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ADULT 1 > EXAM 2: Nutrition and GIT > Flashcards

EXAM 2: Nutrition and GIT Flashcards

1
Q

These nutrients are not synthesized in the body or not enough is made. Instead, they are provided in diet or supplements:

A

essential nutrients

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2
Q

These nutrients do not have to be supplied by the diet because they are not required by body functions or are made in the body in adequate amounts:

A

non-essential nutrients

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3
Q

_______ supply energy and and build tissue

A

Macronutrients (carbs, fats and proteins)

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4
Q

_______ regulate and control body processes

A

Micronutrients

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5
Q

These nutrients are 4 calories per gram/4kcal/g:

A

carbohydrates and proteins

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6
Q

This nutrient is 9 calories per gram/9kcal/g

A

fats

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7
Q

How much of the adult calories should be from carbohydrates?

A

45-65%

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8
Q

How much of the adult calories should be from protein?

A

10-35%

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9
Q

How much of adult calories should be from fats?

A

<10% from saturated fats (bad fats = butters, oils, lard)

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10
Q

This is the most abundant nutrient, the least expensive source of calories, is converted into glucose to provide energy and is also the easiest macronutrient to digest:

A

Carbohydrates

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11
Q

What is an example of a complete protein? What is an example of a incomplete protein?

A

animal sources; plant sources

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12
Q

This nutrient improves taste for some foods and delays gastric emptying so it increases fullness:

A

fats

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13
Q

This is a better source of fat:

A

unsaturated (olive oil, avocados, nuts)

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14
Q

You need this is small amounts for metabolism of carbs, proteins and fats. It is essential in the diet because the body does not make it (or not in sufficient amounts)

A

vitamins

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15
Q

What are the water soluble vitamins?

A

Vitamin C and B

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16
Q

What are the fat soluble vitamins?

A

Vitamin K, A, D, and E (KADE)

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17
Q

These vitamins need to be attached to a protein to get into the blood circulation

A

fat soluble

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18
Q

These vitamins are needed daily and are excreted in urine

A

water soluble

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19
Q

What vitamins create the possibility for toxicity?

A

fat soluble vitamins A & D

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20
Q

These are found in all body fluids and tissues in the form of salt

A

minerals

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21
Q

What is the average intake of water adults should be consuming a day?

A

2,200-3000 mL/day (2-3L/day)

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22
Q

What is the minimum output of water a day in an adult?

A

30 mL/hr

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23
Q

What should your “plate” of food be made up of?

A
  • fruits
  • veggies
  • protein
  • grains
  • dairy
  • ** 1/2 plate needs to comes from fruits and veggies***
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24
Q

How can we obtain an nutritional assessment of a patient?

A

through health history (dietary, medical, & socioeconomic)

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25
Q

What is the formula for BMI and what does it measure?

A

height/weight; overweight and obesity

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26
Q

What increases a patients chance for chronic diseases?

A

large waist circumference (W: >35 and M: >40) + higher BMI

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27
Q

What is a normal BMI?

A

19-25

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28
Q

What is the BMI of an overweight patient?

A

25-29

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29
Q

What is the BMI of a obese patient?

A

30+ is obese

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30
Q

What are the 2 main nursing dx for imbalanced nutrition?

A
  • Imbalanced Nutrition: Less Than Body Requirements

- Imbalanced Nutrition: More Than Body Requirements

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31
Q

If a patient has difficulty swallowing or is on a NG tube, what status should they have?

A

NPO

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32
Q

What is considered a vegetarian diet?

A

replace meats with legumes, grains, and vegetables (May need to supplement Vit B12, Vit A, and iron)

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33
Q

What is considered a clear liquid diet?

A

clear fruit juices, clear broth (chicken, beef or veggie), black coffee only, plain tea, jello, gelatin, popsicles
* absolutely NO MILK PRODUCTS*

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34
Q

What is considered a full liquid diet?

A

includes clear liquids AND milk products, custards, pudding, vegetable juices and ice cream

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35
Q

What is considered a pureed diet?

A

all foods are allowed, they are just blended to modify texture and consistency

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36
Q

What is considered a mechanically altered diet?

A

regular diet that excludes most raw fruits, vegetables, seeds, nuts, and dried fruits; food will have to be chopped, ground, mashed or softened

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37
Q

What is considered a DASH/cardiac diet?

A

a diet low in sodium

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38
Q

What are some short term enteral feedings?

A

nasogastric tube (Levin or Dobbhoff tube)

39
Q

What is a dobbhoff tube?

