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Management Of Nursing Care 2 > Nutrition & Oral Assessment > Flashcards

Nutrition & Oral Assessment Flashcards

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1
Q

What are the learning outcomes of the nutritional part of this course?

A

That student nurses must: Explain the variance in nutritional requirements throughout growth and development, understand dietary reference intakes, list dietary guidelines, discuss major methods of nutritional assessment, identify nutritional problems, and state the goals of enteral and parenteral nutrition.

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2
Q

Define Sustenance.

A

Food and drink regarded as a source of strength and nourishment.

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3
Q

What is the difference between sustenance and symbolic eating?

A

Sustenance is the mere eating to fuel the body and symbolic eating is eating around special occasions such as ceremonies, social gatherings, holiday traditions, and religious events.

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4
Q

Define nutrition

A

What a person eats and how the body uses it.

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5
Q

Define nutrients

A

Energy providers, structural materials for body tissues and regulators of body processes

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6
Q

The body requires fuel to provide energy for what?

A

Cellular metabolism and repair, organ function, and growth and body movement.

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7
Q

Your energy requirements are affected by what?

A

Age, body mass, gender, illness, injury, infection, fever, activity level, and thyroid function.

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8
Q

What is the function of your salivary glands?

A

Your saliva moistens and lubricates your food, amylases in the saliva digest the carbohydrates.

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9
Q

What is the function of the pharynx in eating?

A

It allows for swallowing

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10
Q

What is the function of the oesophagus in the process of eating?

A

It aids in the transport of food.

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11
Q

What is the function of the gall bladder in the process of eating ?

A

Your gallbladder stores and concentrates bile

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12
Q

What is the function of your liver during digestion?

A

It breaks down and builds up many biological molecules. Destroys poisons, old blood cells and produces bile to aid with digestion. It also stores iron .

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13
Q

What is the function of your small intestine in digestion?

A

Completes the digestion process , it absorbs the nutrients and most water for the body.

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14
Q

What is the function of the anus in digestion?

A

It is the opening for feceas

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15
Q

What is the function of the stomach in digestion?

A

It breaks up and churns your food and activates enzymes which will kill germs.

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16
Q

What is the function of your pancreas in digestion?

A

Has hormones which regulate blood glucose levels and has bicarbonate which neutralise stomach acid.

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17
Q

What is the function of the large intestine in digestion?

A

Reabsorbs some water, ions, and vitamins then with the waste forms feces.

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18
Q

What is the function of the rectum in digestion?

A

Stores and expels faeces

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19
Q

What’s does RDI stand for?

A

Recommended dietary intake

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20
Q

What does EAR stand for?

A

Estimated average requirement

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21
Q

What does RDA stand for?

A

Recommended dietary allowance

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22
Q

What does AI stand for?

A

Adequate intake

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23
Q

What does UL stand for?

A

Tolerable upper intake level

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24
Q

What changes occur for the composition/energy expenditure of the older adult?

A

Decrease in lean body mass, basal metabolic rate and physical activity. Increase in fat tissue

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25
Q

What changes occur for the oral/GI of the older adult?

A

Difficulty in chewing (loss of teeth-periodontal disease, decreased nutrient absorption, increase in constipation.

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26
Q

What is a basal metabolic rate?

A

The amount of calories your body needs to accomplish its basic life needs.

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27
Q

Why is constipation more common for the older adult?

A

Decreased peristalsis (loss of abdominal tone), inadequate fluid/fibre intake, medications, and decrease in physical activity.

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28
Q

What are the metabolic changes in the older adult?

A

Altered glucose tolerance and decreased vitamin D synthesis

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29
Q

What are the cns changes in the older adult?

A

Tremors, slowed reaction times, STML, and depression.

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30
Q

What are the sensory losses for the older adult?

A

Hearing, visual acuity, decreased smell, and change of tastebuds.

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31
Q

What are some other generalised changes for the older adult?

A

Change in income, reliance on medications, social isolation, and lowered self esteem.

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32
Q

What is involved in a nutritional assessment?

