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Fundamentals > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

3 macronutrients

A

Carbs, proteins, and fats

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2
Q

2 micronutrients

A

vitamins and minerals

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3
Q

how many kcals in carbs

A

4

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4
Q

Simple carbs energy

A

Give short bursts of energy

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5
Q

Complex carbs energy

A

More long lasting energy

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6
Q

Hypoglycemia S&S and mnemonic

A

Excessive thirst
Cool and clammy, give them candy

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7
Q

Hyperglycemia S&S mnemonic

A

Hot and dry, sugar’s high

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8
Q

6 sources of simple CHOs

A

Sugars, syrups, molasses, honey, fruit, milk

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9
Q

8 sources of complex CHOs

A

Bread, cereal, potatoes, rice, pasta, crackers, flour products, legumes

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10
Q

How many kcals per gram of protein

A

4

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11
Q

Functions of proteins

A

Growth, maintenance, repair of body tissues

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12
Q

6 sources of complete proteins

A

Meat, fish, poultry, milk, cheese, eggs

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13
Q

10 sources of incomplete proteins

A

Dried peas, beans, peanut butter, seeds, fruits, veggies, bread, cereal, rice, pasta

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14
Q

Functions of fats

A

energy, insulation, vitamin absorption

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15
Q

How many kcals per gram of fat

A

9

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16
Q

5 highly saturated sources of fats

A

Beef, lamb, coconut oil, palm oil, palm kernel oil

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17
Q

Less saturated fats

A

Chicken, fish, and veggies

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18
Q

Functions of vitamins

A

Metabolism, growth, development, and body functions

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19
Q

4 fat soluble vitamins

A

A, D, E, K

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20
Q

2 water soluble vitamins and where are they excreted

A

B complex, C
Excreted in the kidneys but held for renal compromise

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21
Q

Calcium sources and what is it besties with

A

Dairy, leafy greens, fish (salmon)
Besties with vitamin D

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22
Q

Iron effects, sources

A

Constipating effects
Chicken, liver, pork, egg yolk, spinach, potatoes, iron fortified foods (meet daily requirement)
Meat products have highest content!

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23
Q

Potassium (what limits it, what drug associated with it, hypo vs hyperkalemia in terms of heart rhythm, sources)

A

PP limits it
Lasix is a popular diuretic for HF and also limits
hypo: DYSrhythmia, hyper: Arrhythmia
Avocadoes, bananas, potatoes, spinach

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24
Q

Sources of iodine

A

Salt, shrimp, and shellfish

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25
Q

Source of fluoride

A

In the city water

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26
Q

Largest section in the food guide

A

Veggies

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27
Q

Mechanical vs chemical digestion

A

Mechanical: GI tract organs (mastication which is chewing)
Chemical: Accessory organs, on a cellular level with enzymes

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28
Q

What gets metabolized

A

Carbs, fats, and proteins (macronutrients)

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29
Q

What contains 70-80% of immune-secreting cells

A

GI tract

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30
Q

What kind of tissue makes up 25% of the GI tract

A

Lymphoid tissue

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31
Q

What should you drink to maintain gut health

A

Probiotics and warm water (warm water dilates the gut and moves things through)

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32
Q

how to calculate BMI

A

Weight in kg divided by height in cm or m

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33
Q

BMI values

A

<25 is good
25-29 overweight
30-34 obesity class 1
35-40 obesity class 2
>40 is obesity class 3

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34
Q

Considerations of nutrition for older adult

A

Decreased metabolism=lower caloric need
Decreased thirst=fluid restriction, increases risk for fluid deficit
decreased sense of smell and taste
calcium deficiency
Need for vitamins and minerals (same as younger adults)
Fiber for GI function

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35
Q

What do jewish people eat

A

Kosher

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36
Q

Mexican American food considerations

A

Not cutting rice, but changing the type or adding veggies/proteins

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37
Q

What causes discomfort during or after eating (5)

A

Esophageal disease or cancer, CVA, GERD, mouth sores

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38
Q

Paralytic ileus

A

Constipation

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39
Q

What conditions increase BMR (body metabolic rate)

