Chp 5,12,13,14 Flashcards
Proper food storage guidelines:
- fresh meat & fish is 1-____days at ____ degrees or colder
- Dairy: milk is good for ___ days & 3-4 weeks for ______
- Eggs: ___ weeks in shell, and 1 week for hard boiled
- fruits & veggies: 3-5 days. _____ fruits and apples keep for 1 week or longer.
- Pantry: dry dark place
- canned: one year
2 40 5 cheese 3 citrus
Cook food to the proper temperature:
- roasts & steak 145 degrees
- chicken: ____ degrees
- ground beef & eggs ____ degrees
180
160
occurs due to eating undercooked or raw meat, poultry, eggs, fish, fruit and dairy products. common symptoms include headache, fever, abdominal cramping, diarrhea, nausea and vomiting. can be fatal
Salmonella
raw or under cooked meat, esp hamburger, can cause this food borne pathogen. findings include severe abdominal pain and diarrhea.
E. coli
poor personal hygiene and improper hand hygiene commonly cause ______. food sources include dairy products and salads. findings include diarrhea
shigella
soft cheese, raw milk products, undercooked poultry, meat, seafood and vegetables can cause _______ monocytogenes. can cause sign problems for newborns (stillborn), prego (miscarriage) and immunocompromised clients.
listeria
______ juice interferes with the metabolism of many medications, resulting in an increased serum level of the med
grapefruit
consumption of food high in vit ___ (green leafy veggies, eggs, liver) can devrease the anticoagulent effect of warfarin
K
foods high in _____, amino acids, and vit b6 can increase the metabolism of the anti parkinson’s meds levodopa, which decreases the duration of its therapeutic effects.
protein
licorice can cause ________. excess ingestion can be dangerous for clients taking digoxin, stimulant laxative, some beta blockers, ace inhibitors
hyperkalemia
Cardiovascular disease is the leading cause of death in the US. ______ heart disease is the single leading cause of death
coronary
________ is a major risk factor for developing CHD. CHD is caused by atherosclerosis, a process of damage and cholesterol deposits on the blood vessels of the heart
Hypercholesterolemia
_____ density lipoprotein is “good” cholesterol because it removes cholesterol from the serum and takes it to the ______
- for females 35-___ mg/dl
- for males 35-____mg/dl
Low density is “bad” cholesterol bec it transports cholesterol out of the _____ and into the circulatory system, where it can form _____ on the coronary artery walls.
expected range is less than ___ mg/dl
high liver 80 65 liver plaques 130
Iron deficiency anemia symptoms include _____, lethargy, pallor of the nail beds, intolerance to cold.
* children with low iron intake can experience _____ attention spans and display poor intellectual performance before anemia begins
fatigue
short
_____ anemia symptoms include pallor, weakness,________, dyspnea & fatigue
macrocytic
palpitations
Vit B12 deficiency anemia include both ____ findings and ____ findings
GI
neurological
GI findings of Vit b12 deficiency include _______(inflamed tongue), anorexia, indigestion, weight loss, frequent _____/and or constipation
glossitis
diarrhea
Neurological findings of vit b12 deficiency include ______ (numbness of the hands and feet), decreased proprioception (sense of body position), ____ muscle coordination, increasing irritability, and _______
paresthesia
poor
delirium
_____ ____ deficiency anemia symptoms include mental confusion, fainting, fatigue, and GI distress.
mimic thos for vit b12 deficiency, except for neuro findings.
Folic acid
The presence of 3 of the 5 following risk factors can result in what syndrome?
- ) ______ obesity, women ___ inch waist, men 40 inch waist.
- ) Triglycerides greater than ____ mg/dl
- ) low HDL, men less than ___, women less than 50 mg/dl
- ) increased blood pressure: sys >130, Dia>85
- ) fasting blood _____ greater than or equal to 110 mg/dl
metabolic abdominal 35 150 40 glucose
consuming a low fat, low cholesterol diet can reduce risk for developing ___ ___ ______. What diet is designed to be a user friendly eating guide to encourage dietary changes?
