Exam 4 Nutrition Flashcards
Definition
Nutrition
Giddens
the science of optimal cellular metabolism and its impact on health and disease
Definition
Nutrition
Yoost
It is the body’s intake and use of adequate amounts of necessary nutrients for tissue growth and energy production
Definition
Malnutrition
Imbalance in the amount of nutrient intake and the body’s needs
Definition
Nutrients
The necessary substances obtained from ingesting food that supply the body with energy; build and maintain bones, muscles, and skin; and aid in the normal growth and function of each system
Definition
Macronutrients
kcal energy containing nutrients (carbs/proteins/fats).
Alcohol is considered kcal
but not macro bc it can’t support function
Scope
Nutrition
- malnutrition
- insufficient
- optimal
- excess
- malnutrition
Definition
Micronutrients
vitamins and minerals- required in minute amounts
Age Related Changes
Expected
6
decreased ability to…
* ingest
* absorb
* metabolize
* chew
* produce saliva
* taste
Age Related Changes
Unexpected
3
Decreased function in
* Liver
* Gallbladder
* Pancreas
Nursing Interventions for nutrition
5
- medical nutrition therapy
- basic therapeutic diets
- dietary supplements
- tube feedings
- collaboration w/ dietitian
Diets
Clear Liquid
What is it and who is it for
-no pulp
for pre-op (short period of time)
Diets
Full Liquid
What is it and who is it for
-foods liquid at room temp
for temporary post-op
Diets
Pureed
What is it and who is it for
“blended”
for pt’s who can’t safely chew
Diets
Mechanical soft
What is it and who is it for
-modified food consistency
for pt’s w/ difficulty chewing effectively
Diets
Thickened liquids
What is it and who is it for
-thickening agent added to avoid aspiration
for pt’s at risk for aspiration
Diets
Regular Diet
What is it and who is it for
“diet as tolerated”
for pt’s with no restrictions
Diets
Diabetic
What is it and who is it for
-(ADA), controlled carb intake
for diabetics
Diets
Cardiac Diet
What is it and who is it for
-low cholesterol, low sodium
for pt’s with HTN, elevated cholesterol, or artherosclerosis
Diets
Renal Diet
What is it and who is it for
-Restricts potassium, sodium, protein and phosphorus
for renal impairment
BMI
Underweight
<18.5
BMI
Overweight
25 - 29.9
BMI
Obesity Class 1
30 - 34.9
BMI
Obesity Class 2
35 - 39.9
BMI
Obesity Class 3
> 40
Percentile
Pediatric overweight
85th - 95th
Percentile
Pediatric Obesity
> 95th
Obesity
Risk Factors
- having pediatric obesity
- non-hispanic black teen
Obesity
ABCDs
10
- airway
- breathing
- backs
- bias
- circulation
- decubitus ulcers
- drugs
- diagnosis
- diet
- durable medical equipment
Bariatric Surgery Complications
Dumping syndrome
and accompanying sx’s
undigested contents of stomach transported/dumped into small intestine too quickly
Sx’s: diarrhea, sweating, tachycardia, and severe hypotension
Bariatric Surgery Complications
Delayed Wound Healing
2
- infection
- wound dehiscence
Enteral Feeding
For what kind of patient?
Duration
Short term, for patients w/ functional GI tract but can not swallow or need additional nutrients
Enteral Feeding
NG Tube
Duration?
Through a nare into the stomach
short term
Enteral Feeding
PEG
Duration?
Percutaneous endoscopic gastrostomy. Tube placed in LUQ
longer term
Enteral Feeding
PEG inedicated for what pt?
4
- neuologocally impaired
- condition affecting the stomach
- esophageal cancer
- trauma to nose and mouth
Parenteral Feeding
TPN given through what
2
- PICC- peripherally inserted central cath
- CVC- central venous cath
(both through pump)
Parenteral Feeding
TPN indicated for?
non-fuctioning GI tract
Parenteral Feeding
TPN Disadvantages
5
- does not preserve GI tract well
- more expensive
- site infection
- air embolism
- dislodgement
Parenteral Feeding
TPN monitoring
6
- weight
- CBC
- glucose
- electrolytes
- BUN
- I&O
Parenteral Feeding
TPN Safety
- formula and tubing assess daily for contamination
- tubing marked so nothing else is put in it
- tubing changed q24hrs
- site changed q48 hrs
- assess signs/sx’s of infection
BUN
What is it?
What does it test for?
Blood Urea Nitrogen
* meaures kidney function
BUN
Normal Range?
Abnormal Indications?
4 elevated, 3 low
Range: 7-20 mg/dL
* Elevated= dehydration/starvation, artherosclerosis, kidney injury, escess protein intake
* Low= fluid overload, decreased liver function, low protein
Albumin
What does it test for?
- Assesses plasma protein levels
- determines liver funciton
Albumin
Normal Range?
Abnormal Indications?
Range: 3.5-5.0
* Elevated= dehydration, exercise, or meds
* Low= renal/liver disorders, meds, chronic disease, malnutrition
Pre-albumin
What does it test for?
amount of protein in the internal organs
(determines nutrition status)
Pre-albumin
Normal Range?
Abnormal Indications?
Range: 16-30 mg/dL
* < 11mg/dL = malnutrition
* Low= stress, inflammation, surgery, renal failure
Hgb
What is it?
What does it test for?
Hemoglobin
* RBCs ability to supply oxygen
* indicates body’s iron-store status
Hgb
Normal Range?
Abnormal Indications?
M vs F
Range:
* M= 14-17.4 mg/dL
* F= 12-16 mg/dL
Low= depleted iron stores, less O2 available (sxs show fatigue, pallor, SOB, increased RR)
Hct
What is it?
What does it test for?
Hematocrit
* # and % of RBCs
Hct
Normal Range?
Abnormal Indications?
M vs F
Range:
* M=42-52%
* F= 36-48%
Low= anemia (type of anemia is determined by shape and size of RBCs)
Transferrin
What does it test for?
test is sensitive to changes in iron and protein stores
Transferrin
Normal Range?
Abnormal Indications?
Range: 200-400 mg/dL
* Elevated= fasting, chronic infection, inflammation, burns, anemia
What labs may indicate dehydration?
3
Elevated…
* BUN
* Creatinine
* Albumin
RBC
Normal Range?
M vs F
M= 4.5-5.5 x 10^6
F= 4.0-5.0 x 10^6
units= cells/mm^3
Anemia
Signs/Sx’s
9
- pallor
- fatigue
- weakness
- SOB w/ activity
- exercise intolerance
- palpitations
- chest pain
- dizziness
- headache
RBCs
Nutrients essenial for RBC production
(3) and why they are needed
- Iron: critical for hemoglobin structure which carries the oxygen in RBCs
- Folate: needed for DNA synthesis during RBC production
- B12: involved in DNA synthesis and RBC maturation
Nitrogen Balance
Positive Balance
- protein intake balanced w/ output & storage
- kidneys able to preserve protein
Nirtogen Balance
Negative Balance
Protein output exceeds intake
* available protein not preserved by kidneys
* increased need for protein (trauma, tissue breakdown, burns, srugery, etc)
