Chapter 24: MNT in Surgical Conditions and Burns

Question 1

is the anatomic alteration of the human organism that is designed to arrest or alleviate a pathologic process

Answer 1

surgery

Question 2

characteristics of this conditions

-insulin resistance
-hormonal changes
-peristalsis is inhibited
-electrolyte losses
-increased utilization of nutrients

Answer 2

surgery

Question 3

hormonal changes during surgery

increased secretion of _____ (3)

Answer 3

Antidiuretic hormone (adh/vasopressin), catecholamines, adlosterone

Question 4

surgery - dietary mgmt (pre-op)

case: elective surgery

diet: ?

rationale: to prevent vomitus aspiration

Answer 4

npo at least 6 hrs before surgery

Question 5

surgery - dietary mgmt (pre-op)

case: elective surgery

diet: ?

rationale: promote glycogen storage and facilitate safe and faster recovery

Answer 5

high calorie

Question 6

surgery - dietary mgmt (pre-op)

case: elective surgery

diet: ?

rationale: if obese, to facilitate safe and faster recovery

Answer 6

low calori

Question 7

surgery - dietary mgmt (pre-op)

case: elective surgery

diet: ?

rationale: build-up nitrogen reserves, increase resistance to infection, wound healing, regeneration of hemoglobin

Answer 7

high protein

Question 8

surgery - dietary mgmt (pre-op)

case: elective surgery

diet: ?

rationale: regulates fluid and electrolyte balance, promoted blood building and clotting

Answer 8

vitamin and mineral supplementation

Question 9

surgery - dietary mgmt (pre-op)

case: emergency surgery

diet: ?

rationale: fastest method of nourishing patient prior to operation; to prevent shock

Answer 9

parenteral feeding

Question 10

surgery - dietary mgmt (post-op)

case: -

diet: ?

rationale: to prevent aspiration

Answer 10

NPO

Question 11

surgery - dietary mgmt (post-op)

case: -

diet: ?

rationale: to adjust to the ability of the patient to digest food

Answer 11

progress to clear liquid to regular diet

Question 12

surgery - dietary mgmt (post-op)

case: -

diet: ?

rationale: to prevent ketosis; for increased metabolism; to spare protein

Answer 12

high calorie

Question 13

surgery - dietary mgmt (post-op)

case: -

diet: ?

rationale: replace protein losses; promotes wound healing; helps prevent infection; promoted blood building

Answer 13

high protein

Question 14

surgery - dietary mgmt (post-op)

case: -

diet: ?

rationale: promotes wound healing; replace losses; prevents dehydration and shock; promotes blood building and clotting

Answer 14

vitamin and mineral supplementation

Question 15

surgery - dietary mgmt (post-op)

case: -

diet: ?

rationale: to meet nutrient requirements

Answer 15

tube feeding or TPN when necessary

Question 16

specific surgical conditions

a surgical procedure that creates an opening from the colon through the abdominal wall to the surface of the skin for defecation when the feces cannot pass through the rectum and anus

Answer 16

colostomy

Question 17

specific surgical conditions

refers to a surgical procedure that creates an opening from the ileum to the surface of the abdominal wall to permit drainage of the contents of the small intestine

Answer 17

ileostomy

Question 18

specific surgical conditions

short segment of the jejunum is joined to the terminal ileum; effectively 90% of the small bowel

Answer 18

jejunoileostomy

Question 19

specific surgical conditions

refers to the surgical removal of the gallbladder

Answer 19

cholecystectomy

Question 20

specific surgical conditions

refers to the surgical removal of tonsilitis

Answer 20

tonsilectomy

Question 21

specific surgical conditions

surgical removal of hemorrhoids

Answer 21

hemmorhoidectomy

Question 22

specific surgical conditions

procedure when the entire colon is bypassed, and opening ic created from the oleum that is attached directly to the anus

Answer 22

ileorectal anastomosis

Question 23

the decrease in plasma volume because of increased peristaltic movement

hypertonic, hyperosmotic food in the jejunum causes rapid emptying time resulting to hypoglycemia, diarrhea, dizziness, and pallor

Answer 23

dumping syndrome

Question 24

nut. absorption and consequences of intestinal surgeries

a. 90-95% of nutrient absorption takes place in the first half of the _____

after a resection, nutrient absorption may be reduced

Answer 24

small intestine

Question 25

Surgery to remove tissue or part or all of an organ

Answer 25

resection

Question 26

nut. absorption and consequences of intestinal surgeries b. there are certain dietary and growth factors that promote intestinal adaptation, like _____ (for glucose source)

Answer 26

glutamine

Question 27

nut. absorption and consequences of intestinal surgeries b. there are certain dietary and growth factors that promote intestinal adaptation, like _____ (for energy)

Answer 27

short-chain fatty acids

Question 28

nut. absorption and consequences of intestinal surgeries b. there are certain dietary and growth factors that promote intestinal adaptation, like _____ (for increased nutrient uptake and utilization)

Answer 28

insulin-like growth factors and growth hormone

Question 29

surgery - dietary mgmt case: tooth extraction and tonsilectomy diet: ? rationale: to prevent bleeding

Answer 29

cold liquid

Question 30

surgery - dietary mgmt case: gastronomy when removal of esophagus is necessary diet: ? rationale: to rest the organ

Answer 30

low fiber, dry meals, cho-restricted

Question 31

surgery - dietary mgmt case: gastric surgery diet: ? rationale: to avoid dumping syndrome

Answer 31

high-chon, no simple sugars

Question 32

surgery - dietary mgmt case: intestinal surgeries diet: ? rationale: to avoid motility and supply electrolytes

