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Exam 4 > Nutritional Modalities > Flashcards

Nutritional Modalities Flashcards

1
Q

What is the definition of nutrition?

A

the science of optimal cellular metabolism and its impact on health and disease

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2
Q

What nutritional assessments can be done?

A
  • Nutritional screening
  • Calorie count
  • Height
  • Weight
  • BMI
  • General assessment
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3
Q

What laboratory diagnostics can be used to assess a patients nutrition?

A
  • CBC
  • Serum glucose
  • Serum albumin and total protein
  • Cholesterol levels
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4
Q

What is gastrointestinal intubation used for?

A
  • Decompress the stomach
  • Lavage the stomach
  • Diagnose GI disorders
  • Administer medications and feeding
  • Compress a bleeding site
  • Aspirate gastric contents for analysis
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5
Q

What types of tubes are there?

A

Lavage and enteric tubes

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6
Q

What two types of lavage tubes are there?

A

Levin and gastric

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7
Q

What type of levin tube is there?

A

Single lumen

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8
Q

What types of gastric tubes are there?

A

Double lumen and radiopaque

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9
Q

What should the nurse do when inserting an NG tube?

A
  • Determine length to be inserted
  • Lubricate tip for easier insertion
  • Place patient in Fowler’s position with towel or bib on chest
  • Insert tube and ask patient to take small sips of water to facilitate passage
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10
Q

To facilitate passage of the NG tube what should you as the patient to do?

A

Take small sips of water

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11
Q

How should you initially confirm placement of the NG tube?

A

by X-ray

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12
Q

Other than X-ray what are the ways to confirm placement of the NG tube?

A
  • Measure tube length
  • Visual assessment of aspirate
  • pH aspirate-acidic
  • Auscultate abdomen over stomach while injecting are
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13
Q

What should you do to the NG after the correct position is confirmed?

A

Secure it

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14
Q

What are Enteric tubes used for?

A

Nutrition

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15
Q

What is it called when using enteric tubes?

A

GI intubation

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16
Q

Where do enteric tubes stay?

A

in duodenum or jejunum

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17
Q

Where are enteric tubes inserted and how long does it take to get to the intestines?

A

Inserted in stomach and takes 24 hours to pass through to intestines

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18
Q

What side should you place a patient on when inserting an enteric tube and why?

A

Laying on right side to facilitate passage

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19
Q

How is the placement of an enteric tube verified?

A

By radiography

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20
Q

What is the purpose of a gastrostomy?

A

To administer foods, fluids, or medications, or for gastric decompression

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21
Q

What is a gastrostomy?

A

An opening in the stomach

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22
Q

What is a PEG tube?

A

A percutaneous endoscopic gastrostomy

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23
Q

When would a PEG tube be clamped?

A

Between feedings

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24
Q

What are the two types of nutritional support?

A

Enteral and Parenteral

25
Q

Parenteral nutritional support goes directly into what part of the body?

A

The circulatory system

26
Q

Enteral nutritional support goes directly into what part of the body?

A

The Gastro-intestinal tract

27
Q

What is the purpose of enteral feedings?

A

Meet nutritional requirements when oral intake is inadequate or not possible and the GI tract is functioning

28
Q

What are the advantages of enteral feedings?

A
  • Safe and cost effective
  • Preserve GI integrity
  • Preserve the normal sequence of intestinal and hepatic metabolism
  • Maintain fat metabolism and lipoprotein synthesis
  • Maintain normal insulin and glucagon ratios
29
Q

Tube feedings are delivered where?

A

To stomach or to distal duodenum or proximal jejunum

30
Q

High osmolality of enteric nutrition may cause what?

A

Dumping syndrome

31
Q

Tube feeding formulas may include what?

A
  • Chemical composition of nutrient source
  • Caloric density
  • Osmolality
  • Residue
  • Bacteriologic safety
  • Vitamins and minerals
32
Q

What are the types of tubes?

A
  • Nasogastric
  • Nasoenteral
  • Gastrostomy
  • Jejunostomy
33
Q

What types of methods are used for tube feedings?

A
  • Intermittent bolus feedings
  • Intermittent gravity drip
  • Continuous infusion
  • Cyclic feeding
34
Q

What is nasoenteric feeding controlled by?

A

Continuous Controlled Pump

35
Q

What is the nursing care required for patient with a nasogastric, nasoenteric, gastrostomy, or jejunostomy tube?

A
  • Patient education and preparation
  • Tube insertion
  • Confirming placement
  • Clearing tube obstruction
  • Monitoring the patient
  • Maintaining tube function
  • Oral and nasal care
  • Monitory, preventing, and managing complications
  • Tube removal
36
Q

What nursing assessment needs to be done on a patient receiving enteral feedings?

