Nutritional Deficits Flashcards
preventing aspiration
assess if PO intake is realistic
sit up 90 degrees
thicken liquids if needed
cut food into small pieces
reduce distractions
ensure assistive devices are available
remove clutter
risk factors for malnutrition
cancer treatment
GI problems
Coma
Hypermetabolism - burns, sepsis, organ transplant
social conditions - remote, food deserts
psychological conditions - EDs, depression, anxiety
unable to prepare foods d/t disability
age
what is wasting?
low weight for height
what is stunting?
low height for age
what is underweight?
low weight for age
manifestations of undernutrition
pale, thick, dry skin
easy bruising
bleeding gums
soft bones
aching joints
swollen or shriveled tongue
night blindness
light sensitivity
what kind of tube can be used to remove stomach contents in an emergency?
NG tube
what is the purpose of a G tube
full dietary needs or just providing supplementation
what is a J tube?
goes to small intestine instead of stomach
when is enteral feeding indicated
pt unable to maintain adequate oral intake
pt with functional GI tract
comatose, dysphagia, upper GI obstruction, increased metabolic demand
when is enteral feeding contraindicated?
bowel necrosis
bowel obstruction
GI bleeding
paralytic ileus
when is total parenteral nutrition indicated?
pt does not have functional GI tract
when is NG tube contraindicated?
nasopharyngeal or esophageal obstruction
maxillofacial trauma, esophageal stricture or diverticulum = risk for perforation
coagulation abnormality = bleeding risk
electrolyte imbalances
nausea and vomiting
who can place NG tube?
RN or LPN
how is NG tube length measured?
tip of nose to earlobe, then nose to xyphoid process
NG tube placement techniques
high fowlers w towel on chest
have patient swallow while passing through pharynx
check placement via xray or pH of gastric contents
maintaining NG tube patentcy
flush with sterile water
q4h, after every feed, after administering medications
type of PPE for NG tube placement and care
clean, not sterile
why is NG vs G tube chosen?
G tube longer term
complications of G tube
wound infection
leakage
GI bleed
clogging
aspiration
what should gastric pH be?
about 5 or less
why is capnography used for NG tube placement?
determine if it is in the pts airway
managing tube occlusion
flush 30-50 mL before and after feeding
warm water bolus for clog
enzyme de-clogging kit
what allergies should be assessed for patient with order for parenteral lipids?
soybeans
safflower
eggs
what can happen if parenteral nutrition is discontinued abruptly?
rebound hypoglycemia
