Module 7 Critical Care Flashcards
How does the inflammatory response to metabolic stressors affect the body?
Select ALL that apply
[mark all correct answers]
a.
Increased blood flow away from the injury
b. Tissue swelling c. Dilated blood vessels at the point of injury d. d. Increased albumin
b.
Tissue swelling
c. Dilated blood vessels at the point of injury
What is the hormonal response to metabolic stress?
a. protein breakdown b. sodium excretion c. increased urinary output d. decreased energy metabolism
a.
protein breakdown
What is likely to occur because of GI motility in acute stressors?
a. it causes them to be immobile b. it interferes with receiving adequate nutrition c. it leads to high blood pressure d. it causes fluid overload
a.
it causes them to be immobile
Albumin losses can lead to: (select all that apply)
[mark all correct answers]
a.
Improved healing after injury
b. Low blood pressure c. Muscle loss d. Weight gain e. Edema f. Shorter hospital stays
Low blood pressure
Muscle loss
edema
Overfeeding a metabolically stressed person can cause:
a. Hyperglycemia b. Rapid weight gain c. Decreased albumin synthesis d. Decreased Co2 production
a.
Hyperglycemia
What will be increased in nutrition therapy for acute metabolic stress?
Select ALL that apply.
[mark all correct answers]
a.
Calories
b. Protein c. Fluid d. Sodium e. Zinc f. Vitamin C
Calories
Protein
Zinc
Vitamin C
Hypermetabolism will usually lead to what problem?
a. Weight gain b. Excess protein synthesis c. Edema d. Malnutrition
malnutrition
What is a dietary change that can help to suppress inflammation?
a. increase intake of fish oils rich in omega-3 fatty acids b. increase intake of vegetable oils rich in omega-6 fatty acids c. increase intake of vitamin C d. increase intake of zinc
increase intake of fish oils rich in omega-3 fatty acids
For critically ill patients, _____ provide the majority of energy.
a. carbohydrate and protein b. protein and fat c. fat and carbohydrate d. fiber and fat
fat & carbohydrate
How does the slowed GI system that often accompanies severe stress affect a person?
Select ALL that apply.
[mark all correct answers]
a.
Diarrhea
b. Poor tolerance of diet or tube feeding c. Lowered immune response. d. Slowed metabolism e. Not tolerating tube feeding
Poor tolerance of diet or tube feeding
Lowered immune response.
Not tolerating tube feeding
Which of the following nutrients are needed for immunity?
a. Vitamin A, vitamin C, and zinc b. Thiamin, riboflavin, and niacin c. Folate, vitamin B6, and vitamin B12 d. Potassium, sodium, and magnesium
a.
Vitamin A, vitamin C, and zinc
What are the challenges of nutrition therapy with a metabolically stressed person? Check all that apply.
[mark all correct answers]
a.
Overfeeding
b. Underfeeding c. Initiating nutrition care before resistance occurs d. Getting the person to pay for nutrition counseling e. Giving too much fluids f. Giving too little fluids
.
Overfeeding
b. Underfeeding c. Initiating nutrition care before resistance occurs
e.
Giving too much fluids
f. Giving too little fluids
What is our goal of nutrition therapy in severe metabolic stress?
a. Promote catabolism b. Minimize nutrient loss c. Achieve positive nitrogen balance d. Provide excess calories for weight gain
b.
Minimize nutrient loss
Needs for which macronutrient significantly increase during metabolic stress?
a. Carbohydrate b. Fat c. Protein d. Fiber
c.
Protein
Which of the following amino acids can help improve outcomes in severely stressed hospitalized patients?
a. tryptophan and valine b. Leucine and isoleucine c. Tyrosine and glycine d. Glutamine and arginine
.
Glutamine and arginine
Respiratory disease usually causes:
a. Lowered metabolism b. Weight loss c. Diarrhea d. Difficulty swallowing liquids
weight loss
Excessive kcalorie intake in COPD patients may:
a. alter taste perception. b. increase respiratory distress. c. interfere with drug therapy. d. increase gas formation
b.
increase respiratory distress.
Which of the following is beneficial to maximize nutrition intake in a person with acute respiratory failure?
a. Provide nutrient dense formula b. Parenteral nutrition c. Serve well cooked foods d. Give steroids to stimulate the appetite
Provide nutrient dense formula
A person with respiratory failure needs more:
a. Calories and fat b. Carbohydrate and fat c. Calories and protein d. Carbohydrate and fluids
c.
Calories and protein
What is a likely to occur with a patient’s weight as COPD advances?
a. weight gain b. weight stays the same c. weight loss d. weight fluctuates up and down
c.
weight loss
What diet advice would benefit a patient with COPD who complains of abdominal discomfort and shortness of breath?
a. small, frequent meals. b. a low-fat diet. c. a high-fiber diet. d. consuming more liquids
a.
small, frequent meals
Medical nutrition therapy for COPD involves which of the following? Select all that apply.
