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Nursing 171 > NURS 171: Week 10 Nutrition > Flashcards

NURS 171: Week 10 Nutrition Flashcards

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1
Q

My Plate

A

-U.S.D.A. guidelines for Americans visually illustrates a healthy meal
Suggestions for:
>variety
>portion size
>activity
>tools for successful nutritional lifestyle

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2
Q

Nutrition Facts Label

A

Labeling Required

  • includes serving size, number of servings per package, total calories and calories from fat per serving
  • contains a list of key nutrients present
  • lists the percent daily values
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3
Q

Macro-nutrients

A

supply body with energy

  • carbohydrates
  • proteins
  • lipids
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4
Q

Micro-nutrients

A

help manufacture, repair, and maintain cells through metabolism

  • vitamins
  • minerals
  • water
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5
Q

Metabolism

A

-body changes and uses nutrients for vital processes and bodily functions
-most triggered by enzymes
ex:
>anabolism (requires energy– building up)
>catabolism (releases energy– breaking down)

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6
Q

Carbohydrates

A

Macro-nutrient
-primary energy source for body
-enhance insulin secretion
-increase a sense of fullness + satisfaction
>simple carbohydrate
>complex carbohydrate
-glucose stored as glycogen in liver + muscle tissue as glycogen

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7
Q

Simple Carbohydrate

A
  • easily + quickly digested

- supply energy

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8
Q

Examples of Simple Carbohydrates

A
  • corn syrup
  • milk
  • honey
  • table sugar
  • molasses
  • sugar cane
  • sugar beets
  • fruits
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9
Q

Complex Carbohydrates

A
  • fiber
  • not digestible by humans
  • provides no usable glucose
  • aids in passage of bowel movements
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10
Q

Examples of Complex Carbohydrates

A
  • vegetables
  • breads
  • cereals
  • pasta
  • grains
  • legumes
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11
Q

Glycogenolysis

A

converts stored carbohydrates back to glucose for energy when needed

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12
Q

Gluconeogensis

A

body converts stored protein and lipids (fats) to use for energy (ketones)

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13
Q

Ketones

A

an alternative fuel when glucose is not available

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14
Q

Proteins

A

-made up of amino acids
-responsible for tissue growth, maintenance, and repair
-metabolism
-immune system function
-regulates fluid + acid-base balance
-secondary energy source
Needs Vary On:
>age
>sex
>weight
>health

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15
Q

Amino Acids

A
  • building blocks of most proteins

- protein synthesis requires all required amino acids to be present

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16
Q

Essential Amino Acids

A
  • can not be synthesized by the body

- obtained through diet

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17
Q

Non-Essential Amino Acids

A

-can be synthesized by the body

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18
Q

Complete Protein

A

foods that contain all essential amino acids for protein synthesis (usually from animal sources)

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19
Q

Incomplete Protein

A

-do not provide all of the essential amino acids
-non animal sources (nuts/grains)
-combined with another incomplete protein can make a complete protein
(Ex: peanut butter on whole rain roll)- important in vegetarian diet

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20
Q

Digestion of Proteins

A
  • begins in stomach
  • occurs mostly in small intestine
  • enzymes break down protein into amino acids
  • nitrogen balance occurs when intake + output of nitrogen (protein) are equal
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21
Q

Functions of Dietary Protein

A
  • tissue building
  • metabolism
  • immune system function
  • fluid balance
  • acid-base balance
  • secondary energy source
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22
Q

Protein: Tissue Building

A

growth, maintenance, and repair of body cells and tissues

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23
Q

Protein: Metabolism

A
  • protein are precursors to digestive enzymes + hormones

- combine with iron to form hemoglobin

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24
Q

Protein: Immune System Function

A
  • Lymphocytes (WBC) are proteins

- Antibodies are proteins

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25
Q

Proteins: Regulate Fluids + Acid Base Balance

A

proteins help regulate fluid + acid base balance

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26
Q

Protein: Secondary Energy Source

A

when carbohydrate stores are low, protein can be broken down for energy

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27
Q

Lipids

A
  • insoluble in water
  • Fats solid at room temperature
  • Oils liquid at room temperature
  • essential nutrient for brain + nerve function
  • metabolism occurs in small intestine
  • stored in adipose tissue fat
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28
Q

Function of Lipids

A
  • supply essential nutrients
  • energy source
  • flavor + satiety
  • cholesterol function
  • insulation
  • protects vital organs
  • component of every cell membrane
  • essential to cell metabolism
  • enables accurate nerve impulse transmission
  • thermoregulation
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29
Q