- daily cholesterol should be less than ____ mg
- conservative use of ___ wine may reduce risk
- increasing ___ and carbs intake, avoid _____ fat, and decrease red meat consumption can decrease risk
- increasing intake of ______-__ fatty acids found in fish, flaxseed, soy bean, canola, walnuts reduces risk
- _______is an amino acid. elevated levels can increase risk of dev CHD. deficiencies in VIt b6 & b12 increase these levels.
coronary heart disease therapeutic lifestyle change TLC 200 red fiber saturated omega-3 homocysteine
secondary prevention efforts for CHD are focused on lifestyle changes that lower ____. include a diet low in cholesterol and sat fat, a diet high in _____, exercise, weight management, and smoking cessation
- sat fat should be less than __% of daily caloric intake
- a high fiber diet includes oats, _____, fruits, veggies, whole grains, barley
LDL
Fiber
7
beans
_______ is a significant risk factor for developing CHD, myocardial infarction and stroke.
*is a sustained elevation in BP greater than or equal to ___/____ mm/hg
hypertension
140/90
What does Dash stand for? it is a diet low in ____, and high ______& _________. proven to lower BP and cholesterol
*NA intake should be less than _____ a day
dietary approaches to stop hypertension
sodium (canned soups, sauces, chips seasoning)
potassium (apricots, banans, tomatoes, potatoes)
calcium (low fat dairy product)
2400mg
_____ ______ is the inability of the heart to maintain adequate blood flow through circulatory system. results in _____ sodium and fluid retention, and edema
- reduce na to recommended level
- monitor and possible restrict fluid intake to 1.5 L a day
heart failure
excess
An _____ _____ occurs when there is an inadequate supply of O2 to the myocardium. frequently this occurs b/c of atherosclerosis
*after this occurs, it is necessary to reduce the myocardical O2 demands related to metabolic activity
- a ____ diet is best for first 24 hrs after
- _____ should be avoided since it stimulates the heart
- small, _____ meals
myocardial infarction
liquid
caffeine
frequent
______results from either a reduction of the RBC or in _______, the oxygen carrying component of blood. can result from a decrease in rbc production, and increase in rbc destruction, or a loss of blood.
- the body requires _____, vit ___, and folic acid to produce RBC
- _____ deficiency anemia is the most common nutritional disorder in the world. affects 10% of population. results from poor intestinal ______,blood loss and inadequate consumption.
*_______anemia is the most common form of vit b12 deficiency. caused by a lack of the protein intrinsic factor which helps the body absorb vit b12. risks include ____, gastric cancer, helicobacter pylori and age greater than 50. people with this require b12 injections
anemia hemoglobin iron b12 iron absorption pernicious surgery
sources of iron include: _____, fish, poultry, tofu, dries peas & _____, whole grain, dried fruit
Iron fortified foods include: infant formula, infant cereal and ready to eat cereals
**medicinal iron overdose is the leading cause of accidental poisoning in small children and can lead to acute iron toxicity.
meat
beans
Vit ___ facilitates the absorption of iron (promote consumption)
C
Natural sources of ____include: fish, meat, poultry, eggs and milk
B12
- *people over 50 are urged to consume most of their vit b12 requirement from supplement or fortified foods.
- *vegans need supplements
____ acid deficiency anemia is caused by poor nutrition, malabsorption (____ disease) and drug use
*sources include green leafy veggies, dried peas and beans, seeds, OJ, cereals and breads fortified with folic acid.
folic
crohn
Nutrition therapy for gastrointestinal disorders is generally aimed at minimizing or preventing symptoms. In some conditions, such as _______ disease, nutrition is the only treatment.
celiac
Assess if the client is experiencing any of the following symptoms:
- difficulty chewing or swallowing (dysphasia), nausea or ______, or diarrhea.
- bloating, excessive flatus, occult blood, ______ (fat in feces), abdominal pain/cramping/distention, pale, sticky bowel mvmts
- changes in weight, ____ ____ or bowel habits
vomiting
steatorrhea
eating patterns
assess if the client uses:
- Tobacco, ______, caffeine, over the counter meds to treat ____ conditions).
