Nutrition Flashcards
What is a source of energy and promotes fat metabolism, spare protein, and enhance lower GI function
Carbohydrates
What are major food sources of carbs
- Milk
- Grains
- Fruits
- Veggies
Provide concentrated source and a stored form of energy, they protect internal organs and maintain body temperature
Fats
What helps build and repair tissues
Protein
What Pts are on clear liquid diets and what does it provide for the body ? and what are the feeding intervals ?
- Postop Pt, Acute vomiting or diarrhea,
- Provides fluid and electrolytes to prevent dehydration
- Acute illness
- Infections
Between 1-2 Hour feeding intervals
Used for bowel prep for surgery or tests and post op also clients with fever, vomiting, or diarrhea, used in gastritis
Clear liquids
Which liquids are not allowed in a clear liquid diet ?
- Fruit juices with pulp
- Milk
( Must be transparent to light)
What types of liquid/food are considered appropriate for a clear liquid diet ?
- Water
- Bouillon
- Clear broth
- Carbonated beverages
- Gelatin
- Hard candy
- Lemonade
- Ice pops
- Regular or Decaf coffee
- Tea
- Popsicle
- Ginger ale
Are dairy products and fruit juices with pulp considered clear liquids ?
No
May a client have sugar and salt ?
Yes
What is a full liquid diet ? What is it used for ?
- A transition diet after clear liquids post Op
- Clients who is having difficulty chewing, swallowing, or tolerating solid foods, GI upset, Acute gastritis, infections, febrile disorders
What does a full liquid diet include? think what types of liquid and how often do you give feedings ?
- All clear liquids
- Ice cream
- Milk
- Sherbet
- Breakfast drinks
- Milkshakes
- Custard
- Soups that are strained
- Refined cooked cereals
- Fruit juices
- Strained juice (Fruit and veggie)
All clear liquids also - Cereal gruels ( like oatmeal)
Feedings are done in intervals 2-4 hours
What is a full liquid diet deficient in ?
- In calories (energy) and many nutrients
What is important to provide to a Pt. on a clear liquid diet ? Think what food is used to repair damaged tissues
High protein
What is a mechanical diet and what Pt. would be put on this diet ?
Mechanical diet is for Pts who have a difficulty in chewing foods are mechanically altered. But these Pts can tolerate foods with more texture than being on a liquid diet.
What kind of Pts are usually put on mechanical diets?
- Pt with dental problems
- Pt who has had surgery of the head or neck or have dysphagia
What may the client be evaluated for if they still have difficulty chewing ?
- Swallowing evaluation
- May require thick liquids
What kind of texture is mechanical food ?
- Pureed
- Mashed
- Ground
- Chopped
What foods are to be avoided if a Pt is on a mechanical diet ? * Think foods that make your throat feel dry or are hard in texture*
- Nuts
- Raw fruits
- Vegetables
- Fried foods
- Chocolate candy
- Tough, smoked, or salted meats
- Foods coarse in texture
What Pts would be put on a soft diet ?
- Pts who have difficulty in swallowing
- Ulcerations of the gums and mouth
- Broken jaws
- Dysphagia
- Oral surgery
- Plastic surgery of the head or neck
- Stroke
What kind of foods should be given to a Pt if they have mouth sores Think what kind of temperature
foods that are cooler in temp
What can be consumed to increase salivary flow ?
Suck on hard candy
What foods should Pts avoid while on a mechanical diet ?
- All food seasoning
- Nuts
- Raw fruits/ veggies
Low-residue, low fiber, What Pt’s are put on this diet ? think GI
- Used for inflammatory bowel disease
- Partial obstructions
- When GI motility is lowed
- Diarrhea
- Gastroenteritis
- GI disorders
- Lower bowel surgery
What are foods that consist of low in residue think of foods that are not suppose to be eaten when on a diet (carbs and starchy foods)
- White bread
- Refined cooked cereals
- Potatoes without skin
- White rice
- Refined pasta
- White processed food
- Roast lamb
- Buttered rice
What foods should be avoided when on a low residue diet ? `
- Raw fruits (except bananas)
- Veggies
- Nuts
- Seeds
- Plant fiber
- Whole grains
- Diary products to be limited to 2 servings a day
- Whole wheat
- Corn
- Bran
High residue, High fiber, High Roughage diet, What Pts are put on this diet ?
