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P&A midterm > Nutrition > Flashcards

Nutrition Flashcards

1
Q

What is enteral nutrition?

A

Nutrition via tube

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2
Q

What is parenteral nutrition?

A

Nutrition via IV

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3
Q

When are people fed?

A

As soon as they have bowel sounds

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4
Q

Characteristics of carbohydrates

A 
Main source of energy
Readily broken down
Simple sugars - honey, fruit milk
Complex sugars - starch
50-60% of calories
Glycogen is body's stored CHO
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5
Q

Characteristics of proteins

A

Polymers of amino acids
Essential for tissue growth, maintenance, repair
Collagen, enzymes, hormones, immune cells are made of protein
20% of calories

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6
Q

Characteristics of fats

A

Lipids
Provides insulation, protects vital organs, provides energy vitamin absorption and transport
25-30% of calories
Saturated fats - 5-6%
Thought to lead to higher LDL and atherosclerosis
- Trans fats - <1%

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7
Q

What factors affect nutrition?

A

Lifespan consideration
Cultural considerations
Intake
Ability to use digested nutrients

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8
Q

What are characteristics of a well-nourished person?

A 
Normal weight and height
Adequate appetite
Active, alert
Firm, healthy skin and mucous membranes
Erect posture
Well-developed muscles without excess body fat
Healthy teeth and gums
Normal excretion, sleep patterns, hemoglobin, hematocrit, and serum protein levels
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9
Q

What are signs of poor nutrition?

A 
Cachectic (skeletal) appearance
Flaccid muscle tone
Weak muscles
Subq fat loss
Mental inattention
Paresthesia - abnormal dermal sensation (tingling, prickling) with no apparent cause
Anorexia
Rapid heart rate
Easily fatigued
Dull, dry brittle hair; lips – dry and scaly; gums – spongy and bleed easily
Tooth loss
Eyes - pale conjunctiva
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10
Q

What is a clear liquid diet?

A

Transparent liquid - gelatin, clear juices, broth, bouillon, popsicles
1 ounce = 30 ml/cc

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11
Q

What is a full liquid diet?

A

Addition of smooth-textured dairy products, cream soups, custard, refined hot cereals, all juices, frozen yogurts, pureed vegetables

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12
Q

What is a soft pureed diet?

A

All of full liquid diet + scrambled eggs, pureed meats, vegetables and fruits; mashed potatoes and gravy

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13
Q

Where are soft pureed diets frequently seen?

A

Geriatric/nursing homes

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14
Q

What is a mechanical soft diet?

A

All of soft pureed diet plus finely diced meats, cheeses, potatoes, flaked fish, pancakes, rice, cooked and canned fruits and veggies

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15
Q

Small-bore feeding tube (NG)

A

Usually into stomach or duodenum (first part of small intestine)
Generally short term
Risk of aspiration

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16
Q

Percutaneous feeding tube

A

Feeding tube is surgically fed into stomach through abdomen (PEG) or jejunum (PEJ)

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17
Q

When is a PEJ used?

A

When there are stomach issues

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18
Q

What is TPN?

A

Total parenteral nutrition
Liquid food via IV
Good for people with Crohn’s disease because their bowel is inflamed

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19
Q

What is a Salem-sump tube?

A

A wide tube put in to decompress stomach and drain gastric fluid
Normally used when there’s decreased motility in GI tract

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20
Q

What is dysphagia?

A

Difficulty swallowing

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21
Q

What are the causes of dysphagia?

A

Myasthenia gravis, aging, stroke, multiple sclerosis, cancers, dementia

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22
Q

What are the complications of dysphagia?

A

Aspiration pneumonia, dehydration, decreased nutritional status and weight loss (malnutrition)

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23
Q

What are the warning signs of dysphagia?

