Unit 8 - HFN, NMT, Feeding Flashcards
What is NPO?
Nothing per oral
Can not have anything to eat or drink! Sips of water for meds only
What is DAT?
Diet as tolerated
May start with pureed food, and graduate to mashed food
What is a regular diet?
One with no restrictions and then can eat anything.
What are classified as full fluids??
Dairy, all fruit juices, pureed vegetables and refined cereals. Thickend fluids
What are clear fluids?
Fluids that you can see through a glass, water, juice, tea
Note: If you put a paper behind the glass… if you are still able to read it then it is a clear fluid.
What is a soft diet?
Low residue, pureed, mechanical soft.
Considerations for assisting with nutrition of client.
Stimulate appetite
have equipment avail (table, shirt saver, utensils)
Have patient sit upright (no hyperextend neck)
provide adequate time to eat
What are some aspiration precautions?
observe for Dysphagia (difficulty swallowing)
offer small bites (if stroke pt, use unaffected side and check for cheek pocketing)
provide cueing.
observe for fatigue
Pt should remain upright for at least 20-30 mins
What is the function of your head and face?
Protect, support and stabilize the brain
house delicate organs
entrance to the digestive and respiratory system.
cranial and facial bones serve attachment for muscles to move our head and help us chew food
What are the structures of the neck?
Muscles
Sternomastoid, Trapezius
Anterior and posterior “triangles”
Thyroid - metabolism
What is the name and order of the Lymph nodes?
Preauricular Posterior auricular (mastoid) Occipital Submental Submandibular Tonsillar (Jugulodigastric) Superficial cervical Deep cervical (chain) Posterior cervical Supraclavicular
What is lymphatic drainage?
A separate vessel system
Manages interstitial fluid
Part of the immune system
(Absorbs fat from the gut)
Lymphatics run parallel to the venous system, picks up the extra fluids and brings back to heart
What is some subjective date to collect for the head face neck assessment?
Unusual headaches, head injury (LOC?)
Dizziness, Neck pain or limited ROM
Lumps or swelling in lymph nodes or salivary glands?
History of surgery?
Are these new? how do they affect your ADL’s?
What are we inspecting on the Head, face, and neck?
Size, shape, facial structures, symmetry, ROM
Where should the trachea lie?
Midline, if it is shifted or tugging there may be an issue with the heart.
What is something we may notice on inspection of an infants head?
Fontanels - Should be firm and slightly concave, Spaces where the skull hasn’t formed yet, make sure not sunken or depressed as that will indicate dehydration.
At which age is the lymphatics most active?
Children, atrophy’s after puberty.
If you were to auscultate the thyroid, what are you listening for?
Bruit
What are the external nose structures?
Bridge, tip, nares, Ala, vestibule
What are the internal nose structures?
Olfactory region, Superior, Middle and Inferior turbinates, meatus, septum
What are the paranasal sinuses?
Frontal
ethmoid
sphenoid
maxillary
What is the purpose of the nose?
First part of the respiratory system
Warms, moistens and filters air
sense of smell
Sound productions and mucus productions
What are the 3 salivary glands?
Parotid
Submandibular
Sublingual
What is the function of the mouth?
First part of the digestive system (and airway)
formation of speech
sense of taste
What are the 3 parts of the pharynx (throat)
Nasopharynx
Tonsils
Oropharynx
What is some subjective data to collect about the nose?
Any discharge? Colds, pain, trauma, allergies, altered smell?
What is Epistaxis?
Nose bleed
what is some subjective data to collect about the mouth and throat?
Any sores, sore throat, bleeding gums, toothaches
hoarseness, altered taste, smoking (how long and how many a day?)
Oral care?
What do you inspect in the mouth and throat?