A

Thyroid diseases and conditions

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40
Q

Where is cortisol released from

A

The adrenal gland

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41
Q

Wasting diseases and S&S

A

Cancers/malignancies and cachexia (frail, sunken face and eyeballs, skin hanging from extremities)

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42
Q

Metabolic syndrome 5 S&S

A

BP >130/85
Waist circumference >40inches in men or 35 for women
Glucose greater than 110
HDL less than 50 in women and 40 in men
Triglycerides higher than 150

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43
Q

healthy BMI

A

20-25

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44
Q

Indication of cancer in terms of bowel movements

A

Change in bowel movements without other S&S, no change in diet or exercise

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45
Q

3 examples of anthropometric measurements

A

Height, weight, waist, etc.

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46
Q

4 parts of swallowing evaluation

A

Inspect and palpate the face, jaw, and neck for symmetry and strength during clenching
Assess cough
Palpate laryngeal protuberance during swallow
Evaluate gag reflex

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47
Q

Signs of low protein

A

Hair: Thin, coarse, lacking luster, breaking easily
Muscles: wasting
Skin: Pressure sores, poor wound healing
Skeletal: Poor posture, painful joints, bowed legs, increase in bone fractures

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48
Q

Signs of low vitamin K

A

Skin: Excessive bruising and bleeding

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49
Q

Signs of low vit C

A

Skin: pressure sores, poor wound healing
Skeletal: poor posture, painful joints, bowed legs, increase in bone fractures

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50
Q

Signs of low calories

A

Lack of growth

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51
Q

Signs of low Calcium and vit D

A

Skeletal: poor posture, painful joints, bowed legs, increase in bone fractures

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52
Q

Signs of low thiamine, niacin, B complex

A

Mental: confusion, motor weakness

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53
Q

Soft foods

A

Don’t require mastication
Apple sauce, pudding, bananas, avocado

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54
Q

Dysphagia diet

A

Difficulty swallowing
Honey, thick liquids, nectar, no straws

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55
Q

When to use liquid diet

A

After surgery
After episodes of acute vomiting and diarrhea
Provides hydration

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56
Q

When to use soft diet (2)

A

transition from liquid to regular diet
GI problems (pureed, mechanical soft, low residue/low fiber)

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57
Q

4 types of solid foods

A

Pureed, mechanical soft, advanced, regular

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58
Q

Types of liquids

A

Spoon-thick (not used much, coat spoon)
Honey-like
Nectar-like
Thin

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59
Q

6 restrictive diets

A

Bland
Low-cholesterol
Sodium-restricted
Gluten free
Lactose free
High-fiber

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60
Q

3 sections of abdomen top to bottom

A

epigastric, umbilical, hypogastric/suprapubic

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61
Q

Pathway of food

A

Pharynx, esophagus, stomach, small intestine, large intestine, rectum, anus

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62
Q

3 parts of small intestine

A

duodenum, jejunum, ileum

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63
Q

4 parts of large intestine

A

Cecum, colon, rectum, anus

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64
Q

Between ileum and cecal and what does it do

A

Ileocecal (slows movement of semi digested food into large intestine)

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65
Q

4 parts of colon

A

ascending, transverse, descending, sigmoid

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66
Q

Where does absorption take place

A

small intestine

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67
Q

What makes stomach stretch and expand

A

Rugae

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68
Q

Protein and fat take more or less time to process than sugar?