A

Coughing or frequent clearing of throat during eating.
Change in voice after swallowing.
Abnormal movements of the mouth, tongue or lips.
Prolonged eating time
Oral pocketing.
Abnormal gag or delayed or absent trigger of swallowing.
Pharyngeal pooling.

24
Q

How do you obtain a more in depth assessment for a dysphagic patient?

A

Referral to a speech pathologist

25
Q

What are some dysphagia interventions?

A

Soft, smooth foods are better tolerated.
Sit patient upright (90 degrees)
Encourage patient to focus on act of swallowing. Be alert to signs of fatigue.
Place food in the strong side of the mouth.
Feed the patient slowly, allowing enough time to chew thoroughly and swallow. Provide rest periods
Encourage the patient to remain upright for 30 minutes following the meal.
Thicken liquids - added to liquids
Give emotional support

26
Q

Percutaneous endoscopic gastronomy

A

Surgically inserted

Preferred for long-term feeding (comfortable and secure) OR pts with facial and neck tumors or surgery.

27
Q

Percutaneous endoscopic jejunostomy

A

Tube is placed beyond the stomach into jejunum
Patients with gastroparesis, GERD, or a history of aspiration pneumonia.
Patients with decreased innervation to the stomach - gastroparesis that results in delayed gastric emptying OR esophageal reflux OR history of aspiration pneumonia

28
Q

What is aspiration?

A

When something comes up from the stomach and down the trachea and ends up in respiratory tracts

29
Q

How do you care for an enteral tube?

A

Check tube placement via x-ray before beginning feedings to prevent accidental aspiration
Can check pH of secretions on the tube (1-4 pH for gastric juice)
Maintain head of bed (HOB) minimum 30 degrees during feeding and 30 min after
Confirm bowel sounds are present/assess respiratory status
Dye should not be used
Use GRV to assess tolerance of enteral feedings
Flush with 30-60 cc warm water

30
Q

How can you identify an intolerance to feeding?

A 
High GRV
Abdominal distention
Nausea
Cramping
Vomiting
31
Q

How to check the GRV?

A

Gather supplies
Connect syringe to end of feeding tube
Slowly and gently pull back to aspirate gastric contents and place into graduated cylinder
Repeat process until no further content can be aspirated
Note and document amount

32
Q

Fat soluble vitamins

A

Vit A, Vit D, Vit K

33
Q

Vitamin A

A

Vision

34
Q

Vitamin D

A

Calcium

35
Q

Vitamin K

A

Liver, prothrombin

36
Q

Water soluble vitamins

A

Vit B2, Vit B3, Vit B12, Vit C

37
Q

Vitamin B2

A

Protein and carb metabolism

38
Q

Vitamin B3

A

Glycogen metabolism, tissue regeneration, fat synthesis

39
Q

Vitamin B12

A

Formation of RBC

40
Q

Vitamin C

A

Protection against infection

41
Q

Minerals

A 
Calcium
Sodium
Potassium
Iodine
Fluoride
Water
42
Q

Calcium

A

Conversion of prothrombin to thrombin

43
Q

Sodium

A

Maintains fluid and acid-base balance

44
Q

Potassium

A

Protein synthesis, fluid balance, muscle contraction

45
Q

Iodine

A

Thyroid

46
Q

Fluoride

A

Bone structure

47
Q

Water

A

Normal cell function

48
Q

Digestive tract

A

Mouth, pharynx, esophagus, stomach, small intestine, large intestine

49
Q

Adduction

A

moving a joint or extremity toward the midline of the body

50
Q

Abduction

A

moving a joint or extremity away from the midline of the body

51
Q

Internal rotation

A

turning a joint or extremity on its axis toward the body’s midline

52
Q

External rotation

A

turning a joint or extremity on its axis from the body’s midline

53
Q

Supination

A

turning the body or a body part to face upward

54
Q

Pronation

A

turning the body or a body part to face downward

55
Q

Circumduction

A

moving a body part in widening circles

P&A midterm (10 decks)

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