Chapter 30 - Nutrition Study Guide Flashcards
protein and caloric deficiency
marasmus
physical wasting
cachexia
difficulty in swallowing
dysphagia
use of energy to change simple materials into complex body substances
anabolism
inhalation of fluid or foreign matter into the lungs and bronchi
aspiration
breaking down of substances from complex to simple, resulting in a release of energy
catabolism
minimum amount of energy required to maintain bodily functions at rest while awake
basal metabolic rate
process of chemically changing nutrients, such as fats and proteins, into end products that are used to meet energy needs of the body or stored for future use
metabolism
what are the macronutrients and micronutrients
Nutrients are necessary substances obtained from ingested food that supply the body with energy; build and maintain bones, muscles and skin, and aid in the normal growth and function of each body system. Macronutrients are water, carbs, fats, and proteins. Micronutrients are vitamins and minerals
What is the difference between simple and complex carbohydrates
Simples carbs are broken down and absorbed quickly, providing a quick source of energy. Complex carbs are composed of starches, glycogen, and fiber. They take longer to break down before absorption and utilization by the body’s cells
Examples of simple and complex carbs
Simple: sugars such as those derived from fruit (fructose), table sugar (sucrose), milk products (lactose), and blood sugar (glucose). Complex: bread, rice, pasta, legumes such as dried beans, peas and lentils, starchy veggies such as corn, pumpkin, green peas and potatoes
Fats
Fats include fatty acids, cholesterol, and phospholipids. Total fat intake should be tween 25% and 35% of total caloric intake. Fat-soluble vitamins are A, D, E, K Examples of essential fatty acids include linolenic (omega-3) and linoleum (omega-6)
Examples of saturated fat
Crackers, cheese, ice-cream
What role do proteins play in your body
Proteins are necessary in the body for the development, maintenance, and repair of the body’s tissues, organs, and cells. Hemoglobin (protein) is responsible for transporting oxygen throughout the body. Prothrombin is the protein necessary for clotting blood. Other tasks include the production of hair and nails, muscles movement, nerve conduction, digestion, and defense against bacteria and viruses
Decreased water in the body is at risk for
An individual with water (fluid) deficiency is anticipated to have signs of dehydration - headache, loss of concentration dry mucous membranes, decreased BP, and decreased urinary output
Examples of foods hight in vitamin A are
carrots, pumpkin, green, leafy veggies
how can the nurse help the patient to eat healthier foods
Determining the patient’s knowledge about nutrients and food sources Having the patient examine his or her own dietary needs Teaching about reading food labels Using fresh rather than processed foods Eating smaller portions Eating fruits, veggies, whole grains, and lean meats Drinking water
The nurse instructs the patient that Vit. C is important in the body for
synthesizing protein collagen (would healing, prepare of bones), antioxidant effects, and antibody production
What is the general role of the B-complex vitamin
to form RBCs, act as coenzymes, and facilitate energy production in the body
Coffee contains a significant amount of which B Vt.?
B3 (Niacin)
The patient is on a diuretic and losing potassium. He should increase dietary intake of?
