Week 10-12 Flashcards
1
Q
History of Canada’s Food Guide
A
- Started in 1940s
- Values set to fatten up soldiers
- Develop from testing on Indigenous children
2
Q
Proper Portions
A
- 1/2 plate fruits/veg
- 1/4 plate protein
- 1/4 plate carbs
- Make water drink of choice
3
Q
Food Deserts
A
- Access barriers
- Connivence stores become primary option - expensive
4
Q
High Fibre
A
- Lower LDL cholesterol
- Lower blood sugar
- Decrease cancer risk
5
Q
High Protein
A
- Delays carb absorption & hunger
6
Q
Potassium
A
- Maintain normal fluid levels within cells
- Muscle contraction
- Normal blood pressure
7
Q
Sodium
A
- Maintain normal fluid levels outside of cells
- Hypertension risk - stroke/heart attack
- Nerve impulse conduction
- Muscle contraction/relaxation
8
Q
Trans Fats
A
- Artificially created HDLs & LDLs
- Raise bad cholesterol
- Lower good cholesterol
- Risk of CV diseases
9
Q
Saturated Fats
A
- Occur naturally in diary, meat
10
Q
Unsaturated Fats
A
- Vegetable - corn oil
11
Q
Polyunsaturated Fats
A
- Beneficial - olive oil
12
Q
Sugar Considerations
A
- Reduced intake of free sugars throughout course of life (less than 10%)
- Limit intake of free sugars to less than 10% of total calorie intake
- 50g of free sugars consumed per day in a 2000 calorie diet
13
Q
Alcohol
A
- 0 drinks per week ‘safe amount’
- Only carcinogen without warning labels
- Leading cause of preventable death
- Occurrence of malignant tumours (oral, pharynx, larynx, esophagus, liver)
14
Q
Water
A
- Drink according to thirst
- 8 glasses of day is a myth
15
Q
Albumin
A
- protein levels
- Malnutrition sign - low
- Liver/kidney disease - low
16
Q
Nitrogen
A
- Blood urea nitrogen test (BUN)
- Poor kidney function - high
- Dehydration - high
17
Q
Transferrin
A
- Amount of iron in body
- Predictor of protein status
18
Q
Lymphocytes
A
- Nutritional deficiencies may impact immune system
19
Q
Hemoglobin
A
- Composed of protein & iron
20
Q
Cholesterol
A
- HDL, good
- LDL, bad
21
Q
Oral Health
A
- High sugar
- Tobacco
- Alcohol
22
Q
Dysphagia
A
- Difficulty swallowing
- Change in voice tone/quality, altered gage, pocketing food, coughing
- Caused by stork, dementia/confusion, motor function
- Aspiration risk
23
Q
Dysphagia Interventions
A
- Changes to diet - SLP consult
- NPO
- IV - dehydration
- TPN - hard on liver/veins (NPO for multiple days)
- Enteral feeds - dehydration
- Nasal gastric tube NGT
- Gastrostomy G Tube
24
Q
Enteral Feeds
A
- Patients at high risk of aspiration
- Provides essential nutrition
- QOL impacts
25
Q
Clinically Signifiant Malnutrition
A
- Serum albumin below 3.5mg/100mL
- Total lymphocyte count below 1800/mm3
- Body weight decreased more than 15%
26
Q
Fluid Volume Deficit
A
- Decrease BP
- Pulse tachycardic, weak, thready
- Slowed cap refill
- Flat neck veins
- Lethargy
- Less than 30mL output/hr - oliguria
27
Q
Fluid Volume Overload
A
- Increase body weight
- Lower leg edema
- Increase BP
- Excess output - polyuria
- Neck vein distension
- Lung crackles
- Confusion
28
Q
Fluid Volume Interventions
A
- Daily weigh ins
- Client education
- Secure access to safe water
29
Q
Fluid Management
A
- Encourage oral
- Enteral (water flushes)
- IV
30
Q
Antibiotic History
A
- Penicillin discovery in 1928
- Used for infections in WWII soldiers
31
Q
Antibiotic Resistance
A
- Overuse
- Inappropriate prescribing
- Extensive agriculture use - injected to humans when food is consumed
- Few new antibiotics - no longer an economical investment
32
Q
Lymphocyte Levels
A
- Elevated with inflammatory response
33
Q
Monocyte Level
A
- Increased protozoal
- TB
34
Q
Eosinophils
A
- Increased parasitic
35
Q
