Set 9 Flashcards
List the macronutrients
Carbohydrates, Fats, Proteins
Main source of energy for the body
Carbohydrates
1g of carbs = ___ calories
4
1g of fat = ___ calories
9
Proteins that the body cannot make
Essential proteins
1g protein = ___ calories
4
List the micronutrients
Vitamins, minerals
Water soluble vitamins
B complex, vitamin C
Vitamins that need regular replacement due to constant loss through urine
Water soluble
Fat soluble vitamins
A, D, E, K
Vitamins that are stored in the body and can cause toxicity
Fat soluble vitamins
Measure of body fat based on height and weight
BMI
BMI calculation
Weight (Kg) / height (meters)^2
Underweight BMI
< 18.5
Healthy BMI
18.5-24.9
Overweight BMI
25-29.9
Obese BMI
> 30
Difficulty swallowing
Dysphagia
A patient with Dysphagia is at an increased risk for
Aspiration
S/S of Dysphagia
Frequent coughing, clearing throat, pocketing food, difficulty eating or drinking
Dysphagia patient education
Tuck chin to chest when swallowing
NPO diet
Nothing by mouth including liquids
Diet of consisting of fluids that are transparent and liquid at room temperature
Clear liquid diet
Clear liquid diet examples
Juices (grape, apple, cranberry), black coffee, tea, water, broth, popsicles, ice chips
Examples of full liquid diet
All the clear liquid items along with orange juice, milk, coffee with creamer, ice cream
Dysphagia diet
Soft foods (b/c they are moistened and puréed), thickened liquids
Capillary blood glucose measurement guidelines
- clean skin with alcohol swab and let it dry completely to prevent inaccurate readings
- use lancet on lateral side of finger
- wipe away first drop of blood; use second for reading
Tube inserted through the nose and to the stomach
Nasogastic tube (NG tube)
NG tube indications
Decompression (removal of fluid/gas), administration of medications/enteral feedings
Two different types of NG tubes
Double lumen and small-bore single lumen
Example of double lumen NG tube
Salem Sump
Double lumen NG tubes are most commonly used for
Decompression
Example of small-bore single lumen NG tubes
Dobhoff
Small bore single lumen NG tubes are best for
Medication administration and feeds
How to measure NG tube?
NEX method: measure from nose to earlobe to xyphoid process at bottom of sternum; mark length with tape
During NG tube insertion, encourage the patient to
Swallow or sip water to help advance the tube and make the process more comfortable
Absolute confirmation for placement of NG tube
X-ray
NG tube placement assessment
check for gastric pH (pull back on NG tube with syringe, test pH, pH should be highly acidic if in stomach (<5.5))
Nutrition that is delivered to the GI tract
Enteral nutrition
Types of enteral nutrition
NG tubes, percutanous tube (PEG, G, GJ)
NG tubes are great for _____-term feedings
Short
Percutaneous tubes are preferred for enteral feedings longer than _____ weeks
Four
Enteral feedings best practices
- HOB 30-45 degrees when feeding to decrease risk of aspiration
- aspirate gastric contents BEFORE feed (if >500 mL, do not return to stomach and report to provider; if <500 mL, return to stomach)
- flush tube with 30 mL of water before and after every feeding, medications, gastric residual volume checks (if continuous feeding, flush every 4 hours)
How often should tubing and delivery sets be changed for enteral feedings?
Every 24 hours (prevents microbial growth)
Nutrition delivered into the vascular space to avoid/go around the GI tract
Parenteral nutrition
What kind of central lines are used for parenteral nutrition?
PICC line or central venous catheter
TPN nursing assessment
Blood glucose levels (is patient getting enough?)
TPN is discarded after ___ hours to prevent microbial growth
24
If the next bag of TPN is unavailable, administer _________ until next bag is available
10-20%DW
