Chp 5,12,13,14 Flashcards
(95 cards)
1
Q
Proper food storage guidelines:
- fresh meat & fish is 1-____days at ____ degrees or colder
- Dairy: milk is good for ___ days & 3-4 weeks for ______
- Eggs: ___ weeks in shell, and 1 week for hard boiled
- fruits & veggies: 3-5 days. _____ fruits and apples keep for 1 week or longer.
- Pantry: dry dark place
- canned: one year
A
2 40 5 cheese 3 citrus
2
Q
Cook food to the proper temperature:
- roasts & steak 145 degrees
- chicken: ____ degrees
- ground beef & eggs ____ degrees
A
180
160
3
Q
occurs due to eating undercooked or raw meat, poultry, eggs, fish, fruit and dairy products. common symptoms include headache, fever, abdominal cramping, diarrhea, nausea and vomiting. can be fatal
A
Salmonella
4
Q
raw or under cooked meat, esp hamburger, can cause this food borne pathogen. findings include severe abdominal pain and diarrhea.
A
E. coli
5
Q
poor personal hygiene and improper hand hygiene commonly cause ______. food sources include dairy products and salads. findings include diarrhea
A
shigella
6
Q
soft cheese, raw milk products, undercooked poultry, meat, seafood and vegetables can cause _______ monocytogenes. can cause sign problems for newborns (stillborn), prego (miscarriage) and immunocompromised clients.
A
listeria
7
Q
______ juice interferes with the metabolism of many medications, resulting in an increased serum level of the med
A
grapefruit
8
Q
consumption of food high in vit ___ (green leafy veggies, eggs, liver) can devrease the anticoagulent effect of warfarin
A
K
9
Q
foods high in _____, amino acids, and vit b6 can increase the metabolism of the anti parkinson’s meds levodopa, which decreases the duration of its therapeutic effects.
A
protein
10
Q
licorice can cause ________. excess ingestion can be dangerous for clients taking digoxin, stimulant laxative, some beta blockers, ace inhibitors
A
hyperkalemia
11
Q
Cardiovascular disease is the leading cause of death in the US. ______ heart disease is the single leading cause of death
A
coronary
12
Q
________ is a major risk factor for developing CHD. CHD is caused by atherosclerosis, a process of damage and cholesterol deposits on the blood vessels of the heart
A
Hypercholesterolemia
13
Q
_____ density lipoprotein is “good” cholesterol because it removes cholesterol from the serum and takes it to the ______
- for females 35-___ mg/dl
- for males 35-____mg/dl
Low density is “bad” cholesterol bec it transports cholesterol out of the _____ and into the circulatory system, where it can form _____ on the coronary artery walls.
expected range is less than ___ mg/dl
A
high liver 80 65 liver plaques 130
14
Q
Iron deficiency anemia symptoms include _____, lethargy, pallor of the nail beds, intolerance to cold.
* children with low iron intake can experience _____ attention spans and display poor intellectual performance before anemia begins
A
fatigue
short
15
Q
_____ anemia symptoms include pallor, weakness,________, dyspnea & fatigue
A
macrocytic
palpitations
16
Q
Vit B12 deficiency anemia include both ____ findings and ____ findings
A
GI
neurological
17
Q
GI findings of Vit b12 deficiency include _______(inflamed tongue), anorexia, indigestion, weight loss, frequent _____/and or constipation
A
glossitis
diarrhea
18
Q
Neurological findings of vit b12 deficiency include ______ (numbness of the hands and feet), decreased proprioception (sense of body position), ____ muscle coordination, increasing irritability, and _______
A
paresthesia
poor
delirium
19
Q
_____ ____ deficiency anemia symptoms include mental confusion, fainting, fatigue, and GI distress.
mimic thos for vit b12 deficiency, except for neuro findings.
A
Folic acid
20
Q
The presence of 3 of the 5 following risk factors can result in what syndrome?
- ) ______ obesity, women ___ inch waist, men 40 inch waist.
- ) Triglycerides greater than ____ mg/dl
- ) low HDL, men less than ___, women less than 50 mg/dl
- ) increased blood pressure: sys >130, Dia>85
- ) fasting blood _____ greater than or equal to 110 mg/dl
A
metabolic abdominal 35 150 40 glucose
21
Q
consuming a low fat, low cholesterol diet can reduce risk for developing ___ ___ ______. What diet is designed to be a user friendly eating guide to encourage dietary changes?
- daily cholesterol should be less than ____ mg
- conservative use of ___ wine may reduce risk
- increasing ___ and carbs intake, avoid _____ fat, and decrease red meat consumption can decrease risk
- increasing intake of ______-__ fatty acids found in fish, flaxseed, soy bean, canola, walnuts reduces risk
- _______is an amino acid. elevated levels can increase risk of dev CHD. deficiencies in VIt b6 & b12 increase these levels.