A

More time

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69
Q

What 4 bacteria are normal in the large intestine

A

E. Coli, kleb, lactobacillus acidophilus, and bacteriocins

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70
Q

What are striae

A

Stretch marks

71
Q

Gravid uterus

A

Pregnant

72
Q

Segmentation

A

Alternating contraction and relaxation of smooth muscle in the intestine

73
Q

Peristalsis

A

Propels the intestinal contents along the entire length of the small and large intestines

74
Q

What system affects the rate of intestinal motility

A

ANS (AUTO, we don’t control intestinal stuff)

75
Q

Sympathetic stimulation does what with the intestine

A

Slows peristalsis and delays passage through the intestine

76
Q

Parasympathetic stimulation does what with the intestine

A

Increases bowel motility and emptying

77
Q

What happens in each section of the small intestine and the large intestine

A

Nutrients and electrolytes in the duodenum and jejunum
Vitamins, iron, and fluid in the ileum
Final absorption of nutrients in the large intestine

78
Q

What kind of feces is in each part of the large intestine

A

Ascending colon: liquid contents
transverse: semisolid and mushy feces
Distal: solid feces

79
Q

Bristol stool scale

A

Type 7: entirely liquid
Type 6: fluffy pieces with ragged edges (mushy)
Type 5: Soft blobs with clear edges (passed easily)
Type 4: like a sausage or snake (good)
Type 3: like a sausage but with cracks
Type 2: sausage but lumpy
Type 1: separate hard lumps like nuts (hard to pass)

80
Q

Abnormal and normal frequency of feces

A

Normal: variable. usually 1-2/day to every 2-3 days
Abnormal: depends on usual pattern, >3/day or <1 every 3 days

81
Q

Abnormal and normal color of feces

A

Normal: brown
Abnormal: black, tarry; reddish brown, maroon; clay colored; yellow green

82
Q

Abnormal and normal consistency of feces

A

Normal: soft formed
Abnormal: hard; loose, liquid; high mucous content

83
Q

Abnormal and normal shape of feces

A

Normal: cylindrical
Abnormal: narrow, pencil thin

84
Q

Normal amount of feces

A

100-300 g/d

85
Q

Abnormal and normal odor of feces

A

Normal: aromatic, pungent
Abnormal: foul, objectionable

86
Q

Lifespan considerations of older adult with GI

A

Motility slows with aging
Frequency of bowel movements decrease
Increase amount of fluids and high-fiber foods to prevent hard stool
Weakened pelvic muscles and decreased activity level contribute to constipation

87
Q

Alcohol and smoking change frequency of pooping

A

Increased bc of relaxation

88
Q

What medication makes stool harder

A

Imodium

89
Q

5 Fs of distention

A

Feces
Fetus
Fat
Flatus
Fluid

90
Q

Constipation

A

NOT defined by consistency of stool, though most people do it that way
Actually defined as fewer than 3 BMs/week

91
Q

How do opioids affect feces

A

Makes them less watery (more dry)

92
Q

fecal impaction, cause, and 2 S&S

A

Accumulation of hard feces in the rectum, can’t get out
Caused from untreated and unrelieved constipation
Passage of liquid stool, abdominal distension (hard stuff stays behind, only liquid gets through)

93
Q

C. Diff 2 treatments

A

Clinda and ceph’s

94
Q

2 injuries that cause fecal incontinence

A

Injury to the cerebral cortex, sacral spinal cord injury

95
Q

What causes swallowed air (5)

A

Straws, carbonated beverages, gum chewing, candy sucking, smoking

96
Q

What causes accumulation of gas in GI tract (6) and what to do

A

Swallowed air
Bacterial action in large intestine
Diffusion from blood
Certain foods (cabbage, onion, legumes, rapid indigestion of fiber)
Obstruction that blocks passage of flatus and intestinal chyme or feces
Constipation and impaction

Measure abdominal girth by marking an “X” at the most distended spot

97
Q

Absent, hypoactive, normal, hyperactive bowel sounds

A

Absent: None for 2 min
Hypoactive: >30 seconds
Normal: Every 5-20 seconds
Hyperactive: Continuous or <5 seconds

98
Q

What are ascites

A

Fluid in organs

99
Q

Where do you hear tympany in the abdomen

A

Over hollow organs and the tummy

100
Q

Where do you hear dullness in the abdomen (5)

A

Solid organs (liver and spleen)
masses
Adipose tissue
Full bladder
Ascites (test shifting dullness)