- nutritional supplements
*______supplements
alcohol
GI
herbal
What are some general gastrointestinal considerations for nutritional guidelines and nursing interventions?
- Monitor gastrointestinal parameters
- Low fiber diets
- High fiber diets
What are some parameters to monitor gastrointestinal activity?
Weight & weight changes lab values bowel sounds elimination patterns I & O
Low-fiber diets avoid food that are high in _____ content (whole-grain breads, _____, raw fruits and vegetables)
- this reduces the _____ and _____ of fecal output and slow transit time of food through digestive tract.
- this diet is used for _____ term for clients who have diarrhea or malabsorption syndromes.
residue
cereal
frequency and volume
short
High fiber diets focus on food containing more than __ g of fiber per serving.
- Increases stool bulk
- stimulates ________
- prevent constipation
- protect against ___ _____
5
peristalsis
colon cancer
Potential causes of ______ and ______ include decreased gastric acid secretion & gastrointestinal motility; ______, bacterial/viral infection, increased ______ pressure, liver, pancreatic, ____ ______ disorders, adverse effects of some meds.
*Determine underlying cause, assess the appearance of the _____ will aid in diagnosis and treatment.
For example, coffee ground emesis indicates ____; pale green indicates _____
nausea vomiting allergy gall bladder emesis blood bile
What kind of diet should you implement for a patient with nausea and vomiting?
*clear liquids followed by full liquids, and advance as tolerated, easy to digest, low fat carb foods (crackers, toast, oatmeal).
Other interventions for patients with nausea and vomiting include:
- avoid liquid with meals as they promote ______
- good ____ _____
- elevate head of bed
- discourage spicy food
- avoid high fat food-contribute to ____ b/c they are difficult to digest.
fullness
oral hygiene (dehydration)
nausea
______ is defined as the lack of appetite. A common finding for numerous physical conditions and adverse effect of certain meds. Not the same as anorexia nervosa.
anorexia
Nursing interventions for Anorexia include:
- decrease _____ at meal times
- assess for adverse effects
- administer meds to _____ appetite
- modify_______, remove items that smell, assess and manage anxiety and depression
- Assess for changes in ____ status.
- _____ to increase gastric motility
- mouth care before and after meals.
stress stimulate environment bowel position
What kind of diet would you implement for someone with anorexia?
*Provide small, frequent meals and avoid high fat foods to help maximize intake
*provide liquid supplements btw meals to improve protein and calorie intake
*ensure the meals appear appealing
serve larger meals early in the day
clients who have _________ have difficult or infrequent passage of stools, which may be hard and ____
constipation
dry
Causes of constipation include: _____ bowel habits, psychogenic factors, ______, chronic laxative use
irregular
inactivity
Encourage ______ for pt with constipation and a diet high in fiber (__ for women, ___ for men), and promote adequate _____ intake to help alleviate symptoms.
*change meds if causes this symptoms
exercise
25 g/day
38 g/day
fluid
Nursing interventions for constipation include:
- assess _____ and ______ of past and present elimination patterns
- what is ______ for the client, activity and stress levels
- assess past medical and surgical history, _____ use (OTC, herbal, laxatives, enemas, and prescriptions)
- presence of rectal _____ and abdominal pain.
*encourage client to gradually increase levels of _____. (preferred treatment)
onset duration normal medication pressure fiber
Diarrhea may cause a significant losses of ______, ______, and fluid as well as nutritional complications.
- common causes include _____ and physical stress, GI disorders, _______disorders, infections, and certain drug therapies.
- A high ___ diet is prescribed unless it caused the diarrhea
- a liberal fluid intake to replace losses is needed.
potassium sodium emotional malabsorption fiber
Causes of Dysphagia include obstruction, ________, and certain neurological disorders
- modifying the ____ of foods and the consistency of liquids will help achieve proper nutrition
- Xerostomia (___ _____) can contribute to dysphagia, evaluate meds being used
inflammation
texture
dry mouth
Clients who have dysphagia are at an increased risk for _____. place the client in an upright or ___-____ position to facilitate swallowing.