Think GI difficulties diseases
- Used for constipation
- Irritable bowel syndrome
- Alternating constipation and diarrhea
- Diverticular disease
What does a high residue, high fiber diet provide for the Pt?
- 20- 35 g of dietary fiber daily
- Speeds the movement of bowels
What kind of foods does a high residue high fiber diet have ? What foods are not allowed ?
-Fruits
- Vegetable
- Whole grain products
- Cracked wheat bread
- Brussel sprouts
- Apple
Foods not allowed:
- White bread
- Pies
- Cakes from white flour “white”
- Processed food
Increase fiber gradually and provide fluids to reduce side effects such as ?
- Abd cramping
- Bloating
- Diarrhea
- Dehydration
- Gas- forming foods should be limited
What are water soluble vitamins ?
- Folic Acid
- Niacin
- Vit B1 (Thiamine)
- Vit B2 (Riboflavin)
- Vit B6 (Pyridoxine)
- Vit B12 (Cobalamin)
- Vit C (Ascorbic acid)
B1
Thiamine
Functions and where are its primary sources ?
- For normal growth
- Carbohydrate metabolism
Primary sources:
- Legumes
- Meat (pork)
- Enriched grains
- Eggs
- Fish
- Cereals
B2
Riboflavin
Functions and where are its primary sources ?
- Used for energy
- Converts carbohydrates into glucose
- Energy metabolism
Primary Sources:
- Milk
- Milk products
- Lean meats
- Fish
- Legumes
- Liver
- Heart
Niacin (Niaspan)
Functions and where are its primary sources ?
- Lower Cholesterol level
Primary sources:
- Meats
- Poultry
- Fish
- Beans
- Peanuts
- Grains
B6
Pyridoxine
Functions and where are its primary sources ?
- Amino acid metabolism
Primary sources:
- Wheat
- Corn
- Meat
- Liver
- Kidney
- Egg yolk
- Yeast
- Spy beans
- Peanuts
Folic Acid (Folacin) Functions and where are its primary sources ?
RBC formation
Primary sources:
- Meat
- Beef
- Liver
- Fish
- Green leafy vegetables
- Legumes
- Grapefruit
- Oranges
Vit B12
Cyanocobalamin
Functions are where are its primary sources ?
- Nerve or neurological function
- RBC formation
Primary resources : - Meat - Liver (only found in animal meat) - Poultry - Eggs - Sea Veggies
What foods have Vit C (ascorbic acid)
- Citrus fruits
- Tomatoes
- Broccoli
- Cabbage
What are fat are fat soluble Vitamins ?
- Vit A
- Vit D
- Vit E
- Vit K
Vit A
Retinol
What are its functions ? and what are the primary foods sources it could be found in ?
- Antioxidant
- Visual acuity
- Adaptation to light and dark
- Normal bone growth
- Tooth development
- Spermatogenesis
- Thyroxine formation
Primary sources :
- Beta carotene
- Carrots
- Yellow fruits
- Veggies
- Butter
- Cheese
- Squash
- Broccoli
- Milk
- Egg yolk
- Liver
- Fish oils
- Kidneys
Vit D think bones
Ergocalciferol Cholecalciferol
What are its functions and what foods can it be found in ?
- Calcification of bones
- Absorption of Ca+
- Phosphorus
- Decreased renal excretion of phos
Primary sources:
- Direct sunlight
- Cod liver and fish oils
- Fortified milk/dairy products
- Tuna
- Mackerel
- Salmon
- Sardine
- Herring
Vit E
Tocopherol
What are its functions and what primary sources can you find them in ?
