nutrition

Question 1

why is protein so important

Answer 1

helps w wound repair and increases skin integrity

Question 2

what do trans fats do in the body?

Answer 2

raise LDL and lower HDL

Question 3

foods on a clear liquid diet include…

Answer 3

water, coffee, tea, broth, apple juice, ginger ale

Question 4

foods on a full liquid diet include…

Answer 4

protein shakes, tomato soup, orange juice, milkshakes, ice cream

Question 5

foods on a mechanical soft diet include…

Answer 5

mashed potatoes, ground up chicken

Question 6

foods to eat on a low sodium diet

Answer 6

fresh fruit & vegetables, whole grains, lean meats like seafood & poultry

Question 7

low sodium diet indications

Answer 7

HTN, HF, kidney disease

Question 8

foods to avoid on a low cholesterol diet

Answer 8

processed meats, full-fat dairy, fatty cuts of meat, anything fried

Question 9

consistent carb diet indicated for…

Answer 9

type 1 and 2 diabetics

Question 10

examples of pureed solids

Answer 10

apple sauce, spaghetti sauce, soups

Question 11

examples of mechanical altered solids

Answer 11

chicken or tuna salad, moistened pancakes

Question 12

examples of altered solids

Answer 12

mashed potatoes, rice, casseroles

Question 13

examples of thin liquids

Answer 13

water

Question 14

examples of nectar-like liquids

Answer 14

milkshake

Question 15

examples of honey-like liquids

Answer 15

heavy syrup, yogurt

Question 16

examples of spoon-thick liquids

Answer 16

pudding, hot cereals, custard

Question 17

causes of dysphagia

Answer 17

cancer, poor dentition, neurological diseases like parkinson’s/strokes

Question 18

big s/s of dysphagia

Answer 18

coughing/choking while eating/drinking; pt states food/liquid is stuck in their throat; leaking out of their mouth; wet/gurgling voice

Question 18

big interventions for dysphasia

Answer 18

use appropriate viscosity; feed them in high-fowlers or in a chair, go slow, give small bites

Question 18

why are NG tubes only used short term?

Answer 18

big aspiration risk - can be pulled out easily; skin breakdown risk

Question 19

if you need enteral nutrition for longer than 4 weeks, you must…

Answer 19

get a gastrostomy, jejunostomy, or gastrojejunostomy

Question 20

nasoenteric tube indications

Answer 20

if pt is unable to empty stomach; has a mass in stomach that must be bypassed; etc.

Question 21

what kind of tube is best for confused patients & why?

Answer 21

jejunostomies or gastrojejunostomies- harder to pull out because they have a balloon

Question 22

which feeding ostomy has the highest aspiration risk?

Answer 22

g tube

Question 23

J tubes cannot be used for… why?

Answer 23

bolus feedings - too much volume

Question 24

in a GJ tube, where should medications be instilled vs feeding?

Answer 24

medications in G; feeding in J

Question 25

tube feedings must be discarded every… why?

Answer 25

24 hours - high carb and sugar content makes it more of a breeding ground for bacteria

Question 26

gastric residual should never be higher than…

Answer 26

hourly rate

Question 27

which delivery method is indicated for critically ill patients

Answer 27

continuous infusion

Question 28

which delivery method reduces the risk of aspiration? why?

Answer 28

continuous infusion - small amounts at a time

Question 29

large residual volumes increase the risk of…

Answer 29

aspiration

Question 30

cyclic feeding is most commonly used for

Answer 30

patients who are up, walking around and eating during the day but need the extra supplementation at night

Question 31

most often uses of intermittent tube feedings

Answer 31

noncritical patients, home tube feedings, pts in rehab

Question 32

intermittent tube feeds vs bolus

Answer 32

bolus is much shorter (5 minutes) than intermittent (30-60 min)

Question 33

every time you place a feeding tube, you need to…

Answer 33

confirm its in the right spot with an x-ray

Question 34

why do we mark the tube?

Answer 34

to know where it should be - if its off then the tube moved & could be in the lungs

Question 35

when fasting, how should gastric fluid appear?

Answer 35

clear, slightly green to colorless

Question 36

ph of the lungs

Answer 36

over 6

Question 37

2 ways to know if the tube is in the lungs

Answer 37

CO2 monitoring
pH testing

Question 38

what should you do if you need to reposition a patient on a feeding tube and pull them up in bed

Answer 38

pause the feeding

Question 39

how to prevent aspiration during enteral nutrition

Answer 39

keep HOB over 30 degrees during and for at least 1 hour after (especially for a bolus)

Question 40

diarrhea during enteral nutrition can be caused by…

Answer 40

they aren’t tolerating it well - not being absorbed properly

Question 41

when should you flush a feeding tube?

Answer 41

q4h; when starting or finishing a feeding; whenever you disconnect the tube in any way

Question 42

how to properly administer medications into a feeding tube

Answer 42

crush and administer medications one at a time

Question 43

what medications should never be crushed?

Answer 43

capsules & extended release

Question 44

what should you do if the tube becomes clogged?

Answer 44

flush with warm water; if that doesn’t work then remove & replace with a new tube

Question 45

what should you do if the tube moves in or out of the patient?

Answer 45

stop feeding immediately; go get an x-ray

Question 46

a patient will have less residual if the feeding tube ends in the…

Answer 46

jejunum

Question 47

how do we keep the gastrostomy site from getting infected?

Answer 47

avoid creams and powders around the stoma; clean stoma & peristomal skin q24h; assess for signs of infection q24h