- provide oral care ____ to eating to enhance taste
- should be referred to a speech therapist for evaluation.
- allow adequate time for eating, use _____eating devices, small bites, thorough chewing
- pills should be taken with at least __ oz of fluid (can be thickened) to prevent meds from remaining in the _______.
- avoid think liquids and sticky foods
aspiration high-fowlers prior adaptive 8 esophagus
Normally, the stomach controls the rate in which nutrients enter the ____ _______, when a portion of the stomach is surgically removed, the contents of the stomach are rapidly emptied into the small intestine, causing ______ syndrome.
small intestine
dumping
Early symptoms of dumping syndrome usually occur __-___ mins after eating. Late symptoms occur 1-3 hrs after eating.
Includes: sensation of fullness, dizziness, diarrhea, _______, tachycardia, palpitations, ______, nausea etc.
- manifestations resolve after intestine is ______. however, there is a rapid rise in ____ ____ and increase in insulin levels immediately after the intestine empties. this leads to ________
- the client experiences _______ spasms, such as dizziness, sweating, palpitations, shakiness, and confusion.
15-30 diaphoresis hypotension emptied blood glucose hypoglycemia vasomotor
Nursing interventions for dumping syndrome include:
- ____, frequent meals
- recommended consumption of _____ and ___ at each meal.
- avoid sugar and restrict ___ intake
- Suggest the client does a ___ diet (consume liquids 1 hr before or after eating instead of during meals)
- instruct client to lie down for 20 to 30 mins after meals to delay ____ ______
- if reflux is a problem, assume a _____ position.
- Monitor clients who are receiving _____ ____ feedings and report symptoms of this.
- monitor client for iron & b12 deficits.
small protein and fat lactose dry gastric emptying reclining enteral tube
_____ occurs as the result of the abnormal reflex of gastric secretions in the esophagus. leads to ____ and heart burn
*long term can cause adenocarcinoma of the esophagus and _____ esophagus
GERD (gastroesophageal reflux disease)
indigestion
Barrett’s
Clinical symptoms of GERD include _____, retrosternal bleeding (esophageal), painful _____, Dyspepsia (______).
- pain may be mistaken for _____ ________
heartburn
swallowing
indigestion
myocardial infarction
Nursing interventions for GERD include:
- avoid abdominal pressure (tight clothing)
- avoid eating __ hr or less before laying down.
- elevate the body on _____ instead of lying flat
- avoid trigger food (citrus fruit, juice, spicy, carbonated drinks)
- avoid items that reduce lower ______ _____(LES) pressure. what are some examples?
2
pillows
esophageal sphincter
fatty foods, caffeine, chocolate, alcohol, cig smoke
_______ is inflam. of the gastric mucosa congested with blood and fluid
- there is a ______in acid produced and an overabundance of _______, superficial _____ occur, sometimes leading to hemorrhages
gastritis
decrease
mucus
ulcers
_____ gastritis occurs with excessive use of NSAIDS, bile ____, ingestion of strong acid/alkali substance, complication of radiation, and trauma (burns, food poisoning, severe infection, liver, kidney, respiratory failure, major surgery)
acute
reflux
chronic gastritis occurs in the presence of ______(benign or malignant), helicobactor pylori, autoimmune disease (pernicious anemia)
ulcers
clinical symptoms of gastritis includes: abdominal pain/discomfort (relieved by eating), ______, nausea, anorexia, sour taste in mouth, ________ (vomiting of blood)
headache
hematemesis
Nursing interventions for gastritis include:
- avoid eating frequent meals and snacks, as they promote increased _____ acid secretion
- tell to avoid alcohol, cigs, ______ and other Nsaids (nonsteroidal anti-inflam drugs, coffee
- monitor for Vit ___ deficiency.
gastric
aspirin
b12
Acute recovery for gastritis usually occurs in ___ day, the client should eat a ____ diet when able to tolerate food. ___ fluid may be required.
- when the condition occurs due to ingestion of strong acids of alkalis, _______ and _________ of the casual agent is needed. avoid _____ and emetics due to potential perforation and esophageal damage.