- Antioxidant
- Production of RBCs
- Muscle and liver integrity
Primary sources:
- Vegetable
- Vegetable oil
- Wheat germ oil
- Legumes
- Nuts
- Fish
- Milk
- Egg yolk
- Muscle meats
- Broccoli
- Spinach
Calcium
Primary function/Primary sources/If deficient in Calcium what are the symptoms ?
Function:
- Bone formation
- Muscle contraction
Primary sources:
- Milk/Milk products (Cheese, soy milk)
- Green leafy vegetables
- Rhubarb (type of plant)
- Sardines
- Tofu
- Yogurt
If Deficient:
- Rickets (Childhood bone disorder, bones become soft and is prone to fracture)
- Porous bones (Bones become brittle)
- Tetany (involuntary contraction of muscles)
Phosphorus
Primary function/Primary sources/If deficient what are symptoms
Function:
- Bone formation
Primary Sources:
- Dairy products (Milk)
- Eggs
- Nuts
- Meat (pork, beef, chicken)
- Whole- grain breads and cereals
Deficiency/Symptoms:
- Rickets
Fluoride
Primary function/Primary sources/If deficient what are symptoms
Functions:
- For dental health
Primary Sources:
- Water supply
Deficiency/Symptoms:
- Dental caries
Iodine
Primary function/Primary sources/If deficient what are the symptoms Think thyroid disease size of a gulf ball
Function:
- Thyroid hormone synthesis
Primary Sources
- Seafood
- Iodized salt
Deficiency/Symptoms:
- Goiter
Sodium
Primary function/Primary sources/If deficient what are the symptoms ?
Primary Function:
- Osmotic pressure
- Acid- Base balance
Primary sources:
- Table salt
- Vegetables
- Milk
- Meat
- Deficiency/Symptoms:
- Fluid and electrolyte imbalance
What diseases are included in a cardiac diet ?
- Atherosclerosis
- Diabetes Mellitus
- Hyperlipidemia
- Hypertension
- Myocardial infarction
- Nephrotic syndrome
- Kidney Failure
What is restricted when on a cardiac diet ?
total amounts of fat such as
- Saturated
- Trans
- Polyunsaturated
- Monounsaturated
- Cholesterol
- Sodium
Fat- restricted diet, What does it help to reduce ? What disorders would need to be on this diet ?
- Pain in Abd
- Steatorrhea ( fatty stools)
- Flatulence
- Diarrhea
- Malabsorption disorders such as
- Pancreatitis
- Cystic Fibrosis
- Gallbladder
- Gastroesophageal Reflux
High Calorie High protein diet What Pts are put on this diet ?
- Severe stress
- Burns
- Cancer
- HIV
- AIDS
- COPD
- Respiratory failure
- Any debilitating disease
Nursing considerations for High calorie, High protein diet
- Encourage high nutrient dense high calorie high protein foods such as :
- Whole milk
- Milk products
- Peanut butter
- Nuts
- Seeds
- Beef
- Chicken
- Fish
- Pork
- Eggs
Carb-consistent diet What Pts are on this diet ?
- Diabetes Mellitus
- Hypoglycemia
- Hyperglycemia
- Obesity
Sodium-restricted diet What Pts are on this diet ?
- Hypertension
- HF
- Kidney disease
- Liver disease (cirrhosis)
How many g of salt can a Na restricted Pt have ? added salt ?
4 g and no added salt
How many g of salt can a Pt on a sodium restricted diet have ? Added salt ?
Fresh, No processed foods such as soup
What Pts are on a protein restricted diet ?
- Kidney disease
- Liver disease
Renal diet Who is on it ?
- Acute kidney disease
- Chronic kidney disease
- Clients who need hemodialysis or peritoneal dialysis (kidneys)
What needs to be controlled when on a Renal diet ?
- Protein
- Sodium
- Phosphorus
- Potassium
- Calcium
- Fluids
- Modification in amount of fiber may be prescribed such a fiber, cholesterol, fat based on individual requirements
Who is on a low potassium diet ?