Function of Lipids: Supply Essential Nutrients

A
  • food fats supply essential fatty acids

- aid in absorption of fat soluble vitamins

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30
Q

Function of Lipids: Energy Source

A

body burns fat for energy as needed

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31
Q

Function of Lipids: Flavor + Satiety

A
  • lipids give food cream taste and texture

- makes us feel “full”

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32
Q

Function of Lipids: Cholesterol Function

A
  • part of every cell in body
  • in bile: helps digest fats
  • serves as a precursor to all steroid hormones
  • can contribute to atherosclerosis
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33
Q

Types + Sources of Lipids

A
  • Glycerides
  • Sterols
  • Phospholipids
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34
Q

Lipids: Glycerides

A

Triglycerides–> main glyceride found in food

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35
Q

Lipids: Sterols

A

-Cholesterols: found in animal proteins, synthesized in liver
>needed for formation of cell membranes, vitamin D, estrogen + testosterone

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36
Q

Lipids: Phospholipids

A

-key component in lipoproteins
-major transport for lipids to cells in the bloodstream
>Low Density Lipoproteins (LDL)
>High Density Lipoproteins (HDL)

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37
Q

Low Density Lipoproteins

A

(LDL)

transports cholesterol to body cells

38
Q

High Density Lipoproteins

A

(HDL)

removes cholesterol from bloodstream, return to liver to produce bile

39
Q

Essential Fatty Acids

A

-body can not manufacture it
>essential acids help protect against heart disease (omega 3 + 6)
>absence of essential acids creates a deficiency disease

40
Q

Why is water an Essential Nutrient?

A
  • makes up large percentage of body weight
  • where chemical processes take place
  • transports substances (oxygen, nutrients, metabolic waste)
  • maintain body temperature
  • fluid balance–> intake = output
  • lubricates joints
  • intake needs 2-3 liters/ day
41
Q

BMR

A

Basal Metabolic Rate

-amount of energy required at rest for major organs to function (heart, liver, brain)

42
Q

Direct Measurement for Basal Metabolic Rate (BMR)?

A

calorimeter

43
Q

Indirect Measurement for Basal Metabolic Rate (BMR)?

A
  • bedside measuring oxygen uptake per unit of time
  • serum thyroxine levels (blood test)
  • formula
44
Q

Factors that Affect BMR

A

-body composition
-growth periods
-body temp
-environmental temp
-disease processes
-prolonged physical exertion
Total Energy Needs:
>replacing calories used for BMR + physical activity
>age, weight, type of activity

45
Q

Factors That Affect Nutrition: Developmental Stage

A
  • physical growth
  • activity level
  • metabolic processes
  • disease prevention
46
Q

What Factors Affect Nutrition In Adults?

A
  • require adequate amounts of protein, vitamins, + minerals
  • calcium, vitamin D, folic acid, + iron are critical (especially in women for bone + reproductive health)
  • women of childbearing age should take folic acid supplement to decrease risk of neural tube defects in fetus
  • BMR decrease–> may gain weight
  • chronic diseases begin to occur related to heredity or poor lifestyle choices
47
Q

Factors That Affect Nutrition In Older Adults

A
  • need less calories but same nutrients; may need supplements
  • lose interest in eating
  • physical changes may include decreased thirst sensation, decreased taste + smell
  • decreased vision + hearing may limit mobility and interacting interfering with shopping and food preparation
  • tooth loss + gum disease limit chewing
  • physical problems (decreased intestinal peristalsis, gastrointestinal reflex disease)
  • may need therapeutic diet
48
Q

Factors That Affect Nutrition: Lifestyle Choices

A
  • dietary patterns
  • cooking methods
  • oral contraceptives
  • using food to cope
  • tobacco use
  • alcohol
  • caffeine
49
Q

Factors That Affect Nutrition: Vegetarianism

A
  • diets that exclude meat + poultry
  • vary other limitations of food (fish, dairy)
  • protein, vitamin, and mineral deprived
  • consult nutrition professional especially during periods of growth, breastfeeding, pregnancy, or recovery from illness
  • choose this diet in hopes of reducing risk of disease + promote wellness
50
Q

Eating For Health

A
  • avoid processed foods, grains, + beverages
  • avoid trans-fats, preservatives + chemical additives
  • consume diet of meats, fish, fresh fruits, vegetables, nuts, seeds, + eggs
51
Q

Eating For Weight Loss

A
  • calorie restriction diet
  • behavior modification
  • variety of food choices + a balance of nutrients
  • encourage physical activity, sleep, reduced stress
52
Q

Overweight/ Obesity

A

consuming nutrients

  • in excess of metabolic demands
  • more than needed for activity, gender, height, weight
  • calculate BMI
  • Overweight = BMI >25 but <29.9
  • Obese = BMI >30
53
Q

