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U of R SCHOOL OF NURSING - 372 > NUR 372 CLASS 3 NUTRITION/FEEDING > Flashcards

NUR 372 CLASS 3 NUTRITION/FEEDING Flashcards

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1
Q

NUTRITION

A
  • provides energy for cellular metabolism and repair, organ function, growth and physical activity
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2
Q

NUTRIENT DENSITY

A
  • ratio of nutrient content to total energy content
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3
Q

ENERGY BALANCE

A
  • equal expenditure of calories in and out
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4
Q

CARBOHYDRATES

A
  • provide energy, assist in fat metabolism, and production of amino acids
  • ex: bread, cereal, rice.
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5
Q

PROTEINS

A
  • vital to growth, development, and normal function of all body systems
  • ex: meat, fish, poultry, milk, cheese, and eggs.
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6
Q

FATS

A
  • provide cellular transport, insulation, protection of vital organs, and energy storage
  • ex: animal and vegetable fats.
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7
Q

IDEAL BODY WEIGHT

A
  • optimal weight for body health and frame size
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8
Q

FACTORS AFFECTING NUTRITION

A
  • physiologic factors
  • psychological State
  • lifestyle, habits, and economic resources
  • culture and beliefs
  • drug and nutrient interactions
  • gender
  • illnesses and treatment, surgery
  • alcohol and drug abuse
  • exercise
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9
Q

AGING ADULT NURSING CONSIDERATIONS

A
  • metabolic rate declines with age
  • need for calories decreases, but not for vitamins and minerals
  • hunger and thirst decrease
  • diets are often deficient in proteins.
  • need fiber to prevent constipation
  • sense of taste and smell diminish.
  • decreased peristalsis and blood flow to GI tract
  • impaired dentition, decreased sense of thirst, and decreases saliva production.
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10
Q

MANIFESTATIONS OF ALTERED NUTRITION

A
  • overweight: 25 – 29.9
  • obesity: > 30
  • underweight: <18.5
    recent significant weight loss or gain
  • decreased Energy
  • altered bowel patterns
  • altered skin, teeth, hair, and mucous membranes
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11
Q

FLUID VOLUME DEFICIT CAUSES

A
  • hypovolemia/dehydration
  • GI losses (diarrhea, vomiting)
  • hemorrhage
  • skin losses (fever, sweating a lot)
  • altered intake (not drinking enough)
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12
Q

FLUID VOLUME DEFICIT SUBJECTIVE ASSESSMENT SIGNS

A
  • dizziness
  • weakness
  • fatigue
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13
Q

FLUID VOLUME DEFICIT OBJECTIVE ASSESSMENT SIGNS

A
  • tachycardia
  • hypotension
  • dry mucous membranes
  • skin turgor
  • weight loss
  • oliguria
  • older: drowsiness, confusion
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14
Q

FLUID VOLUME EXCESS CAUSES

A
  • hypervolemia/overhydration
  • kidney failure
  • heart failure
  • cirrhosis
  • fluid leaking out of the vascular system into the tissues
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15
Q

FLUID VOLUME EXCESS SUBJECTIVE ASSESSMENT SIGNS

A
  • weight gain
  • swelling
  • SOB
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16
Q

FLUID VOLUME EXCESS OBJECTIVE ASSESSMENT SIGNS

A
  • tachycardia
  • hypertension
  • ascites
  • crackles
  • edema
  • distended neck veins
  • daily weight most reliable indicator of fluid volume increase/decrease
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17
Q

SUBJECTIVE DATA COLLECTED IN NUTRITIONAL ASSESSMENT

A
  • normal, risk, dysfunction patterns
  • risk factors: alcohol, eating disorder, age
  • # meals/day
  • fluid intake
  • finances
  • food preferences
  • 24 h diet recall
  • medication use
  • ROS
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18
Q

OBJECTIVE DATA COLLECTED IN NUTRITIONAL ASSESSMENT

A
  • general observation
  • age, body build
  • anthropometric measurements
  • calorie count
  • mouth inspection
  • swallowing evaluation (intact gag reflex)
  • diagnostic tests
  • labs (Hgb, HCT, cholesterol, electrolytes, albumin)
  • intake and output
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19
Q

INDICATIONS FOR NPO

A
  • pre-procedure or pre-surgery
  • GI rest
  • post-operative recovery
  • mouth or facial injuries
  • severe dysphagia
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20
Q

CLEAR LIQUID DIET

A
  • liquid at room temperature
  • prevention of dehydration and relieving of thirst
  • nutritionally inadequate for long periods of time
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21
Q

INDICATIONS OF CLEAR LIQUID DIET

A
  • acute illness
  • reduction of fecal material
  • post-operative recovery.
22
Q

FOODS IN CLEAR LIQUID DIET

A
  • water
  • coffee
  • tea
  • clear juice
  • broth
  • gelatin
  • ginger ale
23
Q

FULL LIQUID DIET

A
  • all foods that can become liquid at room temperature

- can supply adequate amounts of nutrition (may need protein supplements)