Basophils
A
- Normal with infection
36
Q
Neutrophils
A
- Increased suppurative (pus) infection
- Decreased overwhelming infection
37
Q
Infection Response
A
- Remove offending body
- Monitor vitals
- Antibiotics
- Wound care vs DB&C
- Nutrition
- Rest
38
Q
Ulcer Prevention
A
- Sensory perception
- Moisture
- Activity
- Mobility - ability to change position
- Nutrition
- Friction & shear
39
Q
Inflammatory Phase
A
- Reaction to injury
40
Q
Proliferative Phase
A
- Filling wound with granulation tissue, contraction, resurfacing
41
Q
Remodelling Phase
A
- Scar formation
42
Q
Dehiscence
A
- Splitting/bursting open of wound
43
Q
VAC
A
- Decrease air pressure around wound to promote healing
44
Q
Common Vaccines
A
- Flu
- Pneumococcal >65
- Shingles >65
- Covid
- Ebola
45
Q
Colon
A
- Water absorption
46
Q
Age
A
- Decreased peristalsis
- Loss of pelvic floor strength
47
Q
Cystocele
A
- Dropping of bladder into vagina due to muscle loss
48
Q
Rectocele
A
- Dropping of rectum into vagina
49
Q
Constipation causing Medications - CAIAO
A
- Calcium
- Antibiotics
- Iron - dark/black
- Aspirin/NSAIDS
- Opioids
50
Q
Norovirus
A
- GI causing nausea/vomit
- Common in LTC
51
Q
Clostridium Difficile (C-diff)
A
- Gram positive
- 65+
- 3 unformed stools in 24hrs
52
Q
C-Diff Treatment
A
- PPE
- Abx stewardship - stop causing, start treatment
- Fidaxomicin, flagyl, vancomycin - c-diff target
- Specimen collection - sample in orange container
- Fecal microbiota transplant
53
Q
Bowel Routine
A
- Timing, amount of time
- Diet & exercise
- Stimulants/cathartics - laxatives
- Digital stimulation
54
Q
Colorectal Risk Factors
A
- Nutrition (red meat, fibre, milk, vit D)
- Alcohol
- Smoking
- Body fat
- Medications
55
Q
Non-Modifable Colorectal Risk Factors
A
- Family history
- IBD
- Height - tall people
56
Q
Stoma Care
A
- Stool consistency - more removed = more mushy stool
- Frequency of wearing pouch - all the time
- Surgeon attempts to position midline
- Emptied every 4-6hrs
- Pouch lasts 5-7 days
57
Q
Anuria
A
- Absence of urine production
- Scant - less than 50mL in 24hrs
58
Q
Polyuria
A
- Abnormally large volume of urine
- Diabetes
59
Q
Dysuria
A
- Pain/burning/stinging/itching associated with urination
- UTI
60
Q
Nocturia
A
- Need to get up at night to urinate - on regular basis
61
Q
Pyuria
A
- High levels of WBC in urine
62
Q
Oliguria
A
- Abnormally small amount of urine production
63
Q
Ketouria
A
- High levels of ketone in urine
- Diabetes
64
Q
Skin Assesment
A
- Hydration indicator
- Incontinence leads to breakdown
65
Q
Kidney Assessment
A
- Size
- Shape, ultrasound
- Flank pain
66
Q
Bladder Assessment
A
- Palpable when full
67
Q
Transplant for Kidney Disease
A
- Best option
- Immunosuppressant meds
68
Q
Hemodialysis
A
- 3x per week
- blood out, blood clean, blood home
- Fistula/graft needed
69
Q
Peritoneal Dialysis
A
- Performed daily, overnight
70
Q
Incontinence Considerations
A
- Timing
- Fluid intake
- Medications/caffeine
- Pelvic floor muscle exercises
71
Q
Urinalysis
A
- pH 4-6
- Protein
- Glucose - diabetes
- Ketones
- Blood
- Specific gravity - fluid balance/dehydration test
72
Q
Catheter Types
A
- Indwelling/foley
- Condom
- In & out
- CBI - continuous bladder irrigation
- Suprapubic
73
Q
Catheter Removal Barriers
A
- Data hard to find, not accurate, not available
- Not a priority
- Confusion about who has authority to remove
- Lack of agreement on standard protocol
- Communication barriers among clinicians
74
Q
Urinary Diversions
A
- Divert flow to abdominal surface
- Ileal conduit
- Cancer, trauma, radiation, fistulas
- Temporary/permanent
- Changes to urine
- Body image/self esteem