Lips, teeth/gums, tongue, cheeks (mucosa), hard and soft palate, uvual
Tonsils
Identify the facial bone that articulates at a joint instead of a suture: A) Zygomatic B) Maxilla C) Nasal D) Mandible
D) Mandible
Identify the blood vessel that runs diagonally across the sternomastoid muscle: A) Temporal artery B) Carotid artery C) External jugular vein D) internal jugular vein
C) External jugular vein
The isthmus of the thyroid gland lies just below the : A) Mandible B) Cricoid cartilage C) hyoid cartilage D) thyroid cartilage
B) Cricoid cartilage
Select the statement that is true regarding cluster headaches:
A) May be precipitated by alcohol and daytime napping
B) Usual occurrence is two per month, each lasting one to three days
C) Characterized as throbbing
D) Tend to be supraorbital, retro-orbital, or frontotemporal
A) May be precipitated by alcohol and daytime napping
Select the symptom that is least likely to indicate a possible malignancy
A) History of radiation therapy to head, neck, or upper chest
B) history of using chewing tobacco
C) History of high alcohol consumption
D) Tenderness
D) Tenderness
Providing resistance while the patient shrugs the shoulders is a test of the status of cranial nerve: A) II B) V C) IX D) XI
D) XI
Upon examination, the fontanelles should feel:
A) tense or bulging
B) depressed or sunken
C) firm, slightly concave, and well-defined
D) Pulsating
C) Firm, slightly concave, and well-defined
If the thyroid gland is enlarged bilaterally, which of the following maneuvers is appropriate:
A) check for deception of the trachea
B) listen for a bruit over the carotid arteries
C) listen for a murmur over the aortic area
D) listen for a bruit over the thyroid lobes
D) Listen for a bruit over the thyroid lobes
It is normal to palpate a few lymph nodes in the neck of a healthy person. What are the characteristics of these nodes: A) Mobile, soft, non tender B) large, clumped, tender C) matted, fixed, tender, hard D) matted, fixed, non tender
A) Mobile soft non tender
Cephalhematoma is associated with A) subperiosteal hemorrhage B) craniotabes C) bossing D) congenital syphilis
A) Subperiosteal Hemorrhage
Normal cervical lymph nodes are: A) smaller than 1 cm B) warm to palpation C) Fixed D) Firm
A) Smaller than 1 cm
A throbbing, unilateral pain associated with nausea, vomiting and photophobia is characteristics of: A) cluster headaches B) subarachnoid hemorrhage C) migraine headache D) tension headache
C) Migraine headache
The most common site of nosebleeds is A) the turbinates B) the columellae C) Kiesselbach's plexus D) the meatus
C) Kiesselbach’s plexus
The sinuses that are accessible to examination are the : A) ethmoid and sphenoid B) frontal and ethmoid C) Maxillary and sphenoid D) frontal and maxillary
D) Frontal and maxillary
The frenulum is:
A) the midline fold of tissue that connects the tongue to the floor of the mouth.
B) the anterior border of the oral cavity
C) the arching roof of the mouth
D) the free projection hanging down from the middle of the soft palate
A) The midline fold of tissue that connects the tongue to the floor of the mouth
The largest salivary gland is located
A) within the cheeks in front of the ear
B) beneath the mandible at the angle of the jaw
C) within the floor of the mouth under the tongue
D) at the base of the tongue
A) within the cheeks in front of the ear.
A 70 year old woman complains of dry mouth. The most frequent cause of this problem is:
A) the aging process
B) related to medications she may be taking
C) the use of dentures
D) Related to a diminished sense of smell
B) Related to medications she may be taking
Because of the patients history of headache, the examiner inspects the nasal cavity. The nasal mucosa in an individual with a chronic allergy would be described as: A)swollen and bright red B) swollen, boggy, pale, and grey C) pale grey, swollen, and pink D) red with a smooth moist surface
B) swollen boggy, pale and grey
During an inspection of the nares, a deviated septum is noted. The best action is to
A) request a consultation with an ear, nose, and throat specialist
B) document the deviation in the medical record in case the person needs to be suctioned
C) teach the person what to do if a nosebleed should occur
D) explore further because polyps frequently accompany a deviated septum
B) Document the deviation in the medical record in case the person needs to be suctioned
Oral malignancies are most likely to develop: A) on the soft palate B) on the tongue C) in the buccal cavity D) under the tongue
D) Under the tongue
In the medical record, the tonsils are graded as a 3+. The tonsils would be
A) visible
B) hallway between the tonsillar pillars and uvula
C) touching the uvula
D) touching each other
C) touching the uvula
The function of the nasal turbinates is to A) Warm the inhaled air B) detect odours C) stimulate tear formation D) lighten the weight of the skill bones
A) Warm the inhaled air
The opening of an adult's parotid gland (Stensen's duct) is opposite the: A) lower second molar B) Lower incisors C) upper incisors D) Upper second molar
D) Upper second molar
A nasal polyp can be distinguished from the nasal turbinates by three of the following characteristics. Which characteristic is false? A) the polyp is highly vascular B) the polyp is movable C) the polyp is pale grey in colour D) the polyp in non tender.
A) the polyp is highly vascular
