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Exam 4 > Nutrition > Flashcards

Nutrition Flashcards

1
Q

How is nutrition decscribed?

A

It is the science of optimal cellular metabolism and its impact on health and disease.

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2
Q

Can obese patients be malnourished?

A

Yes. Malnourished can also be eating too much of the wrong thing

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3
Q

What is involved in a physical assessment?

A

Nutritional screening, calorie count, heaight, weight, BMI, general assessment

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4
Q

What are the 4 diagnostic tests Used to get an overview of nutritional health?

A

CBC
Serum glucose
Serum albumin and total protein
Cholesterol levels

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5
Q

Albumin levels are important to have correct why?

A

Albumin (protein) aids in wound healing.

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6
Q

What is GI intubation?

A

The insertion of a flexible tube into the stomach or beyond the pullouts into the duodenum or the jejunum.

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7
Q

Where can the GI tube be inserted?

A

The mouth, the nose, or the abdominal wall.

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8
Q

GI intubation may be performed in order to:

A
  • decompress the stomach
  • lavage the stomach
  • diagnose GI disorders
  • Administer meds and food
  • compress a bleeding site:
  • aspirate gastric contents for analysis
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9
Q

What does the use of NG tube provide after surgery?

A

REST

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10
Q

What is NG suction usually set to and why?

A

Low intermittent suction. (You don’t want to suck too much or it will affect stomach lining, which might produce ulcers.

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11
Q

What is a lavage tube?

A

It is the tube that you use to pump the stomach (gastric pumping)

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12
Q

What are the two types of lavage tubing?

A

Levin and Gastric Sump

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13
Q

WHat is a levin lavage tube?

A

A single lumen tube made of plastic or rubber

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14
Q

What is a gastric sump tube?

A

A double lumen plastic tube that is radiopaque

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15
Q

What is gastric/intestinal decompression?

A

A process of removing fluid and gas from upper GI tract

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16
Q

List the 4 steps for inserting the NG tube?

A
  1. Determine length to be inserted
  2. Lubricate tip
  3. Place pt in Fowlers position with towel on chest
  4. Insert tube and ask pt to take small sips of water (help “swallow” the tube)
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17
Q

Why is it important to keep bath basin close when inserting a NG tube?

A

Vomiting from gag reflex

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18
Q

How should you confirm placement of NG tube?

A

By X-ray (per policy)

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19
Q

Other than by x-ray how can you ensure correct NG tube placement?

A
  • Measure tube
  • visual assessment of aspirate
  • pH aspirate - acidic
  • auscultation over stomach (left upper quadrant)while injecting air (whooshing sound = in the lungs)
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20
Q

When should you use a weighted enteric tube?

A

For nutrition, so that its pulled to the right area via gravity

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21
Q

Where are the different locations to put an enteric tube?

A

Duodenum, Jejunum, stomach, depending on what part is still working.

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22
Q

What side should you lay on to facilitate passage of GI intubation?

A

The right side

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23
Q

What is a gastrostomy?

A

Opening in stomach for purpose of administering foods, fluids, or meds for gastric decompression

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24
Q

What is PEG?

A

Percutaneous endoscopic gastrostomy.

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25
Q

How do you measure for an NG tube?

A

Measure from nose to earlobe, then earlobe to tip of the xiphoid process.

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26
Q

Is a PEG usually short term or long term?

A

Long term

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27
Q

What is a jejunostomy?

A

An enteric tube that bypasses the stomach and goes into the jejunum.

28
Q

How should you clean around the stoma?

A

With soap and water.

Assess for redness and drainage

29
Q

How long after a PEG tube gets pulled out is the nurse able to push it back into the stomach?

A

4-6 hours

30
Q

Where are enteral tubes going to be placed?

A

Somewhere in the gastro-intestinal tract

31
Q

Where are parenteral tubes going to be inserted?

A

Somewhere in the bodies circulation system. For is already broken down, is ready to be put into the blood stream and used immediately.

32
Q

Why do we do enteral feedings?

A

To meet nutritional requirements when oral intake in inadequate or not possible, and the GI tract is still functiong

33
Q

What are some of the advantages to enteral feedings?

A
  • Safe and cost-effective
  • preserve GI integrity
  • preserve as much normalcy of hepatic and intestinal metabolism
  • maintain fat metabolism and lipoprotein synthesis
  • maintain normal insulin and glucagon ratios
34
Q

During enteral feedings what can cause dumping syndrome?

A

High osmolality.

35
Q

What do tube feeding formulas include?

