Exam 3 Flashcards
(174 cards)
1
Q
3 macronutrients
A
Carbs, proteins, and fats
2
Q
2 micronutrients
A
vitamins and minerals
3
Q
how many kcals in carbs
A
4
4
Q
Simple carbs energy
A
Give short bursts of energy
5
Q
Complex carbs energy
A
More long lasting energy
6
Q
Hypoglycemia S&S and mnemonic
A
Excessive thirst
Cool and clammy, give them candy
7
Q
Hyperglycemia S&S mnemonic
A
Hot and dry, sugar’s high
8
Q
6 sources of simple CHOs
A
Sugars, syrups, molasses, honey, fruit, milk
9
Q
8 sources of complex CHOs
A
Bread, cereal, potatoes, rice, pasta, crackers, flour products, legumes
10
Q
How many kcals per gram of protein
A
4
11
Q
Functions of proteins
A
Growth, maintenance, repair of body tissues
12
Q
6 sources of complete proteins
A
Meat, fish, poultry, milk, cheese, eggs
13
Q
10 sources of incomplete proteins
A
Dried peas, beans, peanut butter, seeds, fruits, veggies, bread, cereal, rice, pasta
14
Q
Functions of fats
A
energy, insulation, vitamin absorption
15
Q
How many kcals per gram of fat
A
9
16
Q
5 highly saturated sources of fats
A
Beef, lamb, coconut oil, palm oil, palm kernel oil
17
Q
Less saturated fats
A
Chicken, fish, and veggies
18
Q
Functions of vitamins
A
Metabolism, growth, development, and body functions
19
Q
4 fat soluble vitamins
A
A, D, E, K
20
Q
2 water soluble vitamins and where are they excreted
A
B complex, C
Excreted in the kidneys but held for renal compromise
21
Q
Calcium sources and what is it besties with
A
Dairy, leafy greens, fish (salmon)
Besties with vitamin D
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!
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
24
Q
Sources of iodine
A
Salt, shrimp, and shellfish
25
Source of fluoride
In the city water
26
Largest section in the food guide
Veggies
27
Mechanical vs chemical digestion
Mechanical: GI tract organs (mastication which is chewing)
Chemical: Accessory organs, on a cellular level with enzymes
28
What gets metabolized
Carbs, fats, and proteins (macronutrients)
29
What contains 70-80% of immune-secreting cells
GI tract
30
What kind of tissue makes up 25% of the GI tract
Lymphoid tissue
31
What should you drink to maintain gut health
Probiotics and warm water (warm water dilates the gut and moves things through)
32
how to calculate BMI
Weight in kg divided by height in cm or m
33
BMI values
<25 is good
25-29 overweight
30-34 obesity class 1
35-40 obesity class 2
>40 is obesity class 3
34
Considerations of nutrition for older adult
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
35
What do jewish people eat
Kosher
36
Mexican American food considerations
Not cutting rice, but changing the type or adding veggies/proteins
37
What causes discomfort during or after eating (5)
Esophageal disease or cancer, CVA, GERD, mouth sores
38
Paralytic ileus
Constipation
39
What conditions increase BMR (body metabolic rate)
Thyroid diseases and conditions
40
Where is cortisol released from
The adrenal gland
41
Wasting diseases and S&S
Cancers/malignancies and cachexia (frail, sunken face and eyeballs, skin hanging from extremities)
42
Metabolic syndrome 5 S&S
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
43
healthy BMI
20-25
44
Indication of cancer in terms of bowel movements
Change in bowel movements without other S&S, no change in diet or exercise
45
3 examples of anthropometric measurements
Height, weight, waist, etc.
46
4 parts of swallowing evaluation
Inspect and palpate the face, jaw, and neck for symmetry and strength during clenching
Assess cough
Palpate laryngeal protuberance during swallow
Evaluate gag reflex
47
Signs of low protein
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
48
Signs of low vitamin K
Skin: Excessive bruising and bleeding
49
Signs of low vit C
Skin: pressure sores, poor wound healing
Skeletal: poor posture, painful joints, bowed legs, increase in bone fractures
50
Signs of low calories
Lack of growth
51
Signs of low Calcium and vit D
Skeletal: poor posture, painful joints, bowed legs, increase in bone fractures
52
Signs of low thiamine, niacin, B complex
Mental: confusion, motor weakness
53
Soft foods
Don't require mastication
Apple sauce, pudding, bananas, avocado
54
Dysphagia diet
Difficulty swallowing
Honey, thick liquids, nectar, no straws
55
When to use liquid diet
After surgery
After episodes of acute vomiting and diarrhea
Provides hydration
56
When to use soft diet (2)
transition from liquid to regular diet
GI problems (pureed, mechanical soft, low residue/low fiber)
57
4 types of solid foods
Pureed, mechanical soft, advanced, regular
58
Types of liquids
Spoon-thick (not used much, coat spoon)
Honey-like
Nectar-like
Thin
59
6 restrictive diets
Bland
Low-cholesterol
Sodium-restricted
Gluten free
Lactose free
High-fiber
60
3 sections of abdomen top to bottom
epigastric, umbilical, hypogastric/suprapubic
61
Pathway of food
Pharynx, esophagus, stomach, small intestine, large intestine, rectum, anus
62
3 parts of small intestine
duodenum, jejunum, ileum
63
4 parts of large intestine
Cecum, colon, rectum, anus
64
Between ileum and cecal and what does it do
Ileocecal (slows movement of semi digested food into large intestine)
65
4 parts of colon
ascending, transverse, descending, sigmoid
66
Where does absorption take place
small intestine
67
What makes stomach stretch and expand
Rugae
68
Protein and fat take more or less time to process than sugar?