A

Subjective health history, dietary history, clinical examination and observation, anthropometry, laboratory and biochemical tests, and patient expectations.

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33
Q

What are some of the things we look for in a patients nutritional psychosocial history.

A

Prep of meals, nutritional patterns, activity & excercise, sleep & rest, personal health, occupational health patterns, environment, relationships, SES, Culture/religion, and stress.

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34
Q

What are the 4 things we look for in health history?

A

Demographics, current health status, past health history, and family history

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35
Q

What demographic factors do we look for when looking at health history?

A

Age, sex, religion/culture, and financial status.

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36
Q

What current health status factors do we look for when looking at health history?

A

Presence of symptoms/illness, diet changes, weight changes, prescriptions/OTC, bowel activity, and fluid intake.

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37
Q

What past health history factors do we look for when looking at health history?

A

History of food intolerances/allergies, hereditary/familial health issues e.g. Chrons disease, diabetes, anaemias, cardiovascular disease, and obesity.

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38
Q

When preforming a nutritional assessment what are 3 things we look for?

A

You want to screen for nutritional deficiencies, evaluate health history, and consider specific data i.e food diaries.

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39
Q

During a physical examination what are the things we look for that are objective data.

A

Assessment of the skin, head/neck, oral, abdominal, and the M/S and neurological system. Also BMI/waist to hip ratio.

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40
Q

Define anthropometry.

A

The physical measurements of a body and its capability’s.

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41
Q

What do we look at as apart of anthropometry?

A

Weight, height, BMI, circumferences, and skin folds.

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42
Q

What is an undernourished BMI

A

<18.5

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43
Q

What is a normal BMI

A

18.5 - 25

44
Q

What is an overweight BMI

A

25-30

45
Q

What is an obese BMI

A

> 30

46
Q

What is involved in a clear liquid diet?

A

Broth, bouillon, coffee, tea, carbonated drinks, clear fruit juices, gelatin, and ice blocks.

47
Q

What is involved in a full liquid diet?

A

The same as a clear liquid diet with the addition of smooth textured dairy products, custards, refined cooked cereals, , vegetable juice, puréed veges, and all fruit juices.

48
Q

What is involved in a puréed diet?

A

The same as the liquid diet with the addition of scrambled eggs, puréed meats, veges, fruits, mashed potatoes, and gravy

49
Q

What is involved in a mechanical soft diet?

A

The same as a puréed diet with the addition of minced or finely diced meats, fish, cheese, rice, potatoes, pancakes, light breads, bananas, soups, and peanut butter

50
Q

What is involved in a soft diet?

A

The same as a mechanical soft diet with the addition of moist tender meat, soft casseroles, lettuce, tomatoes, cake, and biscuits but without nuts or coconut.

51
Q

What is involved in a regular diet?

A

No restrictions unless specified.

52
Q

What are the implementations for anorexia?

A

Stimulate appetite, provide small nutritious frequent meals, provide supplements, control environment aka consider smell.

53
Q

What health care professionals may you involve in the case of anorexia?

A

Speech therapist, occupational therapist, pharmacology, and a dietitian.

54
Q

What forms of health promotion would you use in the case of anorexia?

A

Educate about good nutritional habits, nutritional knowledge, meal planning, food safety, and early identification of actual or potential problems.

55
Q

What is enteral nutrition?

A

Nutrition via tubes.

56
Q

Enteral access tubes include what?

A

Nasogastric or nasointestinal, gastrostomy or jejunostromy (surgical), and percutaneous endoscopic gastrostromy (PEG) or jejunostromy (PEJ)

57
Q

What rates do you take with the enteral nutrition?

A

Slow rate and first then an increase as tolerance permits to desired rate.

58
Q

During enteral nutrition how should the head of the bed be positioned?

A

To at least 30%

59
Q

What do you do during evaluation in the nutritional assessment?

A

Measure effectivemness of nursing interventions, ascertain if patient has met goals and outcomes, amend nursing interventions and access patients ability to incorporate dietary changes into their lifestyle on discharge.

