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Med-Surg I > Malnutrition > Flashcards

Malnutrition Flashcards

1
Q

Three Forms of Protein-Energy Metabolism (PEM)

A

Marasmus
Kwashiorkor
Marasmic-Kwashiorkor

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2
Q

Malnutrition

A

Protein catabolism exceeds protein intake and synthesis, resulting in negative nitrogen balance, weight loss, decreased muscle mass, and weakness

Results from inadequate nutrient intake, increased nutrient losses, and increased nutrient requirements.

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3
Q

Common Complications of Severe Malnutrition

A
  • Leanness and cachexia (muscle wasting with prolonged malnutrition)
  • Decreased activity tolerance
  • Lethargy
  • Dry, flaking skin and various types of dermatitis
  • Poor wound healing
  • Infection, particularly sepsis
  • Possible Death
  • Brittle nails and hair
  • Weakness
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4
Q

Marasmus

A

Calorie malnutrition in which body fat and protein are wasted

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5
Q

Kwashiorkor

A

Lack of protein quantity and quality in the presence of adequate calories

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6
Q

Marasmus-Kwashiorkor

A

Combined protein and energy malnutrition

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7
Q

GERD

A

Backflow of stomach acid into the esophageal area

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8
Q

Three Major Types of Medications for GERD and Peptic Ulcers

A

Antacids
Histamine blockers
Proton pump inhibitors

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9
Q

Is it better to take liquid or tablet form of antacids?

A

Liquid - it coats the esophagus

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10
Q

Three Common Names of HT Antagonists Medications?

A

Zantac
Pepcid
Axid

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11
Q

Histamine2 Receptor Antagonists

A

Reduce the secretion of acid

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12
Q

Antacids

A

Neutralize excess acid

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13
Q

Types of Antacids

A

Maalox
Mylanta
Gaviscon

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14
Q

Protein Pump Inhibitors

A

Reduce gastric acid secretion and can be given in a single daily dose

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15
Q

Common Names of PPIs

A 
Omeprazole (Prilosec)
Rabeprazole (AcipHex)
Pantoprazole (Protonix)
Esomeprazole (Nexium)
Lansoprazole (Prevacid)
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16
Q

Stress Ulcers

A

Acute gastric mucosal lesion occuring after an acute medical crisis or trauma, such as sepsis or a head injurt

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17
Q

Main Manifestation of Stress Ulcers

A

Bleeding caused by gastric erosion

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18
Q

Peptic Ulcer

A

Mucosal lesion of the stomach or duodenum

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19
Q

Peptic Ulcer Disease

A

Results when mucosal defenses become impaired and no longer protect the epithelium from the effects of acid and pepsin

Symptoms - Pain after eating, belching

Treatment - Antibiotics for H. pylori, PPIs, Antacids, Histamine2 Antagonists

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20
Q

What are gastric and duodenal ulcers most commonly caused by?

A

H. pylori infections

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21
Q

Carafate

A

Binds with bile acids and pepsins to protect the stomach mucousa

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22
Q

Can you take aspirin and pepto bismol together?

A

No, it can cause an aspirin overdose and thin our your blood

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23
Q

A life threatening acute inflammation and infection of the visceral/parietal peritoneum and endothelial lining of the abdominal cavity is called what?

A

Peritonitis

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24
Q

Gastroenteritis

A

A very common health problem worldwide that causes diarrhea and/or vomiting as a result of inflammation of the mucous membranes of the stomach and intestinal tract

25
Q

Four F’s of Gall Stones

A

Female
Forty
Fat
Fertile

26
Q

How to Calculate BMI

A

Weight in lbs. divided by height in inches squared x703

27
Q

TEN

A

Total Enteral Nutrition

Patients cannot meet the desired outcomes of adequate nutrition via their usual oral intake because of increased metabolic demands or a decreased ability to eat.

28
Q

TPN

A

Total Parenteral Nutrition

Delivered through access to central veins, usually through a PICC line or the subclavian or internal jugular veins.

29
Q

Cholecystitis

A

Inflammation of the gallblader

Can be acute or chronic

30
Q

Two Types of Acute cholecystits

A

Calculous and Acalculous

31
Q

Acalculous Cholecystitis

A

Inflammation of the gallbladder occurring in the absence of gall stones

Typically associated with biliary stasis cause by any condition that affects the regular filling or empyting of the gallbladder

32
Q

Calculous Cholecystitis

A

Inflammation of the gallbladder usually following and created by obstruction of the cystic duct by a stone (calculus)

33
Q

Chronic Cholecystitis

A

Results when repeated episodes of cystic duct obstruction cause chronic inflammation

Calculi are almost always present

Slow onset of symptoms which can include:

  • Jaundice
  • Clay colored stools
  • Dark urine
34
Q

Main Risk Factors for Developing Gallstones

A

Obesity
Type 2 Diabetes
Dyslipidemia
Insulin Resistance

35
Q

Risk Factors for Cholecystitis

A 
Women
Aging
American Indian, Mexican American, or Caucasian
Obesity
Rapid weight loss or prolonged fasting
Increased serum cholesterol
Women on HRT
Family History
Crohn's disease
Gastric bypass surgery
Sickle cell disease
Glucose intolerance/
Pregnancy
36
Q

Dyspepsia

A

Indigestion

37
Q

Eructation

38
Q

Blumberg’s Sign

A

Pain felt on abrupt release of steady pressure (rebound tenderness) over the site of abdominal pain

39
Q

Diverticulitis

A

Inflammation of the diverticula

40
Q

Cholestectomy

A

Gall bladder removal

  • Do not eat foods high in fat
  • Can resume normal diet
  • Encourage an increase liquid intake
  • Tell patient to ambulate if pain in shoulder blades; it will help the air to dissipate
41
Q

What care can we provide to an excoriated perineum d/t gastroenteritis?

