Adult Health- Care of Patients with Malnutrition Chapter 60 Flashcards Preview

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Flashcards in Adult Health- Care of Patients with Malnutrition Chapter 60 Deck (41)
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1

What does proper nutrition do?

regulates body temperature, respirations, cardiac output, muscle function, metabolism

2

What is energy balance?

relationship between energy used and energy stored

3

Which population is at risk for malnutrition?

: older adults (60 and up) due to hormonal changes feel les hungry. At risk for malnutrition

4

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

5

What are the top 3 vegetarian diets?

lacto-vegetarians, lacto-ovo, vegan

6

What are Lacto-vegetarians?

consume milk and milk products

7

What are lacto-ovo?

includes milk and eggs

8

what is vegan?

only plant origin food.

9

Vegetarians are at risk for developing _______ anemia?

B12

10

Must ensure that vegetarians consume adequate amounts of what?

Ca, Iron, Zinc, Vitamin D & B12

11

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

12

JCT requires nutritional screening on all hospitalized patients within the first ______ hours?

24

13

What is included in a nutritional screening?

Review of nutrition history
Food and fluid intake
Labs
Food-drug interactions
Anthropometric measures ( Height, Weight, BMI)
Psychosocial assessment
BMI= Weight in Kg/ height in m2

14

What is marasmus?

fat and protein are wasted (serum protein OK)

15

What is Kawashiorkor?

low protein quantity and quality (serum protein Low)

16

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

17

What are the common complications of malnutrition?

Muscle wasting,
Low activity tolerance
Lethargy
Cold intolerance
Edema
Dry flaky skin
Poor wound healing
Infections

18

2 disease contributing to malnutrition are?

anorexia and bulimia

19

Describe a malnutrition assessment,

Ask about appetite and any weight changes
Hair ( hair loss)
Skin ( dry, flaky, slow healing wounds
Nails (brittle, discolored)
Eyes
Oral cavity
Assess difficulty swallowing (pain with chewing)
Neurologic status

20

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

21

What are some nursing interventions for malnourishment?

-Collaborative effort to improve nutritional status
-High calorie high protein food
-6 small meals per day
-Nutritional supplements
-Special supplements for diabetics, kidney and liver patients
Multivitamins
-Iron-constipation
-Zinc- nausea and vomiting
Can also incorperate bolus, continuous and cyclic feedings

22

What are specialized nutrition support?

TEN or TPN

23

What is listed under TEN?

Nasogastric tube
Nasoduodenal tube
PEG tube
PEG/J tube

24

What are some TEN complications?

Obstructed tube, refeeding, tube displacement, abdominal distension, fluid and electrolyte imbalance

25

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

26

What is refeeding?

Due to aggressive re-nourishment
Start slow

27

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

28

What do you do if you have abdominal distension and what usually causes it?

Overfeeding
Check residual q 4-8 hours
If >200ml during 2 consecutive checks hold feedings
Problem with checking may indicate clogged tube

29

What causes the fluid and electrolyte imbalance?

Due to comorbidities (cardiac, kidney)
Caution with osmolal ity of feeding liquid
Hyperkalemia and hypernatrimia

30

Describe PPN

Picc line
IV fat emulsion IVFE ( isotonic)
Amino acid dextrose solution
Home care: collaborative teaching of diet and nutrition
Enteral or parenteral nutrition-home services