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534 > Nutrition > Flashcards

Nutrition Flashcards

1
Q

Hyperkalemia 6.0

A

Heart like potassium 3.5-4.0, if high, would have abnormal rythms

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2
Q

what can a nurse ask in a Nutritional Assessment?

A

find out what patients had for breakfast, lunch, dinner

food allergies and intoerances

eating patterns

food prep/ living location (food deserts)

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3
Q

Types of Enteral Nutrition (Feeding straight to stomach)

A

Nasogastric (NG) Tube: short term, less than 4 weeks. nose –>tomach

  • risk for aspiration to lungs
  • need to be able to have head of bed up during feeding

Nasointestinal (NI) tuve: nose –> small intestine
-avoids potential for gastric reflex, delayed gastric emptying, gastric tumors

Percutaneous endoscopic gastrostomy (PEG): long term

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4
Q

what are types of Parenteral Nutrition? (providing nutrition via IV)

A

TPN- total perental nutrition- highly concentration hypertonic solution. provides caloris, replaces essential fluids vitamins, electrolytes, minerals, trace elements

  • provides bowels a chance to heal
  • PICC (central catheter)
  • Subclavian vein

PPN- inserted in peripheral vein, less concentration.
short term

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5
Q

Signs of dehydration

A

headache
concentrated urine
constipation

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6
Q

Idea body weights

A

women- 100 lbs + 5lbs per inch
men- 106 lbs + 6 lbs per inch
*More muscle mass

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7
Q

BMR

A

how much energy it takes us at rest to function & sustain metabloic activities of cells and tissues
1cal/kg of body weight per hour - men
0.9cal/kg of body weight per hour- women

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8
Q

what factors increase BMR?

A 
growth
infections
fever
emotional tension
extreme environmental temperatures
elevated levels of certain hormones
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9
Q

What decreases BMR

A

aging– everything slows down
prolonged fasting– starvation mode, body knows doesnt have nutrients –> lowers energy requirements
sleep

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10
Q

what are the BMI ranges

*BMI is ratio of weight to height
weight/heightxheight * 703 = BMR

A 
underweight <18.5
healthy 18.5-24.9
overweight 25-29.9
obesity >30 
extreme obesity >40
-increased risk for heart disease, diabetes, hypertention
-athletes have larger muscle mass
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11
Q

3rd space

A

fluid goes to extremities for body to correct themselves

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12
Q

how does waist circumference indicate disease?

A

increased risk for type 2 diabetes
men >40
women >35

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13
Q

what is significant unintentional weight loss

A

> 2% in one week
5% in one month
6.5% in 3 months
10% in 6 months

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14
Q

simple sugars vs complex sugars

A

simple- white, processed. spiked blood pressure

complex- rich in fiber. veggies, beans, fruits. keep full longer.

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15
Q

how much carbs are needed to prevent ketosis?

A

50 to 100g

ketosis= not enough carbs, body breaks down fats instead. produces keytones metabolites

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16
Q

**roles of insulin and glucagon to keep blood glucose constant

A

glucagon: made by liver and give “bump” in sugar. ex at night or times when food is not available as resource
Insulin: released before eating, forces sugar into cells

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17
Q

low HDLs & high LDLs are at risk for what disease?

A

atherosclerosis

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18
Q

what is role of gallbladder?

A

emulsifies fat to increase surface area so pancreatic lipase can break down fat

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19
Q

What is role of fat in gastric emptying time?

A

delays emptying time
*keeps full for longer
carbs- raise blood sugar then crash.

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20
Q

who is most likely to have deficiencies of Vit A,C, folate, vit B6

A

-infants, adolescents, pregnant women, older adults
-smoke, abuse alcohol, long term medication use
chronically ill
-finicky eaters, chronic dieters, food faddists.

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21
Q

Which vitamins are fat-soluble?

A

A- can become toxic, visual acuity & immune functions (liver, carrots, egg yolk, fortified milk)

D- can be toxic, calcium and & phosphorus metabloism (sunlight, fish liver oils)

E- antioxidant, protects vit A, heme synthesis (vegetable oils, whole grains)

K- synthesis of proteins for blood clotting (dark, green leafy veggies)

22
Q

what water soluble vitamins is the body more at risk for deficiency?

A

C,

not stored in the body

23
Q

why do infants have more water accounting for more body weight? (normal 50-60%)

A

can become dehydrated quickly

24
Q

what are some important functions of water in the body

A
  • helps regulate body temperature (sweating = cooling)
  • acts as a solvent– dissolves to help with absorption, circulation, excretion
  • lubricates joints
  • 2/3 is intracellular
25
Q

how long is breast feeding recommended?