A
  • Apply moisture barrier cream

- Use moist wipes when cleaning after toileting

42
Q

The patient is admitted to the acute medical patient care unit. The nurse reviews her admission laboratory results. Which result supports a diagnosis or malnutrition?

A. Hematocrit 37%
B. Hemoglobin 12 g/dL
C. Prealbumin 13 mg/dL
D. Serum albumin 3.5 g/dL

A

C. Prealbumin 13 mg/dL

43
Q

What potential outcome does the nurse anticipate when administering TPN?

A. Infection
B. Dehydration
C. Hyperglycemia
D. Electrolyte imbalance

A

C. Hyperglycemia

44
Q

The patient is ordered daily multiple vitamins with zinc and iron supplements. Which interventions promote oral nutrition intake? Select all that apply.

A. Having a UAP feed the patient
B. Providing mouth care before each meal
C. Placing a small-bore nasoduodenal tube
D. Assisting the patient to sit up in a chair
E. Ordering foods that the patient likes to eat

A

B. Providing mouth care before each meal

D. Assisting the patient to sit up in a chair

E. Ordering foods that the patient likes to eat

45
Q

What percentage of adults in the US are obese (BMI >30)?

A. 14
B. 21
C. 35
D. 47

46
Q

Methods of Administering TEN

A

Nasal tubes (short term):

  • Nasoenteric tube
  • Nasogastric tube
  • Nasoduodenal tube

Enterostomal feeding tubes (long term):

  • Gastrostomy
  • Percutaneous endoscopic gastrostomy (PEG)
  • Jejunostomy
47
Q

What are the two most common electrolyte imbalances associated with TEN?

A

Hyperkalemia and hypernatremia

48
Q

Dumping Syndrome

A

Caused by food entering the small intestine instead of the stomach after gastric bypass

49
Q

Symptoms of Dumping Syndrome

A

Tachycardia
Nausea
Diarrhea
Abdominal cramping

50
Q

If someone comes into the doctors office and they have lost 40 lbs since the last visit, what should the nurse do?

A
  • Ask if intentional
  • Ask why
  • Ask if they are experiencing dysphagia
  • Ask if they experience pain when they eat
  • Are they able to tolerate the food that they are able to eat
  • Possibility of cancer
51
Q

When performing a tube feeding using an NG, what would the nurse do?

A
  • Raise the head of the bed at least 30 degrees to prevent a chance of aspiration
  • Listen to lung sounds before and after
  • Look for residual in the tube
  • Make sure the tube is in its proper place
52
Q

There are several patients on the unit with laboratory values that just came back. Which patient would you assist first?

A. Serum sodium of 138
B. Potassium of 2.6
C. Foul smelling diarrhea
D. Glucose of 138

A

B. Potassium of 2.6

53
Q

What would you teach to a patient that goes on frequent diet?

A
  • Portion control
  • Low carbs
  • Eat when stressed or bored
  • Find out psychological influences
54
Q

How would you promote better nutrition in older adults?

A
  • Find what foods they like
  • Help with resources getting proper food
  • Check dentures, make sure they are in place and they fit well
  • Do not interrupt them a lot – may get distracted easily and forget to eat the rest of their food
  • Can’t see food
  • Noise can be too distracting
55
Q

When you are doing an NG tube and it has become occluded, what are you going to do?

A
  • Always want to try flushing it first to make sure there is patency
  • Do not crush all meds together and administer them because they can clog the tube
  • Administer each med separately and flush in between each
  • Ask if meds can be in a liquid form
  • Flush tube with 30 - 50 mL of water
56
Q

If you are going to have a nurse’s aide feed your patient, what are some things that you would tell the aide?

A
  • How much of their food they normally eat
  • Any restrictions
  • Small bites
  • Sit upright
  • Glasses or dentures?
  • Move urinal or bed pan if given food tray
  • Warm food warm, cold food cold
  • Make it feel like a normal setting
  • Alternate bites of food with sips of water
  • Sit with patient if they are okay with it
57
Q

In community hospitals that don’t typically care for bariatric patients, what are some possible limitations of care?

A
  • Are there are enough resources to take care of the patient?
  • Is there enough staff on hand to transfer or move the patient when needed?
58
Q

If you are in a hospital that does not have a bariatric bed but there is a bariatric patient that needs admitted, what could be hazardous to their health?

A

The bed would be too small and would limit movement on the bed.

Side rails might not be able to go up which could increase the risk for falls.

If the side rails are able to go up, they may cause the bed to be a “tight fit” for the patient and could potentially cause pressure ulcers.

Med-Surg I (7 decks)

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