Mod 5 Flashcards
Adequate food intake consists of what?
Balance of nutrition
Water Carbohydrates Protein Fats Vitamins Minerals
What are the three major functions of nutrients?
Providing energy for the body process and movement
Providing structural material for body tissue
regulating body processes
What is the body’s most basic nutrient need?
Water
What is the body’s second most important nutrient need?
Fuel or energy
Carbohydrates, fats and proteins
What are macronutrients?
Carbohydrates, fats, protein, minerals, vitamins and water
What are micronutrients?
Vitamins and minerals that are required in small amounts
What elements make up carbohydrates?
Carbon
Hydrogen
Oxygen
What are the two types of carbohydrates?
Simple carbohydrates
Complex carbohydrates
High sugar content foods are referred to as what?
Empty calories
What are the simplest of all carbohydrates that are water soluble and are produced naturally by both plants and animals?
Sugars
What is the difference between monosaccharides and disaccharides?
Monosaccharides are single molecule
Disaccharides are double molecules
What are the three monosaccharides?
Glucose
Fructose
Galactose
Out of the monosaccharides which is the most abundant in simple sugars?
Glucose
Polysaccharides come from what?
Starches
Is fiber a complex carbohydrate or a simple carbohydrate?
Complex carbohydrate
How is fiber digested by humans?
It can not be digested
Carbohydrates provide what to the human body?
Energy
How are carbohydrates stored?
Either as glycogen or as fat
Proteins are composed of what elements?
Carbon
Hydrogen
Oxygen
Nitrogen
Three quarters of the body solids are made up of what?
Protein
What is the difference between essential amino acids and nonessential amino acids?
Essential amino acids are those that have to be supplied as part of the protein ingested
Nonessential amino acids can be manufactured by the body
How many essential amino acids are there?
Nine
What are the nonessential amino acids?
Alanine Aspartic acid Cystine Glutamic acid Glycine Hydroxyproline Proline Serine Tyrosine
What is the difference between complete protein and incomplete proteins?
Complete proteins contain all of the essential amino acids plus many of the nonessential ones
Incomplete proteins lack one or more essential amino acids ( most commonly lysine, methionine or tryptophan)
Where does digestion of proteins begin?
Stomach however it is mostly digested in the small intestine
What is nutrition?
Is the sum of all the interaction between an organism and the food it consumes
Protein metabolism includes what three activities?
Anabolism- building tissue
Catabolism- breaking down tissue
Maintaining nitrogen balance
What is the difference between the elements in lipids and the ones in carbohydrates?
Lipids contain a higher proportion of hydrogen
What is fatty acids made up of?
Of carbon chains and hydrogen
What is the determining factor of whether a fatty acid is considered saturated or unsaturated?
The relative number of hydrogen atoms they contain
Where are lipids digested?
It start in the stomach but is mainly digested in the small intestine
What are some water- soluble vitamins?
C and B complex vitamins
What do fat soluble vitamins include?
A, D, E, and K
What is the difference between macro minerals and microminerals?
Macrominerals are required daily amount over 100 mg such as calcium, phosphorus, sodium, potassium, magnesium, chloride and sulfur
Microminerals are less the 100 mg like zinc, manganese, iodine, fluoride, copper, cobalt, chromium and selenium
What is used to determine if an individual’s healthy weight?
Ideal body weight (IBW)
Body mass index (BMW)
When would the the rule of 5 be use to calculate approximate IBW?
If it is a female client rule of 6 is for male clients
When should the BMI not be used to calculate healthy weight?
People who have fluid retention ( ascites or edema)
What BMI is considered underweight?
What BMI is considered normal ?
18.5-24.9
What BMI is considered overweight?
25.0-29.9
What BMI is considered obese?
30.0-34.9
What BMI is considered extreme obesity?
40.0+
How would you calculate BMI?
Height in meters (1 meter is 39.6 in)
Measure weight in kilograms ( 1 kilograms is 2.2 lbs)
Divid the two and you will have the BMI
What are factors affecting nutrition?
Development Sex Ethnicity and culture Beliefs about food Personal preferences Religious practices Life style Economics Medications and therapy Health Alcohol consumption Advertising Psychological factors
How does grapefruit interact with certain medications?
Can cause toxicity when taken with a variety of medication including amiodarone, carbamazepine, cisapride, cyclosporine, diazepam, nifedipine, sequinavir or,statins, terfenadine, verapamil
How does vitamin K interact with certain medications?
