Lab 7 Flashcards
Basic GI tract (flow parts)
Mouth
Esophagus
Stomach
SI
LI
Rectum
Anus
Factors affecting nutrition
Culture, income, food insecurity
What are some factors that affect a persons nutritional status (8)
Stage of development
Culture
Diet
Religion
Mental health
Food insecurity
Medications
Health
How does this affect nutrition status: stage of development
Infants, adolescents, and adults have different nutritional requirements and guidelines
How does this affect nutrition status: culture
Dietary restrictions
Traditional spices and techniques
Food is an important part of culture
How does this affect nutrition status: diet culture
Food fads
Diets
Advertising
How does this affect nutrition status: religious practices
Food prep (kosher, halal)
Types of meats
Caffiene and alcohol
How does this affect nutrition status: mental health
Disordered eating
Emotional state and relationship with food
How does this affect nutrition status: food insecurity
Socioeconomic status and access to food
How does this affect nutrition status: medications
Taste perception
Appetite increase or decrease
Nutrient absorption
How does this affect nutrition status: health
Oral health
Dentures
Decreased bite force and saliva production
GI surgeries or conditions
Substance use
Chronic conditions like diabetes
Nutritional assessment is a process to identify an individual who is:
At risk for malnutrition
Is malnourished
Likely to benefit from further nutrition
Swallowing assessments are conducted by
Speech language pathologists
What happens during a swallowing assessment
Palpation of larynx to ensure up and down movement
YSP
Yale swallow protocol
Dysphasia
Difficulty swallowing
Symptoms of dysphasia
Choking
Coughing
Weak voice
Aspirating
Excessive saliva
Hard time chewing
Pocketing
Storing food in corners of the mouth
Risk factors for dysphasia
Oral cancers
Strokes
Local trauma
Dyspnea
Managing dysphasia
Use of thickened fluids so liquid can pass down esophagus more easily
Nectar, honey, pudding (textures)
Types of diets
General/regular
Clear fluid
Full fluid
Puréed diet
Soft diet
All these diets can also be diabetic, renal, low sodium, etc
Considerations for positioning while feeding
Chair
- upright in high Fowlers
- body aligned
- feed from strong side if relevant
In bed
- high flowers (60 degrees plus
- pillow may be used
Nursing considerations during feeding
Ensure tray s correct
Encourage autonomy
Small amounts
Go at client pace
Wait for them to swallow
Don’t wash down with fluids
Watch for signs of dysphasia like pocketing
Offer nutrient rich food first
Nursing considerations after feeding
Help with oral care
Keep client upright for 30-45 mins to aid in digestion and decrease risk of aspiration
If they must lie down, spider position
Complete doccumentation
Aspiration
Food or fluid going into the lungs
Promoting independence
Use adaptive devices
Use clock method to describe where food is on plate
Protect clothing
Sit at same height
Involve in preferences
Anorexia nervous
Restriction of energy intake leading to low body weight
Fear of gaining weight
Bulimia nervosa
Binge eating
Compensatory behaviours like self induced vomiting, use of laxatives, strict dieting, etc
Bradycardia with pulse under 50 bpm =
Cardiovascular instability
Adults over 65 have a ______ need for energy because the metabolic rate is slower
Decreased
Vitamin and mineral intake remain ________ as you get older
The same
Semi or partial vegetarian
May eat some daily eggs chicken fish but primarily plant based foods
Pesco vegetarian
Avid meat and poultry, included fish eggs and dairy
Lacto-ovo-vegetarian
Avoids meat poultry and fish, eats egg and dairy
Lacto-vegetarian
Avoids meat fish poultry and eggs
Two questions from the Canadian nutritional screening tool
Have you lost weight in the past 6 months without trying?
Have you been eating less than usual for more than a week
If both yes, indication of nutrition risk
Dietary history components
Food practices
- amount
Allergies
Symptoms
- heartburn, gas, etc
Tracking
- in depth log of food and drink in a set period
Chewing
Hunger
Elimination patterns
Chemical substances
- medication?
Knowledge
- beliefs on current diet
Observation in nutritional assessment
Observe for signs of nutritional alterations
Examples
- brittle hair
- swollen face
- dry lips
- easy bleed gums
- poor muscle tone
Aspiration precautions
Patients screened for dysphagia
HOB up to 90 if possible
Watch for pocketing
Before assisting with feeding:
Assess risk of aspiration
Patient upright
Glasses/aids/dentures in
Clothing protected
During assist with feeding
If hemiplegic, feed from strong side
Observe for pocketing
After feeding considerations:
Patient upright for 30-45 mins
Check for pocketing again
Intake noted and doccumented
Oral hygiene
Diet: clear liquid
Broth, coffee, tea, etc
Diet: thickened liquefied
All liquids
Must be thickened to necessary point
Diet: full liquid
Basically puréed diet but excluding meats eggs and stuff like that
Diet: puréed
Everything blended
Diet: mechanically soft
Included all puréed stuff + ground meats, fish, cheese, rice, potatoes, etc
Diet: soft of low residue
Low fibre, easy digest foods like pastas
Diet: high fibre
Fresh fruits, bran, oatmeal etc
Diet: low sodium
Limited to 4g of salt or less a day
Diet: low cholesterol
Under 200mg a day
Diet: diabetic
Decreased fat intake
Malnutrition
Under nutrition, inadequate vitamins or minerals, overweight, obese
Feeding height (chair and bed)
High fowlers
In bed, 60 minimum
Oral hygiene practice
All common sense
Do not rinse with water
Oral hygiene performed regularly for patients who are:
Intubated or ventilated
Have a. Tracheostomy
High aspiration risk
NPO
