Nutrition & Elimination Flashcards
1
Q
define nutrition
A
all interactions between organism and food
2
Q
nutritive value
A
nutrient content of specified amt of food
3
Q
“macro” vitamins & minerals
A
K, P, Na, Ca, Mg, Cl, S
4
Q
“micro” vitamins & minerals
A
Fe, Zn, manganise, I, Fl, Copper, Cobalt, chromium, selenium
5
Q
where do most people get fluoride? who is at risk for deficiency?
A
city water
people who drink from a well
6
Q
major enzyme for carbs
A
Ptyalin (salivary amylase)
7
Q
how to raise a pt’s blood sugar quickly?
A
cake icing
dissolve in mouth
follow up with protein - PB, etc
8
Q
enzyme beginning protein digestion in mouth
A
pepsin
9
Q
trypsin, chymotrypsin, carboxypeptidase are from the…
and digest…
A
pancreas
proteins
10
Q
aminopeptidase, dipeptidase are from the…
and digest…
A
intestine wall
proteins
11
Q
who has to take enzymes with meals?
A
cystic fibrosis pts
12
Q
anabolism vs catabolism
A
ana - building tissue
cata - breaking down
13
Q
define nitrogen balance
A
degree of anabolism & catabolism
+ means more anabolism
- means more catabolism
14
Q
“full” arms of hydrogen
A
saturated fats
15
Q
2 types of unsaturated fats
A
monounsaturated
polyunsaturated
16
Q
enzymes needed for lipid digestion
A
bile
pancreatic lipase
enteric lipase
17
Q
bile
function
made and stored where?
A
emulsifies and increases surface area of fats
made in liver, stored in gallbladder
18
Q
which pts cannot eat lipids?
A
gallbladder removed/nonfunctioning
19
Q
lipid storage
A
adipocytes
20
Q
why are vitamins needed in body
A
to catalyze metabolic processes
21
Q
which vitamins are needed daily because they can’t be stored?
which can be stored?
A
water soluble (C, B) - needed daily
fat soluble (A, D, E, K) - storable
22
Q
energy balance =
A
intake minus what we use
23
Q
carbs - __cal/g
proteins - __cal/g
fats - __cal/g
alcohol - __cal/g
A
4
4
9
7
24
Q
BMR
A
rate at which body metabolizes food to maintain energy requirement of a person awake and at rest
25
REE
amt of energy required to maintain basic body functions or calories required to maintain life
26
what is the rule of 5's/6's?
ideal weight
_FEMALES - rule of 5s_: 100 lbs for first 5 feet - then 5 lbs for every inch \>5 ft
_MALES - rule of 6s_: 106 lbs for first 5 feet - then 6 lbs for every inch \>6 ft
27
use BMI with caution in these pts
retain fluid, athletes, older adults
28
**BMI**
underweight =
healthy =
overweight =
obese =
extremely obese =
* Underweight - \<18.5
* Healthy - 18.5-24.9
* Overweight - 25-29.9
* Obese - 30-39.9
* Extremely obese - 40+
29
what kind of fat distribution is unhealthy? what kind is healthier?
visceral is unhealthy
buttock is healthier
30
why do women need more iron than men?
loss through menstruation
31
nutritional complications of alcohol
wt gain
wt loss
vitamin B deficiency
32
nutrition — birth to 1 year
demand feeding
regurgitation
iron deficiency
bottle mouth syndrome (tooth problem)
33
nutrition — toddlerhood
eats most foods
adjusts to 3 meals/day
feeds self
teeth care
34
nutrition — preschool
eating adult foods
may require snacks
35
nutrition — school age
balanced diet important
start to teach healthy eating habits
poor habits lead to obesity
36
nutrition — adolescents
increased need for nutrients, Ca+
risk for eating disorders
37
nutrition - young adulthood
pay attention to protein, Ca+
limit cholesterol
38
nutrition — postmenopausal women
need Ca+ and vit D (reduces osteoporosis)
39
nutrition — older adults
need same nutritional intake, but less calories
more fluid, fiber, activity
decreases sense of smell & tooth loss
also may have issues c loneliness, transportation & access to food
40
keep fats \< \_\_\_\_\_% of total calories
20-35%
41
how to prevent choking while eating
chin tuck
42
how long can someone be on a clear liquid diet?