101
Q

Which area of the abdomen is examined last

A

Where there is a suspected abnormality

102
Q

Order of abdominal auscultation

A

Start with right lower, then go clockwise

103
Q

Temperature when you have diarrhea

A

High because of dehydration

104
Q

Fecal occult blood test results

A

Blue is positive

105
Q

What to avoid before a FOBT (7), for how long, and why

A

Red meat, iron preparations, bismuth compounds, aspirin, steroids, NSAIDS, Vit C
72 hours
Causes false +

106
Q

Valsalva maneuver

A

Causes straining while pooping
Close nose and bear down

107
Q

How to collect stool if pt is ambulatory

A

hat

108
Q

What 6 bacterias cause diarrhea

A

Salmonella, shigella, C. Diff, ova, parasites, giardia

109
Q

Barium swallow and what does it diagnose (3)

A

Aids visualization of soft tissues and progress of food from esophagus through ileum
Barium enema for lower GI
Diagnoses tumors, obstructions, and filling defects

110
Q

Sigmoidoscopy

A

Examines the rectum and sigmoid colon

111
Q

Colonoscopy

A

Colon up the ileocecal valve (with anesthesia)

112
Q

EGD

A

Esophagus, stomach, and duodenum

113
Q

how much fluid helps elimination

A

1500-2000 mL daily

114
Q

Kegel exercises

A

Pelvic floor exercises

115
Q

When to begin colorectal screening

A

At 45

116
Q

What 2 elements in medication cause constipation

A

Aluminum and calcium

117
Q

What therapy for recurrent C. Diff infection

A

Fecal microbiota transplation

118
Q

What side to do an enema

A

Left side but both are fine

119
Q

What does a small volume enema do

A

Evacuates fecal matter after oral laxative fails

120
Q

Large volume enema

A

Cleanse bowel of stool

121
Q

Return flow enema

A

Relieves accumulated flatus

122
Q

Colostomy

A

Segment of the colon is brought out the abdominal skin

123
Q

Ileostomy

A

Segment of the ileum is used to make the stoma

124
Q

Gynecomastia and when is it normal

A

Enlarged breast tissue in men, not related to weight
Normal if pt is on estrogen

125
Q

What does renin do

A

Constrict blood vessels

126
Q

What does aldosterone do

A

Makes sodium stay in the blood by absorbing and holding onto it

127
Q

Where is retroperitoneal blood from

A

usually the kidneys

128
Q

Normal volume of urine per void

A

250-400 mL

129
Q

Micturation reflex

A

Urine stretches detrusor muscle. Stretch sensation transmitted to sacral segments of the spinal cord
Reflex motor action transmitted back to detrusor muscle causing it to contract.

130
Q

How many times a day to adults void

A

6-8 times

131
Q

Total urine output per day

A

1200-1500 mL

132
Q

Normal urine output per hour and what low output indicates

A

30 mL/hr
Possible renal failure or marked ECF deficit

133
Q

What does removing the prostate gland do in terms of incontinence

A

Causes stress incontinence

134
Q

Treatment for stress incontinence

A

Kegel exercises, weight loss if obese, vaginal pessary, estrogen vaginal creams, male external catheters, surgery

135
Q

Urge urinary incontinence causes

A

Overactivity of the detrusor muscle; decreased bladder capacity; irritation of the bladder; bladder infection; overdistention of the bladder; intake of diuretics, caffeine, or alcohol; reduced estrogen

136
Q

Treatment for urge urinary incontinence (2)

A

Timed voiding schedule, anticholinergic drugs

137
Q

Reflex urinary incontinence

A

Involuntary loss of urine, occurring at somewhat predictable intervals when a specific bladder volume is reached overcoming sphincter control

138
Q

Causes of reflex urinary incontinence

A

Spinal cord impairment above the sacral reflex arc (spinal cord injury, brain tumor) or radical pelvic surgery; flaccid neurogenic bladder

139
Q

Treatment of reflex urinary incontinence and drugs to relax both sphincters

A

In-and-out catheterization; alpha adrenergic drugs to relax internal sphincter, baclofen to relax external sphincter

