Nutrition

Question 1

Clear Liquid Diet

Answer 1

Designed to not last longer than 3 days. Doesn’t provide enough calories to to meet patients nutritional requirements for healing.

Question 2

Clear Liquid Diet Uses & Components

Answer 2

Uses: To rest bowel and GI tract or to progress slowly from surgery.
Components: Clear juices, broth, popsicles, coffee (if caffeine is ok), water..anything clear. no orange juice or anything red

Question 3

Dietician

Answer 3

Assesses all patients w/in first 24-48 hours of admission. Recommends course of action if patient is NPO greater than 72 hours upon admin.

Question 4

Nutrition

Answer 4

Different pt population requires different modes of nutrition. most patients ordered regular diet- 3 meals a day

Question 5

The American Dietetic Association

Answer 5

Includes the Dietary Guidelines for Americans- dictate the necessary requirements for health promotion and disease preventive

Question 6

Dietary Guideline foods

Answer 6

low fat, low sugar, high fiber, low salt, alcohol in moderation, exercise daily, no smoking

Question 7

Full Liquid Diet

Answer 7

provides more calories, but no recommended for long term use as it is not sufficient in fiber.

Question 8

Full liquid Diet uses

Answer 8

To progress the gut after long periods of rest and to provide more calories as it includes milk, grits, oatmeal, pudding, cream soups
be careful with lactose patients, use lactose free protein drinks

Question 9

Modified Consistency Diet

Answer 9

Designed to help patients recovering from CVA’s (may have dysphagia). Regular foods are blended up to ease chewing and swallowing. Diet meets nutritional requirements

Question 10

Special Diets: Diabetic Diet

Answer 10

Dietician uses pts ideal body weight to determine the ideal calorie level for the patient. 1800 calorie diet w/snacks between meals to keep BS stable.

Question 11

Why are carbohydrate levels checked on the Diabetic Diet?

Answer 11

To ensure BS stays w/in normal limits. Pt’s blood glucose levels are usually checked ac and hs (before meals and bedtime)

Question 12

Special Diets: The Renal Diet

Answer 12

Patients with elevated BUN and Creatine will require a restriction in the nutrients that may cause the kidneys to work harder.

Question 13

What is the Renal Diet designed to do?

Answer 13

To reduce the workload on the kidneys

Question 14

What is the Renal Diet low in?

Answer 14

Typically low in protein, potassium, sodium, and fluid

Question 15

Why the Renal Diet?

Answer 15

protein metabolizes to amino acids and further broken down to urea and nitrogen. If the kidneys are unable to rid the blood of the toxic waste, blood levels will elevate and a modification of nutrients will be implemented to prevent damage to the kidneys

Question 16

Enteral Nutriton: Use it or lose it

Answer 16

guideline and the standard of care message. If a patient has a functioning guy (bowl sounds are present), it is recommended to use the GI system if warranted

Question 17

Tube Feedings (aka- enteral nutrition)

Answer 17

If a patient is unable to swallow due to brain injury, the dietician recommends a feeding by NG tube. If long term patient, PEG tube is used

Question 18

Why would a patient get a PEG tube instead of an NG tube?

Answer 18

NG tube- short term; PEG tube-long term. PEG tube patients usually arnt able to swallow because stroke, dysphagia, or any pt at risk for aspiration pneumonia would be a candidate for this type of feeding.

Question 19

Tolerance: Gastric Residuals

Answer 19

Any substance not digested after two hours of feeding.

Question 20

Gastric Residual Testing

Answer 20

place syringe in PEG site and pull back until gastric contents no longer fill syringe, if amount is less than 60ml (# changes per facility), may continue to feed patient. If # is too high, TF may be decreased or discontinued, until tolerance is achieved.

Question 21

Parenteral Nutrition (TPN, PPN)

Answer 21

Indicated when a patient doesnt have a functioning gut. q

Question 22

How is Parenteral Nutrition Administered?

Answer 22

Nutrients that have already been broken down (glucose, amino acids, and lipids) are administered. Infused at a determined rate through a central line to provide patients’ with nutrition who do not have a functioning GI tract

Question 23

Dubnoff Tube

Answer 23

Thinner and yellow color. Goes thru nose and into duodenum. for patients with stomach cancer or patients with ulcers

Question 24

Critical Care patient: Who determines what type of feeding is required?

Answer 24

Depending on the diagnosis of the patient, the family, doctors, patient, and dietician determine what type of feeding is required

Question 25

What will happen if a patient requiring long term feeding has a lack of ability to swallow?

Answer 25

Surgical placement of a feeding tube

Question 26

When is a TPN recommended?

Answer 26

Only when a patient has no gut function. TPN has been shown to cause hyperglycemia, insulin resistance, and pancreatic/liver problems

Question 27

When is it recommended to refer a patient to the dietician and why?

Answer 27

When you recognize a patient with untreated HTN or DM. Lifestyle and diet changes are the FIRSTLINE approach to care for these patients prior to RX treatment

Question 28

What is the first step to well being?

Answer 28

nutrition

Question 29

What does being overweight lead to?

Answer 29

HTN, hyperlipidemia, DM, renal failure, and cancer

Question 30

What is the standard to tx disease now to preventing illness and why

Answer 30

All, if not all disease today is related to nutrition. Preventing illness with adequate nutrition is considered the standard now instead of tx approach

Question 31

When would you use a nasogastric feeding tube?

Answer 31

patient unable to swallow; would us NG tube to decrease risk of infection for not using the gut. Another option is keeping the pt NPO during the acute phase of illness (short term)