Unit 2 Flashcards by Mariela Alvarez

For Nutrition
The nursing assistant should:

The nursing assistant should:
– Encourage residents to follow a healthy diet
– Reinforce teaching done by nurse
– Alert nurse if resident is not following prescribed diet
– Remember informed consent

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Calories:

– Unit of measurement
– Requirements vary among individuals

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Carbohydrates:

– Consist of sugars, starches, and fiber
– Can be simple or complex
– Carbs are broken down into blood glucose
– Fiber helps lower cholesterol, regulate blood sugar, aid in
digestion, and promote regular bowel movements

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Proteins:

Basic building blocks of cells
– Composed of amino acids
– Make up muscle and blood components and help keep other body
organs working
– Good sources of protein include meat, poultry, eggs, nuts, seeds,
seafood, beans, peas, and soy

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Fats:

– Unsaturated fats are typically found in cold-water fish, nuts, and
plant matter
– Saturated fats are found in meat, some dairy products, coconut
oil, and palm oil
– Cholesterol types include LDL and HDL
– High LDL cholesterol levels are linked to heart disease
– Limit saturated fats and LDL cholesterol in diet

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Vitamins and Minerals:

Needed to keep the body healthy
– Vitamins are found in plant matter and animals
– Minerals are elements from the earth
– Residents may require supplements
– There are 2 types of vitamins—fat soluble and water soluble

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Water-soluble vitamins:

– B1, B2, B6, B12, and C
– Niacin
– Folic acid
– Taking in too many fat-soluble vitamins can result in hypervitaminosis

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Fat-soluble vitamins:

– A, D, E, and K
– Taking in too many fat-soluble vitamins can result in hypervitaminosis

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Nutrient __________
Use:
Muscle function
Building bone
Nerve function
Found In:
Dairy products
Spinach
Salmon

Calcium

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Nutrient_________
Use: Prevention of birth defects
Cell growth
Found in: Dark green vegetables
Enriched breads/cereals
Lentils

Folic Acid

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Nutrient_________
Use: Cell growth
Oxygen delivery
Found in: Beef
Liver

Iron

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Nutrient_________
Use: Bone strength
Immune system function
Muscle and nerve function
Found in: Almonds
Spinach
Oatmeal

Magnesium

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Nutrient_________
Use: Immune system function
Wound healing
Cell growth
Found in: Beef
Peanut butter
Beans and peas

Zinc

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Use: Vision health
Bone growth
Immune system function
Found in: Carrots
Milk
Cantaloupe

Vitamin A

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Nutrient_________
Use: Nerve function
Immune system function
Hemoglobin production
Found in: Potatoes
Cereals
Bananas

Vitamin B6

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Nutrient_________
Use: Blood cell formation
DNA synthesis
Found in: Clams
Cereals
Liver

Vitamin B12

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Nutrient_________
Use: Calcium absorption
Inflammation reduction Sun exposure
Found in: Milk
Salmon

Vitamin D

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Nutrient_________
Use: Antioxidant properties
Immune system function
Found in: Almonds
Peanut butter
Sunflower seeds

Vitamin E

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Makes up about 60% of human body

Water

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Helps regulate body temperature
– Transports nutrients and wastes
– Keeps cells and organs working properly
– Best choice of fluid to drink

Water

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Fluid restrictions may be due to…

heart failure, kidney failure, dialysis, or edema

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– Occurs when body takes in less fluid than it excretes
– May be caused by vomiting, fever, or poor intake
– Can be life-threatening

Dehydration

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For Fluid intake It is important to remember…

All fluids are monitored and charted
– Follow directives from nurse or in care plan
– Remind resident of restriction
– Be sensitive to resident’s feelings
– Reinforce teaching done by nurse
– Alert nurse if resident asks for more fluids than allowed
– Remember informed consent

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– Adults should consume 6 to 8 servings per day
– Can help maintain weight, reduce cardiovascular disease, prevent
constipation, and offer protection from anemia

Grains:

