Week 3 (Exam 1) Flashcards
Weight loss is deemed as
calories in < calories out
What are the indications for nutrition/vitamin assessment?
no other causes identified
dietary restrictions
geographic locations
social history
genetic history
underlying medical issues
What are the most common nutrients assessed?
B2, B12, KADE, C, B9, magnesium, calcium, iron
Why is liver important in nutrition?
Conversion of food into essential chemicals
production of bile
- KADE need this for absorption
chronic liver diseases
- associated with malnutrition
- ex: alcoholic liver disease
Define anemia
The reduction of 1 or more of the major RBC measurements obtained as a part of the CBC
incidence of anemia increases after age of 60 y/o
What are the causes of anemia in older adults
1/3 nutritional deficiencies
1/3 kidney disease
1/3 unexplained
What are the common nutritional deficiencies associated with anemia
Copper
- helps absorb iron from gastric tract
B12
- high MMA = deficiency
Folate
Iron
- serum iron, serum transferrin or TIBC (iron studies panel)
- makes hemoglobin
What is the assessment of anemia caused by nutrition
blood tests (serum)
What are other most common causes of nutritional anemia
gastric bypass
zinc supplements (too much = copper def)
From a primary medical perspective, if you cannot find underlying cause of symptoms…
consider nutrition as a source
There are many diagnosis where nutrition can be
both a cause and/or an effect off that diagnosis
What are some common deficiencies secondary to gastric bypass
B1, B12, D, iron, copper
What are some indications based on symptoms of a vitamin deficiency
fatigue
shortness of breath
dizziness
pale or yellowish skin
irregular heartbeats
weight loss
numbness or tingling in hands and feet
muscle weakness
What is the definition of a venous catheterization
surgical puncture of a vein for the withdrawal of blood or for administration of fluids or drugs
What are the indications for IV?
fluid administration
medication administration
blood product administration
diagnostic administration
What are the contraindications for IV
avoid extremities with burns, edema, injury, infection/cellulitis
avoid known areas of phlebitis, known circulation problems
avoid extremities with fistula
Where do we tend to inert an IV
forearm more than hand/wrist
What is a key insertion technique for peripheral IV
once you have blood in flash chamber, lower catheter so nearly parallel with arm and advance the plastic catheter in vein
What are complications with peripheral IV
bleeding, local infection/cellulitis, thrombophlebitis
What are the indications of a venipuncture
obtaining a sample of venous blood fr various lab tests
when needing a larger sample of blood
What are the contraindications of a venipuncture
skin infection, scars, burns, etc
ipsilateral side of mastectomy, IV line, and fistula
Where do we tend to inert a venipuncture
antecubital fossa
- cephalic and basilic veins are most prominent
What angle do we insert a venipuncture
insert into vein at 15-30 degree angle
What do we dispose after a venipuncture
SHARPS
What are complications with venipuncture
cellulitis, phlebitis, thrombosis, hematoma at site, laceration of vein, possible vasovagal response
What is the first test in a blood draw order
blood cultures first!
Where do we insert a central line
internal jugular (right)
femoral
subclavian vein (left)
What are the indications of a central line
fluid resuscitation (including blood products)
central venous pressure monitoring
emergency venous access
- due to difficult peripheral IV access
What are the contraindications of a central line
infection
thrombus
coagulopathy history
combative patients
What are complications with central line
pain
hematoma
infection
air embolism
thrombosis
pneumothorax
What is a finger stick
procedure where the finger is pricked with a lancet to obtain a small amount of capillary blood
What is the purpose of a finger stick
blood glucose testing
mono test
HGB level
some genetic testing
Which finger do we use for finger sticks
3rd or 4th works best
puncture finger on the volar aspect, just off the midline
avoid tip and sides of finger due to increased number of nerve findings
What are complications with finger sticks
localized pain
infection
possible persistent bleeding