Special Diets

A

-regular
-NPO
-diets modified by consistency:
>clear liquids
>full liquids
>mechanical soft diet
>pureed
-diets modified by disease

54
Q

Dietary History

A
  • 24 hour recall
  • food frequency questionnaire
  • food record (most accurate)
55
Q

Anthropometric Measurements

A
  • measures the body composition (proportion of fat in the body)
  • noninvasive physical examination techniques to determine body dimensions
  • height + weight
  • assess growth rate in children
  • indirectly assesses adult protein + fat stores
  • assess overweight, obesity + underweight
56
Q

Assessing Body Composition

A 
Anthropometric Measurements
-circumference measurements of
>arm, abdomen, waist to hip ratio
-BMI
>roughly estimated by using a calculation formula, table or calculator
57
Q

BMI

A

-normal range = 18.5- 24.9
-identify underweight + overweight
-varies for athlete, pregnant + postpartum women
>underweight= <18.5
>healthy= 18.5- 24.9
>pre-obese= 25.0- 29.9
>obese= >30

58
Q

Physical Assessment Findings for Nutritional Imbalance

A
  • alterations in vital signs (include quality of pulse)
  • height, weight, BMI
  • poor skin turgor, poor wound healing
  • health of hair, nails, lip, tongue, teeth, gums, eyes
  • concave abdomen, ascites, bowel sounds
  • change in muscle mass, edema
  • changes in blood glucose, albumin, BUN, hemoglobin
59
Q

Lab Values that Indicate Nutritional Status

A 
-blood glucose
>hyperglycemia
>hypoglycemia
-albumin
-prealbumin
-transferrin
-urea (BUN)
-creatinine
60
Q

Lab Values Indicate Nutritional Status: Blood Glucose

A

amount of fuel available for cellular energy

61
Q

Lab Values Indicate Nutritional Status: Hyperglycemia

A

in non-diabetics, blood sugar above normal level triggers release of insulin which causes the glucose to move into the body cells and be stored in liver + muscles

62
Q

Lab Values Indicate Nutritional Status: Hypoglycemia

A

blood sugar falling below normal triggers release of glucagon, leading to the release of glucose from storage

63
Q

Lab Values Indicate Nutritional Status: Albumin

A
  • low levels associated with malnutrition, malabsorption, liver disease, loss of protein from other sources (Burns)
  • affected by fluid status
64
Q

Lab Values Indicate Nutritional Status: Pre-Albumin

A

acute changes (in nutrition)

65
Q

Lab Values Indicate Nutritional Status: Transferrin

A
  • protein that binds with iron

- measures protein depletion, iron deficiency

66
Q

Lab Values Indicate Nutritional Status: Urea (BUN)

A
  • elevations seen with impaired kidney function, dehydration, excessive protein breakdown or intake
  • low BUN seen with low protein intake
67
Q

Lab Values Indicate Nutritional Status: Creatinine

A
  • end production of skeletal muscle metabolism

- increased levels may indicate impaired kidney function + loss of muscle mass

68
Q

Impaired Swallowing

A 
(dysphagia)
-at risk for choking + aspiration
Caused by:
>mechanical obstruction (tumor)
>neuromuscular impairment (stroke, cerebral palsy)
>anatomical or physiological defect
69
Q

Impaired Swallowing Interventions

A
  • provide/ use assistive devices
  • avoid use of straws
  • tuck chin in preparation for swallowing
  • place food at back of mouth, on unaffected side
  • check mouth for pocketing of food
  • monitor body weight + hydration status
  • position upright (90 degrees) or as far as possible
  • keep HOB elevated 30 to 45 degrees after eating
  • have suction available
  • feed small amounts
  • use thickening agent
70
Q

Assisting With Meals

A
  • if condition allows, encourage to get out of bed and eat meals in dining room
  • assess rituals before meals (blessings)
  • provide toileting, oral hygiene + hand washing before meals
  • encourage independence
  • provide adequate time for chewing + swallowing
71
Q

Assisting With Meals With Patients With Dementia

A
  • assess cognitive limitations + communication abilities
  • minimize distractions
  • cue patient verbally, “take a bite”, “chew”, and “swallow”
  • guide hand
  • involve family members
  • give client time to eat independently
  • do not feed too fast
72
Q

Parenteral Nutrition

A
  • intravenous nutrition

- administered over a 24 hour period

73
Q

Enteral Nutrition

A

(tube feeding)
-delivery of liquid nutrition (at room temp) into upper intestinal tract via a tube
-in addition to feeding or instead of oral intake
-preferred method for patient who needs nutritional support, who has functional GI tract
>trauma, burns, severe malnutrition, neurological disorders that affect swallowing, anorexia nervosa, prematurity, failure to thrive