[mark all correct answers]
a.
promoting a healthy body weight.
b. preventing muscle loss. c. improving food intake. d. decreasing medication usage. e. Higher calorie intake f. Tube feeding
.
promoting a healthy body weight.
b. preventing muscle loss. c. improving food intake
Higher calorie intake
What is the leading risk factor for COPD?
a. obesity b. malnutrition c. exercise d. smoking
d.
smoking
Which nutrients are beneficial for a patient with Acute Respiratory Distress Syndrome?
a. Zinc b. Fiber c. Vitamin D d. Omega-3'
d.
Omega-3’s
What is the primary characteristic of Acute Respiratory Distress Syndrome (ARDS)?
a. sudden, life-threatening inflammation of the lungs that impairs gas exchange b. chronic bronchitis making it difficult to breath c. serious respiratory infections that keep occurring d. incurable emphysema brought on by years of smoking
.
sudden, life-threatening inflammation of the lungs that impairs gas exchange
Why is enteral considered a better choice over parenteral nutrition?
Select ALL that apply.
[mark all correct answers]
a.
enteral is more cost effective
b. parenteral has more serious complications c. enteral is better accepted by clients d. parenteral cannot be use for short term e. enteral maintains gut health
a.
enteral is more cost effective
b. parenteral has more serious complications
e.
enteral maintains gut health
What determines the decision of choosing enteral nutrition versus parenteral nutrition?
a. duration of the feeding b. risk of aspiration c. presence of malnutrition d. whether the gut works
d.
whether the gut works
What is the primary reason for using alternative nutrition support?
a. Not able to consume adequate nutrition orally. b. Severe constipation c. Organ failure d. Edema
Not able to consume adequate nutrition orally
If a patient’s digestion and absorption are impaired, which formula would be recommended?
a. Standard b. Blenderized c. Elemental/hydrolyzed d. High-protein, high-kcalorie
c.
Elemental/hydrolyzed
A formula that approximates the osmolality of normal blood serum:
a. is called hypertonic formula. b. is referred to as an isotonic formula. c. has an osmolality of approximately 500 milliosmoles per liter. d. is usually a hydrolyzed formula.
is referred to as an isotonic formula.
When choosing a transnasal route for tube feeding, what is the best indicator for choosing between nasogastric and nasointestinal tubes?
a. cost b. comfort of the patient c. duration of the feeding d. aspiration risk
aspiration risk
Which feeding tube placement would require surgical placement?
a. Jejunostomy b. Nasojejunal c. Nasoduodenal d. Nasogastric
Jejunostomy
Which of the following formula delivery methods is usually done with a jejunostomy tube?
a. Intermittent feedings b. Continuous feedings c. Bolus feedings d. Intravenous
Continuous feedings
Bolus tube feedings are preferred over continuous enteral feedings when:
a. the client is at risk for nausea or diarrhea. b. the client is critically ill. c. increased mobility is desired. d. the client is at increased risk of aspiration.
c.
increased mobility is desired.
Which of the following feeding methods requires a pump?
a. Intermittent feedings b. Continuous feedings c. Bolus feedings
b.
Continuous feedings
When is the best time to remove a feeding tube?
a. When insurance stops paying for the tube feeding b. When the person can orally consume all of their nutritional needs c. When the person has gained back all of the weight they lost d. When the person can tolerate 2/3 of their nutrition needs from oral diet
.
When the person can tolerate 2/3 of their nutrition needs from oral diet
What is the best way to prevent a feeding tube from getting clogged?
a. Provide a low-fiber formula b. Rinse the tube with water after every feeding c. Keep the head of the bed elevated d. Use a hypertonic formula
Keep the head of the bed elevated
To determine the volume of parenteral solution to give, it is best to assess:
a. Fluid loss b. Persons medical history c. Weight d. Albumin levels
fluid loss
The largest source of calories in total parenteral solutions should come from:
a. Carbohydrate b. Protein c. Fat d. Fiber
carbohydrate
How are electrolyte levels monitored in those receiving parenteral nutrition support?
a. By checking urine output b. By observing blood/lab tests c. By checking for physical signs of dehydration d. By monitoring how much of the parenteral solution the person is tolerating
b.
By observing blood/lab tests
Which of the following nutrients is given separately instead of being included in parenteral solutions?
a. Sodium b. Potassium c. Iron d. Calcium
iron
Some parenteral solutions may exclude:
a. amino acids b. vitamin K c. vitamin C d. potassium
b.
vitamin K
what is supplied as free amino acids
protein source
what nutrient sometimes not given in the parenteral nutrition bag
Iron
what is provided as dextrose
carbohydrate source
Administration of a 2nd solution using a separate port; often used with
Piggyback
Does not include a fat source
2 - in- 1 Solution
Condition that develops when severely malnourished. person is fed to aggressively
refeeding syndrome
Which complication involves excess fat production due to longterm TPN administration?
a. Gallbladder Disease b. Weight loss c. Re-feeding syndrome d. Heart-failure
a.
Gallbladder Disease
Refeeding syndrome is characterized by:
a. hypoglycemia b. excessive weight gain c. fluid and electrolyte imbalances d. clogged feeding tube
c.
fluid and electrolyte imbalances
What is the most likely reason for a patient receiving TPN to experience hypoglycemia?
a. the rate was advanced too quickly b. abruptly stopping the TPN c. the TPN is running at a slow rate d. the TPN is running at a high rate
b.
abruptly stopping the TPN