A

6-12 months

26
Q

what complications can come from bulimia

A

esophageal cancer.

27
Q

what nutrition needs to pregnant women express?

A

weight gain, heart burn
constipation
lactation –> higher caloric needs & fluid intake
second trimester need 340 extra calories/day
3rd trimester (450 extra calories/day)

28
Q

what nutritional changes happen in older adults

A

decrease BMR and phyical activity
loss lean body mass
energy expendature decrease
dec. peristalis = constipation

29
Q

how does alcohol abuse affect nutition?

A

B vitamins metabolize alcohol– used up

liver damage- afects nutrient absorption

30
Q

what can contriubte to poor nutirional status?

A

medication change GI tract

knowledge of

31
Q

What is normal Hemoglobin? what can it tell about nutrition?

A 
12-18
men- 13.5-17.5 g/Dl
women- 12.0-15.5 g/D
low=low O2
high=dehyrdation
32
Q

Albumin levels normal & nutrition changes

A

good indicator of patients nutritional status, can tell a few weeks prior to test
normal 3.5-5.5 g/dL
overhydration- low level
dehydration- high albumin
decreased–>protein depletion, malnutrition, malabsorption

33
Q

what is normal Hematocrit ? what can it say about nutrition

A 
40-50%
men: 38.8-50%
Women: 34.9-44.5%
decreased --> anemia
increased --> dehydration, lung disease, CHF
% of blood that is RBC
34
Q

What is shot term nutritional support?

A

less than 4 weeks. NG tube/nasointestinal

  • feed at at least 45 degree angle
  • make sure in stomach – no aspirations
35
Q

what is gold standard for making sure NG tube in right place and other ways to monitor?

A

1st: Xray-
then check pH (>6.0)of aspirate
-mark tube/measure tube length frequently
CO2 monitoring

36
Q

TPN vs PPN

A

TPN: higher concentration, can get away with more glucose (also increases sepsis/infection)
Phelbitis- inflammation of vein

PPN: lesser concentration

37
Q

What to moitor for administration of parenteral nutrition

A

Vital signs Q4 hours
monitor for sepsis–
blood glucose Q6– signs of infection
in line filter–

38
Q

how do BUN display nutiritional status?

A

BUN- reflects protein intake and body ability to detoxify and excrete metabolic byproduct.
normal 17-18 mg/dL
increased –> starvation, high protein intake, severe dehydration
decreased –> malnutrition, over hydration

39
Q

How does creatinine affect nutritional status?

A

normal 0.4-1.5 mg/dL
directly proportional to muscle mass;
decreased –> severe malnutrition
increased –> dehydration

40
Q

pt wants to lose 2 lbs per week. how many calories would need to delete per day?

A

1 lb of fat = 3,500 calories

to lose 2 lbs per week- adjust cals by 1,000 cal per day

41
Q

What interventions help feeding a pt with dementia?

A

stroke under pt chin to promote swallowing
serve meals at sme place, same time
provide 1 food item at a time
provide between meal snacks

42
Q

How to stimulate appetite of a pt with COPD refusing to eat?

A

allow food from home
schedule rep therapy after meals
give pain meds before meals

43
Q

what intervention would a nurse use with a patient experiencing dysphagia?

A

provide 30 min rest time prior to mealtime to promote swallowing
alternate solid and liquids while feeding
sit upright or elevate head of bed to 90 degree angle
get nutrition consult

44
Q

What type of patients would be best candidates for TPN?

A
  • irritable bowl syndrome
  • intractable diarrhea
  • celiac disease not absorbing from GI tract
  • a patient with burns who has not been able to eat adequately for 5 days
  • oral inadequate over 7 to 14 day period
45
Q

which type of feeding is best for comatose patients?

A

gastrostomy b/c gastroesophageal sphincter remains intact, regurgitation and aspiration less likely than NG tubes

46
Q

Feeding a pt that states is nasueated, what are steps for nurse to take?

A
  1. remove tray from room
  2. offer small amounts of food, cracker/ginger ale
  3. administer prescribed antiemetic
47
Q

what is a priority concern r/t nutrtition of alcoholic?

A

Vitamin B malnutrition

metabolize alcohol.

48
Q

How to care for new NG tube:

A

dip cotton-tipped applicator in sterile saline to cleanse area–> remove crust or drainage
leave open to air
once healed: clean soap and water, rotate 90 degrees once per day

49
Q

what should nurse do if notices tube is clogged before tube feeding?

A

try to use warm water and gentle pressure to remove the log

–> if doesnt work, replace with new tube

50
Q

why would you want to postpone surgery if a pt was taking vitamin E, apririn, or an herbal?

A

anticoagulant properties may increase risk for excessive bleeding.

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