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Nur 333 Fun 2 > Nutrition (Exam 2) > Flashcards

Nutrition (Exam 2) Flashcards

1
Q

Enteral Nutrition

A

Nutrition by the way of the GI tract

Feeding tube

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2
Q

Parenteral Nutrition

A

Feeding someone outside of the GI tract. IV or TPN feedings

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3
Q

3 main functions of the GI System

A

Transportation, Digestion, Absorption

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4
Q

Importance of good nutrition

A

Helps use reach and maintain a healthy weight

reduce risk of chronic disease (CVD, HTN)

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5
Q

Importance of Nutrition

A

-Early recognition of someone who is malnourished is key

-Patients who are malnourished upon admission are at greater risk of complications

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6
Q

Dietary Guidelines

A

-Provides average daily consumption of five food groups

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7
Q

Factors influencing Nutrition

A

-Appetite
-Negative experiences
-Illness
-Medications
-Environmental Factors (Income. Education level. Physical function level. transportation. availability of food.
-Developmental needs
-Alternative food patterns

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8
Q

Nutrition: Older Adults

A

-Older adults need the same amount of Vit. Minerals as younger adults

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9
Q

Older Adult Nutrition: What the nurse must consider

A

-Presence of chronic illnesses

-Medications

-Gastrointestinal changes

-Slower metabolic rate

-Cognitive impairments

-Available transporation

-Functional

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10
Q

Cultural Considerations

A

-Be considerate of pt.’s cultural and ethnic backgrounds

-consider dietary restrictions secondary to religious belief’s

-Don’t assume a each individual in each culture is the same

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11
Q

Nursing Assessment: Screening

A

-Essential part of nursing assessment

-Nutrition screening tools. Subjective and objective measures

-Identify risk factors of malnutrition

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12
Q

Nursing Assessment: Anthropometry

A

-A form of assessment. Study of measurments and porportions of the human body

-Heigh and Weight

-Ideal body weight

-BMI (Weight that they are taking into account their height)

-Registered dieticians

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13
Q

Nursing Assessment: Laboratory and Biochemical test

A

-No single lab test to meet standards

-facotrs that affect lab results:
-Fluid balance
-Liver and kidney problems
-presence of disease

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14
Q

Common nutritional labs in fundamentals

A

-Total Protein
-Albumin
-Prealbumin
-Hemoglobin

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15
Q

Total Protein

A

-Combination of albumin and globulin constitute

-Normal: 6.4-8.3

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16
Q

Albumin

A

-Makes up 60% of total PRO

-Better indicator of chronic illnesses

-Synthesized in the liver

-Half-life-21 days

-Normal: 3.5-5.0

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17
Q

Prealbumin

A

-Preferred for acute conditions

-Half-life-2days

-Normal: 15-36

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18
Q

Albumin is a colloid

A

Colloid creates pulling power in intravascular system. Keeps fluid inside intravascular space

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19
Q

Nutrition Labs: Hemoglobin

A

-Protein responsible for transporting O2 in blood

-Normal: 14-18 male. 12-16 Female

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20
Q

If Hg is low then patients might benefit from eating what kinds of food

A

Food that are rich in iron

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21
Q

Nutrition Assessment: History

A

Diet History
Health History
Other History

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22
Q

Health Nutrition vs Malnutrition chart

A
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23
Q

Cachectic

A

Very gout and skinny

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24
Q

Nutrition Nursing Problems

A

-Poor Nutrition
-Imbalanced Nutrition
-Impaired swallowing
-Risk for Aspiration
-DCN
-Impaired Dentition
-fatigue
-risk of unstable blood glucose

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25
Q

Nutrition Planning

A

-Make it an individualized approach

-Create Goals and Outcome

-Set priorities

-Teamwork and Collaboration

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26
Q

Nursing Implementation: Health Promotion

A

-Patient Educations
-early identifications of nutritional concerns
-Assisting with meal planning for all nutritional needs

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27
Q

Nursing Implementation: Diet Selection

A

-Amount needed
-Ability to eat
-Any alterations in their GI system
-Any special considerations based on their health statues

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28
Q

Types of Diets (P/P Box)

