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NUR 333 > E2 Nutrition & Enteral Nutrition > Flashcards

E2 Nutrition & Enteral Nutrition Flashcards

1
Q

3 main functions of GI system

A

Transportation, Digestion, Absorption

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2
Q

Poor nutrition linked to

A

Increased readmission rate, mortality rate, and cost

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3
Q

________ of someone who is malnourished is KEY

A

early recognition

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4
Q

Patients who are malnourished upon admission are at greater risk of complications:

A

-Dysrhythmias
-Skin breakdown
-Sepsis
-Hemorrhage
-Increased length of stay
-Delayed surgical healing

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5
Q

Healthy lifestyle tips

A
  1. Follow a healthy eating pattern across a lifespan
  2. Focus on variety, nutrient density, and amount
  3. Limit calories from added sugars, saturated fats, and reduce sodium intake
  4. Shift to healthier food and beverage choices
  5. Support healthy eating patterns for all
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6
Q

Factors that influence nutrition

A

-Appetite
-Negative experience
-Disease/ illness
-Medications
-Environmental factors
-Developmental needs
-Alternative food patterns

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7
Q

What are environmental factors that influence nutrition?

A

-Income (healthy is expensive)
-Education level
-Physical function level
-Transportation (can you get to grocery store)
-Availability of food (Fast food)

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8
Q

Standardized tools for nutrition assessment

A
  1. Subjective Global Assessment (SGA)
  2. Mini-nutritional Assessment (MNA)
  3. Malnutrition Screening Tool (MST)
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9
Q

BMI formula

A

BMI= weight (kg) / Height ^2 (m2)

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10
Q

1kg = ____ Ibs

A

2.2

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11
Q

Common labs to assess nutrition

A
  1. Total protein
  2. Albumin
  3. Prealbumin
  4. Hemoglobin
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12
Q

Factors that effect lab results

A

-Fluid imbalance
-Live & kidney function
-Presence of disease

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13
Q

Total protein

A

Combination of albumin & globulin constitute

Normal: 6.4-8.3 g/dL

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14
Q

Albumin

A

-Makes up 60% of total protein
-Chronic illness
-Synthesized in liver
-Half life 21 days
-Normal: 3.5-5.0 g/dL

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15
Q

Prealbumin

A

-Acute condition
-Half-life 2 days
-Normal: 15-36 mg/dL

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16
Q

Hemoglobin

A

Iron containing pigment on RBC that transports oxygen

Normal Male: 14-18 g/dL
Female: 12-16 g/dL

Eat iron rich food if low

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17
Q

Nectar-like consistency

A

Liquids that have been thickened to a consistency that coats and drips off a spoon, similar to unset gelatin

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18
Q

Spoon-thick consistency

A

Liquids that have been thickened to a pudding consistency. They remain on the spoon in a soft mass

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19
Q

Honey-like consistency

A

Liquids that have been thickened to honey consistency. The liquid flows off a spoon in ribbon like honey

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20
Q

CC2 diet

A

Diabetic diet, balances carbs/fats/proteins, and considers caloric intake

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21
Q

Cardiac diet

A

low salt, low saturated fats, low cholesterol

22
Q

Low residue diet

A

low roughage, low fiber, low dairy, crohns disease, ulcercolitis, decrease hyperactivity of bowels

23
Q

High fiber diet

A

-Prevent colon cancer & constipation
-Grains, fruits, veggies

24
Q

Gluten free diet

A

-Celiac disease or gluten intolerance
-No wheat, barley, rice, oats

25
Q

Bland diet

A

-Avoid irritation in GI and decrease peristalsis
-Acid reflux or ulcers

26
Q

Being NPO for more than _____ are at high nutritional risk

A

5-7 days

27
Q

How would you advance a diet as tolerated?

A

Clear liquid -> Full liquid -> Low residue (if needed) or regular

28
Q

Dysphagia

A

Difficulty swallowing

29
Q

Warning signs of dysphagia

A

-Speech: uncoordinated, slow, weak
-Gag reflex less than resilient
-Delay in swallowing
-Drooling or pocketing food
-Problem with regurgitation
-Weight loss/ not eating
-Sign of chest or throat discomfort

30
Q

Silent aspiration

A

-Food or fluid accidentally goes in airway instead of stomach
-Cause pneumonia by initiating inflammatory process
-Decreased sensation and don’t cough
-detected by asculating adventitious sound

31
Q

What counts as intake for I/Os?

A

-Oral intake
-IV fluids
-Blood product
-Tube feeding
-Flushes

32
Q

What counts as output for I/Os?

A

-Urine
-Bowel movements (occurrences)
-Emesis
-Drainage (JP or chest tube)

33
Q

Parenteral nutrition

A

Feeding intravenously, bypass the usual process of eating and digestion

-Feed through central vein

34
Q

Enteral nutrion

A

Liquid supplemental nutrition is either taken by mouth or is given via a feeding tube

-Preferred method if pt can’t swallow and gut is functioning

35
Q

Nasal or oral feeding tubes terminates at:

A
  1. Stomach (Nasogastric)
  2. Duodenum (Nasoduodenal)
  3. Jejunum (Nasojejunal)
36
Q

PEG

A

Feeding tube that leads through an artificial external opening into the stomach (Gastrostomy)

37
Q

PEGJ

A

Feeding tube that leads through an artificial external opening in to the small intestine (Jejunostomy)

38
Q

Indications of Enteral nutrition

A

-Prolonged anorexia
-Severe protein-energy malnourishment
-Coma
-Impaired swallowing
-Critical illnesses

39
Q

Benefit of Enteral over parenteral nutrition

A

-Reduce sepsis
-Minimize the hypermetabolic response to trauma
-Decreases hospital mortality
-Maintains intestinal structure and function (will atrophy w/o use)

40
Q

Signs of Tube feeding intolerance

A

-High gastric residuals
-Nausea
-Cramping
-Vomiting
-Diarrhea

41
Q

Compliations of Tube feeding

A

-Pulmonary aspiration
-DIARRHEA
-Constipation
-Abd cramping with N/V
-Tube occlusion or displacement
-DELAYED gastric emptying
-Serum electrolyte imbalance
-FLUID OVERLOAD
-Hyperosmolar dehydration

42
Q

Nurses role in placement of Feeding tube

A

-Insert NG using water soluble lubricant
-Landmarks (gastric)- nose, ear, xiphoid process, add 8-10 inches for jejunum

43
Q

Nasograstric or Nasojejunal tubes are placed for how long

A

<4 weeks

44
Q

Surgically or endoscopically placed tubes are placed for how long

A

More than 6 weeks

45
Q

HOB for Tube Feeding patients

A

Min 30 degrees Best is 45

46
Q

How often should you check gastric residual in continuous feeding?

A

Every 4-6 hours

47
Q

How often should you check gastric residual in intermittent feeding?

A

Immediately before

48
Q

What does High gastric residual indicate?

A

Delayed gastric emptying

49
Q

What do you do if gastric residue is >250 mLs?

A

Put back into pt, hold for 1 hour then recheck

50
Q

What do you do if gastric residue is >500 mLs ?

A

Put back into pt, Hold and notify HCP

NUR 333 (15 decks)

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