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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

25
How to help decrease pancreatic secretions
NPO and specialized feeds to help decrease stimulation of pancreas
26
How should you suction NG
Intermittent LOW suction
27
When no longer NPO, what kind of diet?
Progressive diet of HIGH CHO AND PROTEIN and LOW FAT
28
What should be started early to prevent infection?
Antibiotics
29
Chronic Pancreatitis manifestations (6)
- 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
Steatorrhea
Oily grey color stools due to malabsorption of fats
31
PERT
Oral Pancreatic Enzyme Replacement Therapy = standard of care to prevent malnutrition, malabsorption, and excessive weight loss
32
PERT instructions
- 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
PERT documentation
Record the number and consistency of stools to manage effectiveness Effective: less frequent, less fatty
34
Most reliable Pancreatitis diagnostic
Contrast induced CT scan
35
Pancreatitis diagnostics
- abdominal ultrasound - contrast induced CT - abdominal and chest x ray to differentiate pancreatitis from other disorders - ERCP (visualization through esophogus)
36
Cholelithiasis
Gall stones | - common biliary disorder
37
Cholecystitis
Inflammation of gallbladder associated with cholelithiasis
38
Biliary tract disorder risk factors
- 4 Fs - forty, fat, female, fertile - aging - race, ethnicity - family hx - DM - prolonged TPN
39
Biliary tract disorder manifestations (many)
- 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
Chronic Cholecystitis manifestations (4)
- fat intolerance - dyspepsia - heartburn - flatulence
41
Cholelithiasis/Cholecystitis complications
- abscess - pancreatitis - gallbladder rupture
42
Meds for Cholelithiasis/Cholecystitis
- Opioid (Morphine, Dilaudid) - Antibiotics - Anti-emetics
43
Gold Standard surgery for Cholelithiasis/Cholecystitis
Laparoscopic Cholecystectomy: removal of gallbladder through a high abdominal incision
44
What device is used post op Cholecystectomy?
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
T - Tube drainage
- 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
How often should drainage be recorded?
- q2-4 hrs for first 24 hrs | - then q8 hrs
47
How should a pt with a T tube be positioned?
Semi-Fowler's
48
Where should the T tube bag be?
Below the level of gallbladder
49
Should you irrigate the T Tube?
NEVER irrigate, aspirate or clamp WITHOUT a HCP order

AE 3 (8 decks)

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