More time
69
What 4 bacteria are normal in the large intestine
E. Coli, kleb, lactobacillus acidophilus, and bacteriocins
70
What are striae
Stretch marks
71
Gravid uterus
Pregnant
72
Segmentation
Alternating contraction and relaxation of smooth muscle in the intestine
73
Peristalsis
Propels the intestinal contents along the entire length of the small and large intestines
74
What system affects the rate of intestinal motility
ANS (AUTO, we don't control intestinal stuff)
75
Sympathetic stimulation does what with the intestine
Slows peristalsis and delays passage through the intestine
76
Parasympathetic stimulation does what with the intestine
Increases bowel motility and emptying
77
What happens in each section of the small intestine and the large intestine
Nutrients and electrolytes in the duodenum and jejunum
Vitamins, iron, and fluid in the ileum
Final absorption of nutrients in the large intestine
78
What kind of feces is in each part of the large intestine
Ascending colon: liquid contents
transverse: semisolid and mushy feces
Distal: solid feces
79
Bristol stool scale
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
Abnormal and normal frequency of feces
Normal: variable. usually 1-2/day to every 2-3 days
Abnormal: depends on usual pattern, >3/day or <1 every 3 days
81
Abnormal and normal color of feces
Normal: brown
Abnormal: black, tarry; reddish brown, maroon; clay colored; yellow green
82
Abnormal and normal consistency of feces
Normal: soft formed
Abnormal: hard; loose, liquid; high mucous content
83
Abnormal and normal shape of feces
Normal: cylindrical
Abnormal: narrow, pencil thin
84
Normal amount of feces
100-300 g/d
85
Abnormal and normal odor of feces
Normal: aromatic, pungent
Abnormal: foul, objectionable
86
Lifespan considerations of older adult with GI
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
Alcohol and smoking change frequency of pooping
Increased bc of relaxation
88
What medication makes stool harder
Imodium
89
5 Fs of distention
Feces
Fetus
Fat
Flatus
Fluid
90
Constipation
NOT defined by consistency of stool, though most people do it that way
Actually defined as fewer than 3 BMs/week
91
How do opioids affect feces
Makes them less watery (more dry)
92
fecal impaction, cause, and 2 S&S
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
C. Diff 2 treatments
Clinda and ceph's
94
2 injuries that cause fecal incontinence
Injury to the cerebral cortex, sacral spinal cord injury
95
What causes swallowed air (5)
Straws, carbonated beverages, gum chewing, candy sucking, smoking
96
What causes accumulation of gas in GI tract (6) and what to do
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
Absent, hypoactive, normal, hyperactive bowel sounds
Absent: None for 2 min
Hypoactive: >30 seconds
Normal: Every 5-20 seconds
Hyperactive: Continuous or <5 seconds
98
What are ascites
Fluid in organs
99
Where do you hear tympany in the abdomen
Over hollow organs and the tummy
100
Where do you hear dullness in the abdomen (5)
Solid organs (liver and spleen)
masses
Adipose tissue
Full bladder
Ascites (test shifting dullness)
101
Which area of the abdomen is examined last
Where there is a suspected abnormality
102
Order of abdominal auscultation
Start with right lower, then go clockwise
103
Temperature when you have diarrhea
High because of dehydration
104
Fecal occult blood test results
Blue is positive
105
What to avoid before a FOBT (7), for how long, and why
Red meat, iron preparations, bismuth compounds, aspirin, steroids, NSAIDS, Vit C
72 hours
Causes false +
106
Valsalva maneuver
Causes straining while pooping
Close nose and bear down
107
How to collect stool if pt is ambulatory
hat
108
What 6 bacterias cause diarrhea
Salmonella, shigella, C. Diff, ova, parasites, giardia
109
Barium swallow and what does it diagnose (3)
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
Sigmoidoscopy
Examines the rectum and sigmoid colon
111
Colonoscopy
Colon up the ileocecal valve (with anesthesia)
112
EGD
Esophagus, stomach, and duodenum
113
how much fluid helps elimination
1500-2000 mL daily
114
Kegel exercises
Pelvic floor exercises
115
When to begin colorectal screening
At 45
116
What 2 elements in medication cause constipation
Aluminum and calcium
117
What therapy for recurrent C. Diff infection
Fecal microbiota transplation
118
What side to do an enema
Left side but both are fine
119
What does a small volume enema do
Evacuates fecal matter after oral laxative fails
120
Large volume enema
Cleanse bowel of stool
121
Return flow enema
Relieves accumulated flatus
122
Colostomy
Segment of the colon is brought out the abdominal skin
123
Ileostomy
Segment of the ileum is used to make the stoma
124
Gynecomastia and when is it normal
Enlarged breast tissue in men, not related to weight
Normal if pt is on estrogen
125
What does renin do