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Include fruit and 100% fruit juice
– Juice does not offer fiber
– Adults should eat about 2 cups daily
– Help maintain healthy body weight and can reduce risk of stroke,
cardiovascular disease, diabetes, and some cancers

Fruits:

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– Subcategories include dark green leafy, orange, and starchy
vegetables; dried beans and peas; and other
– Adults should eat at least 2 to 3 cups daily
– Can help reduce risk of stroke, cardiovascular disease, diabetes,
and some cancers

Vegetables:

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– Include any milk-based product that retains calcium content after
processing
– Most adults should get 3 servings daily
– Serving = 1 cup of milk or 1.5 ounces of cheese
– Can help maintain healthy weight, bone mass, and blood
pressure

Dairy products:

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– Includes meat, poultry, fish, eggs, nuts, seeds, dried beans and
peas, and some items from dairy group
– Adults should eat about 5 to 6 ounces daily
– High-fat choices can increase risk of obesity, heart disease, and
some cancers

Protein:

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Assisting in feeding a resident( things to remember)

Be respectful and engage in conversation
– Provide homelike environment
– Offer to toilet resident before meals
– Wash both your hands and resident’s
– Verify meal tray is for correct resident

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Assisting in feeding a resident( things to remember)

Ensure tray has appropriate diet and adaptive equipment for
resident
– Make sure resident is sitting upright
– Season food to resident’s preferences
– Place clothing protector if they choose

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Assisting in feeding a resident( things to remember)

Test temperature of food and drink before offering to resident
– Do not touch food items with bare hands
– Sit next to resident when assisting
– Ask resident what item they would like first
– Alternate food bites with sips of liquid

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one ounce = how many cc’s

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how many KGs is =

2.2 oz

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DASH:

– Recommended for all adults and children as a heart-healthy way of eating
– Reduces cholesterol and increases insulin receptivity
– Helps lower blood pressure without the use of medication

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DASH encourages:

– Vegetables, fruits, beans, and nuts
– Low-fat dairy products, lean protein, and fiber
– Foods rich in potassium, magnesium, and calcium
– Food and drinks with no added sugar

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Diabetic:

– Individualized plan that considers all carbohydrates
– Typically developed by registered dietician
– Factors in age, weight, physical activity, gender, and medical conditions of
resident

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Caring for the resident with diabetes:

– Ensure nurse has taken resident’s blood sugar before he begins to eat
– Monitor food intake closely during meals and snacks
– Report poor intake promptly
– Watch for signs and symptoms of hyper- and hypoglycemia

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Low-sodium

– For residents with edema, kidney disease, high blood pressure, or diabetes
– May be limited to only 1,500 mg sodium daily
– Daily recommended amount for healthy adult is 2,300 mg
– Encourage residents to eat fruits and vegetables

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Low-cholesterol:

– For residents with heart disease, diabetes, high cholesterol, or history of heart
attack or stroke
– Avoid cholesterol, saturated fat, and trans fats
– Encourage intake of plant matter and meat alternatives

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Gluten-free:

– Necessary for residents with celiac disease
– Any grain—except rice—is eliminated from diet
– Avoid foods that use gluten as filler
– Reduces symptoms such as abdominal pain, bloating, and diarrhea

Lactose-free:

– Residents may need to avoid dairy products, take lactase enzyme tablets, or
eat lactose-free products
– Reduces symptoms of lactose intolerance such as abdominal bloating,
nausea, and diarrhea

Mechanically altered diets and fluids:

– For residents who have difficulties with eating or swallowing
– Can help promote independence
– Assistant should be respectful and display positive attitude

Mechanically altered diets and fluids:

– Cut-up diet
– Ground or easy-to-chew
– Pureed
– Thickened

Thickened liquids

May be necessary for residents with swallowing problems
– All fluids must be thickened to ordered consistency
– Includes nectar, honey, and pudding consistencie

Diets for the post-surgical resident:

– Include NPO, clear liquid, full liquid, soft or bland, and normal
diets
– Advanced as tolerated by resident
– Follow nurse directives
– Inform nurse if resident complains of nausea, vomiting, or
stomach upset