- For hyperkalemia
- Impaired renal function
- Hypoaldosteronism
- Addison’s
- Angiotensin- converting enzyme inhibitor medications
- Potassium retaining Diuretics
- Immunosuppressive medications
- Chronic HyperK
Who is on a High potassium diet ?
- Hypokalemia
- Renal tubule acidosis
- GI losses (vomiting, diarrhea)
- Potassium wasting diuretics
- Antibiotics
- Mineralocorticoid
- Glucocorticoid excess caused by secondary aldosteronism
- Cushing’s syndrome
Who is on a low purine diet ?
- Gout
- Kidney stones
- Elevated uric acid levels
What foods must you restrict that contain purines ?
- Anchovies
- Herring
- Mackerel
- Sardines
- Scallops
- Glandular meats
- Gravies
- Meat extracts
What food are high in iron ?
- Organ meats
- Egg yolks
- Whole Wheat products
- Dark leafy green veggies
- Dried fruit
- Legumes
What relieves thirst ?
- Chewing gum
- Sucking on hard candy
- Freeze fluids
- Add lemon juice to water
- Gargle with refrigerated mouthwash
Enteral Nutrition, which Pts need this ? what is used to administer it ?
- Provides liquid foods to GI tract via a tube
- Used when GI tract is functional but oral intake is not
What Pts are Enteral Nutrition ? Think of complications
- Swallowing problems
- Burns
- Major Trauma
- Liver
- Organ failure
- Severe Malnutrition
Nursing considerations for Pts on enteral nutrition *Pts complications related to what kind of formula is being given? What can or can not be given to certain Pts? *
- Lactose intolerance Pts ( this causes diarrhea, bloating, cramping)
- They need to be places on lactose- free formulas
Parenteral Nutrition or total parenteral nutrition , which Pts need this ?
- Pts with severe dysfunctional or nonfunctioning GI tracts
- Unable to process nutrients
- Pt does not take enough food by mouth to meet their nutrient needs
- Multiple GI surgeries
- GI trauma
- Intolerance to Enteral feedings
- Intestinal obstructions
- Needing to rest the bowel for healing
- Pts on Chemo
- Cancer
- AIDS
- Burn injuries
How can parenteral nutrition be administered ?
- Central vein when larger amounts of carbohydrates are needed
- Subclavian or internal jugular vein is used when PN is used short- term ( <4 weeks)
If Pt needs PN > 4 weeks more permanent cath is used via peripherally inserted central line (PICC)
Can a PN be administered through a peripheral vein (arm) ?
Yes, through a intravenous catheter or a midline catheter that is placed on upper arm vein (brachial or cephalic)
Delivery of hypertonic solutions into a peripheral vein can cause what ?
- Sclerosis
- Phlebitis
- Swelling
Air embolism when receiving parenteral nutrition ? possible cause and signs/symptoms ?
- Cath system is open
- IV disconnected
- Air entering on IV tubing changes
S/SX:
Apprehension
Chest pain
Dyspnea
Hypotension
Loud churning sound over pericardium
Rapid weak pulse
Respiratory distress
How to arrange food for visually impaired Pt.
- Placement of various food on plate goes on counter clock wise order
- Ask what Pt prefers to eat first (gives Pt. sense of control)
What do you offer to visually impaired Pt if they have a difficulty in swallowing ?
- Offer liquids carefully with spoon or feeding syringe (this helps prevent aspiration)
- Pureed or soft food (custard, gelatin) may be easier to swallow than liquid
Visually impaired Pt without difficulty in swallowing what can you offer to them ?
Straw to reduce spills
What is important to do during feeding ?
- Pause whenever Pt wants to rest
What is the purpose of a sodium restricted diet ?
- Lower body water
- Promote excretion
What are meal samples for a sodium restricted diet ? What foods are not allowed in this diet ?