Answer 32

TPN and tube feeding when necessary

Question 33

surgery - dietary mgmt case: intestinal surgeries diet: ? rationale: to adjust to the ability of the body to digest and absorb food

Answer 33

gradual progress from npo to normal diet

Question 34

surgery - dietary mgmt case: ileostomy diet: ? rationale: b12 is absorbed in the ileum

Answer 34

vitamin b12 supplementation

Question 35

surgery - dietary mgmt case: ileostomy diet: ? rationale: to prevent irritation, gradual introduction of food

Answer 35

low fiber, low residue, clear

Question 36

surgery - dietary mgmt case: ileostomy diet: ? rationale: there is fat absorption

Answer 36

low fat

Question 37

surgery - dietary mgmt case: colostomy diet: ? rationale: to prevent irritation; gradual introduction of food

Answer 37

low fiber, low residue, clear

Question 38

surgery - dietary mgmt case: colostomy diet: ? rationale: there is fat malabsorption

Answer 38

low fat

Question 39

surgery - dietary mgmt case: jejunoileostomy diet: ? rationale: to prevent irritation; gradual introduction of food

Answer 39

low fiber, low residue, clear

Question 40

surgery - dietary mgmt case: jejunoileostomy diet: ? rationale: there is fat malabsorption

Answer 40

low fat

Question 41

surgery - dietary mgmt case: jejunoileostomy diet: ? rationale: to prevent fatty liver; to allow fat transport

Answer 41

high chon

Question 42

surgery - dietary mgmt case: jejunoileostomy diet: ? rationale: to prevent fermentation

Answer 42

low cho

Question 43

surgery - dietary mgmt case: hemorrhoidectomy diet: ? rationale: to prevent irritation; gradual introduction of food

Answer 43

low fiber, low residue, clear

Question 44

surgery - dietary mgmt case: jejunoileostomy diet: ? rationale: to replenish losses

Answer 44

supplement of vitamins and minerals

Question 45

surgery - dietary mgmt case: cholecystectomy diet: ? rationale: to adjust to the ability to emulsify fat

Answer 45

low fat then normal

Question 46

surgery - dietary mgmt case: peritonitis and intestinal obstruction diet: ? rationale: no peristaltic action

Answer 46

NPO, IVF

Question 47

surgery - dietary mgmt case: peritonitis and intestinal obstruction diet: ? rationale: to adjust to the ability to digest and absorb food

Answer 47

progressive diets

Question 48

surgery - dietary mgmt case: peritonitis and intestinal obstruction diet: ? rationale: to prevent irritation

Answer 48

low residue

Question 49

absorption of vitamins and minerals begins in the _____ and continues throughout the length of the small intestine

Answer 49

duodenum

Question 50

possible consequences of resection on nutrient absorption nutrient absorbed: -simple cho -fats -amino acids -vitamins -minerals -water

Answer 50

duodenum/jejunum

Question 51

possible consequences of resection on nutrient absorption nutrient absorbed: -bile salts -vitamin b12 -water

Answer 51

ileum

Question 52

possible consequences of resection on nutrient absorption nutrient absorbed: -water -electrolytes -short-chain fatty acids

Answer 52

colon

Question 53

possible consequences of resection on what intestinal part -minimal consequences if the ileum remains intact -calcium and iron malabsorption if duodenum resected

Answer 53

duodenum/jejunum

Question 54

possible consequences of resection on what intestinal part -fat malabsorption; protein malabsorption -cho malabsorption -calcium, magnesium, and phosphorous malabsorption -fluid and electrolyte losses -diarrhea/steatorrhea

Answer 54

ileum

Question 55

possible consequences of resection on what intestinal part -fluid and electrolytes losses -diarrhea (losses are compounded if ileum is also resected)

Answer 55

colon

Question 56

are the injured tissue caused by heat, flame, chemicals, electricity, or radiation characterized by decrease of blood volume, plasma loss, edema, damage to blood vessel walls, increased metabolic rate, weight losses, nitrogen and nutrient losses, and hyperglycemia

Answer 56

burns

Question 57

burns - medical mgmt fluid and electrolyte replacement timeframe

Answer 57

in the first 24 to 48 hrs treatment

Question 58

burns - medical mgmt mgmt: ? rationale: for epithelial regeneration

Answer 58

pain relievers, anti-infective drugs

Question 59

dietary mgmt case: burns diet: ? rationale: to replace fluid losses

Answer 59

IVF

Question 60

dietary mgmt case: burns diet: ? rationale: to meet energy requirements when oral intake is impossible

Answer 60

tube feeding when necessary

Question 61

dietary mgmt case: burns diet: ? rationale: to control water retention

Answer 61

fluid and na controlled

Question 62

dietary mgmt case: burns diet: ? rationale: to provide energy reserves

Answer 62

high kcal

Question 63

dietary mgmt case: burns diet: ? rationale: replace losses, increase in gluconeogenesis, wound healing

Answer 63

high chon, 20-25% TER, HBV

Question 64

dietary mgmt case: burns diet: ? rationale: for energy metabolism, wound healing

Answer 64

vitamins and minerals

Question 65

dietary mgmt case: burns diet: ? rationale: for immune system and epithelia tissue

Answer 65

vitamin a

Question 66

dietary mgmt case: burns diet: ? rationale: for tissue regeneration

Answer 66

vitamin c

Question 67

dietary mgmt case: burns diet: ? rationale: to supply oxidative enzymes for cho and chon metabolism

Answer 67

thiamin, riboflavin, and niacin

Question 68

dietary mgmt case: burns diet: ? rationale: for wound healing

Answer 68

zinc