A
  • Nutritional status and assessment
  • Weights
  • Factors or illnesses that increase metabolic needs
  • Hydration and fluid needs, I & O
  • Digestive tract function
  • Renal function and electrolyte status
  • Medications and other therapies that affect nutrition intake and function of GI tract
  • Compare the dietary prescription with the patients needs.
37
Q

What are the potential complications of enteral tube feedings?

A
  • Diarrhea
  • Nausea and vomiting
  • Gas, bloating, cramping
  • Dumping syndrome
  • Aspiration pneumonia
  • Tube displacement
  • Tube obstruction
  • Nasopharyngeal irritation
  • Hyperglycemia
  • Dehydration and azotemia
38
Q

In order to insure enteral tube safety what are the nutritional mangements?

A
  • Initate enteral feedings as prescribed
  • Advance tube feedings as tolerated
  • Monitor for tolerance
39
Q

What are the aspiration precautions for enteral tube safety?

A
  • Position with head of bed elevated a minimum of 30 degrees
  • Check tube placement every 4 to 6 hours
  • Check gastric residual volume every 4 hours
40
Q

When should you administer water in order to maintain nutrition balance and tube function?

A
  • Before and after each medication and feeding
  • Before and after checking residual
  • Every 4-6 hours
  • Whenever the tube feeding is discontinued or interrupted
41
Q

What should you NOT mix with tube feedings?

A

medications

42
Q

What size syringe should you use to check residual on a tube feeding?

A

30 mL or larger

43
Q

In order to avoid bacterial contamination of the tube function what should you not do?

A

Hang more than 4 hours of feeding in an open system

44
Q 
What position should the patient's head be in when receiving a tube feeding to prevent aspiration?
A. Flat
B. 10 to 20 degrees of elevation
C. 30 to 45 degrees of elevation
D. 45 to 90 degrees of elevation
A

C. 30 to 45 degrees of elevation

45
Q

How is parenteral nutrition described?

A

A method to provide nutrients to the body by an IV route

46
Q

What does Parenteral nutrition contain?

A

A complex mixture of proteins, carbohydrates, electrolytes, vitamins, trace minerals, and sterile water in a single container

47
Q

What my be piggybacked when administering parenteral nutrition?

A

Fats

48
Q

What is the goal of parenteral nutrition?

A

Improve nutritional status and to attain a positive nitrogen status

49
Q

How is parenteral nutrition delivered?

A

Peripherally or via a central line

50
Q

How is it decided whether to administer parenteral nutrition peripherally or via a central line?

A

It depends on the solutions toxicity

51
Q

What are the indications for parenteral nutrition?

A
  • Intake is insufficient to maintain anabolic state
  • Ability to ingest food orally or by tube is impaired
  • patient in not interest or is unwilling to ingest adequate nutrients
  • The underlying medical condition precludes oral or tube feeding.
  • Preoperative and postoperative nutritional needs are prolonged
52
Q

What do you need to monitor on a patient receiving parenteral nutrition?

A
  • Nutrition status
  • Daily weights
  • Hydration status
  • I and O
  • Electrolytes
  • Signs and symptoms of hypoglycemia or hyperglycemia
  • Monitor blood glucose
53
Q

What should a nurse be checking to assess for potential complications in patients receiving parenteral nutrition?

A
  • -Vital signs
  • Temperature q 4hours or by protocol
  • WBC
54
Q

What are the nursing diagnoses for a patient receiving parenteral nutrition?

A
  • Imbalanced nutrition
  • Risk for infection
  • Risk for excess or deficient fluid
  • Risk for immobility
55
Q

What are the two delivery options for parenteral therapy?

A

Peripheral method and central method

56
Q

What are the ways of central method delivery for parenteral therapy?

A
  • Nontunneled catheter
  • Peripherally inserted central catheter
  • Tunneled central catheter
  • Implanted ports
57
Q

What are the potential complications of parenteral therapy?

A
  • Pneumothorax
  • Clotted or displaced catheter
  • Sepsis
  • Hyperglycemia
  • Rebound hypoglycemia
  • Fluid overload
  • Thrombosis, embolism
58
Q

What are ways to prevent infection in those who are undergoing parenteral therapies?

A
  • Appropriate catheter and IV site care
  • Strict sterile technique for dressing changes
  • Wear make when changing the dressing
  • Assess insertion site
  • Assess for indicators of infection
  • Proper IV and tubing care
59
Q

What are ways to maintain proper fluid balance in patient who receive parenteral therapies?

A
  • Use infusion pumps so flow rates are not increased or decreased rapidly
  • Monitor indicators of fluid balance and electrolyte levels
  • I and O
  • Weights
  • Monitor blood glucose levels

Exam 4 (13 decks)

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