Nutrition and Bowel Elimination Flashcards
What is anthropometric?
Anthropometric: measurements of the body and body parts
what is basal metabolism?
basal metabolism the rate at which the body uses energy while at rest to maintain vital functions (maintaining body temp, muscle tone, propelling food through GI tract, inflating lungs, and contracting heart muscles).
what is dysphagia?
-
Dysphagia: difficulty or inability to swallow.
- Seen in patients with stroke, paralysis.
What is a gastrostomy?
surgical creation of an opening in the stomach
what is Enteral Nutrition?
alternate form of feeding that involves passing a tube into the gastrointestinal tract (stomach) or small intestine
What is Parenteral Nutrition (PN)?
Supplemental nutrition provided via IV therapy. Patients who can’t meet their nutritional needs by the oral or enteral route
What are the 6 classes of nutrients?
- Carbohydrates
- Lipids
- Proteins
- Vitamins
- Water
- Minerals
Which 3 classes of nutrients supply energy?
- Carbohydrates
- Protein
- Lipids
Which 3 classes of nutrients regulate body processes?
- Vitamins
- Minerals
- Water
What is normal albumin range?
3.5-5.5 g/dL
(remember protein shakes contain 3-5 ingredients)
what is prealbumin range?
23-43 mg/dL
What are signs of poor nutrition during a physical assessment?
- Poor skin
- Brittle hair/nails
- Poor dentition (discolored teeth)
- Dysphagia
What is normal BMI?
18.5-24.9 kg/m/2
What are some populations that BMI would not be accurate for?
- Athletes
- People with edema
- People with dehydration
- Older people
- Those who have lost muscle mass.
How is megadosing a risk factor for poor nutritional status?
some nutrients compete against each other for absorption, an excess of one nutrient can lead to a deficiency (or increase the requirement) of another, especially is absorbed preferentially.
Which type of feeding is described?
“tube inserted through the nose and into the stomach.”
nasogastric (NG) tube
Which type of feeding is described?
“tube inserted through the nose and into the upper portion of the small intestine.”
Nasointestinal (NI) tube
Which tubes are used for short term feeding? and long term?
nasogastric and Nasointestinal tubes are for short term feeding while PEG tubes are used for long term.
What are the 4 ways to confirm NG tube placement?
- Radiographic examination
- pH and visual assessment of aspirate.
- Measurement of tube length and tube marking
- CO2 monitoring
what are the ways to confirm Nasointestinal** tube placement?
- Radiographic examination
- pH and visual assessment of aspirate.
What are the methods for long-Term Nutritional Support: via Enteral Nutrition?
stomach (gastrostomy)
jejunum (jejunostomy).
What is the preferred method for feeding for a comatose patient?
stomach (gastrostomy)
gastroesophageal sphincter remains intact, making regurgitation and aspiration less likely than with NG tube feedings
What are the two ways parenteral nutrition can be administered?
Central venous access
Peripheral venous access
What are the characteristics of a Total Parenteral Nutrition (TPN)?
- Type of solution
- Duration
- Area of access
- Hypertonic solution
- Indicated > 7-14 days
- Central venous access
What are the characteristics of a Partial Parenteral Nutrition (PPN)?
- Type of solution
- Duration
- Area of access
- Isotonic solution
- Indicated < 14 days
- Peripheral venous access
What are some major concerns with Total Parenteral Nutrition (TPN)?
- Blood glucose must be monitored due to highly concentrated solution
- TPN must be gradually discontinued.
- What is Bowel (Fecal) incontinence?
- What is a nursing diagnosis accompanying this?
- the inability of the anal sphincter to control the discharge of fecal and gaseous material.
- Risk of skin breakdown. Must monitor their skin integrity.
What is a Colostomy?
an opening into the colon that permits feces to exit through the stoma
What is Fecal impaction?
collection in the rectum of hardened feces that cannot be passed.
Developmentally which population is more at risk for constipation? why?
Older adults may be more at risk due.
- Increased medication that alter bowel movements.
- Physiological changes
- Lifestyle changes
What is the recommended fiber intake?
25-30 g
How does activity and muscle tone affect bowel movement?
(sedentary life style, Anesthesia , exercise)
- Sedentary lifestyle (causes ↓ metabolism, at risk for constipation)
- Anesthesia causes ↓ in GI (muscle tone)motility
- Exercise ↑ peristalsis
what is the condition where the motor (peristalsis) activity of the bowel is impaired, usually without the presence of a physical obstruction.
Paralytic ileus
What is the order of assessment for abdomen?
- Inspection
- Auscultation
- Percussion
- Palpation
How would describe normal stool characteristics?
Like a sausage but with cracks on it’s surface
or
like sausage or snake, smooth and soft.
What findings would the following stool sample be interpreted as?
“separate hard lumps, difficult to pass”
Type 1: Constipation
What findings would the following stool sample be interpreted as?
“Water, no solid pieces”
diarrhea or possibly constipation
What effect would medications (anticoagulants, Aspirin) that can cause GI bleeding have on stool?
pink to red to black stool
What effect would iron salts have on stool?
Black stool
What effect would antacids have on stool?
white discoloration or speckling in stool
What effect would antibiotics have on stool?
green-gray color stool
What effect can Bismuth subsalicylate used to treat diarrhea have on stool?
Black stool
What is occult blood?
Occult blood in the stool (blood that is hidden in the specimen or cannot be seen on gross examination) can be detected with screening tests
What is an endoscopy?
direct visualization of hollow organs of the body using an endoscope (a flexible, lighted tube)
What are some important guidelines for stool collection?
- Collect using medical aseptic technique
- Void first so the urine does not contaminate stool sample
- Obtain stool culture before medication is administered.
- Collect the first stool of the day
What are the least invasive to most invasive tests for GI?
- Fecal occult blood test
- Barium studies
- Endoscopic examination
Recommended water intake
2-3 L
Which people are at most risk for constipation?
- patients with central nervous system disease or local lesions that cause pain while defecating.
- patients with reduced fluids, bulk, or fiber in their diet
- people who are depressed
- patients on bedrest or with decreased mobility
- medications that cause constipation (e.g., opioids, anti-cholinergic)
- Digital removal of fecal mass can stimulate ___ nerve, which results in what?
- What should the nurse do after triggering it?
- Vagus, resulting in ↓ HR
- Nurse should stop the procedure, monitor HR and BP, and notify provider.
What is a stoma?
general term referring to an artificial opening; usually used to refer to an opening created for the excretion of body wastes
What is the function of an ileostomy?
An ileostomy allows liquid fecal content from the ileum of the small intestine to be eliminated through the stoma
What is the function of a colostomy?
an opening into the colon that permits feces to exit through the stoma
What should be noted when inspecting patient’s stoma?
- What is the normal characteristic of the stoma?
- When will size stabilization occur?
- What should the characteristic of the skin around the stoma be?
- Stoma should be dark pink-red and moist.
- Stoma size should stabilize b/w 6-8 weeks
- Skin around stoma should be clean and dry.