A

Chemical composition of nutrient source, caloric density, osmolality, residue, bacteriological safety, vitamins and minerals

36
Q

Where are the different types of tubes for enteral feeding?

A
  • Nasogastric or nasoenteral tubes

- Gastrostomy or jejunostomy tubes for long-term

37
Q

What are the different methods of enteral feeding?

A
  • intermittent bolus
  • intermittent gravity drip
  • continuous infusion
  • cyclic feeding (4 hrs on, 4 hrs off
38
Q

What do you HAVE to check for before you do a tube feeding?

A

Residue

39
Q

What should you be elevated at to avoid aspiration?

A

30-45 degrees

40
Q

Explain the what is important in the nursing care of pt with feeding tubes.

A
  • pt education and prep
  • tube insertion
  • confirming placement
  • clearing tube obstruction(coke)
  • monitoring pt
  • maintaining tube function
  • oral and nasal care
  • tube removal
41
Q

What is the #1 thing to assess on a pt that has enteral feedings?

A

Are they having bowel movements.

42
Q

What are the collaborative problems and potential complications of enteral feeding?

A
  • D/V/N
  • Gas, bloating, cramping
  • dumping syndrome
  • aspiration pneumonia
  • tube displacement, obstruction
  • nasopharyngeal irritation
  • yperglycemia (check blood sugar to ensure right formula for pt)
  • dehydration an azotemia
43
Q

What is azotemia?

A

Abnormally high levels of nitrogen-containing compounds.

44
Q

How often should you check tube placement?

A

Every 4-6 hours.

45
Q

How often should you check gastric residual volume?

A

Every 4 hours

46
Q

When should you administer water into tube?

A
  • before and after each med and feeding
  • before and after checking residual
  • every 4-6 hours
  • whenever tube feeding is discontinued or interrupted
47
Q

Is it ok to mix feedings with meds?

A

Absolutely not,

48
Q

How big of a syringe do you use when working with an enteral tube?

A

At least a 30 ml syringe, but usually a 60 ml

49
Q

What is parenteral nutrition?

A

A method to provide nutrients to body by an IV route

50
Q

What is the main reason for parenteral feedings?

A

To maintain muscle mass.

51
Q

What does the complex mixture for a parenteral feeding contain?

A
  • proteins, carbs, electrolytes, vitamins, trace minerals, sterile water
  • fates are piggybacked in
52
Q

What are the goals of parenteral nutrition?

A

Improve nutritional status and to attain positive nitrogen status

53
Q

Where can parenteral nutrition be delivered?

A

Peripherally or via a central line

54
Q

What determines the parenteral nutrition location?

A

Solution’s tonicity

55
Q

When you do a lipid IV which port do you use?

A

The port distal to insertion site.

56
Q

WHat are the indication for parenteral nutrition?

A
  • intake is insufficient to maintain anabolic state
  • inability to eat orally or by tube
  • pt is not interested or unwilling to ingest adequate nutrients (anorexia)
  • if the underlying medical condition precludes oral or tube feeding
  • pre-op or post-op nutritional needs are prolonged
57
Q

What needs to be monitored in the care of pts with PN?

A
  • nutrition status, daily wights
  • hydration status, I&O
  • Electrolytes
  • S&S of hypoglycemia or hyperglycemia
  • blood glucose
58
Q

You can assess for potential complications of PN by monitoring what?

A

VS, including temp every 4 hrs or by protocol, WBC, central line entry point

59
Q

What are the delivery options for Parenteral therapy?

A 
Peripheral method (PPN only)
Central method (CPN)
60
Q

What are the 4 different types Central method of PN?

A
  • nontunneled cath
  • PICC
  • Tunneled central cath
  • implanted ports
61
Q

What are the collaborative problems and potential complications of PN?

A
  • Pneumothorax
  • Clotted of displaced cath
  • sepsis
  • hyperglycemia
  • rebound hypoglycemia
  • fluid overload
  • thrombosis, embolism
62
Q

What should you always do to avoid fluid overload with PN?

A

Calculate drip factor manually

63
Q

How can you prevent infection with PN?

A
  • appropriate cath and IV site care
  • strict sterile technique for dressing changes
  • wear a mask when changing dressing
  • assess insertion site
  • assess for indicators of infection
  • proper IV and tubing care
64
Q

How can you maintain fluid balance?

A
  • use infusion pump,(but still calculate manually and assess often)
  • Monitor indicators of fluid balance nd electrolyte levels
  • I&Os
  • Weights
  • Monitor blood glucose levels
65
Q

Who can decide to hold fluids and nutrition?

A

Pt.

Exam 4 (13 decks)

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