Nutrition Flashcards
dysphagia
difficulty swallowing
aspiration
chocking, food going into the lungs
enteral nutrition
nutrition delivered in a liquid form through a tube
total parenteral nutrition (TPN)
a method of feeding that bypasses the GI tract (used for patients that dont have a GI)
malnutrtion
lack of proper nutrition
carbs
provides energy, regulates protein and fat metabolism, fiber is a card that eliminates bowel elimination (ex: grains, potatoes, pasta, beans)
protein
growth maintenance and repair of body tissues, aids in transportation of vitamins, supports immune system (ex: eggs, poultry)
fats/lipids
provides energy and vitamins, need for hormone reproduction, padding to vital organs, maintains body temperature (ex: salmon, olive oil)
what can happen if we have an excess amount of carbs, protein, fats/lipids, vitamins?
- too many carbs and fats can lead to obesity and/or diabetes
- too much protein can lead to damage of the kidneys, calcium loss, heart disease
- too much vitamins can lead to toxicity
what can happen if we dont have enough of carbs, proteins, fat/lipids, vitamins?
- lack of carbs and protein intake can lead to malnutrition
- disorders: anemia, anorexia, bulimia, binge eating
- lack of vitamin intake: B-complex, vitamin C for stress and illness, D for bone demineralization
what are the factors that can affect our nutritional status?
-age
-medication
-economical status
-income
-knowledge
-cultural/religion
-lifestyle
-illiteracy (not being able to read food labels)
what is included in a nutritional assessment?
- 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
what are the tools to determine nutritional status?
- weight, height, BMI
-BMI: weight (kg) divided by height (m) ^2
what lab value is the best indicator to determine nutritional status, and what is the correct range?
- albumin (3.5-5dl) (KNOW FOR TEST)
-PREalbumin (15-36) is normal anything less than 10 is considered malnutrition
What other lab values are important related to nutrition?
- I&Os should be comparable to each other
-kidney function (BUN), increased creatinine is DEHYDRATION
-cholesterol and triglyceride levels
what are the 10 therapeutic diets?
- NPO (nothing by mouth, order must be provided)
- liquid diet (no residue and liquid is room temp, full milk, icecream, juice)
- pureed (clear and full liquids plus pureed meats and scrambled eggs)
- mechanical soft (clear and full liquids plus dry or ground food)
- low residue (low fiber and easy to digest–to rest the bowel)
- high fiber (increased fiber for constipation)
- low sodium/cholesterol (mostly in cardiac units)
- diabetic (must consume x amount of calories a day)
- dysphagia (pureed foods with thickened liquids)
- regular (no restrictions)
how does a nurse monitor nutritional status?
-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
what is the difference between enteral and parental nutrition?
- enteral: feeding through a tube, requires functioning GI tract
-parental: used for patients w/out functioning GI tract
why would we start enteral or parental nutrition?
if the patient is not meeting their nutritional intake orally
how is enteral nutrition administered?
- NG tube (used for short term)
- gastrostomy (g-tube)
- Jejunostomy (j-tube)
how is parenteral nutrition administered?
- TPN (most used)- bowels rest, highly concentrated, provided total nutrition, given through central venous access (ON TEST), up to 30% glucose
- PPN- less concentrated, 10% glucose, may be on orals, given through peripheral access
what are nursing interventions/ possible complications while administering enteral nutrition?
- 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)
- complications: cramping, diarrhea, nausea, dumping syndrome, infection of stoma
what are nursing interventions/ possible complications while administering parenteral nutrition?
- interventions: check glucose regularly, vital signs, ect (same as enteral)
- 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)
what is the best way to assess patency for a NG tube?
- chest x-ray (KNOW FOR TEST!!!!!!)
