Exam 2: Chapter 7 Flashcards
What is a nutritional screening?
Identify persons who are malnourished or at nutritional risk performed by a dietician or RN
What are three areas of concern for long term facilities that have been identified by centers for Medicare and Medicaid Services
- Pressure ulcers
- Inadequate nutrition
- Inadequate hydration
______ ____ are available for nutritional screening
Standardized tools
How often are nutritional assessments done
Facilities are assessed every three months. People who develop malnutrition are assessed every month
What are some functional limitations of nutrition
chewing and swallowing, edentulous, loss of dexterity, reduced mobility, sensory loss, and decreased taste/smell
What does dysphagic mean
difficulty swallowing
What does edentulous have to do with nutrition
People that don’t have dentures or their dentures don’t fit right so they don’t wear them…this means they don’t eat enough or the right types of foods
What does a loss of dexterity have to do with nutrition
If they can’t cut their food or hold utensils to eat by themselves they may develop malnutrition
What does sensory loss have to do with nutrition
If they cant see what they are eating or smell/taste, they will not have a big appetite
What are the different types of specific disease processes that are checked during nutritional assessment
Chronic hyperglycemia, GI disorders, Hip fractures, and SCI
Why is chronic hyperglycemia checked during a nutritional assessment
Because they might be diabetic with an uncontrolled glucose level so the body cannot manage bacteria (sugar) like it should
Why are GI disorders checked during a nutritional assessment
Anything from gastritis or cancer can affect the absorption of nutrients and causes malnutrition
Why are hip fractures and SCI checked during nutritional assessments
Patients with these are very restricted in mobility and typically starts the beginning of the end for them
During the nutritional assessment, consider the patient’s _____ and possible side effects associated with them
medication
Corticosteroids _____ protein which is part of collagen. A reduction of collagen causes people to have a lower resistance to ______
inhibits; infections
What do speech therapists do in determining the nutritional care plan
they determine diet texture and the need for special feeding techniques
What do occupational therapists do in determining the nutritional care plan
they determine the need for adaptive feeding equipment
What does physical therapy do in determining the nutritional care plan
PT requires an increased expenditure of energy and a need for more calories which must be considered in the plan
What is the term that describes pure protein and every deficiency, which is reversed solely by the administration of nutrients
undernutrition
True or False:
Nutritional status can deteriorate over time
true
What are skin conditions related to nutritional status
Dry skin, breakdown, nonhealing wounds, bruised, dehydration, skin that tents, loose skin, edema/ascites
What does ascites mean?
Edema in the abdominal cavity indicating there is a liver problem
What is anthropometry and what what are the four aspects to consider with it
It is a measurement of body, size, weight and proportions. Consider the normal changes of aging, height/weight, BMI, and unintentional weight loss
What is the goal of therapeutic diets
Have adequate intake of nutrients that promotes wound healing
What medications/drugs should be considered for a nutritional assessment
Radiation/chemo
Dialysis
Constipation/diarrhea
Laxative abuse
What tests are available to check nutrition level
none
Which three proteins are linked to nutrition but also have been found to relate to acute changes in status such as infection, trauma, or injury/inflammation
albumin, pre-albumin, and transferrin
What is albumin
A protein that is made by your liver
What is pre-albumin
It carries Vitamin A and hormones through the body
What is transferrin
A protein in the blood that binds to iron and transports it through the body
Are carbohydrates a macro or micro nutrient
macronutrient
What is the role of carbohydrates in wound healing
provide energy, spares protein to build tissue, regulates metabolism, fiber, and adds flavor/color
What is the role of proteins in wound healing
provides energy, building blocks for growth/repair, immune system, hormones, electrolyte balance, transports lipids in blood
What is the role of fats in wound healing
most concentrated source of energy and main source of energy during sleep/rest, and exercise, absorbs fat soluble vitamins, insulation, protection, adds flavor/texture
What are the symptoms of dehydration
weight loss, dry skin, cracked lips, thirst, poor skin turgor, fever or low body temp, altered sensation, loss of appetite/nausea, dizziness/confusion
Dehydration causes and (increase/decrease) of blood pressure,
(increase/decrease) of pulse,
(constipation/diarrhea) and concentrated urine
Decrease BP
Increased pulse
Constipation
and concentrated urine
What is enteral nutrition
a tube that is inserted into the GI tract when a patient can no longer chew, swallow or absorb nutrients
What is parenteral nutrition
Nutrients administered directly into the venous system
How can an individual receive additional nutritional support
nutritional supplement or fortified foods, enteral nutrients, and parenteral nutrients
What are the general external factors that affect wound healing in acute surgical wounds
- Preoperative period
- Intraoperative period
- Postoperative period
What is the preoperative period
The length of hospital stay prior to surgery and/or preparation of the operative site
True or False:
The longer you stay in the hospital, the higher risk you have of developing an infection
true
Which vitamins are fat-soluble
A, D, E & K
What does fat-soluble mean
The vitamins are stored and not secreted.