- chronic mgmt: modify diet, reduce stress, avoid alcohol and _____. if condition is persistent, the provider will prescribe an ____-receptor antagonist such as ranitidine (zantac)
1 bland IV dilution neutralization lavage nsaids H2
_____ ulcer disease is characterized by an erosion of the mucosal layer of the stomach or duodenum
- may be caused by a bacterial infection (H. Pylori-use ______ therapy) or the chronic use of _____
- some clients who have this are _________. others report anemia, tarry stools due to intestinal bleeding, epigastic pain (gnawing or burning)
- Eating may temporarily relieve pain, anemia can occur due to blood loss.
peptic triple-combo of antibiotics and acid reducting meds takin for 14 days nsaids (aspirin &ibprofen) aymptomatic burning
Lactose intolerance results from an inadequate supply of ______ in the intestine, the enzyme that digests lactose.
- the enzyme that converts lactose into _____ and ______ is absent or insufficient.
- symptoms include distention, ______, flatus, and osmotic diarrhea.
- monitor client for vit__ and _____ deficiency
lactase glucose galactose cramps D Calcium
An ______is a surgically created opening on the surface of the abdomen from either the end of the small intestine (_____) or from the colon (colostomy).
- _____ and ______ maintenance is the primary concern
- The colon absorbs large amounts of fluid, ____ and _______
- nutriton therapy is a diet high in fluids and soluble fiber
- increase intake of calories and protein to promote _______ of stoma site.
- emotional support
ostomy ileostomy fluid electrolyte sodium potassium healing
_______are pouches protruding through the muscle of the intestinal wall, usually from increased intraluminal pressure. usually occur in the _____ colon, cause no problem unless infection
- diverticulosis is a condition characterized by presence of diverticular.
- diverticulitis is inflam. that occurs when fecal matter becomes _____ in the diverticula. (clear liquid diet until inflam decreases, then a high fiber, low fat diet
- avoid foods with seeds, husks (corn, berries)
diverticula
sigmoid
trapped
*abdominal pain, nausea, vomit, constipation/diarrhea, fever with chills/tachycardia.
\_\_\_\_\_ disease (regional enteritis) and ulcerative colitis are are chronic, inflam. \_\_\_\_ diseases characterized by periods of exacerbation and remission * diets are low in \_\_\_\_\_
Crohn’s
bowel
fiber
What kind of diet is prescribed to a pt with inflam bowel disease?
*____ _______ nutrition (TPN) is indicated for clients who are severely ill during acute phase of illness.
a low residue, high protein, high calorie diet with vit and min. supplementation. fluid and electrolytes with iv or oral fluids
Total parenteral
______ is inflam. of the gall bladder
*the gallbladder stores and releases _____ that aids in the digestion of _____.
- pain in the _____ right abdomen, can also have referred pain in the right shoulder
- limit fat
- diet modifications are not needed for healthy people with asymptomatic gallstones.
cholecystitis
bile
fats
upper
The pancreas is responsible for secreting ______ needed to digest fats, carbs, and protein.
- pancreatitis
- acute: prescribed NPO, nasogastric tube to suction gastric contents.
- chronic pancreatitis: low ___, high protein, high carb. Vit C & b complex
enzymes
fat
the _____ is involved in the metabolism of almost all nutrients.
- disorders include cirrhosis, hepatitis, and cancer
- increased protein to promote ____ nitrogen balance
- B, C & K vitamins
liver
Celiac disease is also known as ______-sensitive enteropathy (GSE), celiac sprue, and gluten intolerance.
- chronic, ______, genetic
- lack enzyme DPP-IV
- eliminate gluten-found in wheat, rye and barley.
- gluten free options include: milk, cheese, _____, corn eggs, potatoes
*symptoms: steatorrhea, anemia, diarrhea, pain, bloating, osteomalacia.
glucose
inherited
the kidneys have 2 basic functions: 1.) maintain normal ____ _____ and 2.) excreting _____ products
*profound effect on nutritional state
*_____ is a waste by product of protein metabolism, and these levels rise with renal disease
*short term disease requires _____ support rather than dietary restrictions. dependent on stage.
blood volume
waste
urea
nutritional
Pre-stage chronic kidney disease (CKD) is distinguished by an increase in serum ______.
