Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 120 > Nutrition > Flashcards

Nutrition Flashcards

1
Q

What is the percentage of malnourished patients upon admission?

A

35-50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Malnutrition affects:

A
  • illness
  • recovery
  • wound healing
  • infections are prolonged
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Important factor for the hospitalized patient:

A

-intake of nutritious food (can shorter hospitalized stays)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the percentage of obesity in the U.S?

A

30.5% with a BMI > or = 30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Impacts of obesity

A
  • obese pts stay an average of 1.5 days longer
  • wound healing is impaired (diminished tissue perfusion)
  • obesity carries a nearly 6-fold increase in MORTALITY rate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Challenges with obese pts

A
  • respiratory (sleep apnea)
  • challenging x-ray reading
  • entubating is difficult
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Basal Metabolism

A

Energy required to carry on the involuntary activities of the body at rest (maintaining body T *, muscle tone, secretions, inflating lungs…)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Factors for BMR increase

A
  • growth
  • infection
  • fever
  • emotional tension
  • elevated hormones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Factors for BMR decrease

A
  • aging
  • prolonged fasting
  • sleep
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

RDA

A

Recommended Dietary Allowance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Role of Vitamins

A

Needed for metabolism of carbohydrates, proteins and fats.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Water-soluble Vitamins

A

Vitamin C: collagen formation,enhances iron absorption
Vitamin B Complex: coenzyme helps glucose (B6, B12)
Riboflavin: carb, protein, fat metabolism
Niacin: carb, protein, fat metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Fat-soluble Vitamins

A

A, D, E, K!

A: visual acuity
D: calcium absorption
E: antioxidant
K: help clotting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

CARBOHYDRATES

A
  • sugar and starches
  • most abundant and least expensive
  • 90% of carb intake is ingested
  • turned into GLUCOSE to provide energy transported through blood
  • RDA intake 50-60 % of total cal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

PROTEINS

A
  • required for formation of all body structures
  • labeled “complete” or “incomplete” based on amino acid composition. Ex: animal proteins are complete, plants are incomplete. (Exceptions: soy and quinoa = complete proteins)
  • RDA intake 10-20% total cal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

KETOSIS

A

Is a metabolism of fats, it occurs when the liver is low in glycogen (stored glucose). In inappropriate intake of glucose, the body will utilize fats to provide energy.
As a result, ketones are often found in urine.
Often associated to acidosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

FATS (LIPIDS)

A
  • 95% of lipids in diet are triglycerides = VDLs
  • digested in small intestine
  • RDA should be < 30% cal intake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Excess Vitamin Consumption

A

Can result in kidney dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Importance of Folate vitamin in pregnant women?

A

Help proper neurological development in fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Factors affecting NUTRITION in adults:

A
  • decline BMR
  • decrease in calorie intake
  • lactating women: need increase in nutrients to support growth and maintain maternal homeostasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are Anthropometric measurements used for?

A

To determine body measurements (body protein and fat storage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Dysphagia =

A

Difficulty swallowing or inability to swallow –> will increase risk of aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Dysphagia can result from:

A
  • poor health
  • cancer
  • neurological disease
  • Parkinson’s
  • Dementia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Signs and Symptoms of poor nutritional status

A
  • Fatigue,
  • Overweight/underweight,
  • Dark circles under eyes,
  • Swollen lips
  • Beefy red tongue
  • Cavities
  • Enlargement of thyroid gland
  • Skin is dry, flaky, petechiae, bruises…
  • Poor posture
  • Wasted muscle
  • Swollen abdomen
  • CNS: loss of ankle and knee reflexes, mental confusion, depression,sensory loss, motor weakness
  • Cardio: tachycardia, abnormal BP, cardiac enlargement
  • GI: enlarged liver or spleen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Diet Orders

1) Clear liquids

A

Anything that is clear at room T *
Ex: jello, Popsicles, tea, ginger ale, bouillon, fruit juice (w/ no pulp)
NO milk or juices w/ pulp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Diet Orders

2)Full liquids

A

Things you can poor at room T *

Ex: milkshakes, soups, custards (NO jam, fruit, or solid foods)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Diet Orders

3) Soft diet

A

No fats, low in fiber, no salt or seasoning
Ex: all full liquids, cooked vegetables, canned fruit, banana, avocado, potatoes, rice, lean meats and fish, eggs, yogurt.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Diet Orders

4) Puréed

A

Thickness and viscosity based on pt’s tolerance
Ex: mashed potatoes, puréed vegetables, shakes (everything that can be blended)
–> good for stroke patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Diet Orders

5) Mechanical soft

A

Softer foods that can be cut up. Good for pts w/ chewing ability.
Ex: mashed, soft ripened fruit such as bananas, peaches, pears, cooked mashed soft veggies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Diet Orders

6) NPO

A

Nothing By Mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Lab Data

Hemoglobin:

A

12-18 g/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Lab data

Hematocrit:

A

40-50%

High levels = Dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Lab data

Albumin:

A

3.5-5.5 g/dL

Decreased level –> malnutrition (prolonged protein depletion), malabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Lab data

Prealbumin:

A

23-43 mg/dL

  • If levels fall below 15 mg/dL = severe malnourishment, unsafe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Lab data

Transferrin:

A

240-480 mg/dL

High level means low iron
Low level means elevated iron, protein deficiency

36
Q

Lab data

BUN:

A

10-20 mg/dL

37
Q

Lab data

Creatinine:

A

0.4-1.5 mg/dL
Increased–> dehydration
Decreased–> reduction in total muscle mass, severe malnutrition

38
Q

Low lab value of H & H can be a sign of?