24-36 hrs
43
exceptions to clear liquid diets
CANNOT have: red liquid
CAN have: coffee; popsicles; gelatin; honey; hard candy
44
exceptions to full liquid diets
CAN have: pudding; ice cream; cream; butter; eggs; yogurt
45
intervention that can help people with neuro, musculoskeletal, etc problems eat/drink
altered utensils
46
purposes of NG tube (5)
* Feedings
* Medications
* Suctioning stomach contents to prevent distension & n/v
* Remove stomach contents for analysis
* Lavage (wash) stomach in case of poisoning, OD
47
offer oral care q __ hr for NG tube pts
2 hr
48
flush NG tube with _____ mL water
10-30
49
how to give meds via NG tube
* dilute liquids, especially viscious
* crush and dissolve (if allowed)
* draw up fluid from capsule (if allowed)
* give each med alone with 30-60 mL warm water
* flush after each med with 15-30 mL
* change amt of water used according to how many meds there are
50
ways to check NG tube placement
air bolus
pH
bilirubin
x-ray
51
which NG tube needs more attention to flushing
Dobhoff
52
having pts in high Fowlers during NG tube placement, feeding, & med admin prevents…
aspiration
53
always do before administering tube feeding
check residual
do not give feeding if it is over amt given by the policy
give residual back
54
anytime you take cap off of the NG tube, you must…
kink the tubing
55
upper urinary tract organs
kidneys
ureters
56
lower urinary tract organs
bladder
urethra
pelvic floor
57
location of kidneys
retroperitoneal on either side of spine
58
kidney function
filter blood, remove metabolic wastes
regulate acid/base
regulate fluid
59
capacity of bladder
300-600 mL
60
what causes bladder spasm?
voiding too quickly
61
base of the bladder
trigone
62
length of urethra in women & men
women - 3-4 cm
men - 20 cm
63
why are women more prone to UTI?
anus closer to urethra
shorter urethra
64
what do we want UTI pts to do?
drink a lot of fluid
void every 2-3 hr
65
components of continence mechanism
internal sphincter involuntary
external sphincter voluntary
66
process of urination (6)
1. Urine **collects** in bladder
2. Pressure stimulates **stretch receptors**
3. Stretch receptors transmit impulses to **spinal cord voiding reflex center**
4. **Internal** sphincter relaxes, stimulating urge
5. If appropriate, conscious portion of brain relaxes **external** urethral sphincter muscle
6. Urine is **eliminated**
67
which exercises help voluntary control of urination?
kegel
pelvic floor
68
when does fetal kidney start to produce urine?
11-12 weeks
69
urination in infants
no voluntary control
20x/day
minimal concentration - colorless, odorless
70
urination in children
kidneys become more efficient
able to control urge to void around 2.5-3 years
full control (day & night) occurs at 4-5 years
71
urination in older adults
declining ability to concentrate urine
bladder muscle tone diminshes - nocturia
increased residual urine
incontinence - mobility problems, neuro impairments
72
nocturnal enuresis
bedwetting
73
when does bedwetting become abnormal?
