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Nursing 314: Assessing and Promoting Wellness > Exam 4: Nutrition > Flashcards

Exam 4: Nutrition Flashcards

1
Q

Chyme

A

Liquified acidic food product

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2
Q

Bile

A

Released from liver, secretin and cholecystokinin from the small intestine

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3
Q

Peristalsis

A

Moves chyme along, gradual decreasing acidity

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4
Q

Digestion occurs in the

A

Small intestine

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5
Q

Primary site of absorption

A

Small intestine via the villi

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6
Q

Active transport

A

Higher concentration lower, carrier moves nutrient across the cell membrane

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7
Q

Passive diffusion

A

Particles move from higher to lesser concentration WITHOUT carrier

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8
Q

Osmosis

A

Movement of water across a membrane to equalize pressure

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9
Q

Pinocytosis

A

Absorbing cell engulfs large nutrients

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10
Q

What is needed for cell function as it depends on fluid environemtn

A

Water

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11
Q

Essential for metabolism and is water soluble OR fat soluble

A

Vitamine

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12
Q

Catalysts for enzymatic run

A

Minerals

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13
Q

main source of energy

A

Carbohydrates

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14
Q

Carbohydrates is ____ kcal/gram

A

4 kcal/gram

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15
Q

necessary for nitrogen balance

A

Proteins

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16
Q

proteins are ____ kcal/g

A

4 kcal/g

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17
Q

fats are ___ kcal/grams

A

9 kcal/gram

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18
Q

Fat soluble vitamins

A

A
D
E
K

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19
Q

High doses of fat-soluble vitamins are at risk for

A

Hyper - Vitaminosis

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20
Q

Who has a larger percent of their body composed of water? Someone with BM I of 23 or BMI of 48?

A

Someone with a BMI of 23

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21
Q

Dietary reference intakes

A

Acceptable range of quantities of vitamins and minerals for each gender and a few group

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22
Q

UNderstand factors associates with intake of food and fluids in each society and culture

A

Celebrations
Traditions
Values, beliefs, and attitudes can affect what food is purchased, prepared, and consumed
Development, body composition, activity, pregnancy/lactation, and disease can alter nutritional requirements.
Environment: what is available? Famine? Feast? Food deserts?

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23
Q

Infants and toddlers

A

Breastfeeding/formula

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24
Q

Infants/toddlers when do they have soft solids

A

6-8 months and supplement with milk and formula

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25
Q

Infants/toddlers need a

A

gradual increase in texture and volume

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26
Q

Adolescence needs an ____ to support growth support

A

Increase in diet to support GS

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27
Q

Adolescence needs more

A

Calcium and iron

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28
Q

Females need iron for

A

Menstruation

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29
Q

Males nee iron for

A

Muscle devleopemnt

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30
Q

Pregnancy/lactation need

A

Additional calories and fluid needs for 2

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31
Q

Elderly need

A

Decrease caloric needs r/t decreased BMR

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32
Q

assessment for nutrition

A

Age
Physical assessment:
Height, Weight (changes?), Fat Distribution, BMI Calculation
Health history/Oral health
Laboratory tests
Primary diagnosis & Comorbidities
Screening tools (e.g. Mini-Nutritional Assessment MNA)
Alternative food patterns & Patient’s general nutrition knowledge
Cultural, Religious, or Personal Food Preferences
Socioeconomic status
Psychological factors
Use of alcohol/illegal drugs

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33
Q

Physical signs of nutrition or malnutrition

A 
General appearance
Height/Weight
Posture/muscle development/nerve conduction
GI function
CV function
General energy
Hair/Skin/Nails
Lips/tongue/gum/teeth/oral membranes
Eyes
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34
Q

Antrhopometry

A

measurement system of the size & makeup of the body

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35
Q

BMI measure

A

weight corrected for height & serves as an alternative to traditional height-weight relationships