A

a feeding tube that has weights on the end

40
Q

What are some long term enteral feedings?

A

gastrostomy or PEG (is surgically placed=long term feeding every night; less chance of aspiration and regurgitation because of placement)

41
Q

What angle should patients on enteral feedings be placed in?

A

45 degree angle (semi-fowlers position)

42
Q

What is a continuous enteral feeding?

A

one that is very slow (over 12-18 hours) and allows the patient to get used to the formula

43
Q

What is a intermittent enteral feeding?

A

one that has regular intervals and mimic normal feeding patterns

44
Q

What is cyclic enteral feedings?

A

usually given at night, therefore the patient has normal actives during the day b/c they are not attached to the pump

45
Q

What should the pH of stomach contents drawn from a enteral feeding be?

A

around 5.5

46
Q

If the stomach content/residual is >250mL twice OR >500mL once, what should you do and why?

A

call the provider b/c patient is at risk for aspiration; hold the feeding

47
Q

What should you flush a clogged enteral feeding tube with?

A

warm water

48
Q

What is the #1 way to confirm the proper placement of a enteral feeding tube?

A

x-ray

49
Q

What complications can occur from an enteral feeding?

A
  • infection
  • aspiration (patient should be at 30-45 degrees)
  • clogging
50
Q

What factors contribute to constipation?

A
  • medications (narcotics)
  • low fiber diet/dehydration
  • low activity levels (immobility)
  • diseases/conditions
  • stress
  • ignoring urge to defecate
51
Q

What is the proper order of assessing the abdomen?

A
  • inspection
  • auscultation
  • percussion
  • palpation
52
Q

What does a focused assessment of bowel function look like?

A
  • patterns: frequency, time of day, stool characteristics, straining, impaction
  • aids: liquids, laxatives, enemas
  • recent changes: color, stool, blood, appearance
  • problems: are your bowels causing any problems now?
  • artificial orifices (colostomy/ileostomy): usual routine with ostomy, any problems with ostomy, affecting any activities
53
Q

What is the rating of bowel movement?

A
  • 1-2 = constipation
  • 3-5 = ideal
  • 6-7 = diarrhea * ileostomy is always a 7 b/c of its location*
54
Q

What should you tell your patient before a GI diagnostic?

A
  • occult blood is blood you cannot see
  • do not use any laxatives, enemas, or suppositories for 3 days before the test because they can irritate the GI system and cause bleeding
  • avoid certain medications such as NSAIDS, steroid and iron because they can lead to false positives
  • avoid Vitamin C or fresh fruit for 3 days before collecting a specimen because they can interfere with results
55
Q

What is a endoscopy?

A

a procedure that goes down the throat

56
Q

What is a colonoscopy?

A

a procedure that goes up the anus and upwards recommended to start getting these at age 45-50 to detect cancer

57
Q

What does the nurse do for a patient who has fecal impaction?

A

the nurse must digitally remove poop with her fingers (a true impaction will not be relieved by laxatives or other methods)

58
Q

What is a vasovagal (cardiogenic syncope)?

A

a drop in HR and BP when the vagal nerve is stimulated in the rectum; this can occur during fecal impaction removal and if it does, you need to stop what your doing immediately

59
Q

What is considered contipation?

A

having < 3 BM’s a week (a BM everyday is not necessary) that are hard, dry, small or difficult to pass

60
Q

What might need to be given to a patient experiencing diarrhea/vomiting?

A

they might need F&E replacement depending on severity

61
Q

How can you assess a patient for constipation?

A
  • abdominal distension
  • pain
  • bloating
  • stool characteristics
62
Q

What are some risk factors for consitpation?

A
  • pregnant women
  • recent surgery
  • older adults
  • lower socioeconomic status
63
Q

What are some complication of constipation?

A
  • valsalva maneuver
  • hemorrhoids
  • fissures
  • impaction
64
Q

What are some examples of laxatives?

A
  • bulk forming
  • saline agent (BM within 2 hours)
  • lubricant
  • stimulant (fast working)
  • emollient (preferred over laxative; hydrates stool making them easier to pass)
  • osmotic (commonly given before a procedure/surgery)
  • lubiprostone
65
Q

What are the different types of enemas?

A
  • tap water (15 minutes)
  • normal saline (15 minutes) - safest due to = osmotic pressure
  • soap (10-15 minutes) - increases risk for electrolyte imbalance
  • hypertonic (5-10 minutes) - used in dehydrated clients or those who cant tolerate high volume
  • oil (30 minutes) - lubrication for easier passage of stool
66
Q

How does enemas work?

