pain relievers, anti-infective drugs

59
Q

dietary mgmt

case: burns

diet: ?

rationale: to replace fluid losses

A

IVF

60
Q

dietary mgmt

case: burns

diet: ?

rationale: to meet energy requirements when oral intake is impossible

A

tube feeding when necessary

61
Q

dietary mgmt

case: burns

diet: ?

rationale: to control water retention

A

fluid and na controlled

62
Q

dietary mgmt

case: burns

diet: ?

rationale: to provide energy reserves

A

high kcal

63
Q

dietary mgmt

case: burns

diet: ?

rationale: replace losses, increase in gluconeogenesis, wound healing

A

high chon, 20-25% TER, HBV

64
Q

dietary mgmt

case: burns

diet: ?

rationale: for energy metabolism, wound healing

A

vitamins and minerals

65
Q

dietary mgmt

case: burns

diet: ?

rationale: for immune system and epithelia tissue

A

vitamin a

66
Q

dietary mgmt

case: burns

diet: ?

rationale: for tissue regeneration

A

vitamin c

67
Q

dietary mgmt

case: burns

diet: ?

rationale: to supply oxidative enzymes for cho and chon metabolism

A

thiamin, riboflavin, and niacin

68
Q

dietary mgmt

case: burns

diet: ?

rationale: for wound healing

A

zinc

NBCD (55 decks)

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