Clients with Special Needs (C) Flashcards
What is iatrogenic malnutrition?
Malnutrition occurring as a result of a hospital stay
What are the symptoms of protein energy malnutrition?
Weight loss, pale dry skin, impaired wound healing and immune system, and anemia
What nutrients are important to consume pre-surgery?
Protein (wound and blood regeneration), carbs (stored energy), B vitamins (hypermetabolic state), vitamins A and C and zinc (wound healing), iron (blood), and calcium and potassium (bone health)
What type of diet is used before GI surgery?
Low-residue
What nutrition is given for 24 hours post surgery?
IV only: water, 5-10% dextrose, electrolytes, vitamins, and medication. Max 400-500 calories per day
What are the calorie needs immediately following surgery?
35-45 calories per kg of body weight
What is the recommended protein intake post surgery?
1.5-2.0g per kg of body weight
When peristalsis returns, what might be given to see if a clear-liquid diet will be tolerated?
Ice chips
When are dumping syndrome symptoms experienced?
15-30 minutes after eating
What is the dietary treatment for dumping syndrome?
Small frequent meals, restricting of sugar and dried fruits, 4oz or less of fluids at meals (can drink again 30 minutes after). Milk may be a sensitivity
What is enteral nutrition?
Nutrition directly into the digestive tract
When is tube feeding used?
When food cannot be ingested through the mouth, but the GI tract is functioning
A nasogastric (NG) tube to the stomach or small intestine is used when enteral nutrition will last how long?
Under six weeks
When enteral nutrition will last 4-6+ weeks, what is used?
An enterostomy in either esophagostomy, gastrostomy, or jejunostomy
When are percutaneous endoscopic gastrostomy tubes (PEGs) and JPEGs used?
PEGs if no risk for aspiration– if risk, pass into the duodenum (JPEG)
What are polymeric formulas?
1-2 calories per mL; intact macronutrients
What are elemental/hydrolyzed formulas?
1 calorie per mL; containing products of digestion and lactose free
What are modular formulas?
3.8-4.0 calories per mL; supplementary or customized (use decreasing in favor of high-protein formulas)
What is intermittent feedings in terms of enteral nutrition?
Tube feeding at night and solids in the day. If interaction with medication, stopped 1 hour before and after
What is bolus feeding in terms of enteral nutrition?
Typically used with PEG but also NG; 6 servings of under 400cc a day over 15 minutes and followed by 25-60mL of water
What volume do continuous feedings start at?
20-25mL per hour, increasing by 10-25mL every 4 hours until tolerance is established
What is a possible side effect of high osmolality feeding solutions?
Drawing water from the body, leading to weakness and diarrhea
What are possible causes of diarrhea in patients with enteral nutrition?
Medication containing sorbitol, C. diff, or high osmolality feeding solutions (rule out other causes before solution)
How should aspiration be avoided with enteral feeding patients?
Check the placement of the tube with an x-ray, raise the head of the bed, or check gastric pH.
What is hyperalimentation?
Other term for TPN
In what situations is a peripheral vein used for TPN?
Treatment lasting under 2 weeks (otherwise central through the subclavian or superior vena cava)
What are the benefits to administering TPN via the superior vena cava?
Increases dilution due to blood flow and decreases risk or phlebitis and thrombosis
Why is TPN solution not combined until just before entry?
It is not stable
What must the nutrition status of the patient be prior to weaning off PN?
Calories and fluid requirements are near-met
Why must feeding solution not be unrefrigerated for 24 hours?
Risk of bacterial or fungal infection
What is the immediate nutritional treatment for burns?
IV fluids and electrolytes; no glucose for 2-3 days to prevent hyperglycemia
What are the calorie and protein requirements of a client with burns?
35-40 calories and 1.5-2.0g protein per kg of body weight (2.5-3.0 for children)
What percent of nonprotein calories should come from fat in a burn client?
12-15%
Which nutrients are important for patients with burns?
Vitamin C and zinc (tissue healing), B vitamins (metabolism), vitamin A (immune system and epithelial tissue healing), arginine (collagen formation and nitrogen retention), and glutamin (to preserve gut integrity and prevent infection) + fluids!!
How much does each degree of fever increase BMR?
7%
What complication can a high antibiotic dose cause?
Oral thrush (candida bacteria present if healthy, but grows if compromised)
What can soothe oral thrush?
Acidophilus capsules or yogurt containing aciophilus
How does HIV cause opportunistic infections?
Invades the T-cells and impairs the immune system
What are common symptoms present during AIDS?
Fatigue, rashes, headache, sweats, diarrhea, weight loss, lesions, cough, and fever
What causes HIV wasting syndrome?
PEM leading to hypoalbuminemia and weight loss
How should a client in need of assistance be fed?
Sit near the side of the bed and place small amounts of food toward the back of the mouth
What plate arrangement can be useful for blind patients?
Clock-face
Pressure ulcers increase the requirement for what nutrients?
Vitamin C, zinc, protein, and calories
How should clients with dysphagia be fed?
Upright with their chin tucked
