Miscellaneous Flashcards
What are some ways to ensure mindful eating habits?
- Listen to body’s hunger and fullness signals
- Eat at the table, with others when possible
- Just eat, don’t multitask.
- Enjoy what you’re eating
- Savor the food
How much weight should a woman gained if pregnant?
o Underweight (BMI < 18.5) = 12.5-18kg (28-40lbs) o Health (BMI 18.5-24.9) = 11.5-16kg (25-35lbs) o Overweight (BMI 25.0-29.9) = 7-11.5kg (15-25lbs) o Obese (BMI > 30) = 5-9kg (11-20lbs)
What are the energy requirement for pregnant women per trimester?
- 1st trimester = + 0 Kcal/day
- 2nd trimester = +340 kcal/day
- 3rd trimester = +450 kcal/day
What are the macronutrient requirement for pregnant women?
- Protein = +25g/day
- Carbohydrates = > 175g/day
- Fat = no change
How many calories per day does a lactating women need in the first 6 months?
500 kcals/day (Advised to eat 330)
How do you prevent weight stigma when talking about weight loss goals?
Focus on:
- Healthy lifestyle behaviours
- Healthy relationship with food
- Health outcomes for chronic disease and QOL
What two questions are asked in the Canadian Nutrition Screening Tool (CNST)?
- Have you lost weight in the past 6 months without trying to?
- Have you been eating less than usual for more than a week?
If patient says yes to both questions on the Canadian Nutrition Screening Tool, what do you do next?
Ensure a Subjective global assessment (SGA) is completed by dietitian
When monitoring food/fluid intake, when do you do a referral to a dietitian?
When intake is below 50% >2 meals/day x 3 days
Name factors used for diagnosing malnutrition. How many are needed? *Which are used for obese patients?
2 factors are needed amongst: o Energy intake* o Weight loss* o Body fat loss o Muscle mass wasting o Fluid (edema) o Handgrip strength
How do you inspect the temple for bilateral muscle wasting?
- Look at patient straight on and have them turn their head from side to side
- Inspect for scooping or hollowing of temporal region
- Such signs = wasting of temporalis muscle
How do you inspect the deltoids for bilateral muscle wasting?
- Inspect straight on with patient’s arms at side
- Squaring of shoulders
- Loss of roundness at junction of shoulder and neck
- Loss of deltoid muscle at junction of shoulder and arm
- Acromion process may protrude
How do you inspect the clavicle for bilateral muscle wasting?
- Inspect for prominence of bone
2. Indicates wasting of pectoral and deltoid muscles
How do you inspect the scapula for bilateral muscle wasting?
- Have patient lift arms and push against hard object
- Inspect for prominent bones or depression between bones
- Such signs indicate loss of trapezius and deltoid muscles
Name all regions known for bilateral muscle wasting.
Upper body: temples, deltoids, clavicles, scapula, interosseous
Lower body: thigh, knee, calf
How do you check for subcutaneous fat loss in malnutrition?
- Orbital fat pads = Loss of bulge under eyes (fat pads), characterized by hollow eye
- Triceps = Palpate (pinch skin) between thumb and forefinger to determine the amount of fat present
- Anterior low ribs = Ribs visible in patients with fat loss
Name other signs of malnutrition (not subcutaneous fat loss nor bilateral muscle wasting)
o Delayed wound healing o Dry, cracked skin o Unintended weight loss o Loose skin o Edema o Dry hair, brittle nails o Eating < 50% of meals and snacks o Pressure injury
Name some nursing responsibilities in terms of oral nutritional supplemental therapy.
o Provide patient (60ml given at time of medications)
o Document consumption/refusal
o Weight patient weekly
enteral feedings are usually given in over a _____ hour period.
16 hour period (24 in acute settings)
Names signs of dysphagia
o Coughing, clearing throat, choking, shortness of breath while eating
o Long time to chew and eat food
o Gurgling, wet voice
o Drooling, leakage of food and drinks from mouth
o Food pocketing in mouth or stuck in throat
o Weight loss
o Refusal to eat, poor positioning
name some feeding tips
- Same level as patient
- Don’t rush, go at their rhythm
- Head slightly tilted forward
- 90°
- Propped up if needed
- Tell them the food item
- Try to avoid stirring everything together if it is pureed
- Oral hygiene is important
Name the modified texture and consistency from most permissive to most restrictive according to the Quebec: APNED system
Solids: Tender, soft, minced, pureed
Liquids: Clear, nectar, honey, pudding
what is the difference between no added sodium diet and low sodium diet?
no added sodium diet = < 3000 mg of sodium
Low sodium diet = 1500 – 2300 mg of sodium (2/3 – 1 tsp salt)
Name the aspects of nutritional therapy for COPD patients
o Small, frequent meals
o High energy, high protein diet
o May need oral nutritional supplements