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AE 3 > Nutrition/Digestion/Elimination > Flashcards

Nutrition/Digestion/Elimination Flashcards

1
Q

Hypogeusia

A

Decreased taste

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2
Q

Hyposmia

A

Decreased smell

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3
Q

Achlorhydria

A

Decreased production of gastric acids

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4
Q

What aging change causes ineffective digestion of B12?

A

Achlorhydia

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5
Q

Xerostomia

A

Decreased saliva production (dry mouth)

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6
Q

An intervention for increased cholecystokinin and nutrient requirement

A

Help meet nutrient requirements with MORE FREQUENT SMALLER meals with NUTRIENT DENSE foods

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7
Q

Clinically significant weight changes

A

> 5% in 1 month
7.5% in 3 months
10% in 6 months

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8
Q

Gold standard physical assessment for older adults

A

Membrane assessment

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9
Q

Normal Albumin

A

3.5-5.5

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10
Q

Normal Prealbumin

A

19.5-35

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11
Q

Transferrin (iron carrying protein)

A

240-360

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12
Q 
Mini Nutrition Screen 
A-
B-
C-
D-
E-
F-
A 
A- has food intake declined in past 3 mo.?
B - weight loss during the last 3 months
C- mobility 
D- psychological stress or acute disease
E- neuropsychological problems
F - BMI and calf circumference
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13
Q

Considerations before starting a meal

A
  • make food appetizing
  • meal atmosphere
  • have them eat in chair if possible
  • GOOD RESPIRATORY status
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14
Q

How to alleviate dry mouth

A
  • mouth and oral care

- avoid caffeine, alcohol, tobacco, spicy/acidic foods

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15
Q

What risk increases with enteral nutrition?

A

risk for ASPIRATION

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16
Q

What risk increases with parenteral nutrition?

A

risk for INFECTION (due to high sugar and fat content)

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17
Q

What kind of diet do you want for gallbladder disease?

A

Low fat

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18
Q

Megastrol (Megase)

  • what is it
  • side effect
A

Steroid based medication that should increase appetite

Side Effect: DVT r/t increased hypercoagulability

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19
Q

What is the least dangerous fluid to use during a swallow test?

A

Water

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20
Q

Common causes of Pancreatitis

A
  • alcoholism
  • gall stones
  • trauma
  • drug use
  • infection
  • unknown
21
Q

Cardinal sign of Acute Pancreatitis

A

SUDDEN onset of SEVERE epigastric pain after a large meal or alcohol

(pain can radiate to the back/left shoulder)

22
Q

What manifests if there is a biliary obstruction?

A
  • jaundice

- dark urine

23
Q

Manifestations of Acute Pancreatitis (9)

A
  • cardinal sign
  • jaundice
  • malaise
  • restlessness
  • lung involvment, respiratory distress
  • decreased urine output
  • decreased bowel sounds
  • ascites
  • “Acute Abdomen” (curling, guarding, abdominal tenderness)
24
Q

Pain management in Acute Pancreatitis

A

Opioids

25
Q

How to help decrease pancreatic secretions

A

NPO and specialized feeds to help decrease stimulation of pancreas

26
Q

How should you suction NG

A

Intermittent LOW suction

27
Q

When no longer NPO, what kind of diet?

A

Progressive diet of HIGH CHO AND PROTEIN and LOW FAT

28
Q

What should be started early to prevent infection?

A

Antibiotics

29
Q

Chronic Pancreatitis manifestations (6)

A
  • serious loss of exocrine and endocrine pancreatic function (onset of DM symptoms)
  • deterioration of pancreatic structure
  • exacerbations and remissions
  • CONSTANT epigastric pain
  • steatorrhea
  • severe weight loss
30
Q

Steatorrhea

A

Oily grey color stools due to malabsorption of fats

31
Q

PERT

A

Oral Pancreatic Enzyme Replacement Therapy = standard of care to prevent malnutrition, malabsorption, and excessive weight loss

32
Q

PERT instructions

A
  • take 30 min before meal
  • take with FULL glass of water
  • take after an antacid or H2 blockers
  • swallow tablets or capsules without chewing to minimize oral irritation (if you can’t swallow, pierce and put in apple sauce)
  • do NOT mix in protein containing foods
  • wipe lips after
33
Q

PERT documentation

A

Record the number and consistency of stools to manage effectiveness

Effective: less frequent, less fatty

34
Q

Most reliable Pancreatitis diagnostic

A

Contrast induced CT scan

35
Q

Pancreatitis diagnostics

A
  • abdominal ultrasound
  • contrast induced CT
  • abdominal and chest x ray to differentiate pancreatitis from other disorders
  • ERCP (visualization through esophogus)
36
Q

Cholelithiasis

A

Gall stones

- common biliary disorder

37
Q

Cholecystitis

A

Inflammation of gallbladder associated with cholelithiasis

38
Q

Biliary tract disorder risk factors

A
  • 4 Fs - forty, fat, female, fertile
  • aging
  • race, ethnicity
  • family hx
  • DM
  • prolonged TPN
39
Q

Biliary tract disorder manifestations (many)

A
  • pain in RUQ referred to R shoulder, scapula, biliary colic, biliary obstruction
  • diaphoresis
  • N/V
  • clay colored stools
  • attacks that occur 3-6 hrs after a heavy or high fat meal or lying down
  • leukocytosis
  • fever
  • jaundice
  • steatorrhea
  • pruritis
  • jaundice
40
Q

Chronic Cholecystitis manifestations (4)

A
  • fat intolerance
  • dyspepsia
  • heartburn
  • flatulence
41
Q

Cholelithiasis/Cholecystitis complications

A
  • abscess
  • pancreatitis
  • gallbladder rupture
42
Q

Meds for Cholelithiasis/Cholecystitis

A
  • Opioid (Morphine, Dilaudid)
  • Antibiotics
  • Anti-emetics
43
Q

Gold Standard surgery for Cholelithiasis/Cholecystitis

A

Laparoscopic Cholecystectomy: removal of gallbladder through a high abdominal incision

44
Q

What device is used post op Cholecystectomy?

A

T-Tube - inserted into the duct and connected to drainage

  • ensures patency of duct until edema subsides
  • allows excess bile to drain while small intestine receives a continuous flow of bile
45
Q

T - Tube drainage

A
  • appx 400 mL/day
  • Report > 1000 mL/day or sudden increase
  • should be bloody initially –> then bright yellow to dark green + acidic odor + thick
46
Q

How often should drainage be recorded?

A
  • q2-4 hrs for first 24 hrs

- then q8 hrs

47
Q

How should a pt with a T tube be positioned?

A

Semi-Fowler’s

48
Q

Where should the T tube bag be?

A

Below the level of gallbladder

49
Q

Should you irrigate the T Tube?

A

NEVER irrigate, aspirate or clamp WITHOUT a HCP order

AE 3 (8 decks)

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