74
Q

Risk Associated With Enteral Feedings

A

> aspiration into lungs
-can lead to infection, pneumonia, abscess formation, adult respiratory distress syndrome (ARDS), death
source of bacterial growth
-check expiration date
diarrhea, nausea + vomiting, nasopharyngeal trauma
alteration in drug absorption + metabolism

75
Q

Reason For Enteric Tubes

A
  • administer liquid nutrition
  • instead of or in addition to oral intake
  • lavage of the stomach (irrigation/ washing out, drainage of stomach contents)
  • collecting a specimen of stomach contents
  • prevent nausea, vomiting + gastric distention postoperatively
76
Q

Selecting a Feeding Tube: Different kinds

A
  • Nasogastric (NG tube)
  • Feeding Nasogastric Feeding Tube
  • Oropharyngeal Tube
  • Nasoenteric Tube (NE)
  • Gastrostomy Tube (G tube)
77
Q

Nasogastric (NG) Tube

A
  • for short term use (< 6 weeks)

- for feeding or drainage of stomach contents

78
Q

Feeding Nasogastric Feeding Tube

A

inserted through one naris, passed through the nasopharynx into the esophagus then into the stomach

79
Q

Oropharyngeal Tube

A

inserted through the mouth, may trigger gagging or unconscious chewing on the tube

80
Q

Nasoenteric (NE) Tube

A
  • longer than NG tube, extended down into the duodenum or jejunum
  • for patients at risk for aspiration (decreased level of consciousness, absent or diminished gag reflex, or severe gastroesophageal reflux)
81
Q

Gastrostomy (G) Tube

A
  • long term feeding tube

- placed surgically or endoscopically through the skin and the abdominal wall into the stomach or jejunum

82
Q

Administering Enteral Feedings: Feeding Schedules

A
  • continuous
  • cyclic
  • intermittent “closed”
  • intermittent bolus “open”
83
Q

Feeding Schedule: Continuous

A

Ex: 50 mL/hour for 24 hours

  • debilitated to patients who require intensive nutritional support
  • constant flow
  • feeding interrupted for installation of medication and flushing with water
  • pump recommended
84
Q

Feeding Schedule: Cyclic

A
  • infusion time less than 24 hours per day
  • some feedings only given at night
  • some patients may “eat” during the day
85
Q

Feeding Schedule: Intermittent Bolus Feedings “open system”

A
  • uses a syringe or bag to deliver formula over a 5 to 10 minute period into gastric tube
  • easy to teach family members
  • frees patient from mechanical devices that limit activity
  • increases risk of respiration aspiration + stomach distention
  • exposed to environment; risk of contamination
86
Q

Feeding Schedule: Intermittent “closed” system (bag or bottle)

A

-prefilled system
-supplement oral intake or
-for patients who want greater mobility
-given on regular basis for 30 to 60 minutes
Ex: “give 250 mL of enteral nutrition very 4 to 6 hours”
-may be given with pump; has drip chamber
-decrease risk of contamination
-functions like IV fluid–> nurse spikes

87
Q

Preventing Contamination of Enteral Feedings

A
  • check expiration date
  • label container with date + time
  • use hand hygiene, non sterile gloves
  • tubing + supplies are sterile when opened; handle with care
  • replace equipment per policy
  • keep unopened solutions at room temp
  • never allow feeding to hang below level of stomach
88
Q

Parenteral Nutrition Solutions

A
  • contain 20% concentration of dextrose in water, along with amino acids, vitamins, minerals, + trace elements
  • calories depend on patients energy need
  • solutions standardized or individualized to meet patients needs
  • delivered through a large, high-flow vein through a central venous access catheter (subclavian vein)
89
Q

Parenteral Nutrition: Lipid Emulsions

A
  • contain essential fatty acids, triglycerides, and supplemental calories
  • administered to prevent essential fatty acid deficiency
  • lipids may be administered at the same time as parenteral nutrition through a peripheral line or by a connected tubing through the central line
90
Q

Monitor + Maintenance For Patients Receiving Parenteral Nutrition

A
  • assess catheter insertion site + dressing
  • monitor tube connections
  • check rate + amount infused
  • regularly weigh patient per policy
  • check glucose level of patient per policy
  • monitor intake + output
  • check lab values: albumin, transferrin, prealbumin, CBC, liver function, BUN
  • do not use PN infusion line for administering other meds or solutions

Nursing 171 (38 decks)

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