A

Anemia = poor dietary intake

39
Q

What does the BUN measure?

A

The nitrogen balance = which is the balance between Catabolism and Anabolism

40
Q

What does a + or - BUN value indicates?

A

It indicates:

  • kidney function
  • dietary intake
  • nutritional status

Increased BUN –> starvation, high protein intake, severe dehydration
Decreased BUN –> malnutrition, overhydration

41
Q

Total Blood Cholesterol measurements:

A

200 mg/dL = normal
200-239 mg/dL = borderline high
> 240 mg/dL = high

42
Q

Desirable LDL level:

Bad cholesterol

A

< 100 mg/dL (newer target of < 70 can be considered in high risk patients)

43
Q

HDL level:

Good cholesterol

A

> 60 mg/dL

44
Q

Triglycerides level:

A

< 150 Normal range, low risk

44
Q

When can a diet be advanced?

A

When the patient reports no nausea experience and can consume at least 50% of tray

45
Q

IMPLEMENTING

A

Teach about nutritional info

  • tailor diet instructions
  • food safety issues
  • teach pt to cook at safe T *
  • nutrition management
  • nutrition therapy
  • nutrition monitoring
  • exercise promotion
  • weight management
46
Q

IMPLEMENTING –> special considerations to the older adult

A

Consider: loss of senses, GI reflux, slow intestinal peristalsis, lower glucose tolerance, physical handicaps, low income, drug/food interactions.

47
Q

Oral Feeding Safety:

A
  • Ensure gag reflex is functioning
  • Feed small amounts and ensure swallowing and tolerance
  • HOB elevated 45-90 * and 60 min following feeding
  • involve pt to maintain dignity
  • Encourage oral feeding as much as possible before opting for TPN
48
Q

When is enteral nutrition (feeding) recommended?

Short term

A
  • Cancer
  • Neuro or muscular disorders
  • GI disorders
  • Prolonged intubation
  • Inadequate oral intake
49
Q

What is “enteric”?

A

= stomach or small intestine (feeding)

50
Q

What is “parenteral”?

A

= through vascular system

51
Q

What are the 2 Enteral Nutrition options for short term (< 6 weeks)?

A

NG tube through nose into stomach

  • -> stomach regulates amounts released into small intestine
  • High risk of Aspiration!

NI tube into Small Intestine

  • -> minimal risk for aspiration
  • -> HIGH risk for Dumping Syndrome
52
Q

Signs and Symptoms of Dumping Syndrome?

A
  • Overdistention of abdomen
  • Nausea
  • Diarrhea
  • Cramping
  • Light headedness
53
Q

Why choose an NI tube versus NG tube?

A
  • No gag reflex

- Slow gastric motility

54
Q

What are the 2 Enteral Nutrition options for long term (> 6 weeks)?

A
  • Tube is inserted surgically through opening created into:
    1) Jejunum = JT jejunomy
    2) Stomach = GT gastronomy
  • If GI tract normal functioning –> PEG (percutaneous endoscopic gastronomy)
55
Q

When is long term enteral feeding appropriate?

A
  • Coma
  • Trauma to esophagus (Cancer)
  • ALS
  • Lost swallow ability (Dysphagia)
56
Q

Maintenance of NG equipment?

A

Open system, bag and tubing: Change Q 24 h
Closed system: Change Q 48 h
Feeding solution (food): 8 h MAX at room T * and 24 h after opening if refrigirated

57
Q

What is the purpose of Continual Feeding in stomach?

A

Promotes maximal absorption

  • Risk of reflux and aspiration
58
Q

What is the purpose of Continuous Feeding in the intestine?

A

Avoids triggering “Dumping Syndrome”

–> installed via gravity or feeding pump

59
Q

What is the purpose of Intermittent Feeding in stomach?

A

Preferred method to avoid reflux and aspiration

60
Q

What is the purpose of Cyclic Feeding?

A

Continuous feeding for a portion of the 24 h, usually for 12-16 h
–> Allows pt to attempt eating regular meals during the day

61
Q

Unexpected situations when inserting a NG tube?

A
  • Gag reflex (normal) –> pause and have pt put chin down and take sips of water
  • Nurse unable to pass tube –> inspect nostril and throat (tube could be coiled)
  • Signs of resp distress –> tube in lungs!
  • No gastric content can be aspirated –> move pt onto side, tube might be against gastric ruggae
  • Epistaxis
62
Q

How to confirm NG placement?

