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Fundamentals 2 > nutrition > Flashcards

nutrition Flashcards

1
Q

3 Main Functions of Gastrointestinal System

A

Transportation, Digestion, & Absorption

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2
Q

Patients who are malnourished upon admission are a greater risk of what 6 complications

A 
Dysrhythmias
Skin breakdown
Sepsis
Hemorrhage
Increase length of stay
Delayed surgical healing
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3
Q

what are food guidelines

A

Provides average daily consumption of five food groups

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4
Q

5 dietary guidelines

A
  1. Follow a healthy eating pattern across the lifespan.
  2. Focus on variety, nutrient density, & amount.
  3. Limit calories from added sugars & saturated fats & reduce sodium intake.
  4. Shift to healthier food & beverage choices
  5. Support healthy eating patterns for all
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5
Q

7 factors influencing nutrition

A 
Appetite
Negative Experiences
Disease & Illness
Medications
Environmental Factors
- Income
-Education level
-Physical function level
-Transportation
-Availability of foods
Developmental Needs
Alternative Food Patterns
-Religion
-Cultural background
-Health beliefs
-Personal preferences
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6
Q

What must nurses consider during older adult nutritioin

A

Presence of chronic illnesses

Medications

Gastrointestinal changes

Slower metabolic rate

Cognitive impairments

Available transportation

Functional ability

Fixed income

Many need calcium
supplementation

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7
Q

Name 4 nutrition screening tools

A

Subjective screening

Objective measures

Identify risk factors of

malnutrition

Standardized tools

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8
Q

Name 3 standardized tools for screening

A

Subjective Global

Assessment (SGA)
Mini-nutritional

Assessment (MNA)
Malnutrition Screening Tools (MST)

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9
Q

Anthropometry Assessment

A

Measure of size and make up of body:

Height & Weight

Ideal Body Weight

Body Mass Index

Skin Fold Measures

Fat Percentage

Registered Dieticians can assist

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10
Q

Factors that affect lab results

A

Fluid balance
Liver & kidney function
Presence of disease

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11
Q

Common labs discussed in FUNDAMENTALS

A

Total Protein
Albumin
Prealbumin
Hemoglobin

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12
Q

Total Protein

A

Combination of albumin & globulin constitute

Normal: 6.4-8.3 g/dL (UKHC 6.3-7.9 g/dL)

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13
Q

Albumin

A 
Makes up 60% of total PRO
Better indicator of chronic illnesses
Synthesized in the liver
Half-life- 21 days
Normal: 3.5-5.0 g/dL (UKHC 3.3-4.6
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14
Q

prealbumin

A

Preferred for acute conditions
Half-life- 2 days
Normal: 15-36 mg/dL (UKHC 20-41)

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15
Q

what is Hemoglobin

A

Protein responsible for transporting oxygen in the blood

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16
Q

Normal levels of hemoglobin

A

Male 14-18g/dL (UKHC 13.7-17.5)

Female 12-16g/dL (UKHC 11.2-15.7)

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17
Q

If hemoglobin is low what may a patient benefit from?

A

Eating foods rich in iron

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18
Q

Factors of Diet History (8)

A 
Dietary intake
Food preferences
intolerances
Unpleasant symptoms
Allergies
Taste, chewing, swallowing
Appetite
Weight
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19
Q

Factors of health history (4)

A

Illness
Activity level
Health status
Medications:

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20
Q

factors of other history in nutrition history

A 
Age
Socioeconomic status
Cultural background
Religious beliefs
Transportation
Psychological factors
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21
Q

8 nutrition nursing problems

A

Imbalanced Nutrition: Less than body requirements – or simply poor nutrition or the like

Imbalanced Nutrition: More than body requirements – or Overweight/Obesity

Impaired swallowing

Risk for aspiration

Diarrhea, Constipation, Nausea

Impaired Dentition

Fatigue

Risk of unstable blood glucose

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22
Q

4 categories of Planning

A

INDIVIDUALIZED approach

Goals & Outcomes

Setting priorities

Teamwork & Collaboration

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23
Q

5 categories of assessment of nutritional status

A

Screening

Anthropometry

Laboratory & Biochemical Tests

Diet & Health
History

Physical
Examination

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24
Q

6 areas of nutritional nursing implementation

A

Health Promotion

Diet Selection

Advancing Diet

Care of Common Nutritional Issues

Measuring Intake & Output (I&O)

Obtaining Height & Weight

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25
Q

4 areas of Diet selection

A

Amt needed

Ability to eat

GI alterations?

Any special consideration based on health status

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26
Q

5 Types of Diets

A

Regular

Liquid Diets & Special Considerations

Modified Texture diets

Therapeutic Diets
Modified for Nutrients

Supplements

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27
Q

What is a Regular Diet and it’s aim?

A

No restrictions & no signs of intolerances

Pt. has no comorbidities

Encourage healthy choices

Regular consistency

Aim is to provide a well-balanced diet to meet nutritional needs

28
Q

5 types of modified texture diets

A

Mechanical Soft

Pureed

Minced

Ground

Chopped

29
Q

What is the differences between clear and full liquid diet

A

Clear liquid diet is any liquid you can see through

Full liquid diet is anything liquid

30
Q

What are the 2 special considerateions for liquid diet

A

fluid restriction

Modified consistency of liquid

31
Q

Purpose of clear liquid diet

A

surgery
digestive problems
acute illness

leave little fiber in GI tract

32
Q

full liquid diet is usually used for what?