24
Q

INDICATIONS OF FULL LIQUID DIET

A
  • post-op recovery

- GI rest

25
Q

FOODS IN FULL LIQUID DIET

A
  • all clear liquids
  • milk
  • ice cream
  • soup
  • vegetable/fruit juices
  • pureed vegetables
26
Q

PUREED DIET

A
  • liquids and foods that are pureed to liquid form

- each food is pureed separately to preserve individual flavor

27
Q

INDICATIONS OF PUREED DIET

A
  • chewing or swallowing difficulties
  • oral or facial surgery
  • wired jaws
28
Q

FOODS IN PUREED DIET

A
  • clear and full liquids

- pureed meats, fruits, and eggs

29
Q

SOFT (LOW FIBER) DIET

A
  • contains whole foods that are low in fiber, lightly seasoned, and easily digested
  • increases risk of constipation
30
Q

INDICATIONS OF SOFT (LOW FIBER) DIET

A
  • acute infections
  • chewing difficulties
  • gastrointestinal disorders
31
Q

FOODS IN SOFT (LOW FIBER) DIET

A
  • smooth, creamy, crisp texture

- raw fruits and vegetables, coarse breads and cereals, beans, and other potentially gas-forming foods are excluded

32
Q

MECHANICALLY SOFT DIET

A
  • regular diet that is modified in texture
33
Q

INDICATIONS OF MECHANICALLY SOFT DIET

A
  • chewing difficulties
  • dysphagia
  • poorly fitting dentures
  • clients with no teeth
  • surgery to the head, neck, or mouth
  • strictures of the intestinal tract
34
Q

FOODS IN MECHANICALLY SOFT DIET

A
  • ground meats
  • canned fruit
  • softly cooked vegetables
  • excludes: dry fruits/veggies, nuts
35
Q

DYSPHAGIA DIET

A
  • prescribed when swallowing is impaired, such as following a stroke
36
Q

LEVELS OF DYSPHAGIA DIET

A
  • level 1: pureed - foods are totally pureed to a smooth consistency with a pudding-like texture.
  • level 2: mechanically altered - soft-textured, moist, semi-solid foods that are easily chewed and swallowed.
  • level 3: advanced – near-normal textured foods that are moist. hard, sticky foods are eliminated.
37
Q

TYPES OF “THICKNESS” DYSPHAGIA DIET

A
  • thin: non-restrictive; unthickened beverages and supplements.
  • nectar-like: liquids that are thin enough to sip through a straw but thicker than water
  • honey-like: pourable but thickened; eaten with a spoon but cannot be sipped through a straw.
  • spoon-thick: liquids thickened to maintain their shape and eaten with a spoon – given to patients who are most likely to aspirate
38
Q

REGULAR DIET

A
  • no restrictions
39
Q

CARDIAC DIET

A
  • low sodium and low fat diet

- DASH diet for patient with HTN

40
Q

DIABETIC DIET

A
  • balances intake of protein, fats and carbs
41
Q

RENAL DIET

A
  • protein-restricted diets for renal impairment or liver disease to control end products of protein metabolism (nitrogenous wastes)
  • low phosphorous
  • low potassium
42
Q

VEGETARIAN DIET

A
  • plants for food
  • fruits/vegetables
  • dried beans/peas
  • grains, seeds, and nuts
43
Q

VEGAN DIET

A
  • excludes all meat and animal products

- B12 and vitamin D supplementation might be needed

44
Q

LACTO VEGETARIAN DIET

A
  • includes dairy products
45
Q

LACTO-OVO VEGETARIAN DIET

A
  • includes dairy products and eggs
46
Q

FEEDING PREPARATION/PRECAUTIONS

A
  • chin tuck
  • HOB 45-90 dg
  • listen to patient
  • follow aspiration precautions
  • listen to lung sounds before/after
  • provide encouragement
  • careful observation
  • mouth empty before providing more food or drink
  • do not use straw if oral muscle weakness/cognitive deficits
  • monitor rate, depth and effort every 4 hours
47
Q

SIGNS/SYMPTOMS OF DYSPHAGIA

A
  • coughing
  • choking (difficulty breathing)
  • eating very slowly
  • swallowing several times
  • “wet” voice after eating
  • drooling
  • decreased LOC or sleeping during meals
  • spitting out food or drinks
  • holding food in mouth
  • pocketing food between tongue and cheek
48
Q

INTAKE & OUTPUT

A
  • measurement of fluids that enter and leave the body

- usual intake and output 2500-3000 mL

49
Q

WHAT DOES INTAKE INCLUDE

A
  • PO fluids (juices, ginger ale, gelatin)
  • IV fluids/meds
  • enteral feedings
  • liquid meds
50
Q

WHAT DOES OUTPUT INCLUDE

A
  • urine
  • stool (if liquid)
  • emesis
  • drainage from chest tube
  • NG tube
  • wound drains

U of R SCHOOL OF NURSING - 372 (12 decks)

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