True or False:
All of the fat-soluble vitamins are not produced naturally by the body
False: the body produces D and K
Which vitamin is required for the inflammatory response
Vitamin A
Which vitamin deals with calcium regulation for bone health, cell differentiation, and healthy immune system
Vitamin D
Which vitamin protects cell membranes from oxidation; enhances immune function
E
Which vitamin deals with bone health and blood clotting
Vitamin K
Which vitamins are water-soluble
B, C, & thiamine and riboflavin
Which vitamin aids in the production of energy; maintains cellular integrity and forms red blood cells
Vitamin B
Which vitamin deals with cross-linking and collagenation
thiamine and riboflavin
Which vitamin increases activation of leukocytes and macrophages
Vitamin C
What happens if there is a Vitamin C deficiency
impaired fibroblast function, decreased collagen synthesis, delayed wound healing, fragile capillaries, and impaired immune system
What does it mean if vitamins are water soluble
they are secreted into the body
True or False:
Minerals are organic
true
Minerals activate _____
enzymes
What are the three minerals discussed in the PowerPoint
Iron, copper, and Zinc
Which mineral functions to transport oxygen
iron
which mineral deals with cross-linking of collagen fibers
copper
Which mineral deals with the formation of collagen and protein synthesis
zinc
What happens if there is a deficiency of zinc
wound healing is delayed as well as the function of epithelial cells and fibroblasts
Which nutrient transports substances to cells and carries wastes away, aids in oxygen perfusion, and maintains body temperature
water
When should water intake be used with caution
When working with congestive heart failure patients and patients with kidney failure
Why should we use caution of water intake with patients with congestive heart failure
because the heart is not pumping like it should so they have a hard time maintaining balance of fluid
Why should we use caution of water intake with patients with kidney failure
Because they are not excreting the right amount of fluid/urine which means the water intake is retained within the body and will eventually affect the heart
When is an intake of water appropriate for patients with congestive heart failure or kidney failure
When they have a lot of exudate or when sweating is more than normal
These three things need enough water to work properly
- interstitial or intrastitial
- Intervascular or intravascular
- Intercellular or intracelluar
interstitial
Intervascular
Intracellular
When a patient is dehydrated they may have concentrated urine. This also means there’s concentrated toxins because of too much what?
BUN, Keratins, increase or decrease of Na, and hematocrit
What are factors that affect the healing of a surgical wound
systemic state of client nutritional status comorbidities postoperative wound care skin prep/suture used
What are factors that affect the healing of burn wounds
extend of depth lost protein through exudate hypermetabolism protein catabolism increased urinary nitrogen excretion
What are factors that affect skin tears wound healing
proper nutrition
medication
skin elasticity
decreased subcutaneous fat
What are factors that affect leg ulcer wound healing
lifestyle (obese or smoke)
Nutrition
Possible vascular issues
What is the medical term for a yeast infection in your mouth
oral candidiasis
What does oral candidiasis mean
a yeast infection in your mouth
What types of population are more likely to get oral candidiasis
diabetes, depressed cell mediated immunity, elderly, cancer, use of corticosteroids, use of immunosuppressants or antibiotics
Describe what oral candidiasis looks and feels like
They are painful, white-curd like patches in the mouth that can cover the tongue, throat, or over the inside of the mouth
What type of patients are likely to use enteral nutrition
Cancer, stroke, Parkinson patients
When is parenteral nutrition used
when enteral nutrition is not practical
Patients that are on feeding tubes have excessive ____ or loose _____ which can impact periwound skin
diarrhea; loose