60
Q

What are the learning outcomes of the oral part of this course?

A

Explain facial and oral structure and function, ability to preform oral assessment, understanding of dysphagia.

61
Q

Define paranasal sinuses.

A

The sinuses lighten the skull or improve our voices, but their main function is to produce a mucus that moisturizes the inside of the nose. This mucus layer protects the nose from pollutants, micro-organisms, dust and dirt.

62
Q

What are the four paranasal sinuses?

A

Frontal, maxillary, ethmoid, and sphemoid.

63
Q

What is the structure of the nose?

A

The combination of the external nose and the nasal cavity which together provides air for respiration, serves the sense of smell, conditions the air by filtering, warming, and moistening it, and cleans itself of foreign debris extracted from inhalations.

64
Q

What is the function of the septum?

A

The septum allows the air that we breathe in through our nostrils to go directly from the tip of the nose into the back of the nose and into the lungs. Without the septum, the air that we breathe in might “get lost” in our nose

65
Q

What is the function of the turbinates in the nose?

A

The turbinates have three main functions. They warm the air we breathe, humidify this air as it passes through the nose, and the mucous layer of the turbinates assist in filtering particles such as dust and pollen. They can also block breathing when enlarged.

66
Q

Define Partoid gland.

A

The parotid gland is one of the major salivary glands, located just infront of the ears. These glands make saliva. This is the watery substance used to lubricate your mouth and start the digestion process.

67
Q

Defne stensens duct.

A

The parotid duct or Stensen duct is a duct and the route that saliva takes from the major salivary gland, the parotid gland, into the mouth.

68
Q

What is the function of the lingual vein?

A

The vein under the tongue important clinically as they are capable of rapid absorption of drugs; for this reason, nitroglycerin is given under the tongue to patients

69
Q

What is the function of the frenulum?

A

The lingual frenulum helps to anchor your tongue in your mouth. It also works to stabilize the movements of the tongue. Therefore important for most functions of the mouth.

70
Q

What is the function of the submandibular gland?

A

The submandibular gland produces saliva, which moistens the mouth and aids in chewing, swallowing, digestion, and helps to keep the mouth and teeth clean.

71
Q

What is the function of the whartons duct?

A

Allows the passage of saliva from the submandibular gland

72
Q

What is the function of the sublingual gland?

A

The sublingual glands are considered mixed glands because they produce both mucus and serous fluid, a clear to pale yellow watery fluid that is found in the body. However, it primarily produces a thick mucus. It lubricates the tissues of your mouth, helps you digest food, and allows you to swallow it

73
Q

What is the function of the uvula?

A

During swallowing, the soft palate and the uvula move together to close off the nasopharynx, and prevent food from entering the nasal cavity

74
Q

What is the function of the tonsils?

A

To trap germs (bacteria and viruses) which you may breathe in.

75
Q

What is the posterior pharyngeal wall?

A

The posterior pharyngeal wall is the back wall of the swallowing passage.

76
Q

What is the function of the vallate papilla at base of the tongue?

A

The vallate papillae carry taste buds

77
Q

What are the developmental considerations of the mouth, face, nose of a pregnant female?

A

Nasal stuffiness, epistaxis, and hyperemic gums.

78
Q

What are the developmental considerations of the mouth, face, nose of an aging adult?

A

Diminishing smell and taste, atrophic tissues, and dental changes.

79
Q

What subjective questions would you ask regarding the nose?

A

You would ask about: Discharge, colds, sinus pain, epistaxis, allergies, and alterations in smell.

80
Q

What subjective questions would you ask regarding the mouth and throat?

A

You would ask about: sores/lesions, sore throat, bleeding gums, toothache, hoarseness, dysphagia, altered taste, smoking, alcohol consumption, and self-care behaviours.

81
Q

What subjective questions would you ask regarding the health history of the mouth (for infants)

A

You would ask about previous: mouth infections, sore throats, tooth eruptions, and self care.

82
Q

What subjective questions would you ask regarding the health history of the mouth (for the aging adult)

A

You would ask about: mouth dryness, tooth loss, care of teeth and dentures, and changes to taste and smell.

83
Q

What equipment do you need for a mouth/nose examination?

A

Penlight, two tounge blades, cotton gauze pad, and gloves.

84
Q

What are the steps of a physical examination of the mouth, face, and nose?

A

Prepare, position, Inspect and palpate.

85
Q

What do we inspect the lips for?

A

colour, moisture, cracking, and lesions.

86
Q

What are some abnormalities of the lips?

A

Cleft lip, herpes simple I, angular cheilitis, carcinoma, and retention (cyst).

87
Q

What is perleche aka angular cheilitis of the lips?

A

Angular cheilitis is a common inflammatory condition affecting the corners of the mouth or oral commissures.

88
Q

What is herpes simplex 1 of the lips?

A

The herpes sores (lesions) typically last a week to 10 days. They most often occur on the lips, tongue, roof of the mouth, or the gums. The sores occur first as fluid-filled blisters that burst (rupture) after a day or 2.

89
Q

What is lip carcinoma of the lips?

A

A type of lip cancer develops from growth of abnormal cells on the lips.

90
Q

What is the buccal mucosa?

A

The buccal mucosa is the lining of the cheeks and the back of the lips, inside the mouth where they touch the teeth.

91
Q

What are aphthous ulcers?

A

An aphthous ulcer is typically a solitary round or oval punched-out sore or ulcer inside the mouth on an area where the mucosa is not tightly bound

92
Q

What is leukoplakia?

A

Leukoplakia is a condition in which one or more white patches or spots (lesions) forms inside the mouth.

93
Q

What is candidiasis?

A

Infection with candida, especially as causing oral or vaginal thrush.

94
Q

What are the abnormalities that we look for in the tounge?

A

Enlarged, patches, reddened areas, fissures or cracks, if you can see the papillae and if there is any presence of anklyloglossia.

95
Q

What is the oropharynx?

A

The part of the throat at the back of the mouth behind the oral cavity

96
Q

What are some abnormalities of the oropharynx?

A

Cleft palate, a bifd uvula, and acute tonsillitis and pharyngitis.

97
Q

What is cleft palate?

A

A cleft palate is an opening or split in the roof of the mouth that occurs when the tissue doesn’t fuse together during development in the womb.

98
Q

What is bifid uvula?

A

A bifid uvula, also known as a cleft uvula, is a uvula that is split in two

99
Q

What is anklyloglossia?

A

This is a tounge tie. Tongue-tie happens when the tongue and frenulum don’t form quite normally.

100
Q

What are the two main types of dysphagia?

A

Mouth & Throat. aka Oropharyngeal dysphagia and then oessophagus aka oesophageal dysphagia

101
Q

What conditions cause dysphagia?

A

Parkinsons disease, stroke, dementia, motor neuron disease, brain tumours, cerebral palsy, cleft palate, cancers, scleroderma, and achalasia.

102
Q

What are some of the clinical manifestations of dysphagia?

A

Difficulty eating and initiating swallowing, drooling, nasal regurgitation, slurring, fear of swallowing, bad intake, slowness, loss of weight, coughing, and poor chest condition.

103
Q

What are the things you need to know about a dysphagia assessment?

A

It need to be done before food/fluids are offered, it is preformed by a speech therapist in consultation with a medical specialist. And an individualised management plan must be put in place as a result.

104
Q

How do we manage dysphagia as nurses?

A

Have the patient sitting upright or side lying position if flat in bed. Pace feed and only assist as needed. Ask the client in what order they want their food, and encourage self feeding.

105
Q

After feeding a patient what do you check for?

A

Food deposits in mouth, oral hygiene, and that the patient remains upright for half an hour.

106
Q

How do we document feeding.

A

Document the time of the meal - the amount of food and fluid ingested - and any symptoms of intolerance to foods or fluids or symptoms chewing, swallowing, or ingesting. In this order.

Management Of Nursing Care 2 (11 decks)

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