nutrition Flashcards
why is protein so important
helps w wound repair and increases skin integrity
what do trans fats do in the body?
raise LDL and lower HDL
foods on a clear liquid diet include…
water, coffee, tea, broth, apple juice, ginger ale
foods on a full liquid diet include…
protein shakes, tomato soup, orange juice, milkshakes, ice cream
foods on a mechanical soft diet include…
mashed potatoes, ground up chicken
foods to eat on a low sodium diet
fresh fruit & vegetables, whole grains, lean meats like seafood & poultry
low sodium diet indications
HTN, HF, kidney disease
foods to avoid on a low cholesterol diet
processed meats, full-fat dairy, fatty cuts of meat, anything fried
consistent carb diet indicated for…
type 1 and 2 diabetics
examples of pureed solids
apple sauce, spaghetti sauce, soups
examples of mechanical altered solids
chicken or tuna salad, moistened pancakes
examples of altered solids
mashed potatoes, rice, casseroles
examples of thin liquids
water
examples of nectar-like liquids
milkshake
examples of honey-like liquids
heavy syrup, yogurt
examples of spoon-thick liquids
pudding, hot cereals, custard
causes of dysphagia
cancer, poor dentition, neurological diseases like parkinson’s/strokes
big s/s of dysphagia
coughing/choking while eating/drinking; pt states food/liquid is stuck in their throat; leaking out of their mouth; wet/gurgling voice
big interventions for dysphasia
use appropriate viscosity; feed them in high-fowlers or in a chair, go slow, give small bites
why are NG tubes only used short term?
big aspiration risk - can be pulled out easily; skin breakdown risk
if you need enteral nutrition for longer than 4 weeks, you must…
get a gastrostomy, jejunostomy, or gastrojejunostomy
nasoenteric tube indications
if pt is unable to empty stomach; has a mass in stomach that must be bypassed; etc.
what kind of tube is best for confused patients & why?
jejunostomies or gastrojejunostomies- harder to pull out because they have a balloon
which feeding ostomy has the highest aspiration risk?
g tube
J tubes cannot be used for… why?
bolus feedings - too much volume
in a GJ tube, where should medications be instilled vs feeding?
medications in G; feeding in J
tube feedings must be discarded every… why?
24 hours - high carb and sugar content makes it more of a breeding ground for bacteria
gastric residual should never be higher than…
hourly rate
which delivery method is indicated for critically ill patients
continuous infusion
which delivery method reduces the risk of aspiration? why?
continuous infusion - small amounts at a time
large residual volumes increase the risk of…
aspiration
cyclic feeding is most commonly used for
patients who are up, walking around and eating during the day but need the extra supplementation at night
most often uses of intermittent tube feedings
noncritical patients, home tube feedings, pts in rehab
intermittent tube feeds vs bolus
bolus is much shorter (5 minutes) than intermittent (30-60 min)
every time you place a feeding tube, you need to…
confirm its in the right spot with an x-ray
why do we mark the tube?
to know where it should be - if its off then the tube moved & could be in the lungs
when fasting, how should gastric fluid appear?
clear, slightly green to colorless
ph of the lungs
over 6
2 ways to know if the tube is in the lungs
CO2 monitoring
pH testing
what should you do if you need to reposition a patient on a feeding tube and pull them up in bed
pause the feeding
how to prevent aspiration during enteral nutrition
keep HOB over 30 degrees during and for at least 1 hour after (especially for a bolus)
diarrhea during enteral nutrition can be caused by…
they aren’t tolerating it well - not being absorbed properly
when should you flush a feeding tube?
q4h; when starting or finishing a feeding; whenever you disconnect the tube in any way
how to properly administer medications into a feeding tube
crush and administer medications one at a time
what medications should never be crushed?
capsules & extended release
what should you do if the tube becomes clogged?
flush with warm water; if that doesn’t work then remove & replace with a new tube
what should you do if the tube moves in or out of the patient?
stop feeding immediately; go get an x-ray
a patient will have less residual if the feeding tube ends in the…
jejunum
how do we keep the gastrostomy site from getting infected?
avoid creams and powders around the stoma; clean stoma & peristomal skin q24h; assess for signs of infection q24h
