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exam 3: metabolic stress Flashcards

1
Q

metabolic rate speeds ______ during severe stress

A

increase

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2
Q

purpose of inflammation

A
  • capillaries dilate so immune factors can come

- helps repair tissue

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3
Q

stress mobilizes nutrients into _____ and ______

A
  • glucose

- amino acids

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4
Q

what can happen if the immune factors fail?

A

an abcess

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5
Q

symptoms of systemic inflammatory response syndrome (SIRS)

A
  • increased body temp
  • increased HR
  • anorexia
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6
Q

blood _____ rises at the expense of _____

A
  • glucose

- protein

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7
Q

stress causes increases in (6)

A
  • cortisol
  • insulin
  • glucagon
  • catecholamines
  • ADH
  • aldosterone
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8
Q

stress effects on the body:

increased _____ _____ levels

A

-blood sugar

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9
Q

stress effects on the body:

_____ and ____ retention

A

-sodium and fluid

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10
Q

stress effects on the body:

elevated ________ levels

A

blood urea

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11
Q

stress effects on the body:

loss of _____

A

potassium

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12
Q

stress effects on the body:

negative ______ balance

A

nitrogen

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13
Q

_____ and _______ losses are high

A

-energy and protein

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14
Q

_____ causes depletion of protein in muscle, bone, connective tissue, and skin

A

cortisol

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15
Q

effects of too much cortisol

A
  • impairs wound healing
  • inhibits protein synthesis
  • increases insulin resistance
  • suppresses immune system
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16
Q

can kill bacterial invaders

A

stomach acid

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17
Q

what is the intestinal barrier?

A

villi crowded closely together so invaders cannot pass barrier

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18
Q

what is bacterial translocation?

A

infectious agent crosses intestinal barrier to enter body

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19
Q

____ to ___% of body’s immunologic secreting cells are in the _____

A

70-80%

-intestines

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20
Q

what can bacterial translocation lead to?

A
  • sepsis

- organ failure

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21
Q

immobility causes:

loss of ____ and ____

A
  • calcium

- protein

22
Q

immobility can cause ____ _____

A

kidney stones

23
Q

bacterial translocation example

A

long term use of broad spectrum antibiotics

24
Q

microvilli _____

25
microvilli function
site for absorption of nutrients
26
re-feeding syndrome
nourishment introduced too rapidly
27
most immediate task
fluid and electrolytes
28
_____ improves immune response
arginine
29
vitamin __, __, and _____ used for wound healing
- A - C - zinc
30
protein requirements during stress
1.2 to 2 g/kg
31
burn patients may need ___g/kg of protein
2.5
32
what is a routine progressive diet?
starts with clear liquids and then to full liquid diet to a soft diet
33
enteral feeding is feeding through the _____
intestines
34
parenteral feeding is through an ____
IV
35
peristalsis returns more quickly to the _____ than ______
- intestines | - stomach
36
early enteral feeding benefits
- stimulates peristalsis - minimizes hyper metabolism - prevents bacterial translocation
37
if GI tract is functional use ______ nutrition
enteral
38
standard (intact) formula concentrations
- 1 kcal - 1.5 kcal - 2 kcal/mL
39
hydrolyzed (elemental) formula contains
protein broken down into small peptides or amino acids
40
medium chained triglycerides (MCT) can make ______ easier
digestion
41
modular formulas are made up of
only a single nutrient
42
polycose as carbohydrates
modular formula
43
transnasal tube examples
- nasoduodenal tube - NG tube - nasojejunal tube
44
enterostomy is used if feeding is needed for more than
4 weeks
45
enterostomy examples
- jejunosotomy | - gastrostomy
46
placing the tube further down in the stomach can decrease the risk for ______
aspiration
47
what is a bolus feeding?
large volume delivered into stomach
48
how many mL is a bolus feeding?
200-400mL
49
how do you measure the gastric residual?
slowly aspirate stomach contents with a syringe then measure what is left
50
what amount of gastric residual would cause the nurse to withhold the feeding?
over 500mL
51
how much of nutrition needs to be by mouth in order for a feeding tube to be removed?
2/3
52
feeding rate
30-40mL per kg of body weight

nutrition (11 decks)

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