140
Q

Functional urinary incontinence

A

Inability of a normally continent person to reach the bathroom in time

141
Q

Functional urinary incontinence causes

A

Altered environment treat and sensory, cognitive, psychological, neurovascular, or mobility deficits

142
Q

Functional urinary incontinence treatments

A

Toileting routine, verbal cuing reminders with assistance to bathroom, alteration of environment for easy access to the bathroom, clothing that is easy to remove

143
Q

causes of total urinary incontinence

A

neurologic lesion, trauma to or congenital malformation in the spinal cord or brain, severe cognitive deficits

144
Q

Treatments of total urinary incontinence

A

Toileting routine and verbal reminders, external catheters for men, absorbent products, excellent skin care and hygiene

145
Q

What are kidneys a regulator of and how does this change with age

A

ECF, regulates less as you get older which leads to residual

146
Q

What 2 drugs make urine orange

A

Pyridium and rifampin

147
Q

What drug makes urine bright yellow

A

Riboflavin (B complex)

148
Q

Normal output according to intake

A

Within 300 mL

149
Q

Which direction to do percussion of abdomen

A

Start at umbilicus and go down

150
Q

Clean catch/mainstream specimen

A

Sterile

151
Q

24 hour specimen is done when and in what container

A

Early in the morning after pts first void in dark container bc sun damage

152
Q

Normal Color, turbidity, pH, protein, glucose, ketones, RBC, WBC, bacteria/yeast in urine

A

Light yellow-amber
Clear
4.6-8, 6 is best
None-trace
None
None
0-30
0-5
None-few

153
Q

Who is at risk of proteinuria (4)

A

Preeclampsia, HTN, renal disease, severe stress

154
Q

Indwelling catheter uses (4) for pts with what kind of pressure injury and where

A

Monitoring exact output of critically of acutely ill pts
Urinary retention not manageable by intermittent catheterization
Management of incontinence only in pts with stage III or IV pressure injuries on the sacrum
Continuous bladder irrigation (three-way)

155
Q

Straight catheter 3 uses

A

Sterile specimen
Check residuals
Routine emptying of bladder for neurogenic bladder

156
Q

2 incontinent bowel diversions

A

Ileal conduit
Urostomy

157
Q

Continent bowel diversion

A

(cock?) pouch
Reservoir from ileum, every 2-3 hours then every 5-6 once pouch expands
Neobladder is created by ileum

158
Q

TSE of testicular self-exam

A

Timing
Shower
Examination points

159
Q

Where are the kidneys

A

On each side of the spinal column, behind the abdominal cavity wall, just above the waistline

160
Q

Major functioning unit of kidneys

A

Nephrons

161
Q

Which kidney is lower and why

A

Right bc liver

162
Q

What kind of container is a random specimen (UA) contained in and how much

A

20-30 mL and orange/blue top cup or test tube

163
Q

What kind of specimen and how much for urine culture and sensitivity and what should you clean first

A

2-3 mL and sterile specimen and urethral meatus

164
Q

Normal urine pH

A

4.6-8

165
Q

Diet for renal disease (4)

A

restrict intake of sodium, potassium, protein, and possibly fluids

166
Q

Diet for liver disease (cirrhosis) (2)

A

restrict intake of sodium, increase intake of protein, unless hepatic coma is pending, at which time protein is virtually eliminated

167
Q

Diet for CHF (2)

A

Restrict intake of sodium and calories

168
Q

Diet for CAD (3)

A

restrict intake of sodium, calories, and fats (saturated and cholesterol)

169
Q

Diet for burns (4)

A

Increase calories, protein, vit C and B

170
Q

Diet for resp (emphysema) (3)

A

Soft, high-cal, high protein

171
Q

Diet for TB (4)

A

Increase protein, calories, calcium, and vit A

172
Q

Diet for HTN

A

Decrease sodium; lose weight

173
Q

How often to encourage voiding

A

Every 4 hours

174
Q

What foods cause accumulation of gas in the GI (4)

A

cabbage, onion, legumes, rapid indigestion of fiber

Fundamentals (5 decks)

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