Nutrition

Question 1

feeding a blind pt

Answer 1

• plate is a clock and food are the numbers

- ask food preference (#1)

Question 2

BMI calculation

Answer 2

kg/(m^2)

Treas 963

Question 3

albumin

Answer 3

• used to detect nutritional problems (prealbumin = better indicator)
• made in liver + is 60% of body’s total protein
• low level = malnutrition, malabsorption, acute and chronic liver disease, repeated loss of protein via burns, wounds, etc
• CONTRAINDICATIONS: don’t test on pt w fluid imbalance (albumin levels are affected by FLUID status)

Treas 964

Question 4

care for NPO pt

Answer 4

• oral care (keep mouth moist)
• ice chips, hard candy, gum (incr saliva)
• tell fam not to eat or drink around pt
• NPO> 3 days = incr r/f malnutrition
• NPO bc of test or procedure? schedule them earlier in day to decr time pt is NPO (if possible) or if test is late in day, ask if pt can have early breakfast
• glucose and electrolytes received via IV lipid infusion

Treas 958, 968

Question 5

why some pts are told NPO preop?

Answer 5

to limit risk of aspiration during surgery or invasive procedure

Question 6

nutrition for the elderly

Answer 6

• decr kcal, incr nutrients (bc of decr physical activity, lean body mass, decr BMR)
• have decr sensation (decr appetite and thirst)
• chronic disease? diet low in salt, simple sugars, and fat
• soft food (tooth loss/edentulism and gum disease limit ability to masticate)
• diminished vision or hearing (limits mobility and interaction –> decr difficulty purchasing and preparing food)
• arthritis (need help making and eating food, can’t drive anymore –> may rely on local markets which can be limited and more expensive)

Treas 952-955; Table 28-6

Question 7

sources of fiber

Answer 7

fruits and veggies
whole-grain foods
flaxseeds, dried beans, legumes
popcorn 
peas

Question 8

prolonged bedrest and protein

Answer 8

• needed for growth, maintenance and repair of body cells and tissues
• attract water so proteins in cells and bloodstream help regulate fluid balance
• lymphocytes and antibodies are proteins

Question 9

sources of protein

Answer 9

chicken
broccoli
eggs
beef

Question 10

pt doesn’t wanna eat. WYD?

Answer 10

• WHAT DOES PT LIKE TO EAT?
• small, frequent meals of highly nutritious foods
  offer high protein supplements
• controls symptoms they have (pain, fatigue, etc)
• help w oral hygiene
• try to control odor and sights that are unpleasant to pt
  keep eating area clean and neat
• may need to remove medical equipment
• order late food tray or warm food if pt isn’t in room during mealtime
• does pt need tube feedings or IV fluids?

Question 11

false positive on occult blood test (food)

Answer 11

turnips
horseradish
chicken
fish
> 250 mg in ascorbic acid (vitamin C)
red meat

Question 12

excess fiber…

Answer 12

incr r/f bowel obstruction due to:

• opioid-induced decr peristalsis
• prolonged intestinal transit time of feces
• delayed gastric emptying

Question 13

Clear liquid diet

Answer 13

• Pedialyte, clear brother, gelatin, popsicles
• water, juice (no pulp), tea, ginger ale, plain coffee (no creamer)
• NOT ice cream