A
coronary heart disease therapeutic lifestyle change TLC 200 red fiber saturated omega-3 homocysteine
22
Q
secondary prevention efforts for CHD are focused on lifestyle changes that lower ____. include a diet low in cholesterol and sat fat, a diet high in _____, exercise, weight management, and smoking cessation
- sat fat should be less than __% of daily caloric intake
- a high fiber diet includes oats, _____, fruits, veggies, whole grains, barley
A
LDL
Fiber
7
beans
23
Q
_______ is a significant risk factor for developing CHD, myocardial infarction and stroke.
*is a sustained elevation in BP greater than or equal to ___/____ mm/hg
A
hypertension
140/90
24
Q
What does Dash stand for? it is a diet low in ____, and high ______& _________. proven to lower BP and cholesterol
*NA intake should be less than _____ a day
A
dietary approaches to stop hypertension
sodium (canned soups, sauces, chips seasoning)
potassium (apricots, banans, tomatoes, potatoes)
calcium (low fat dairy product)
2400mg
25
_____ ______ is the inability of the heart to maintain adequate blood flow through circulatory system. results in _____ sodium and fluid retention, and edema
* reduce na to recommended level
* monitor and possible restrict fluid intake to 1.5 L a day
heart failure
| excess
26
An _____ _____ occurs when there is an inadequate supply of O2 to the myocardium. frequently this occurs b/c of atherosclerosis
*after this occurs, it is necessary to reduce the myocardical O2 demands related to metabolic activity
* a ____ diet is best for first 24 hrs after
* _____ should be avoided since it stimulates the heart
* small, _____ meals
myocardial infarction
liquid
caffeine
frequent
27
______results from either a reduction of the RBC or in _______, the oxygen carrying component of blood. can result from a decrease in rbc production, and increase in rbc destruction, or a loss of blood.
* the body requires _____, vit ___, and folic acid to produce RBC
* _____ deficiency anemia is the most common nutritional disorder in the world. affects 10% of population. results from poor intestinal ______,blood loss and inadequate consumption.
*_______anemia is the most common form of vit b12 deficiency. caused by a lack of the protein intrinsic factor which helps the body absorb vit b12. risks include ____, gastric cancer, helicobacter pylori and age greater than 50. people with this require b12 injections
```
anemia
hemoglobin
iron
b12
iron
absorption
pernicious
surgery
```
28
sources of iron include: _____, fish, poultry, tofu, dries peas & _____, whole grain, dried fruit
Iron fortified foods include: infant formula, infant cereal and ready to eat cereals
****medicinal iron overdose is the leading cause of accidental poisoning in small children and can lead to acute iron toxicity.
meat
| beans
29
Vit ___ facilitates the absorption of iron (promote consumption)
C
30
Natural sources of ____include: fish, meat, poultry, eggs and milk
B12
* *people over 50 are urged to consume most of their vit b12 requirement from supplement or fortified foods.
* *vegans need supplements
31
____ acid deficiency anemia is caused by poor nutrition, malabsorption (____ disease) and drug use
*sources include green leafy veggies, dried peas and beans, seeds, OJ, cereals and breads fortified with folic acid.
folic
| crohn
32
Nutrition therapy for gastrointestinal disorders is generally aimed at minimizing or preventing symptoms. In some conditions, such as _______ disease, nutrition is the only treatment.
celiac
33
Assess if the client is experiencing any of the following symptoms:
* difficulty chewing or swallowing (dysphasia), nausea or ______, or diarrhea.
* bloating, excessive flatus, occult blood, ______ (fat in feces), abdominal pain/cramping/distention, pale, sticky bowel mvmts
* changes in weight, ____ ____ or bowel habits
vomiting
steatorrhea
eating patterns
34
assess if the client uses:
* Tobacco, ______, caffeine, over the counter meds to treat ____ conditions).
* nutritional supplements
*______supplements
alcohol
GI
herbal
35
What are some general gastrointestinal considerations for nutritional guidelines and nursing interventions?
- Monitor gastrointestinal parameters
- Low fiber diets
- High fiber diets
36
What are some parameters to monitor gastrointestinal activity?
```
Weight & weight changes
lab values
bowel sounds
elimination patterns
I & O
```
37
Low-fiber diets avoid food that are high in _____ content (whole-grain breads, _____, raw fruits and vegetables)
* this reduces the _____ and _____ of fecal output and slow transit time of food through digestive tract.
* this diet is used for _____ term for clients who have diarrhea or malabsorption syndromes.
residue
cereal
frequency and volume
short
38
High fiber diets focus on food containing more than __ g of fiber per serving.