*symptoms include fatigue, _____ pain, and appetite changes.
creatine
back
End-state kidney disease (ESKD) or CKD symptoms include fatigue, decrease ______, anemia, decreased urination, headache, weight loss.
alertness
Acute kidney injury symptoms include a decrease in ______, decreased sensation in _____ extremities and flank pain
- characterized by rising blood levels of _____ and other nitrogenous wastes
urination
lower
urea
Nephrotic syndrome’s most pronounced symptoms is ______ and high _________.
edema
proteinuria
Kidney stones have sudden _____pain. Symptoms of diaphoresis, nausea, and vomiting, and there can be _____ in the urine.
*80% of stones contain ______
intense
blood
calcium
Nurses should monitor _____ daily for general renal considerations since it is an indicator of fluid status and is a primary concern.
- monitor fluid _____ & encourage compliance with fluid restrictions.
- monitor urine output
- monitor _____
weight
intake
constipation
Pre-state CKD, or ________ kidney reserve/insufficiency, characterized by a increase in serum _______
- control blood glucose and ______, which are risk factors
- help preserve remaining kidney function by limiting the intake of ______ & _______ (slows progression)
diminished creatinine hypertension calcium phosphorus
what are dietary restrictions for pre stage CKD?
- the daily protein intake is __ to ___ g/kg of ideal body weight.
- ______ restrictions are decreased as disease progresses to end stage.
restrict sodium to maintain blood pressure
.6-1.0
protein
High ______value proteins are recommended for clients who have kidney failure to prevent _____of muscle tissue. these proteins include _____, meats (5-6 oz men/4 for female), poultry, game, fish, soy, and dairy (1/2 cup).
- limit high ______ foods (peanut butter, dried peas beans, beer
biologic
catabolism
eggs
phosphorus
End-state kidney disease or CKD occurs when the ______ _____ rate is less than 29 ml/min, the serum creatine level steadily rises, or _____ or transplantation is necessary.
glomerular filtration
What kind of diet for End stage kidney disease?
- once dialysis begins, ____ intake will be increased
- vit d and calcium are nutrients of concern
-high protein
-low phosphorus and potassium, sodium, fl restricted
protein
foods high in phosphorus include _____, beef liver, chocolate, nuts and lugumes
* phosphate _____ (ca carbonate, ca acetate) must be taken with all meals and snacks
milk
binders
Vit _ deficiency occurs b/c kidneys cannot convert into the active form.
*this alters the metabolism of ______, _____ and _______ leading to hyper levels of all three.
*____ supplements will likely be required b/c foods high in phosphorus (which are restricted) are also high in calcium
D Calcium Phosphorus Magnesium calcium
Acute kidney _____ is an abrupt, rapid decline in kidney _____ causes by trauma, sepsis, poor perfusion, or medications and is usually ______
*can cause Hyper-Na/K/Ca/phos.
*_____is a complication and is leading cause of death in these clients
*three phases of AKI are?
abrupt function reversible infection oliguric, diuretic, recovery
Potassium is restricted to ___ to ____ meq/day when on dialysis
60-70
______ is restricted to 1 to 3 g/day is not receiving dialysis, if they are increases from 1-__ g/day
sodium
4
______ requirements are of less than 2000 mg daily if on hemodialysis or peritoneal dialysis
calcium
______ syndrome results in the increased excretion of serum proteins in the urine
nephrotic
results in hypoalbuminemia, edema, hyperlipidemia. watch for prolonged protein loss
____ _____, kidney damage due to meds/ chemicals, autoimmune, and infections can cause nephrotic syndrome.
diabetes mellitus
recommendation for calcium _______stone formation is to limit animal protein, excess sodium, alcohol, and caffeine. low K may also be a factor
*foods high in oxalate include spinach, rhubarb, beets, nuts should be limited, also mega doses of Vit C, which increases the amount of exalate excreted.
Oxalate
for prevention of ____ acid stones, limit foods high in purines
uric