Can decrease the effectiveness of warfarin
How does tyramine interact with certain medications?
In combination with monomine oxidase inhibitors medication isocarboxazid, isoniazid, linezolid, phenelizine and tranlcypromine it creates sudden increase in epinephrine leading to headaches, increased pluse and blood pressure and possible death
How does milk interact with certain medications?
Interferes with absorption of tetracycline antibiotics
What is the benefits of on demand feelings for newborns/ infants?
Decreases problems with over feeding or under feeding
What is the stomach capacity of a infant?
90 mls
When should solid food be introduced to a baby’s diet?
4-6 months
Why should one food be introduced to a infant at a time?
To see if it is tolerated and that there are no allergies
Why should infants under one year of age not me feed honey?
Because it contains spores of clostridium botulinum and can cause infection and death
How much fluid should a toddler have a day?
1,250 ml in a 24 hour period
How many calories are required for a toddler?
1000-1400 Kcal/day
What can help toddlers meet nutritional needs?
Make mealtime pleasant Offer a variety of simple attractive foods Do not use food as a reward Schedule mealtime Avoid routine use of sweet desserts
How much liquid does a preschooler require?
75 ml of liquid per kilogram of body weight per day 1,500 ml every 24 hours
How many calories do school age kids require?
1,600- 2,200 Kcal/ day
18% of American children between the ages of 6-18 are what?
Overweight
How much milk should adolescent drink and why?
1 quart a day because their peak bone mineralization occurs at 12 for girls and 14 for boys
What are common nutrition and self esteem problems among adolescents?
Obesity
Anorexia nervosa (refusal to eat)
Bulimia ( binge/ purge)
How much iron should young adult females intake?
18 mg of iron daily
Why would an healthy middle aged adult gain weight?
Decreased metabolic activity and decreased physical activity
What are some problems associated with nutrition in older adults?
Difficulty chewing Lowered glucose tolerance Deceased social interaction Loss of appetite and senses of smell and taste Limited income Difficulty sleeping at night
What are nursing diagnosis for nutritional problems?
Imbalanced nutrition: less than body requirement
Obesity
Overweight
Readiness for enhanced nutrition
What are signs of malnutrition?
Appearance- apathetic, listless, looks tired, easily fatigued
Weight- overweight/ underweight
Skin- dry flaky or scaly, pale or pigmented presence of petechia or bruises lack of fat or edema
Nails- brittle, pale, ridged or spoon shaped
Hair- dry, dull, sparse, loss of color, brittle
Eyes- pale/ red conjunctiva,dryness, soft cornea, dull cornea, night blindness
Lips- swollen, red cracked at the sides of the mouth, vertical fissures
Tongue- swollen, beefy red or magenta colored, smooth in appearance, decreased in size
Gums- spongy, swollen, inflamed, bleed easily
Muscles- underdeveloped, flaccid, wasted, soft
GI system- anorexia, indigestion, diarrhea, constipation, enlarged liver, protruding abdomen
Nervous system- decreased reflexes, sensory loss, burning and tingling of hands and feet, mental confusion
What are the devises used for long term nutritional support?
Gastrostomy and jejunostomy
How long should a clear liquid diet be used?
Short term 24to 36 hours
How many meals per day should someone have that is on a full liquid diet to have adequate intake?
6 feeding or more
What is the difference between a soft diet and a puréed diet?
Soft diets are used for clients that have difficulty chewing or swallowing
Puréed diets have liquid added to the food
What is the difference between the Levin tube and the Salem sump tube?
The levin tube is a single lumen and the Salem sump tube is a double lumen
What is the purpose of a nasogastric tube?
To deliver medication and food to clients who can not swallow without aspirating and suctioning stomach contents
What should you assess before inserting a nasogastric tube?
History of nasal surgery Deviated septum Patency of nares Gag reflex is present Mental status
Why do you use a water soluble lubricant when inserting a nasogastric tube?
Because if it is accidentally inserted in to the lungs it will devolve and won’t cause respiratory problems
What should you do if the nasogastric tube becomes coiled in the throat?
Withdraw it until it is straight and try to insert it again
When preparing the nasogastric tube, large bore tube why should you place it in warm water?
It allows the tube to become more pliable and flexible
What methods can a nurse use to check placement of a nasogastric tube?