A
  • X rays –> most reliable
  • Visual assessment (markings on tube)
  • pH measurement of aspirate
  • Check exposed tube length
  • Comatose pts have to be xrayed for confirmation
63
Q

Patient Safety when on NG tube:

A
  • Check tube placement
  • Check residual –> should be interrupted if 10-20% above hourly rate
  • HOB at least 30 * during feeding and for 1 hour after to prevent reflux and aspiration
  • Prevent contamination
64
Q

Preventive interventions for potential complications with Enteral Feeding:

A
  • Clogged tube: flush tube with sterile water before and after feeding and medication, also every 4 h (can use warm water 30 mL)
  • Check nostrils every shift for signs of pressure
  • Clean and moisten nares Q 4-8 h
  • Start feeding at a slow rate
  • Check residual Q 4 h when on continuous feeding
  • Clean stoma every shift with warm soap and water
  • Assess for S x S of infection at stoma (consult w/ wound care specialist)
65
Q

What is “Refeeding Syndrome”?

A

An electrolyte and metabolic disorder that occurs when a nutritionally depleted pt is fed enterally and parenterally.

66
Q

What are the S x S of “Refeeding Syndrome”?

A
  • Muscle weakness
  • Low K + level
  • Administer K + and Phosphorous if needed
67
Q

What is TPN?

A

Total Parenteral Nutrition –> highly concentrated, hypertonic nutrient solution that

  • provides calories (carbs, proteins, fats), restores nitrogen balance,
  • replaces essential fluids, electrolytes, vitamins and minerals
68
Q

What is PPN?

A

Peripheral Parenteral Nutrition that is less concentrated than TPN for malfunctioning GI tract pts, solution is isotonic and is administered through a peripheral vein.

69
Q

How many kcal are in carbohydrates, proteins and fats per 1 gram?

A 
Carbs = 4kcal
Proteins = 4 kcal
Fats = 9 kcal
  • Fats will provide more energy than carbs and proteins with the same amount.
70
Q

What is the color of aspirate obtained from the following?

1) Stomach
2) Intestines
3) Respiratory tract

A

1) Stomach - grassy green, bloody or brown
2) Intestines - yellow, may be greenish brown if stained w/ bile
3) Respiratory tract - off white or clear

70
Q

Factors to assess proper nutrition:

A
  • usual dietary intake
  • food allergies or tolerance
  • type of dietary practices
  • eating disorder patterns
70
Q

Nutritional Screening: D-E-T-E-R-M-I-N-E

A

D-isease: illness, chronic condition
E-ating poorly: too little/too much
T-ooth loss/mouth pain: interfere with feeding
E-conomic hardship: spending less on food
R-educed social contact: being with people has a + effect on eating and well being
M-ultiple medicines: polypharmacy
I-nvoluntary weight loss: sign of serious health problems
N-eeds assistance in self-care
E-lderly years above 80: increase in health pbs

70
Q

Considerations with the older adult:

A
  • low serum of albumin and hemoglobin
  • vitamin and mineral use
  • OTC to assess food/drug interactions
70
Q

Factors affecting food habits:

A

Physical: geographic, location, income, food technology

Physiologic: health, hunger, stage of development

Psychosocial: culture, religion, education, social status

70
Q

Eating disorders such as anorexia and bulimia can result in?

A

Electrolyte imbalance

70
Q

Chemotherapy and Radiation risk?

A

Decrease in appetite (calories should be increased when ill)

70
Q

BMI

A

Body Mass Index

BMI = [weight in pounds/(height in inches) x (height in inches)] x 703
BMI = weight in kg/(height in m) x (height in m)

Know weight and height of pt for:

  • medication dosage
  • measure I & Os
  • baseline data
  • to calculate BMI
70
Q
  • BMI scale:
A

Normal = 18.5-24.9
Overweight = 25-29.9
Obese = 30-39.9
Extreme obesity = 40-54

70
Q

What does the waist circumference indicate?

A
  • risk of heart disease, diabetes and hypertension.
75
Q

What is the role of vitamin A in relation to wound healing?

A

Vitamin A is necessary for collagen synthesis and epithelialization.

76
Q

What is the role of vitamin B complex in relation to wound healing?

A

Vitamin B complex serves as a cofactor of enzyme reactions needed for wound healing.

77
Q

What is the role of vitamin C in relation to wound healing?

A

Vitamin C is needed for collagen synthesis, capillary formation and resistance to infection.

78
Q

What is the role of vitamin K in relation to wound healing?

A

Vitamin K is needed for the synthesis of prothrombin which helps in clotting.

79
Q

What are the S x S of aspiration?

A
  • Coughing
  • Cyanosis
  • Choking
  • Gurgling
80
Q

What is the right procedure when gastric contents leak?

A
  • Clean
  • Reinflate balloon
  • Call physician

NURS 120 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions