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AE III Exam 3 > Nutrition, Oral Health > Flashcards

Nutrition, Oral Health Flashcards

1
Q

malnutrition definition

A
  • a geriatric syndrome
  • faulty or inadequate nutritional status
  • undernourishment characterized by insufficient dietary intake, poor appetite, muscle wasting, and weight loss
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2
Q

nutrition-related changes associated with age (8)

A
  • decreased BMR
  • hypogeusia - decreased taste
  • hyposmia - decreased smell
  • achlorhydria - decreased production of gastric acids
  • diminished thirst sensation
  • decreased bone density and lean body mass
  • xerostomia - decreased saliva production
  • increased cholecystokinin (stimulates gallbladder to release bile; leads to early satiety)
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3
Q

BMI indicative of malnutrition/mortality in older adults

A

22

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4
Q

clinically significant percent weight changes

A

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

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5
Q

3 visceral proteins

A

albumin, prealbumin, transferrin

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6
Q

normal albumin levels

A

3.5-5.5 g/dL

<3.5 = concern

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7
Q

normal prealbumin levels

A

19.5-35 mg/dL

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8
Q

normal transferrin levels

A

204-360 mg/dL

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9
Q

interventions to improve intake (7)

A
  • small frequent meals/snacks
  • make food appetizing
  • provide assistance
  • conducive environment for meals
  • alleviate dry mouth
  • analgesics, antiemetics, oxygen
  • meds to increase appetite - Megestrol
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10
Q

complications of parenteral nutrition

A
  • infection, sepsis, death

- fluid/electrolyte imbalance - monitor electrolytes, glucose

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11
Q

acute pancreatitis patho

A

inflammation of pancreas caused by early activation of excessive pancreatic enzymes → auto-digestion

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12
Q

acute pancreatitis causes (5)

A
  • alcoholism
  • gallstones
  • abdominal/operative trauma
  • drug use
  • infection
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13
Q

chronic pancreatitis patho

A

irreversible, histological changes that causes loss of exocrine and endocrine function of the pancreas

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14
Q

major cause of chronic pancreatitis

A

ETOH use

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15
Q

labs for pancreatitis (6)

A
  • increased amylase, lipase, trypsin
  • increased bilirubin if biliary obstruction
  • increased liver enzymes
  • increased glucose
  • increased WBC
  • decreased calcium, magnesium
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16
Q

most reliable diagnostic test for pancreatitis

A

contrast-induced CT scan

17
Q

acute pancreatitis symptoms (9)

A
  • CARDINAL SIGN: sudden severe epigastric pain after large meals or ETOH
  • pain can radiate to back/left shoulder
  • biliary symptoms
  • malaise, restlessness
  • decreased urine output
  • decreased bowel sounds
  • ascites
  • lung involvement
  • guarding, acute abdomen
18
Q

chronic pancreatitis symptoms (5)

A
  • periods of exacerbation and remission
  • constant, dull epigastric pain
  • steatorrhea
  • severe weight loss
  • onset of DM symptoms
19
Q

acute pancreatitis management (6)

A
  • ABCs
  • opioids for pain
  • decrease pancreatic stimulation/secretions - NPO, NG suctioning
  • progressive diet when not NPO - low fat, high carb/protein
  • control fluid/electrolyte imbalances - volume expanders, monitor output
  • prophylactic antibiotics for infection prevention
20
Q

chronic pancreatitis management (6)

A
  • long-term pain management
  • oral pancreatic enzyme replacement therapy (PERT)
  • alcohol rehab
  • treat diabetes - oral hypoglycemics, insulin
  • nutritional therapy - low fat, high carb/protein; TPN
  • cholecystectomy if biliary obstruction
21
Q

oral pancreatic enzyme replacement therapy (PERT) teaching

A
  • take 30 mins-1 hour before meals with full glass of water
  • wipe/rinse mouth after
  • don’t chew
22
Q

cholelithiasis

A

gallstones - lodged in neck of cystic duct

23
Q

cholecystitis

A

inflammation of gallbladder associated with cholelithiasis

24
Q

cholecystitis risk factors

A
  • 4 Fs = female, forty, fat, fertile
  • aging
  • race/ethnicity
  • family history
  • diabetes mellitus
  • prolonged TPN
25
Q

cholecystitis symptoms (7)

A
  • initial: pain in RUQ, can radiate to right shoulder/scapula
  • attacks occur 3-6 hours after heavy/high-fat meal or when lying down
  • diaphoresis
  • nausea/vomiting
  • leukocytosis, fever, infection
  • biliary obstruction symptoms - steatorrhea, jaundice, pruritus, dark amber urine, clay-colored stools
  • chronic: fat intolerance, dyspepsia, heartburn, flatulence
26
Q

cholecystitis management (6)

A
  • meds - analgesics (Dilaudid, morphine), antibiotics, antiemetics
  • NPO until symptoms subside
  • gastric decompression
  • weight reduction
  • avoidance of fatty/fried foods
  • surgery - laparoscopic/traditional cholecystectomy, cholecystostomy
27
Q

t-tube care (8)

A
  • ensure patency of duct until edema subsides
  • drains 400 mL/day - report if more than 1000 or sudden increase
  • record drainage q2-4h for 24hrs then q8 - color, amount (initially bloody, then bright yellow to dark green w/ acid odor and thick consistency)
  • semi-fowler’s position
  • keep drainage bag below level of gallbladder
  • protect skin around site
  • monitor for infection
  • never irrigate, aspirate, clamp without HCP order
28
Q

denture care (3)

A
  • remove at night to let oral tissue rest
  • brush with hand soap, dishwashing liquid, or denture cleaning paste (avoid regular toothpaste)
  • soak overnight in water or denture cleaner
29
Q

gingivitis patho/symptoms

A
  • inflammation of gums (but no destruction to periodontal ligament/bone)
  • tenderness, erythema, bleeding of gums
  • due to: plaque buildup, changes in hormone levels, oral foreign objects
30
Q

periodontitis patho/symptoms

A
  • destruction of periodontal ligament, loss of supporting bone, tooth loosening
  • due to chronic plaque and inflammation
31
Q

gingivitis treatment

A

good oral hygiene, regular dental visits

32
Q

periodontitis treatment (4)

A
  • good oral hygiene, regular dental visits
  • cessation of tobacco/other irritants
  • dental referral for deep root scaling
  • oral antibiotics, topical solutions - chlorhexidine
33
Q

xerostomia patho

A
  • sensation of dry mouth due to decreased salivary flow
  • causes: common in elderly, patients w/ rheumatic disease, Siorgren’s syndrome, after radiation, medications
  • decreased saliva increases risk for caries and periodontal disease
34
Q

xerostomia management (6)

A
  • avoid inciting meds, irritants (alcohol, caffeine, smoking), sugar-containing drinks/candies
  • take sips of water, esp. during meals
  • sugarless gum/mints
  • saliva substitutes, salivary stimulants (pilocarpine)
  • meticulous oral hygiene
  • increased strength topical fluorides (1.1% sodium fluoride)

AE III Exam 3 (4 decks)

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