Aspirate gi secretions
Measures the ph of aspirated fluids
Confirm the length of the tube with the insertion mark
What does urinary elimination depend on?
Effective functioning of the upper urinary tract kidneys, ureters and the lower urinary tract urinary bladder, urethra and pelvic floor
Why is the right kidney lower then the left kidney?
Due to the position of the liver
What do the kidneys do?
They are the primary regulators of fluid and acid base balance in the body
What are the functional units of the kidneys?
Nephrons, filter the blood and remove metabolic waste
How much cardiac output passes through the kidneys of an average adult every min?
21 %
Each kidney contains how many nephrons?
1 million
What is reabsorbed in the loop of Henle?
Glucose
What causes more water to be reabsorbed in the distal tubule and less urine is excreted?
ADH that is released from the posterior pituitary
When fluid intake is is high or blood solute concentration is low what is suppressed?
ADH
How long are adult ureters?
25 to 30 cm
What is the flap like fold of mucous membranes on the end of the ureter connected to the bladder for?
Reflux or back flow of urine
What are the four layers of the bladder?
An inner mucous layer
A connective tissue layer
Three layers of smooth muscle fibers
An outer serous layer
What does the smooth detrusor muscles do?
Allows the bladder to expand to fill up with urine and contract to release it
What is the trigone?
At the base of the bladder is a triangular area marked by the ureter openings at the posterior corners and the opening of the urethra at the anterior inferior corner
What is the normal bladder capacity?
300 and 600 ml of urine
What is the size difference between the male urethra and female urethra?
Females is 3-4 cm
Males is 20 cm
What passes through the pelvic floor?
Virginia, urethra and rectum
When is urinary control developed?
2-5 years of age
What rule should you teach preschool female about urination?
To wipe front to back
Kidneys do what between the age of 5-10 years?
Doubles in size
What is enuresis?
Involuntary passing of urine when control should be established
When should nocturnal enuresis be considered a problem?
After the age of 6
When do fetal kidneys begin to excrete urine?
Between the 11th and 12th week of development
Why dose infant urine appear light yellow?
Because the ability to concentrate urine is minimal
When dose urine concentration begin to appear Amber?
When kidneys become mature at the first and second year of life
When do kidneys reach their full size?
Between 35 and 40 years of age
After 50 what happens to the kidneys?
They begin to diminish in size and function
At the age of 80 what happens to nephrons?
30% are lost
Why do fluid such as alcohol increase urine out put?
Because they inhibit the production of anti diuretic hormones
What fluids can change the color of urine?
Beets can cause urine to be red and foods containing carotene can cause the urine to appear yellower than usual
How do diuretic work?
They increase formation by preventing the reabsorption of water and electrolytes from tubules of the kidneys into the bloodstream
What disorders effect blood flow to the kidneys?
Heart failure
Shock
Hypertension
What medication cause urinary retention?
Anticholinergic med- atropine, robinul, pro-banthine
Antidepressant/antipsychotic agents- tricyclics, antidepressants and MAO inhibitors
Antihistamine- pseudoephedrine (sudafed)
Anti hypertensive- hydra lazing and methyldopa
Antiparkinsonism drugs
Beta-adrenergic blockers
Opioids
What is polyuria?
Abnormally large amounts of urine by the kidneys
What is polydipsia?
Excessive fluid intake which can occur after polyuria
What is oliguria?
Is low urine out put usually less then 500 ml a day 30 mls an hour for an adult
What is anuria?
Lack of urine production
What are the two most common methods of dialysis?
Hemodialysis and peritoneal dialysis
What is the difference between hemodialysis and peritoneal dialysis?
Hemodialysis uses an external machine and with peritoneal dialysis the solution is instilled in the abdominal cavity
What is nocturia?
Voiding two or more time at night
What is urgency?
Is the sudden strong desire to void
What is dysuria?
Voiding is painful of difficult
What affect can urinary overdistenion have on the bladder?
Causes poor contractility of the detrusor muscles
What is the normal ph level of urine?
4.5-8
What are nursing diagnosis of urinary elimination?
Impaired urinary elimination
Readiness for enhanced urinary elimination
What can you do to prevent a urinary tract infection?
Drink 8, 8 oz glasses of water per day Void 2-4 hours/ after intercourse Avoid harsh soaps in the perineal area Avoid tight fitting underclothes Wear Cotton rather then nylon Wipe front to back Take shower rather than baths