- Cold baked chicken
- lettuce
- Sliced tomatoes
- Apple sauce
Foods not allowed : - Cheese
- Fried foods
- Milk products
- Canned foods
- Added salts
What is an example of a renal diet meal ?
- Unsalted veggies
- White rice
- Canned fruits
- Sweets
What is the purpose of a renal diet ? *What are you levels are you trying to keep low ?
- Protein
- Potassium
- Sodium
What foods are not allowed in a renal diet ?
- Bran
- Cereals
- Citrus fruits
Low phenylalanine diet, Who is on this diet ?
PKU
Sample meals for PKU ?
- Low PKU milk
- Jams
- Fats
- Fruits
What is the purpose of a low PKU diet ?
- Low protein diet to prevent brain damage from imbalance of amino acids
What foods are not allowed for a low PKU diet ?
- Meat
- Eggs
- Beans
- Bread
Vit K
What are its functions and what are primary sources ?
- Catalyst (increasing rate of reaction) for production of prothrombin and blood clotting
- Clotting factors VII, IX, X by the liver
Primary sources:
- Spinach
- Cabbage
- Broccoli
- Pork
- Liver
- Egg yolk
- Cheese synthesized by intestinal bacteria
Clinical manifestations (or if deficient in Vit A)
- Night blindness
- Skin Infection
- Xeropthalmia (Abnormal dryness of the conjunctiva and cornea of the eye)
- Corneal ulceration
- Impaired bone formation
- Defective tooth enamel
- CNS Changes (lethargy, headache)
- GI (Portal Hypertension), Veins coming from the stomach, spleen, and pancreas
- Jaundice
- Excess pigmentation: color returns in 2-6 weeks
Clinical manifestation in Vit D
- Ricketts (soft bone, poor bone growth, deformity of bones, bow legged)
- Delayed closing of fontanels
- Delayed calcification of teeth
- Hypercalcemia
- Renal Calculi
- Osteoporosis of the long bones
- Rickets, Decrease in phosphorus
- Osteomalacia, decrease phosphorus in adults
Clinical manifestations of Vit E
- Protection of Vit A (think because of skin)
- Breakdown of RBC (hemolytic anemia)
- Less toxic than other fat soluble vitamins
Clinical manifestations of Vit K
- Bleeding
- Bruises
- Anemia
- Liver/Renal damage
- intestinal bacteria
for Vit B1 Thiamine
- Beriberi ( effects many systems of the body such as the heart, nerves, and digestive symptoms such as shortness of breath, swelling of legs, numbess)
- Wernicke- Korsakoff syndrome (Brain disorder)
- Shock
B2 Riboflavin clinical manifestations
- AriBOFLAVINOSIS (deficient in B2)
- Tissue inflammation
- Pruritus
- Parasthesias
Niacin clinical manifestations
*Think 4 Ds that have to do with Skin, Bowels, When elderly forget everything completely and if excess of these symptoms will do without any treatment)
- Pellagra (causes dermatitis, diarrhea, dementia, and death)
- Vasodilation
- Flushing
Pyridoxine (B6) clinical manifestations think low blood and how you feel when you are low blood
- Anemia
- CNS changes (seizures)
- Peripheral neuropathy
- Peripheral nervous toxicity
- Numbness (related to both above)
Folic acid (Folacin) clinical manifestations think low blood
- Anemia
- Rare but cause insomnia and irritability
Cyanocobalamin B12 clinical manifestations Think brain development what is it when deficient in B12 and low blood deficit specifically related to B12 deficiency
- Pernicious Anemia
- Delayed brain growth
- Excess is rare
Potassium
Primary function/Primary Sources
Deficiency symptoms
Think about heart rhythm
Primary Function:
- Osmotic pressure
- Acid - Base balance
Primary Sources:
- Table salt
- Vegetables
- Meat
- Milk
Deficiency/Symptoms:
- Arrhythmias
- Fluid and electrolyte imbalance
Iron
Primary function/Primary sources/Deficiency symptoms
Primary Functions:
- Hemoglobin synthesis
Primary Sources:
- Liver
- Oysters
- Leafy greens
- Apricots
Deficiency/Symptoms:
- Anemia
- Lethargy
What are conditions that require enteral feedings ? What are the causes for each ?