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36
Q

Alternative food patterns based on

A

Religion, cultural background, ethics, health beliefs, preference

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37
Q

Vegetarian diets

A

No animal flesh for sure and consists of predominately plant foots

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38
Q

Ovolactovegetarian

A

No meat, but will ear eggs and milk

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39
Q

Vegan

A

Consumes only plant foods, no animal products at all

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40
Q

Less common food patterns

A

Lactovegetarian (no meat/eggs…does eat dairy)
Fruitarian: consumes fruit, nuts, honey, & olive oil
Zen macrobiotic: brown rice & grains, vegetables

41
Q

Factors affecting nutrition include

A 
Fluid balance/hydration
Liver Function
Kidney Function
Digestive function
Presence of disease
Medications
Supplements
Diet choices
42
Q

Lab tests for nutrition status

A

Hemoglobin and hematocrit

Serum Albumin

43
Q

Hemoglobin and hematocrit is dependent on

A

Plasma volume! They are Concentration!

44
Q

If a patients is hypovolemic, their hemoglobin and hemtocrit will appear

A

Higher than normovolemic

45
Q

If a patient is hypervolemic, they will have a

A

Lover level of HgB and Hct

46
Q

Malnutrtion affects serum albumin in

A

Leading to hypoalbuminemia

47
Q

If albumin is depleted, free floating drug levels will

A

be elevated, which can lead to drug toxicities

48
Q

Serum ferritin

A

A protein that STORES iron

49
Q

Serum transferrin

A

an iron TRANSPORT protein

50
Q

the longer the binding capacity (there is space left) the

A

Lower the iron levels

51
Q

Absorption of drugs is ____ with food

52
Q

Some foods can have what effect on drugs

A

Can be antidotes or deactivate medication

53
Q

Some drugs are also associated with a decrease of

A

Certain vitamins like iron, B12, calcium, vitamin D,K etc.

54
Q

Cachexia

A

dramatic weight loss/muscle atrophy seen in patients with chronic illness & age-associated failure to thrive syndromes

55
Q

What is common in older population because of decrease sebaceous gland activity

A

Dry, flake, skin (Xerosis)

56
Q

Mal-nutrition can have what manifestations

A

Spoon-shaped, brittle nails (koilonychia)
Smooth, “beefy” red tongue (glossitis)
Cracked lips, especially in corners of mouth (cheilosis)
Dull, dry, sparse hair
Poor wound healing
Pallor and pallor conjunctiva

57
Q

Koilonychia

A

Spoon-shaped, brittle nails

58
Q

Glossitis

A

Inflammation and swelling of the tongue in part or fully

59
Q

Glossitis is a sign of what deficiency

A

Decrease in B complex vitamins, iron

60
Q

Cheilosis

A

Cracked lips, especially in corners of mouth

61
Q

Cheilosis is due to

A

Decreased iron, B complex vitamins

62
Q

Heart rate and respiratory rate from someone with malnutrition

A

Increased HR and RR

63
Q

Edema from malnutrition is due to

A

Osmotic shift with low albumin levels

64
Q

Malnutrition can lead to what effect in extremities

A

Numbness, burning, tingling (paresthesia)

65
Q

Malnutrition and reflexes

A

Decrease reflexes fur to slowed neuromuscular run, electrolyte imbalances, altered LOC

66
Q

dysphaGIA

A

Difficulty swallowing

67
Q

Dysphagia assess for

A

Drooling, vocal quality, head control/position, wet cough, pocketing of food, dry cough, choking, etc…

68
Q

Causes of dysphaGIA

A

Myogenic: muscular (aging, MD, polymyositis)
Neurogenic: neurogenic (CVA, CP, MS, ALS, DM Neuropathy, Parkinson’s)
Obstructive: physical blockage (Stricture, Candidiasis, CA lesions, Inflammation, Trauma, Cervical Spondylosis)
Other: Catch-all (GI/Esophogeal resection, Rheumatalogical, Connective Tissue Disorders, Vagotomy)

69
Q

changes with dysphaGIA

A

Dysphagia Pureed
Everything is pureed to pudding-like consistency
Dysphagia Mechanically Altered
Moist (mashed potatoes instead of rice/couscous)
Soft-textured (hamburger instead of steak, peas instead of celery)
Dysphagia Advanced
Most foods but tougher, harder, and stickier items worked into bite-sized pieces
Steak OK if cut small
Regular/General Diet