A

-regular
-Liquid
-modified texture
-therapeutic
-supplements

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29
Q

Regular Diet

A

No restrictions and encourage healthy choices

Aim to provide a well-balanced diet to meet nutritional needs

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30
Q

Modified Texture Diets

A

-Mechanical Soft Diet (soft and small in size. Easier to eat and soft in texture) (Blended or Chopped)

-Pureed Diet: Smooth like pudding that their is no chewing

-Minced Diet: Chopped up to 1/8 inch big which is similar to a sesame seed

Ground diet: Like rice 1/4 inches

Chopped diet: 1/2 inch

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31
Q

Clear and Full Liquid Diet

A

Clear: Before medical procedure or need to rest gut. Associated with acute illness and you are trying to leave little residue in the GI tract. Anything that you can see through. Broth, Juice, Pulp free Orange juice, black coffee, popsicle, gelatin

Full: Typically transition from clear to regular diet. Any juice, milk, frozen yogurt, everything on clear and things measured in mL

32
Q

Fluid Restriction Diet

A

Limiting amount of fluid per day

Patients who have heart failure or kidney failure. They are retaining water.

Patients who have lower serum sodium. Hyponatremic

33
Q

Modified Consistency of Liquid

A

-Any who has Dysphagia patient. Someone who has stroke and cant swallow like normal

34
Q

Best way to measure fluid volume statues in a patient

A

Weighing them daily is better that keep tract of I/O’s

35
Q

NO DIFFERENT TYPES OF LIQUDS

A
36
Q

Therapeutic Diet Orders

A

-Consistent Carbohydrate (DM)

-Cardiac Diet or Heart Healthy Diet (Low salt, Low Sat, Low Chol)

-Low Residue (low ruffage) (low fiber)(Limit dairy)(People with Ulcertivie colitlts. Chrons.)

-High fiber: Improve Chol levels.

-Gluten Free: Celica’s disease

-Lactose Free: People who dont digest sugar in dairy products well

-Bland Diet: Avoid irritation and decrease peristalsis

37
Q

NPO Diet

A

Nothing by mouth

-Before procedure or coming back from procedure. Medical problems

NPO after midnight except meds

38
Q

NPO risk

A

Nutritional risk if it last more than 5-7 days. TPN (Central Line)

39
Q

Advance Diet as Tolerated

A

Clear Liquid. full liquid. Low residue. Regular diet

-Only if patient is tolerating. Do assessments first

40
Q

Common Nutritional Issues

A

Anorexia

Inability to feed self

dysphagia

nausea and vomiting

41
Q

Anorexia

A

Loss or lack of appetite

Pain
fatigue
Effects of medications

42
Q

Increasing Anorexia Appetite

A

-Treat cause
-Use creative approaches t stimulate appetite
-Environment
-Smaller meals and more frequent
-Allow for food preferences
-Season
-Oral hygiene
-Ensure comfort
-Provide medication

43
Q

Assisting Patient With Oral Feedinds

A

-Protect Safety, Independence and Dignity?

-Make Sure tray in reach?

-Assess risk of aspiration

-Supervision?

-Motor or visual deficits?

-PLATE AS A CLOCK

44
Q

Dysphagia

A

-Nurses should screen for this

-G means swallowing

-Treat causes

45
Q

Dysphagia Warning Signs

A

-Slow weak speech

-Non gag reflex

-delay swallowing

46
Q

Silent Aspiration

A

food in airway and not stomach. Can lead to PNA

47
Q

Dysphagia Complications

A

-Aspiration pneumonia
-Dehydration
-Malnutrition
-Weight loss

48
Q

WTD if Dysphagia is suspected

A

Refer to SLP or RD

Preform swallow evaluatons

49
Q

Nursing care Dysphagia: Do’s

A

-Sit in high fowlers
-Minimize environmental distractions
-Allow for time in between bites and drinks
-Check for oral pocketing
-Chin tuck
-Double swallowing
-Suction
-Oral Care
-Monitor for choking and coughing

50
Q

Nursing care dysphagia: Don’t

A

-Feed when altered LOC
-Leave Unattended
-Administer sedatives or hypnotics
-Use a straw