TOTAL PARENTERAL NUTRITION

-Contains necessary vitamins and minerals
- Usually given at same time as lipids
-Used when GI tract needs rest
- Temporary

ENTERAL FEEDING

Special formula given via tube surgically
implanted into stomach
-Given continuously or in a bolus every several
hours
Resident must be in Fowler’s or seated position

COMMON CAUSES OF NAUSEA AND VOMITING

Gastric illness
Bowel obstruction
Gastroesophageal reflux disease (GERD)
Reaction to medication
Pregnancy
Problems with equilibrium and balance

To ease nausea and vomiting:

– Ensure ordered diet is followed
– Offer clear liquids or bland foods as tolerated
– Provide quiet environment
– Limit movement
– Eliminate strong odors

Monitor for signs of dehydration:

– Listless behavior or weakness
– Dry skin
– Inability to sweat or make tears
– Dry mucous membranes
– Low urine output
– Confusion

COMMON CAUSES OF DIARRHEA

Gastric illness
Bowel obstruction
Celiac disease
Irritable Bowel Syndrome (IBS)
Reaction to medication
Excessive fiber intake
Contaminated food or water
Food intolerances

Care for the resident experiencing diarrhea:

– Keep bedside commode nearby
– Answer call light promptly
– Offer incontinence garment
– Use barrier creams
– Monitor skin closely

Body does not receive the calories and nutrients needed to
remain healthy

Malnutrition:

– Disorder characterized by eating large amounts of food in short
amount of time, even if not hungry

Binge eating:

Your resident drank a 4-oz glass of juice and a 6-oz glass of
milk. This should be documented as
a) 10 mL.
b) 100 mL.
c) 240 mL.
d) 300 mL.

d) 300 mL

Your resident drank an 8-oz glass of water and a 4-oz glass of orange juice. This should be documented as
a) 240 mL.
b) 300 mL.
c) 360 mL.
d) 480 mL.

c) 360 mL

Your resident drank a 5-oz glass of apple juice and a 7-oz glass of milk. This should be documented as
a) 210 mL.
b) 350 mL.
c) 370 mL.
d) 420 mL.

c) 360 mL.

Your resident drank a 10-oz glass of soda and a 6-oz glass of milk. This should be documented as
a) 150 mL.
b) 300 mL.
c) 480 mL.
d) 510 mL.

c) 480 mL.

Your resident drank a 12-oz glass of iced tea and a 5-oz glass of water. This should be documented as
a) 510 mL.
b) 700 mL.
c) 770 mL.
d) 900 mL

a) 510 mL.

Your resident has undergone knee repair surgery and has just returned to
the medical-surgical floor. He is complaining of nausea and asks you for
some ginger ale and crackers. Before you can give these to him, he would
have to
a) have bowel sounds.
b) sit upright for 30 minutes.
c) tolerate chicken broth.
d) ambulate 30 feet.

have bowel sounds.

Inadequate oral care can lead to:

– Poor overall health
– Decreased self-esteem
– Tooth decay and loss
– Poor nutritional intake
– Pain
– Embarrassment
– Increased risk of choking

Oral Care

Should be performed every morning and evening at
minimum, offer after meals as well
* Frequent mouth care for residents who are:
– on oxygen
– unconscious
– receiving tube feedings
– end of life care
– NPO (check with nurse if swabs are okay

Assisting a resident with their own teeth:

– Brush at least twice daily
– Clean all surfaces of teeth and mouth
– Hold toothbrush at 45-degree angle for outside of teeth
– Use tip of brush for inside surfaces
– Brush tongue with back-to-front motion
– Use mouthwash before or after brushing, if appropriate for
resident
– Stop brushing if bleeding occurs and update nurse
– Use oral swabs for residents unable to swish and spit

Denture care:

