Nutrition

Question 1

NPO

Answer 1

Nothing by Mouth

Question 2

Clear Liquid Diet

Answer 2

See through i.e. jello, broth, juice

Question 3

Full liquid Diet

Answer 3

Contains clear liquids plus…
-Any food items that are liquid at room temperature
-Soups, milk, milkshakes, puddings, custards, juices, yogurt…

Question 4

Mechanical Soft Diet

Answer 4

For patients with chewing difficulties

-Includes soft vegetables and fruits, breads, pastries, eggs, cheese, chopped ground or shredded meats

-Grinding or blending other foods to make them soft can also be included

Question 5

Pureed Diet

Answer 5

Blended diet

-Liquids are often added to create a liquid texture
(Pts. typically don’t eat due to appearance of meal)

Question 6

Why would a pt. be on thickened liquids?

Answer 6

Aspiration risk, difficulty swallowing

Question 7

What helps nurses mange nutritional imbalances?

Answer 7

Identify the etiology(cause) of the imbalance

Question 8

What are some dietary guidelines to include in pt/family teaching for older adults?

Answer 8

-Eat small, well balanced meals and nutritious snacks
-Increase protein, supplements
-Check food security based on income

Question 9

What are ways to improve pt. appetite?

Answer 9

-Offer small frequent meals
-Keep environment clean and neat
-Provide good oral hygiene
-Serve food attractively
-Position person comfortably
-Learn personal preferences
-Control pain
-Medication

Question 10

What are ways to assist pts. during meals?

Answer 10

-Assess functional ability, nutritional adequacy
-Serve one food at a time
-Serve small amounts
-Encourage independence
– allow choices
-Serve finger food
-Provide privacy
-Maintain dignity
-Sit down while feeding – don’t rush; converse
-Prepare food on tray if client can feed self.

Question 11

What are examples of alternative feeding methods?

Answer 11

Enteral Nutrition
-Deliver liquid nutrition via a tube into the G.I. tract (only used when pt. can’t swallow or take nutrients orally)

Parenteral Nutrition
-Deliver of nutrition
intravenously

Question 12

Enteral Nutrition (Tube Feeding)

Answer 12

-Preferred method over parenteral (IV) if patient has functional GI tract but needs nutritional support

-Can be used for short and long term therapy

Question 13

What are possible risks of enteral nutrition?

Answer 13

aspiration, infection, diarrhea, metabolic disturbances, alteration in drug absorption and metabolism

Question 14

What are the types of enteric tubes for pts. less than 4 weeks?

Answer 14

Nasogastric (nose to stomach)
Nasoenteric( nose to jejunum/duodenum

Question 15

How is a lumen measured?

Answer 15

French Scale
-Larger the number, larger diameter

Question 16

Important things to remember when checking tube placement?

Answer 16

Must be verified prior to any feeding
-Or once each shift for
continuous feedings
-Risk of aspiration if tube
placement is changed.
-Radiographic verification
– most reliable
-Used to verify initial
placement.
Other methods:
-Aspiration of stomach
contents
-Measuring the pH of the
aspirate
-Injecting air - not reliable

Question 17

What are other uses for a nasogastric tube?

Answer 17

-Lavage of the stomach (washing out of stomach)

-Collecting stomach content specimens

-To prevent nausea, vomiting, and gastric distention after surgery or with bowel obstruction

Question 18

What are types of enteric feeding for pts. greater than 4 weeks?

Answer 18

-Percutaneous gastrostomy tube (PEG)

-Jejunostomy tube (J-tube)

-Placed via laparoscopy through skin and abdominal wall into the stomach or jejunum

Question 19

Types of enteral feeding schedules

Answer 19

-Continuous feedings

-Intermittent feedings (bolus)

Question 20

What does the nurse monitor during enteral feeding tubes?

Answer 20

-Tube placement

-Skin condition (insertion site, diarrhea)

-Lab values (glucose, BUN,
& electrolytes,pre-
albumin)

Question 21

Why is parenteral nutrition preferred over enteral?

Answer 21

Preferred method of feeding for clients who cannot be nourished through the GI tract

Question 22

Two types of Parenteral Nutrition

Answer 22

Partial Parenteral Nutrition(PPN)
-Can take some of their nutritional intake orally
-IV nutrition is supplemental

Total Parenteral Nutrition(TPN)
-Require total resting of GI Tract
-Extensive burns or trauma, severely malnourished

Question 23

Composition of TPN

Answer 23

10-50% concentration of dextrose
(Blood sugar checks regular)
-Vitals and Minerals
-Prepared under antiseptic conditions

Question 24

How is TPN administered?

Answer 24

CVC (central venous catheter)
-central line, PICC line
-Only hang for 12-24 hrs

Question 25

Mr. Conrad is in chronic kidney disease stage 4 (CKD-4) and is a hemodialysis (HD) patient. A renal diet is ordered for him by the LIP. Which of the following is a low potassium source of protein for Mr. Conrad?

A. Eggs
B. Beans
C. Beef
D. Brussel Sprouts

Answer 25

Eggs
-low potassium protien source