Condition(s):
- Pre-op need for nutritional support
Cause(s):
- Inadequate intake Pre-op results in poor nutritional state
Enteral feedings with GI problems what are the causes ? why are they on feedings
- Fistulas (Abnormal connections between two parts of the body ex: Bowel and vagina)
- Small Bowel syndrome (Parts of small intestine removed and without it you are not getting enough nutrients and water from food you eat can cause diarrhea)
- Chron’s (Inflammation, Abd pain, diarrhea)
- Malabsorption
Enteral feedings for oncology therapy Pts. What is the cause ? Why do they need these feedings ?
- Radiation
- Chemotherapy
Enteral feedings for Alcoholism, chronic depression, and eating disorders. What is the cause ? Why do they need feedings ?
- Chronic illness
- Psych or neuro disorder
Enteral feedings for Head, neck, or surgery. What is the cause? Why do they need feedings ?
- Disease
- Trauma
Complication with enteral feedings in:
- Mechanical tube displacement
What should the nurse do ?
Replace the tube
Complication with enteral feedings in:
- Aspirations
What should the nurse do ?
- Elevate HOB
- Check residuals before feeding
Complications with enteral feedings in: - GI cramping - Vomiting - Diarrhea What should the nurse do for the Pt
- Decrease feeding rate
- Change formula
- Administer at room temp
Complications with enteral feedings in:
- Metabolic
- Hyperosmolar nonketotic coma, glucose intolerance
- Monitor glucose
- Serum osmolality
- Give insulin if needed
- Reduce infusion rate
What should the nurse do with a Pt who has sepsis on TPN ?
- Maintain closed IV line with filter
- NO MEDS or BLOOD DRAWN while on TPN line
- Dry sterile occlusive dressing applied to site
What should the nurse do if the Pt has a pneumothorax ( Abnormal collection of air in the pleural space between the lung and chest wall) due to line placement think x ray
TPN to be started ONLY after chest X-ray shows the correct placement
What should the nurse do if the Pt has Hyperosmolar coma and is on TPN ? Think Diabetes what are you checking for?
- Monitor blood glucose level
- Serum osmolality
- Monitor urine fractional for glucose and acetone
Soft Diet
What Pt’s are on this diet ?
- Between full and light or regular diet
- Acute illness and convalescence
- Acute infections
- Chewing difficulties
- GI disorders 3 meals with or without food inbetween meals
What kind of meals should Pts on a soft diet be on ? Think texture of food and another word for absorbing food
- Normal diet
- No roughage
- Liquids and semisolid food
- Easily digested
What are foods that are allowed in a soft diet ?
- All liquids
- Fine and strained cereals
- Cooked tender or pureed veggies
- cooked fruits without skin and seeds
- Ripe bananas
- Ground of minced meat, fish, poultry
- Eggs
- Mild cheeses
- Plain cake and puddings
- Moderately seasoned foods
What Pts are on a regular house diet ?
- Ambulatory
- Immobilized people not requiring therapeutic diets
What do you do before giving a TPN ?
- Solution
- Equipment
- Pt ALL READY
- Remove solution from fridge
- Wait at least 1hr before administration to avoid pain, hypothermia, venous spasm, venous constriction
- Check solution against doctor’s orders such as
- Correct Pt name
- Expiration date
- Formula components
- Observe container for cracks and cloudiness in solution, turbidity, or particles
How long should you wait before giving a TPN and what are you avoiding by waiting at least an hour before administration ?
- Must wait at least 1 hr before administering TPN
- 1 hr to avoid Pt reactions such as:
Venous spasm
Venous constriction
Hypothermia
Pain
When ready to administer what will you do ? think Pt teaching
- Explain procedure
- Check name on solution and wristband
- Wear gloves and mask per hospital policy
- Use strict aseptic technique