A

solution is introduced into the large intestine via the rectum and the patient needs to hold in the solution. these mostly increase peristalsis.

67
Q

How will stool be in a person with a colostomy?

A

stool is formed b/c its at the end of the GIT

68
Q

How will stool be in a person with a ileostomy?

A

stool will be liquid

69
Q

How will stool be in a person with a urostomy?

A

urine

70
Q

How should a healthy stoma look?

A

it should be pink/moist (a beefy red stoma typically means its new but if they have had it a long time, that could be an infection); should be cleaned with mild soap and water and then dried

71
Q

What is gastritis?

A

Inflammation of the gastric/stomach mucosa

72
Q

What are the risk factors for gastritis?

A
  • older adults
  • those who use aspirin and NSAIDS
  • alcohol consumption
  • gastric radiation treatments
  • H. Pylori infection
73
Q

What are the s/sx of acute gastritis?

A
  • epigastric pain
  • dyspepsia (indigestion)
  • N/V with or without blood
  • melena (dark tarry stools)
  • hematochezia (blood in stools/anus)
74
Q

What are the s/sx of chronic gastritis?

A
  • fatigue
  • pyrosis (heart burn)
  • belching
  • sour taste in mouth
  • low B12
  • no symptoms
75
Q

How is gastritis diagnosed?

A
  • endoscopy with tissue biopsy
  • CBC
  • H. Pylori culture
76
Q

How is gastritis treated?

A
  • medication (antibiotics)
  • emergency surgery
  • avoid alcohol and food
  • smoking cessation
77
Q

What is the nursing interventions for gastritis?

A
  • reduce anxiety
  • relieve pain
  • manage N/V and pyrosis
  • NPO/IVF
  • discourage caffeine, alcohol, smoking
  • monitor for hemorrhage
78
Q

What patient education should be provided to a patient with gastritis?

A
  • stress management
  • dietary consolidation/foods to avoid
  • medications
  • B12 injections
  • lifestyle changes
79
Q

What is a peptic ulcer?

A

A hollowed area in GIT that forms in the mucosa of the stomach, pyloris, duodenum or esophagus (patho: erosion occurs due to increased activity of acid pepsin or decreased resistance of the normally protective mucosal barrier).

80
Q

What is a peptic ulcer usually a result of?

A
  • H.Pylori

- NSAID abuse

81
Q

What are the s/sx of a peptic ulcer?

A
  • no s/sx
  • dull, gnawing pain or burning sensation with mid-epigastric area or back
  • pain occurs after eating
  • N/V, diarrhea and bleeding
82
Q

How is a peptic ulcer treated?

A
  • with medication for 10-14 days and education to avoid alcohol, smoking and NSAIDs
83
Q

What kind of pain is always a priority?

A

acute pain

84
Q

What are the nursing interventions for a peptic ulcer?

A
  • relieve pain (no NSAIDS)
  • reduce anxiety
  • IV therapy
  • NGT to low intermittent suction (clears everything out)
  • dietary education/weight (foods to avoid=spicy food and alcohol)
  • monitor for complications (hemorrhage, perforation, obstructions)
85
Q

What education should be provided for a patient with a peptic ulcer?

A
  • avoid NSAIDS
  • avoid alcohol
  • stop smoking
86
Q

What is GERD?

A

the back-flow of gastric or duodenal content into the esophagus

87
Q

What causes GERD?

A

Incompetent lower esophageal sphincter, pyloric stenosis, hiatal hernia or motility disorder

88
Q

What are the risk factors for GERD?

A
  • age
  • IBS
  • obstructive airway diseases (asthma, peptic ulcer, angina)
89
Q

What increases a persons risk for GERD?

A
  • tobacco use
  • coffee use
  • alcohol use
  • H. Pylori infections
90
Q

What are the s/sx of GERD?

A
  • dysphagia
  • pyrosis
  • dyspepsia
  • regurgitation
  • dental issues
  • pulmonary complications
  • may mimic MI
91
Q

How is GERD diagnosed and treated?

A
  • endoscopy
  • barium swallow (a drink)
  • 12-36 hour wireless capsule pH monitoring
92
Q

What are the nursing interventions for GERD?

A
  • instruct the patient to eat a low fat diet, avoid caffeine, tobacco, beer, milk, mint, carbonated beverages
  • do not eat 2hrs before bedtime, elevate HOB at least 30 degrees
  • maintain normal body weight and do not wear tight clothing
93
Q

Where are carbohydrates stored?

A

in the liver after they have been converted to glucose for blood transfer

ADULT 1 (9 decks)

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