70
Q

FLuid changes for dysphaGIA

A

Thickeners alter the consistency to make swallowing easier and safer (reduce ASPIRATION)
Thickeners are often starch or gum-based powders

71
Q

Fluid consistencies

A

Thins
Nectar thick (apricot nectar)
Honey thick
Spoon/Pudding thick

72
Q

Advancing diets

A

Gradual progression of dietary intake or therapeutic diet to manage illness

73
Q

Oral feeding support

A

Involve entire team: RD, SLP, NAC, Restorative, Patient/Family, OT (what can an OT do???)
Decrease clutter and distractions (low stim)
Upright positioning imperative r/t risk of aspiration
Slow/patient feeding
Small bites
Monitor for pocketing in cheeks
Adaptive devices (built up utensils, plate guards, divided plates, special glasses/cups, long straws)
Chin tilt during swallow
Clearing throat between bites

74
Q

Dignity in dining

A 
Clients have the RIGHT, and the facility is legally required to ensure dignity in care and services.
Groomed and dressed for dining
Palatable foods: appearance and taste
Comfortable and supportive physical environment
--Tablecloths
--Music
--Noise control
--Respectful conversations
75
Q

Therapeutic diets

A 
Clear liquid
Full liquid
Low residue
High fiber
Low sodium
Low cholesterol
Diabetic/Controlled Carbohydrates
Gluten Free
BRAT diet: bananas, rice, applesauce, toast
76
Q

Malnourished patient and drug toxicity

A

Malnourished = decreased in albumin = free floating drugs and drug toxicity

77
Q

Enteral nutrition/enteral feeding means patient has a

A

Functional GI tract

78
Q

Enteral Nutrition/Enteral Feeding flows into

A

GI tract; stomach to intestines

79
Q

Enteral Nutrition/Enteral Feeding is because of

A

Swallow issue, but still able to absorb nutrients

80
Q

Parenteral nutrition (IV) is due to a

A

NONFUNCTIONAL GI tract

81
Q

Parenteral Nutrition (Intravenous) flows into

A

Vascular system

82
Q

Parenteral Nutrition (Intravenous) issues

A

Critical illness

Extended bowel rest/absorption issues

83
Q

Enteral nutrition (EN): Nutrition directly

A

into GI tract !

84
Q

Enteral nutrition (EN) is to be started

85
Q

Enteral nutrition (EN): can be … (administration)

A

Continuous infusion or intermittent bolus

86
Q

Enteral nutrition (EN): flush formula/mesication with

A

H2O as ordered

87
Q

Nasogastric, jejunal, or gastric tubes are

A

surgical or endoscopic placement

88
Q

Nasogastric:

A

nose entry

89
Q

Gastrostomy

A

: PEG (percutaneous endoscopic gastrostomy) stomach

90
Q

Jejunostomy:

A

PEJ (percutaneous endoscopic jejunostomy) small intestine

91
Q

Feeding tubes have a risk of

A

aspiration: greater w/PEG but possible with PEJ.

92
Q

Remember, for tube feeding, NEVER

A

allow head of bed (HOB) to be flat during feedings or for at least 1 hour after.

93
Q

Tube feeding: Formula can be

A

Aspirated into the bronchial tree and lungs

94
Q

tube feeding irritation of tissue causes

A

Inflammation
Pneumonia
Acute respiratory distress syndrome

95
Q

Sarcopenia

A

Specifically decrease in lean muscle mass

96
Q

Tube feeding: Delayed gastric emptying is a risk for

A

Aspiration

97
Q

For delayed gastric emptying, administer

A

Prokinetic medication as ordered to promote peristalsis

98
Q

Measure gastric residual volumes

A
  • -Adults: delayed gastric emptying is a concern if: ≥ 250 mL remains in stomach on 2 consecutive feedings or if > 500 mL for one feeding.
  • -Smaller people tolerate lesser volumes due to smaller stomachs. Infants/children, petite adults.

Nursing 314: Assessing and Promoting Wellness (26 decks)

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