test #3 Flashcards
1
Q
education levels of nutrion
A
nutritionist: masters
dietician: bachelors
2
Q
Join commission guidelines on nutrition
A
- dietician assesses all patients within 24-48 hours of admission
- and must recommend a course of action if patient is NPO greater than 72 hours
3
Q
nutrition guidelines
A
- regular diest: eat anything, 3 times daily
- low fat
- low sugar
- high fiber
- low salt
- alcohol in moderation
- exercise daily
- no smoking
4
Q
clear liquid diet
A
- will not meet nutritional requirements
- no longer than 3 days
- uses: to rest bowel and GI tract or to progress slowly from surgery
- components: clear juices, broth, popsicles, coffee, water, anything you can see through (nothing red)
5
Q
full liquid diet
A
- may provide more calories than clear liquid but not sustainable with enough calories
- Uses: to progress the gut after long periods of rest and to provide more calores as it includes milk, grits, oatmeal, pudding, cream soups
- mindful of lactose intolerant patients
6
Q
modified consistency diet
A
- same as general diet, just different consistency
- uses: help patients recover from CVAs; patients with difficult with swallowing
- blended, pureed, mechanically modified for easy of chewing and swallowing
- will meet nutritional requirements
7
Q
diabetic diet
A
- dietician uses patients ideal body weight to determine the ideal calorie level for the patient
- 1800 ADA is a typical diabetic diet that consists of 1800 calories and includes between meal and bedtime snacks to help keep blood sugars stable
- carbohydrates are counted
8
Q
Renal Diet
A
- patients with elevated BUN and Creatine will require restiction in nutrients that may cause the kidneys to work harder
- designed to reduce the workload of the kidneys
- low in protein, potassium, sodium and fluid
- when protein metabolizes into amino acides and then into urea and nitrogen –> kidneys are unable to rid the blood of the toxic waste so nutrients need to be monitored to reduce workload of kidney
9
Q
Enteral Nutrition
A
- Use it or lose it: use the GI system always if you can. it will stop working if it is not in use for periods of time
- Tube Feedings/Enteral Nutrition: unable to swallow due to brain injury, use NG or PEG tubes.
- Dohoff Tube: yellow, thing, goes into duodeunum and bypasses stomach if needed. xray needed
10
Q
Gastric Residuals
A
- Gastric Residual: any substance not digested after two hours of feeding
- if amount is less than 60ml may continue to feed patient
- if amount is too high, decrease or stop tube feeding until tolerance is achieved
11
Q
Parenteral Nutrition
A
- TPN central line to heart
- PPN IV in arm/leg
- goes directly into veins
- indicated when a patient does not have a functioning gut
- adminster foods that have already been broken down (glucose, amino acids, lipids)
- infused through a central line with a rate set by provider
- test with labwork to make sure they are getting the proper nutrients
12
Q
Critical Care Patients and Nutrition
A
- depeding on prognosis of patient, the family, doctors, patient and dietician decide what type of feeding is required
- short term = NG tube
- long term = G Tube
- only when NO gut functioning is TPN recommended as it has been shown to cause hyperglycemia, insulin resistence, pancreatic/liver problems
13
Q
Dietician
A
- if pt has untreated HTN or DM it is recommended to refer these patients to a dietician
- lifestyle and diet changes are the FIRST line approach to care of these patients prior to Rx treatment
- nutrition is the first step to wellbeing
- overweight, leads to obesity, leads to HTN, Hyperlipidemia, DM, renal failure and cancer
14
Q
GI Tract Functions
A
- prepare food for absorption and use
- absorb nutrients and fluid (small intestine)
- Temporary storage of waste
- electrolyte balancing (diarhea and vomiting)
- remove secretions (25% solids, 75% liquids; fiber, fat, inorganic matter, little protein)
15
Q
GI Tract Parts
A
- mouth: mechanical and chemical breakdown (saliva, teeth, tongue, swallowing)
- esophagus: to stomach, airway protection (2 sphincters, upper and lower prevent reflux)
- stomach: storage, mixing, emptying (HCL, pepsin (protein breakdown), mucous (protection), intrinsic factor (B12))
- small intestine: digestion and absorption of most nutrients
- Large Intestine: organ of elimination