A

Transition to regular diet

33
Q

3 types of patients on fluid restriction

A

heart failure
renal failure
low serum sodium

34
Q

Best indicator of patient fluid status

A

weight of patient everyday at same time in same clothes

35
Q

6 types of therapeutic diet orders

A

Consistent Carbohydrate

Cardiac Diet or Heart Healthy Diet

Low residue

High Fiber

Gluten Free

Lactose Free

Bland

36
Q

who would have low residue diet

A

ulcerative colitis

chrons disease

37
Q

who would have a high fiber diet

A

improving cholesterol
prevent colon cancer
constipation

38
Q

NPO means

A

Nothing by mouth

39
Q

T/F Being NPO for more than 5-7 days are high nutritional risk

A

True

40
Q

What are 4 common nutritional issues

A

Anorexia
Inability to feed self
Dysphagia
Nausea & Vomiting

41
Q

what does anorexia mean

A

lack or loss of appetite

42
Q

causes of anorexia

A

pain
fatigue
effects of medications

43
Q

9 approaches to increase appetite

A

Treat the cause

Use creative approaches to stimulate appetite

Environment

Smaller meals, more frequent meals

Allow for food preferences

Seasonings to improve taste

Provide oral hygiene

Ensure patient is comfortable

Medications for appetite stimulation

44
Q

6 steps to assisting patients with oral feedings

A

Protect safety, independence & dignity

Make sure tray is within reach

Assess risk of aspiration

Does patient need to be supervised

Any visual deficits?

Decreased motor skills

45
Q

Dysphagia complications

A

Aspiration pneumonia
Dehydration
Malnutrition s/t decreased intake
Weight loss

46
Q

If dysphagia is suspected

A

Make referrals to Speech Language Pathologist (SLP) & Registered Dietician (RD)
Perform swallow evaluations

47
Q

The Do’s of Dysphagia (11)

A 
Sit in high fowlers
Minimize environmental distractions
Allow for time in between bites and drinks
Check for oral pocketing
Chin tuck
Double swallowing
Have suction available
Perform oral care
Monitor for choking and coughing
48
Q

The Don’ts of Dysphagia (4)

A

Feed when altered LOC
Leave unattended
Administer sedatives or hypnotics
Use a straw

49
Q

7 stages of Dysphagia diet

A 
0 - Thin
1sligtly thick
2midly thick
3moderately thick/liquidised
4exremely thick/pureed
5minced
6 soft
7- regular/easy chew
50
Q

Strick I&O

A

Measurement of all intake and all output

Record in patient medical record

Can measure in amount (mls) or in occurrences

51
Q

who needs strict I&Os

A 
Critical care patients
Unstable patients
Post-Operative patients
Pt.’s who have catheters, lines, drains, tubes 
Patient’s with history of/ or current 
Heart failure, liver failure, renal failure
Malnourished or patients who are NPO
Receiving medications such as diuretics
Changes in weight
52
Q

what is considered intake 5

A 
Oral intake
IV Fluids
Blood products
Tube feeding
Flushes
53
Q

what is considered output 4

A

Urine
Bowel movements
Emesis
Drainage tubes

54
Q

What is enteral nutrition

A

Provides nutrients in GI tract

Preferred method if patient cannot swallow & gut is functioning

55
Q

what is parenteral nutrition

A

Form of specialized nutrition support provided intravenously

56
Q

Characteristics of enteral nutrition

A

Receive formula through nasogastric tubes, jejunal or gastric tubes
Delivered to gastric or jejunum
Risk for gastric reflux_ jejunum feedings
When placed MUST CONFIRM PLACEMENT

57
Q

indications of EN

A 
Prolonged anorexia
	Some patients simply WILL NOT eat
Severe protein-energy malnutrition
Coma
Impaired swallowing
Critical illnesses
58
Q

Benefits of EN vs PN

A

Reduce sepsis
Minimizes the hypermetabolic response to trauma
Decreases hospital mortality
Maintains intestinal structure & function

59
Q

Signs of Tube feeding intolerance

A 
High gastric residuals
Nausea
Cramping
Vomiting
Diarrhea
60
Q

complications of tube feeding

A 
Pulmonary aspiration
Diarrhea
Constipation
Abd cramping, nausea, vomiting
Tube occlusion or displacement
Delayed gastric emptying
Serum electrolyte imbalance
Fluid overload
Hyperosmolar dehydration
61
Q

placement of feeding tubes

A

Through the nose
Nasogastric or nasointestinal (duodenal)
Surgically
Gastronomy
Jejunostomy
Endoscopically
Percutaneous Endoscopic Gastronomy (PEG)
Percutaneous Endoscopic Jejunostomy (PEJ)

62
Q

nurse role in tube placement

A

Insert NG tube using water soluble lubricant
Landmarks (gastric)- nose_ ear_ xiphoid process
Add 8-10 inches for jejenum

63
Q

Nasogastric or Nasojejunal

characteristics

A

Typically for EN < 4 weeks
Large bore & small bore
Typical for adults: 8-12 Fr, 36-44 inches long
Come with a stylet
Connectors are not standard for EN feeding tubes

64
Q

surgically or endo tube characteristics

A

Preferred long-term feeding

More than 6 weeks

65
Q

checking gastric residual

A

Continuous- Every 4-6 hours
Intermittent- immediately before
High gastric residual can indicate delayed gastric emptying
How much is too much?
Know hospital policy as well as KNOW your patient
> 250 ml_ hold for 1 hour and recheck
> 500 mls_ hold and notify HCP

Fundamentals 2 (5 decks)

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