– Ask resident to remove dentures; assist if necessary
– Remove bottom plate first
– Slide index finger to back of gum line
– Use hooked finger to remove plate
– Place removed plate in denture cup or emesis basin
– Rinse mouth with mouthwash or water
– Place barrier in sink to prevent breakage
– Brush all surfaces using toothpaste and denture brush

Denture care:

– Place clean denture in resident’s mouth or in clean
denture cup
– Use denture adhesive or lip balm, if resident wishes
– Cover stored dentures with water or solution
– Denture cup and lid should be labeled with resident’s
name or room
– Check resident’s mouth daily

REPORT TO THE NURSE

Sores in the mouth
Ill-fitting dentures
Cracked or bleeding lips
White patches in the mouth
Complaints of pain Sweet- or foul-smelling breath
Missing dentures or partials Damaged or missing teeth
Refusal of oral care Bleeding in the mouth

Prosthesis

– Artificial limb or body part
– May be necessary due to disease, damage, trauma, or birth
defect
– Custom-made to fit each individual

Types of prostheses:

– Arms and legs
– Breasts—Total or partial
– Prosthetic eyes—Nonfunctioning, acrylic, and concave

Skin care:

– Clean skin with mild soap and water daily; rinse and dry
thoroughly
– Do not soak residual limb
– Do not apply lotions or creams, unless ordered by doctor
– Check skin at least twice daily—before putting prosthesis
on and after taking it off
– Report red, swollen, blistered, or excoriated areas to nurse
– Do not use prosthesis until irritated skin is healed

Skin damage may occur if:

– Fit is not precise
– Resident experiences fluctuations in weight or fluid
volume
– Sock or gel cushion shifts or becomes wrinkled
– Resident heals slowly or has fragile skin

Care of prosthesis:

– Clean socket of limb prosthesis daily with mild soap and water
– Ensure socket is completely dry before use
– Report any damage to prosthesis promptly

Care of sock/gel insert:

Wash with soap and water daily
– Ensure it is completely dry before use
– Fit should be snug but not tight
– Should be free of wrinkles

– Measured periodically throughout lifespan
– Obtained using standing scale, stadiometer, or tape measure
– May need to obtain while resident is in bed

Height

– Should be measured at least once a week
– Weight typically taken daily in hospital setting and should be
measured at the same time each day for accurate comparison
– Obtained using upright scale, wheelchair scale, mechanical lift,
or bed scale

Weight:

You are assigned to take care of Elisabeth, an older resident
with dementia. She refuses to allow you to brush her teeth this
morning. You should
a) offer her a small amount of mouthwash instead of
brushing.
b) inform the nurse that you are unable to provide
oral care.
c) not provide oral care, since she has the right to
refuse.
d) use a premoistened oral swab to provide oral care.

use a premoistened oral swab to provide oral care.

After taking off your resident’s prosthesis, you see a small
blistered area. You should
a) cleanse the area with hydrogen peroxide to dry the
blister.
b) apply barrier cream to the skin to prevent further
friction.
c) place clean gauze under the prosthetic for comfort.
d) not apply the prosthetic and then report to the
nurse.

not apply the prosthetic and then report to the nurse.

1 kilogram =

2.2 pounds

1 ounce =

30 mL

30 mL =

30 cc

30 cc =

1 ounce

One of your residents’ weight this morning is 83 pounds. The
nurse asks you how many kilograms the resident weighs. The
correct reply is
a) 37.7 kilograms.
b) 182.6 kilograms.
c) 166 kilograms.
d) 41.5 kilograms

37.7 kilograms.

In healthcare, measurements most often documented in the
metric system include
a) fluid intake.
b) food intake.
c) blood pressure.
d) both A and C.

both A and C.

If you see a patient with candies in their room, what should you do?

A) Ignore the candies and continue with your duties.
B) Take the candies away immediately.
C) Check the patient’s care plan and dietary restrictions before taking any action.
D) Encourage the patient to share the candies with others.

A) ignore the candies

What is receptive aphasia?

A) A condition where a person has difficulty speaking or finding the right words.
B) A condition where a person has difficulty understanding spoken language.
C) A condition where a person cannot read or write.
D) A condition where a person loses the ability to see clearly.

