Flashcards in Adult Health- Care of Patients with Malnutrition Chapter 60 Deck (41)
What does proper nutrition do?
regulates body temperature, respirations, cardiac output, muscle function, metabolism
What is energy balance?
relationship between energy used and energy stored
Which population is at risk for malnutrition?
: older adults (60 and up) due to hormonal changes feel les hungry. At risk for malnutrition
What are the dietary guidelines for Americans?
The 2010 Dietary Guidelines was designed to help people choose a healthy diet. It emphasizes 3 major goals for Americans:
Balance calories with physical activity to manage weight
Consume more of certain foods and nutrients such as fruits, vegetables, whole grains, fat-free and low-fat dairy products, and seafood
Consume fewer foods with sodium (salt), saturated fats, trans fats, cholesterol, added sugars, and refined grains
What are the top 3 vegetarian diets?
lacto-vegetarians, lacto-ovo, vegan
What are Lacto-vegetarians?
consume milk and milk products
What are lacto-ovo?
includes milk and eggs
what is vegan?
only plant origin food.
Vegetarians are at risk for developing _______ anemia?
Must ensure that vegetarians consume adequate amounts of what?
Ca, Iron, Zinc, Vitamin D & B12
What is nutritional status?
reflects the balance between nutrient intake and requirements- Affected by age, gender, disease, economic factors, eating behaviors cultural influence and emotional balance
JCT requires nutritional screening on all hospitalized patients within the first ______ hours?
What is included in a nutritional screening?
Review of nutrition history
Food and fluid intake
Anthropometric measures ( Height, Weight, BMI)
BMI= Weight in Kg/ height in m2
What is marasmus?
fat and protein are wasted (serum protein OK)
What is Kawashiorkor?
low protein quantity and quality (serum protein Low)
What are the 3 protein energy malnutrition things?
Marasmus, Kawashiorkor and a combo of both---- all of these negatively affect the functions of the liver, heart, lungs, and the GI tract
What are the common complications of malnutrition?
Low activity tolerance
Dry flaky skin
Poor wound healing
2 disease contributing to malnutrition are?
anorexia and bulimia
Describe a malnutrition assessment,
Ask about appetite and any weight changes
Hair ( hair loss)
Skin ( dry, flaky, slow healing wounds
Nails (brittle, discolored)
Assess difficulty swallowing (pain with chewing)
What are some labs that would go along with a malnutrition assessment?
Low H&H (anemias, hemorrhage, liver issues)
Thyroxine binding prealbumin (nutritional deficiency)
Cholesterol less then 160
Total lymphocyte count (TLC) low
Immune function measurement
What are some nursing interventions for malnourishment?
-Collaborative effort to improve nutritional status
-High calorie high protein food
-6 small meals per day
-Special supplements for diabetics, kidney and liver patients
-Zinc- nausea and vomiting
Can also incorperate bolus, continuous and cyclic feedings
What are specialized nutrition support?
TEN or TPN
What is listed under TEN?
What are some TEN complications?
Obstructed tube, refeeding, tube displacement, abdominal distension, fluid and electrolyte imbalance
What do you do if you have an obstructed tube?
Flush the tube with 20-30 ml H2O q4 hours, before and after each feeding & drug administration
If clogged use 30 ml H2O and flush
What is refeeding?
Due to aggressive re-nourishment
What do you do with tube displacement and what can happen?
Can cause aspiration
Fever, tachycardia, dehydration, low output
Listen to lungs q 4-8 hours
Pull the tube out
X-ray to confirm placement
What do you do if you have abdominal distension and what usually causes it?
Check residual q 4-8 hours
If >200ml during 2 consecutive checks hold feedings
Problem with checking may indicate clogged tube
What causes the fluid and electrolyte imbalance?
Due to comorbidities (cardiac, kidney)
Caution with osmolal ity of feeding liquid
Hyperkalemia and hypernatrimia