Bananas, tomatoes, and orange juice. Dietary sources of potassium include: milk, bananas, legumes, green leaf vegetables, orange juice, tomatoes, vegetable juice, avocados, and cantaloupe
Antioxidants are thought to prevent the development of what problems
heart disease, cancer, and diabetes
Vit. E can act as an antioxidant. Identify at least two food sources of this vitamin
Olives, soybeans, corn oil, nuts whole grains, legumes, and dark leafy veggies
For the child with a milk allergy or other digestive difficulty, what type of formulas will be recommended
soy based or hydrolyzed protein formula
How can individual’s culture influence nutritional intake
Food preferences
What effects occur to the musculoskeletal system from nutritional deficiency
softening of the bone due to vitamin D deficiency (osteomalacia), osteopenia, or osteoporosis, with increased bone fragility and greater risk of fractures
What effects occur to the cardiopulmonary system from nutritional deficiency
atherosclerotic heart disease (ASHD) with potential for cardia damage or heart attack
What is true regarding obesity
The prevalence of obesity in the US more than tripled amount children and adolescents from 1980-2008 A person with a BMI greater than 40 is classified as morbidly obese High BMI levels increase the risk for hypertension
Identify the primary treatment option for individuals with eating disorders
develop a sense of control and positive body image, build relationships, and improve nutritional intake
Two common ways to obtain info about a patients food intake
24 hour recall or 3-5 day journal of foods eaten amounts, an dhow the foods were prepared
A focused physical assessment for nutritional status should include
Measurement of height and weight, calculation of bed mass index, review of laboratory values, and identification of unanticipated findings (poor skin condition etc.). IN addition waist circumference, vital signs, medical history , medications, and activity level can determine risk factors
BMI interpretation 1. 61kg-1.65m 2. 72kg-1.8m 3. 95kg-1.7m
- normal weight 2. normal weight 3. obese, class 1
What indicators are associated with metabolic syndrome
Insulin resistance Abdominal fat Increased blood glucose, triglycerides, serum cholesterol Hypertension
Symptoms associated with nutritional deficit
Dry, stiff hair, Constipation, Decreased albumin level, Petechiae
How can a nurse prevent aspiration
Following orders for dietary consistencies and textures Following the manufacturer’s instructions and facility policies and procedures for sickening of liquids as ordered Elevating the head of the bed to 45 degrees or higher during eating and for a minimum of 45 minutes after eating Keeping the head of the bed elevated at 30 degrees at all other times, including during enteral feeding Encouraging slow eating patterns Instructing the patient to avoid eating or drinking for 2-3 hours before sleep Administering GI medications as orders Inspecting the patient’s mouth for pocketing of food Observing the patient for swallowing between bites of food and fluids Instructing the patient to alternate between bites of food and sips of fluids to facilitate swallowing Maintaining the patient’s status of no food or fluids by mouth following procedures in which the throat was anesthetized until a gag reflux has been verified.
The patient has an iron deficiency. What foods should the nurse recommend
Iron is found in liver dark green leafy veggies, seafood, and bran
For the Quality and Safety Education for Nurses (QSEN) competency of teamwork and collaboration, who should be included in the planning of care for a patient with an identified nutritional concern
nutritionist or registered dietitian, case manager, speech therapist (impaired swallowing), psychologist (eating disorders) and UAPs
S/S of dysphagia
coughing, incomplete lip closure, poor tongue control, excessive chewing, gagging before swallowing, failure to swallow, foods held in the cheek, or refusal to eat
For the patient who is a vegetarian, what foods whould the nurse recommend in t
When assessing the patient for dysphagia, what are the s/s and how can the nurse assist an adult with feeding
S/S; caughing, incomplete lip cosure poor tounue control, excessive chewing, gagging before swallowing, failure to swallow, foods held in cheek, or refusal to eat
Assistance: Provide oral care before and after feeding
Ensure that dentures, if worn, are in place and well fitted
Elevate teh patient’s head at least 30-45 degrees unless contraindicated
Special caution should be taken if the patient has impaired swallowing
If the patient has one sided muscle weakness, have the patient turn the head to the afected side to assist in airway protection
Chin tucking may help prevent aspiration
Follow the occupational or nutrition therapy guidlines or the manufacturers inscructions for use of any assistive devises
Position yourself so that the patient can see you
Allow at least thirty min. for reach meal. Offer small bites (1/2 to 1 tsp)
Wait at least 10 minutes between bites
Avoid unnecessary use of straws to prevent air ingestion
Observe for rise and fall of teh patients larynx to verify swallowing
Check teh pateints mouth frequently to prevent retention of food in the cheeks (pocketing)
The patient’s percuaneous endogastric (PEG) tuve becomes occluded. What actions should the nurse take to try to remove the occlusion?
Flush the PEG tube with small amount of air. If this does not work, then use 50-60 mL syringe to flush the tube with 20-30 mL of warm water, carbonated beverages, or pine apple juice (if not contraindicated)