Answer: B) A condition where a person has difficulty understanding spoken language.

How long should a CNA lather their hands when washing them?

A) 10 seconds
B) 20 seconds
C) 30 seconds
D) 60 seconds

Answer: B) 20 seconds

Fluid restrictions are most likely to be in place for a resident with:

A) Digestive disorders.
B) Kidney failure or heart failure.
C) Respiratory infections.
D) Skin conditions.

Answer: B) Kidney failure or heart failure.

What are the symptoms of dehydration in a resident?

A) Increased appetite and weight gain.
B) Dry mouth, sunken eyes, decreased urine output, and confusion.
C) Excessive sweating and frequent urination.
D) Clear, pale urine and high energy levels.

Answer: B) Dry mouth, sunken eyes, decreased urine output, and confusion.

When providing oral care to a resident with natural teeth, at what angle should the toothbrush be held?

A) 15 degrees
B) 30 degrees
C) 45 degrees
D) 90 degrees

Answer: C) 45 degrees

When should CNAs check the skin beneath a prosthetic?

A) Only before putting it on.
B) Only after taking it off.
C) Both before putting it on and after taking it off.
D) Only if the resident complains of discomfort.

Answer: C) Both before putting it on and after taking it off.

How can you decrease the pocketing of food in a resident’s mouth?

A) Encourage the resident to eat quickly.
B) Use a straw for all liquids.
C) Offer small bites of food, ensure thorough chewing and swallowing before offering more, and offer drinks in between to help wash the food down.
D) Provide only pureed foods.

Answer: C) Offer small bites of food, ensure thorough chewing and swallowing before offering more, and offer drinks in between to help wash the food down.

When assisting a resident with denture care, the CNA observes that the upper plate is cracked and there is a sore in the resident’s mouth, but they are not complaining of pain. What should the CNA do?

A) Ignore the issue since there is no pain.
B) Continue to clean the dentures as usual.
C) Report the cracked upper plate and sore in the resident’s mouth to the nurse immediately.
D) Remove the dentures and leave them out permanently.

Answer: C) Report the cracked upper plate and sore in the resident’s mouth to the nurse immediately.

What abbreviation means “no food, no water”?

A) NBM
B) NPO
C) NOC
D) NKA

Answer: B) NPO

A resident is on a gluten-free diet. What should they avoid?

A) Dairy products
B) Foods containing wheat
C) Foods high in sugar
D) High-fat foods

Answer: B) Foods containing wheat

When assisting a resident with eating, what should you do to maintain proper hygiene?

A) Wash your hands only.
B) Wash the resident’s hands only.
C) Wash both your hands and the resident’s hands.
D) Use hand sanitizer on your hands only.

Answer: C) Wash both your hands and the resident’s hands.

Miss Bock is diabetic. For her mid-afternoon nourishment, the kitchen has sent a carton of ice cream. What should be your first action?

A) Allow her to eat the ice cream.
B) Substitute the ice cream with another snack.
C) Hold the nourishment and report to the nurse.
D) Give her a smaller portion of the ice cream.

Answer: C) Hold the nourishment and report to the nurse.

Mrs. Garcia is on a pureed diet due to swallowing difficulties. You receive a meal tray with whole pieces of chicken and vegetables. What should you do?

A) Puree the food yourself.
B) Cut the food into smaller pieces.
C) Hold the meal and report to the nurse.
D) Serve the meal as it is.

Answer: C) Hold the meal and report to the nurse.

How do you convert ounces (oz) to milliliters (ml)? What do you multiply by?

A) Multiply by 10.
B) Multiply by 30.
C) Multiply by 50.
D) Multiply by 100.

Answer: B) Multiply by 30.

Which of the following foods are liquid at room temperature?

A) Bread and butter
B) Ice cream and gelatin
C) Cheese and crackers
D) Apple and carrot sticks

Answer: B) Ice cream and gelatin

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Unit 2 Flashcards

week 2

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