Nutrition Flashcards by mallorie schoesler

Hyperkalemia 6.0

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

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what can a nurse ask in a Nutritional Assessment?

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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Types of Enteral Nutrition (Feeding straight to stomach)

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

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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Signs of dehydration

headache
concentrated urine
constipation

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Idea body weights

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

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BMR

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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what factors increase BMR?

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

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What decreases BMR

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

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what are the BMI ranges

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

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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3rd space

fluid goes to extremities for body to correct themselves

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how does waist circumference indicate disease?

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

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what is significant unintentional weight loss

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

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simple sugars vs complex sugars

simple- white, processed. spiked blood pressure

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

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how much carbs are needed to prevent ketosis?

50 to 100g

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

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

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

atherosclerosis

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what is role of gallbladder?

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

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What is role of fat in gastric emptying time?

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

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

-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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Which vitamins are fat-soluble?

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)

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

not stored in the body

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

can become dehydrated quickly

what are some important functions of water in the body

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

how long is breast feeding recommended?

6-12 months

what complications can come from bulimia

esophageal cancer.

what nutrition needs to pregnant women express?

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

what nutritional changes happen in older adults

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

how does alcohol abuse affect nutition?

B vitamins metabolize alcohol-- used up | liver damage- afects nutrient absorption

what can contriubte to poor nutirional status?

medication change GI tract | knowledge of

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

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

Albumin levels normal & nutrition changes

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

what is normal Hematocrit ? what can it say about nutrition

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

What is shot term nutritional support?

less than 4 weeks. NG tube/nasointestinal - feed at at least 45 degree angle - make sure in stomach -- no aspirations

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

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

TPN vs PPN

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

What to moitor for administration of parenteral nutrition

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

how do BUN display nutiritional status?

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

How does creatinine affect nutritional status?

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

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

1 lb of fat = 3,500 calories | to lose 2 lbs per week- adjust cals by 1,000 cal per day

What interventions help feeding a pt with dementia?

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

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

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

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

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

What type of patients would be best candidates for TPN?

- 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

which type of feeding is best for comatose patients?

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

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

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

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

Vitamin B malnutrition | metabolize alcohol.

How to care for new NG tube:

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

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

try to use warm water and gentle pressure to remove the log | --> if doesnt work, replace with new tube

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

anticoagulant properties may increase risk for excessive bleeding.