\>6yo
74
psychological factors affecting urination
privacy
natural position
being rushed
75
why does alcohol increase urinary output?
decreases ADH
76
why does caffeine increase urinary output?
irrirates urinary tract
77
natural diuretic
grapefruit juice
78
adverse effects of diuretics
loss of potassium
cramping
79
voiding position for men with prostate enlargement
sitting down
80
cytoscopy
inspection of bladder
81
polyuria
excessive urination
82
polydipsia
excessive thirst
83
oliguria
low urine output
\<500 mL/day
\<30 mL/hour
84
interventions for oliguria
offer fluids
assess for dehydration
85
anuria
no urine
86
sx of UTI
frequency
urgency
nocturia
dysuria
87
primary urinary problems (4)
enuresis, incontinence, retention, neurogenic bladder
88
urinary frequency \> \_\_x/day
4-6
89
nocturia \>\_\_x/night
2+
90
sudden strong desire to void - with or without large amt of urine in bladder
urgency
91
dysuria
painful/difficult urination
92
involuntary urination in children beyond age of bladder control
enuresis
93
bedwetting affects girls or boys more?
boys
94
emptying of bladder impaired - associated c overflow incontinence - prostate enlargement - having a catheter in for a long time
urinary retention
95
stress incontinence
weak pelvic floor
96
urgency incontinence
inability to stop voiding
97
overflow incontinence
neurogenic bladder
can't perceive fullness
98
transient & functional incontinence
factors outside urinary tract - physical limitations
99
NORMAL URINE
amt in 24 hours
color
clarity
odor
sterility
pH
specific gravity
glucose
ketones
blood
1200-1500/24hr
straw colored
transparent
faintly aromatic odor
sterile
4. 5-8 pH
1. 010 to 1.025 specific gravity
no glucose, ketones, blood
100
who might not have non-sterile urine normally?
females - touches lots of things on its way out
101
how to calculate urine output with continuous bladder irrigation
measured output - irrigation put in = true output
102
PVR
normal
how to measure
post-void residual urine
50-100 mL
bladder scan or straight cath
103
preventing UTI (8)
* Drink 8 8oz glasses of **water**
* Frequent **voiding** - q2-4hr
* Avoid **harsh** soaps, bubble baths, powders, sprays in perineal area
* Avoid **tight** clothing
* Wear **cotton** underwear
* **Wipe** front to back
* Take **showers** rather than baths
* Urinate before/after **sex**
104
crede maneuver
pushing on bladder to void
105
for men, what type of catheter is preferred?
condom
106
catheter care
no kinks
clean away from pt multiple times per shift
check skin integrity
107
may be used in females who otherwise have to self-cath & have difficulty
suprapubic catheter
108
\_\_\_\_\_ mL chyme moves from sm intestine to lg intestine daily
1500
109
length of rectum
4-6 inches
110
length of anal canal
1-2 inches
111
distended veins in rectum
hemorrhoids
112
NORMAL FECES
color (adult, infant)
consistency
shape
amt
odor
constituents
brown in adults, yellow in infants
formed, soft, semisolid, moist
cylindrical; 2.5 cm diameter
100-400 g/day
aromatic
undigested roughage, dead bacteria & epithelium, dried constituents of digestive juices
113
feces are \_\_\_\_**%** water**,** \_\_\_\_% solid
75% water
25% solid
114
first stool of newborn
meconium
115
toddlers achieve some control of defecation by _____ yo
1.5-2
116
tx for constipation
FFA
fluid, fiber, activity
117
GI considerations/interventions after surgery
anesthesia stops peristalsis
assess for peristalsis, flatus
auscultate bowels
118
decreased frequency; hard dry formed stools; straining; painful; feeling of fullness; anorexia & nausea; h/a
constipation
119
high risk pts for constipation
school age children
older adults
pts on pain meds
120
causes of constipation (7)
IBS; pelvic floor dysfunction; slow transit; neurologic conditions; emotional disturbances; medications; habitual denial/suppression of urge
121
mass or collection of hardened stools in folds of rectum
fecal impaction
122
what is a life threatening concern with constipation?
straining can activate vasovagal response
can cause heart failure
123
which pts would you be especially cautious about digital removal of fecal impactions with?
heart patients
| (vasovagal response)
124
passage of liquid feces; increased frequency; cramps & increased bowel sounds; fatigue, weakness, malaise, emaciation, dehydration
diarrhea
125
eructation
burping
126
how long should a pt be on a bedpan?
no more than 15 mins
127
how long should a pt hold an enema?
as long as they can
30 mins