51
Q

Dysphagia Diet

A

-SLP recommends
-Stages
-Position of patient
-Aspiration precautions

chart in PP

52
Q

Intervention: Strict I/O

A

-Measuring of all intake and all output
-Mls or Occurrences

53
Q

Who needs strict I/O

A

Critical Care patients

Unstable patients

Post-opp

Heart, liver, or kidney failure

Pt’s with tubes

malnourished or npo

pt’s on diuretics

changes in weight issues

54
Q

Intake

A

Oral Fluids
IV
Blood Products
Tube feeding
Flushes

anything in mL’s

55
Q

Output

A

Urine
Bowel Movements
Emesis
Drainage tubes (JP or Chest)

56
Q

Nurses Role I/O

A

Can be delegated
Collaborate with NA
Educate patient and family
Communicate with everything
Assess and monitor trends

57
Q

Parenteral Nutrition

A

-Feeding outside of the GI tract. Intravenously, bypassing the usual process of eating and digestion

58
Q

Enteral Nutrition

A

Liquid supplemental nutrition is either taken by mouth or is given via a feeding tube. Going to the GI tract

59
Q

Look and understand the routes of enteral nutrition

A
60
Q

Enteral Nutrition

A

Patient receive formula through nasogastric tubes, jejunal or gastric tubes

Delivered to stomach or jejunum

Risk for gastric reflux.

MUST CONFIRM PLACEMENT.

61
Q

Indications of EN

A

-Prolonged anorexia. (will not eat)

-Severe protein energy malnutrition

-Coma

-Impaired swallowing

-Critical Illnesses

62
Q

Benefits of EN versus PN

A

-Reduces sepsis

-Minimizes the hypermetabolic response to trauma

-Decreases hospital mortality

-Maintains intestinal structure and function

63
Q

Nepro

A

For kidney issues

64
Q

Administration Rate of Tube Feeding

A

-Started at full strength, slow rate

-Increase per RD recommendation or HCP order (increase very 8-12 hours, amount of increases is set until reach goal rate, increase if no signs of intolerance)

-Assess for signs of intolerance. (High gastric residuals, NCVD)

65
Q

Administration of Tube Feeding

A

Bolus (Intermittent) vs Pump (continuous)

66
Q

Compilations of Tube feedings (potter and perry)

A

-Pulmonary aspiration
-Delayed gastric emptying
-Serum electrolyte imbalance
-Fluid overload

67
Q

Placement of Feeding tubes

A

Through nose: Nasogastric or Nonintentional (doudenal)

Surgically: gastronomy, jejunostomy

Endoscopically: PEG (Percutaneous Endoscopic gastronomy) and PEJ (Percutaneous Endoscopic Jejunostomy)

68
Q

Nursing Role in Placement

A

NG tube us a water soluble lubricant

-landmarks (gastric) - nose- ear- xiphoid process.
-Add 8-10 inches for jejunum

69
Q

Feeding Tube: Conformation of Placement

A

-Historically: Insert air into tube and auscultate over stomach for bubbling

-XRAY is the only 100% way to confirm

-Once verified with x-ray, an ongoing placement verification ca be to test the pH

70
Q

Nasogastric or Nasojejunal Tube

A

Typically for EN < 4 weeks

Large bore and small bore

Typically for adults; 8-13 Fr, 36-44 inches long

Come with stylet

Connectors are not standard for EN feeding tube

71
Q

Surgically or endoscopically placed tubes

A

-Preferred long-term feeding

-More than 6 weeks

72
Q

Feeding Tube: Assessment and Monitoring

A

-Abd focused assessment
-Check skin around tube for breakdown
-Assess nutritional status
-Assess for intolerance
-Assess I&O
-Assess and Monitor Labs

73
Q

Decrease rick of aspiration in tube feeding

A

Elevate HOB to at least 30 degrees

74
Q

Checking Gastric Residual

A

For continuous check every 4-6 hours. For intermittent check immediatley before

High gastric residual can indicate delayed gastric emptying

How much is to much?

75
Q

> 250 ml gastric residual

A

Hold for an 1 hour and recheck

76
Q

> 500 mls

A

Hold and notify HCP

77
Q

Tube Feeding Administration of Medication

A

-Follow 5 rights of med administration

-Ensure med can be administered via tube

-Always verify placement

-Flush with water before and after administration

-Administer on med at a time

Nur 333 Fun 2 (12 decks)

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