Nutrition

Question 1

dysphagia

Answer 1

difficulty swallowing

Question 2

aspiration

Answer 2

chocking, food going into the lungs

Question 3

enteral nutrition

Answer 3

nutrition delivered in a liquid form through a tube

Question 4

total parenteral nutrition (TPN)

Answer 4

a method of feeding that bypasses the GI tract (used for patients that dont have a GI)

Question 5

malnutrtion

Answer 5

lack of proper nutrition

Question 6

carbs

Answer 6

provides energy, regulates protein and fat metabolism, fiber is a card that eliminates bowel elimination (ex: grains, potatoes, pasta, beans)

Question 7

protein

Answer 7

growth maintenance and repair of body tissues, aids in transportation of vitamins, supports immune system (ex: eggs, poultry)

Question 8

fats/lipids

Answer 8

provides energy and vitamins, need for hormone reproduction, padding to vital organs, maintains body temperature (ex: salmon, olive oil)

Question 9

what can happen if we have an excess amount of carbs, protein, fats/lipids, vitamins?

Answer 9

1. too many carbs and fats can lead to obesity and/or diabetes
2. too much protein can lead to damage of the kidneys, calcium loss, heart disease
3. too much vitamins can lead to toxicity

Question 10

what can happen if we dont have enough of carbs, proteins, fat/lipids, vitamins?

Answer 10

1. lack of carbs and protein intake can lead to malnutrition
2. disorders: anemia, anorexia, bulimia, binge eating
3. lack of vitamin intake: B-complex, vitamin C for stress and illness, D for bone demineralization

Question 11

what are the factors that can affect our nutritional status?

Answer 11

-age
-medication
-economical status
-income
-knowledge
-cultural/religion
-lifestyle
-illiteracy (not being able to read food labels)

Question 12

what is included in a nutritional assessment?

Answer 12

• diet history (food diary)
• time, type, amounts of food consumed and how is it consumed
  -any difficulties chewing or swallowing
  -hx of indigestion and heartburn
  -predisposed risks

Question 13

what are the tools to determine nutritional status?

Answer 13

• weight, height, BMI
  -BMI: weight (kg) divided by height (m) ^2

Question 14

what lab value is the best indicator to determine nutritional status, and what is the correct range?

Answer 14

• albumin (3.5-5dl) (KNOW FOR TEST)
  -PREalbumin (15-36) is normal anything less than 10 is considered malnutrition

Question 15

What other lab values are important related to nutrition?

Answer 15

• I&Os should be comparable to each other
  -kidney function (BUN), increased creatinine is DEHYDRATION
  -cholesterol and triglyceride levels

Question 16

what are the 10 therapeutic diets?

Answer 16

1. NPO (nothing by mouth, order must be provided)
2. liquid diet (no residue and liquid is room temp, full milk, icecream, juice)
3. pureed (clear and full liquids plus pureed meats and scrambled eggs)
4. mechanical soft (clear and full liquids plus dry or ground food)
5. low residue (low fiber and easy to digest–to rest the bowel)
6. high fiber (increased fiber for constipation)
7. low sodium/cholesterol (mostly in cardiac units)
8. diabetic (must consume x amount of calories a day)
9. dysphagia (pureed foods with thickened liquids)
10. regular (no restrictions)

Question 17

how does a nurse monitor nutritional status?

Answer 17

-monitor input and output: all fluid intake, all fluid coming out
-input: add up all oz and multiply by 30 to get mL then add cc’s
-daily weights: take pt weight same time everyday, with same type of clothing
- education: teach pt how to read food labels correctly and the importance of nutrition
-safety: handwashing, storing foods at proper temps, food allergies, food and medication interactions

Question 18

what is the difference between enteral and parental nutrition?

Answer 18

• enteral: feeding through a tube, requires functioning GI tract
  -parental: used for patients w/out functioning GI tract

Question 19

why would we start enteral or parental nutrition?

Answer 19

if the patient is not meeting their nutritional intake orally

Question 20

how is enteral nutrition administered?

Answer 20

1. NG tube (used for short term)
2. gastrostomy (g-tube)
3. Jejunostomy (j-tube)

Question 21

how is parenteral nutrition administered?

Answer 21

1. TPN (most used)- bowels rest, highly concentrated, provided total nutrition, given through central venous access (ON TEST), up to 30% glucose
2. PPN- less concentrated, 10% glucose, may be on orals, given through peripheral access

Question 22

what are nursing interventions/ possible complications while administering enteral nutrition?

Answer 22

1. interventions: oral hygiene, insertion of site care, monitoring of I&Os, daily weights, patency (x-ray), pt position (must be at least in semi-fowler)
2. complications: cramping, diarrhea, nausea, dumping syndrome, infection of stoma

Question 23

what are nursing interventions/ possible complications while administering parenteral nutrition?

Answer 23

1. interventions: check glucose regularly, vital signs, ect (same as enteral)
2. complications:
   - metabolic (BP may drop b/c of immediate stop of high glucose levels, fluid overload, electrolyte imbalances)
   - infection (line can get infected, bad solution)
   - mechanical (dislodgment, bloodclot, obstruction by not flushing correctly)
   - refeeding syndrome (body not being able to keep up w/ increases in cellular intake, confusion/ seizures, irregular HR, acidosis)

Question 24

what is the best way to assess patency for a NG tube?

Answer 24

• chest x-ray (KNOW FOR TEST!!!!!!)