Constrict blood vessels
126
What does aldosterone do
Makes sodium stay in the blood by absorbing and holding onto it
127
Where is retroperitoneal blood from
usually the kidneys
128
Normal volume of urine per void
250-400 mL
129
Micturation reflex
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
How many times a day to adults void
6-8 times
131
Total urine output per day
1200-1500 mL
132
Normal urine output per hour and what low output indicates
30 mL/hr
Possible renal failure or marked ECF deficit
133
What does removing the prostate gland do in terms of incontinence
Causes stress incontinence
134
Treatment for stress incontinence
Kegel exercises, weight loss if obese, vaginal pessary, estrogen vaginal creams, male external catheters, surgery
135
Urge urinary incontinence causes
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
Treatment for urge urinary incontinence (2)
Timed voiding schedule, anticholinergic drugs
137
Reflex urinary incontinence
Involuntary loss of urine, occurring at somewhat predictable intervals when a specific bladder volume is reached overcoming sphincter control
138
Causes of reflex urinary incontinence
Spinal cord impairment above the sacral reflex arc (spinal cord injury, brain tumor) or radical pelvic surgery; flaccid neurogenic bladder
139
Treatment of reflex urinary incontinence and drugs to relax both sphincters
In-and-out catheterization; alpha adrenergic drugs to relax internal sphincter, baclofen to relax external sphincter
140
Functional urinary incontinence
Inability of a normally continent person to reach the bathroom in time
141
Functional urinary incontinence causes
Altered environment treat and sensory, cognitive, psychological, neurovascular, or mobility deficits
142
Functional urinary incontinence treatments
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
causes of total urinary incontinence
neurologic lesion, trauma to or congenital malformation in the spinal cord or brain, severe cognitive deficits
144
Treatments of total urinary incontinence
Toileting routine and verbal reminders, external catheters for men, absorbent products, excellent skin care and hygiene
145
What are kidneys a regulator of and how does this change with age
ECF, regulates less as you get older which leads to residual
146
What 2 drugs make urine orange
Pyridium and rifampin
147
What drug makes urine bright yellow
Riboflavin (B complex)
148
Normal output according to intake
Within 300 mL
149
Which direction to do percussion of abdomen
Start at umbilicus and go down
150
Clean catch/mainstream specimen
Sterile
151
24 hour specimen is done when and in what container
Early in the morning after pts first void in dark container bc sun damage
152
Normal Color, turbidity, pH, protein, glucose, ketones, RBC, WBC, bacteria/yeast in urine
Light yellow-amber
Clear
4.6-8, 6 is best
None-trace
None
None
0-30
0-5
None-few
153
Who is at risk of proteinuria (4)
Preeclampsia, HTN, renal disease, severe stress
154
Indwelling catheter uses (4) for pts with what kind of pressure injury and where
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
Straight catheter 3 uses
Sterile specimen
Check residuals
Routine emptying of bladder for neurogenic bladder
156
2 incontinent bowel diversions
Ileal conduit
Urostomy
157
Continent bowel diversion
(cock?) pouch
Reservoir from ileum, every 2-3 hours then every 5-6 once pouch expands
Neobladder is created by ileum
158
TSE of testicular self-exam
Timing
Shower
Examination points
159
Where are the kidneys
On each side of the spinal column, behind the abdominal cavity wall, just above the waistline
160
Major functioning unit of kidneys
Nephrons
161
Which kidney is lower and why
Right bc liver
162
What kind of container is a random specimen (UA) contained in and how much
20-30 mL and orange/blue top cup or test tube
163
What kind of specimen and how much for urine culture and sensitivity and what should you clean first
2-3 mL and sterile specimen and urethral meatus
164
Normal urine pH
4.6-8
165
Diet for renal disease (4)
restrict intake of sodium, potassium, protein, and possibly fluids
166
Diet for liver disease (cirrhosis) (2)
restrict intake of sodium, increase intake of protein, unless hepatic coma is pending, at which time protein is virtually eliminated
167
Diet for CHF (2)
Restrict intake of sodium and calories
168
Diet for CAD (3)
restrict intake of sodium, calories, and fats (saturated and cholesterol)
169
Diet for burns (4)
Increase calories, protein, vit C and B
170
Diet for resp (emphysema) (3)
Soft, high-cal, high protein
171
Diet for TB (4)
Increase protein, calories, calcium, and vit A
172
Diet for HTN
Decrease sodium; lose weight
173
How often to encourage voiding
Every 4 hours
174
What foods cause accumulation of gas in the GI (4)
cabbage, onion, legumes, rapid indigestion of fiber
