nutrition Flashcards
botulism symptoms
mild discomfort to death in 24 hr; nausea, vomiting, dizziness, weakness progressing to motor (respiratory) paralysis
Escherichia coli symptoms
severe cramps, nausea, vomiting, (bloody) diarrhea, renal failure, 1-8 days after eating, lasts 1-7 days
Listeriosis symptoms
severe diarrhea, fever, headache, pneumonia, meningitis, endocarditis, 3-21 days after infection
Perfringens enteritis symptoms
mild diarrhea, vomiting, 8-24hr after meal, lasts 1-2 days
Salmonellosis symptoms
mild / severe diarrhea, cramps, vomiting, 72 hrs post meal, lasts 4-7 days
Shigellosis symptoms
cramps, diarrhea, fatal dysentry, 12-50 hrs post meal, lasts 3-14 days
Staphylococcus symptoms
severe abdominal cramps, pain, vomiting, diarrhea, perspiration, headache, fever, prostration, 1-6 hrs post meal, lasts 1-2 days
Botulism food source
improperly home canned foods, smoked and salted fish, ham, sausage, shellfish
E. coli food source
undercooked meat (ground beef)
Listerioriosis food sorce
soft cheese, meat (hod dog, pate, lunch meats), unpasteurized milk, poultry, seafood
Perfingens enteritis food source
cooked meats, meat dishes at room / warm temp
Salmonellosis food source
milk, custard, eggs, salad dressing, sandwich fillings, polluted shellfish
Shigellosis food source
milk, seafood, salads
Staphylococcus food source
custards, cream fillings, processed meat, ham, cheese, ice cream, potato salad, sauces, casserole
Botulism organism
Clostridium botulinum
Listeriosis organism
Listeria monocytogenes
Perfringens enteritis organism
Clostridium perfringens
Salmonellosis organism
Salmonella, S. typhi, S. partyphi
Shigellosis organism
Shigella dysenteriae
Staphyloccocus organism
Staphylococcus aureus
NPO
nothing by mouth - in acute care settings
patients at high risk of aspiration
decreased alertness, gag/ cough reflexes; difficulty managing saliva
dysphagia
difficulty swallowing; usu. obstructive or motor disorders of esphagus
large handled adaptive utensils recommended for
patients with impaired vision and motor skills
EN formula types
Polymeric, modular, elemental, specialty
Polymeric formula
1-2 kcal/mL, whole nutrient
Modular formula
3.8-4kcal/mL, single macronutrient, added to other foods
Elemental formula
1-3 kcal/mL, predigested nutrients
Specialty formula
1-2 kcal / mL, for specific illness- HIV, liver failure, pulmonary dis
EN benefits
Reduces sepsis, min. Hypermetabolic response to trauma, dec. hospital mortality, maintains intestinal fn and structure; 24-48 hrs post surgery
Most significant EN complication
Aspiration of formula into lungs
Aspiration of EN formula results in
Dec. blood to affected pulmonary tissue, necrotizing infection, pneumonia, abscesses, ARDS; high glucose = bacterial growth
Risk factors for EN aspiration
Cough, gerd,nasotreacheal suction, artificial airway, dec. consciousness, lying flat
To decrease risk of aspiration
Elevate head of bed 30-45 def, prokinetic meds, measure gastric residual vol every 4-6 hr (continuous) or prior (intermittent)
Prokinetic meds
Promote gastric emptying - metoclopramide, erythromycin, cisapride
Delayed gastric emptying
250 mL + in stomach on 2 assessments 1 hr apart or single 500 mL
Enteral tube feeding complications
Pulmonary aspiration, diarrhea, constipation, tube occlusion/ displacement, abdominal cramps, nausea/ vomiting, delayed gastric emptying, serum electrolyte imbalance, fluid overload, hyperosmolar dehydration
Pulmonary aspiration causes
Regurgitation of formula, feeding tube displaced, deficient gag reflex, delayed gastric emptying
ET complication- diarrhea causes
Hyperosmolar formula or meds, antibiotic tx, bacteria, malabsorption
EN complication- constipation
Lack of fiber or H2O, inactivity
Enteral tube occlusion causes
Pulverized meds given per tube, sedimentation of formula, meds react with formula
Enteral tube displacement causes
Vomiting, coughing, insecurely taped
EN complication- cramps, nausea, vomiting
High osmolality or fat of formula, rapid inc. in rate/ vol, lactose intolerance, intestinal obstruction, cold formula
Delayed gastric emptying causes
Diabetic gastroparesis, inactivity, illness
EN complication- Serum electrolyte imbalance causes
Excess GI losses, dehydration, disease- cirrhosis, renal insufficiency, heart failure, diabetes m
EN complication- fluid overload
Refeeding syndrome in malnutrition, excess free H2O or diluted/ hypotonic formula
EN complication- hyperosmolar dehydration
Hypertonic formula with insufficient free H2O