* Increases stool bulk
* stimulates ________
* prevent constipation
* protect against ___ _____
5
peristalsis
colon cancer
39
Potential causes of ______ and ______ include decreased gastric acid secretion & gastrointestinal motility; ______, bacterial/viral infection, increased ______ pressure, liver, pancreatic, ____ ______ disorders, adverse effects of some meds.
*Determine underlying cause, assess the appearance of the _____ will aid in diagnosis and treatment.
For example, coffee ground emesis indicates ____; pale green indicates _____
```
nausea
vomiting
allergy
gall bladder
emesis
blood
bile
```
40
What kind of diet should you implement for a patient with nausea and vomiting?
*clear liquids followed by full liquids, and advance as tolerated, easy to digest, low fat carb foods (crackers, toast, oatmeal).
41
Other interventions for patients with nausea and vomiting include:
* avoid liquid with meals as they promote ______
* good ____ _____
* elevate head of bed
* discourage spicy food
* avoid high fat food-contribute to ____ b/c they are difficult to digest.
fullness
oral hygiene (dehydration)
nausea
42
______ is defined as the lack of appetite. A common finding for numerous physical conditions and adverse effect of certain meds. Not the same as anorexia nervosa.
anorexia
43
Nursing interventions for Anorexia include:
* decrease _____ at meal times
* assess for adverse effects
* administer meds to _____ appetite
* modify_______, remove items that smell, assess and manage anxiety and depression
* Assess for changes in ____ status.
* _____ to increase gastric motility
* mouth care before and after meals.
```
stress
stimulate
environment
bowel
position
```
44
What kind of diet would you implement for someone with anorexia?
*Provide small, frequent meals and avoid high fat foods to help maximize intake
*provide liquid supplements btw meals to improve protein and calorie intake
*ensure the meals appear appealing
serve larger meals early in the day
45
clients who have _________ have difficult or infrequent passage of stools, which may be hard and ____
constipation
| dry
46
Causes of constipation include: _____ bowel habits, psychogenic factors, ______, chronic laxative use
irregular
| inactivity
47
Encourage ______ for pt with constipation and a diet high in fiber (__ for women, ___ for men), and promote adequate _____ intake to help alleviate symptoms.
*change meds if causes this symptoms
exercise
25 g/day
38 g/day
fluid
48
Nursing interventions for constipation include:
* assess _____ and ______ of past and present elimination patterns
* what is ______ for the client, activity and stress levels
* assess past medical and surgical history, _____ use (OTC, herbal, laxatives, enemas, and prescriptions)
* presence of rectal _____ and abdominal pain.
*encourage client to gradually increase levels of _____. (preferred treatment)
```
onset
duration
normal
medication
pressure
fiber
```
49
Diarrhea may cause a significant losses of ______, ______, and fluid as well as nutritional complications.
* common causes include _____ and physical stress, GI disorders, _______disorders, infections, and certain drug therapies.
* A high ___ diet is prescribed unless it caused the diarrhea
* a liberal fluid intake to replace losses is needed.
```
potassium
sodium
emotional
malabsorption
fiber
```
50
Causes of Dysphagia include obstruction, ________, and certain neurological disorders
* modifying the ____ of foods and the consistency of liquids will help achieve proper nutrition
* Xerostomia (___ _____) can contribute to dysphagia, evaluate meds being used
inflammation
texture
dry mouth
51
Clients who have dysphagia are at an increased risk for _____. place the client in an upright or ___-____ position to facilitate swallowing.
* provide oral care ____ to eating to enhance taste
* should be referred to a speech therapist for evaluation.
* allow adequate time for eating, use _____eating devices, small bites, thorough chewing
* pills should be taken with at least __ oz of fluid (can be thickened) to prevent meds from remaining in the _______.
* avoid think liquids and sticky foods
```
aspiration
high-fowlers
prior
adaptive
8
esophagus
```
52
Normally, the stomach controls the rate in which nutrients enter the ____ _______, when a portion of the stomach is surgically removed, the contents of the stomach are rapidly emptied into the small intestine, causing ______ syndrome.
small intestine
| dumping
53
Early symptoms of dumping syndrome usually occur __-___ mins after eating. Late symptoms occur 1-3 hrs after eating.
Includes: sensation of fullness, dizziness, diarrhea, _______, tachycardia, palpitations, ______, nausea etc.
* manifestations resolve after intestine is ______. however, there is a rapid rise in ____ ____ and increase in insulin levels immediately after the intestine empties. this leads to ________
* the client experiences _______ spasms, such as dizziness, sweating, palpitations, shakiness, and confusion.
```
15-30
diaphoresis
hypotension
emptied
blood glucose
hypoglycemia
vasomotor
```
54
Nursing interventions for dumping syndrome include:
* ____, frequent meals
* recommended consumption of _____ and ___ at each meal.
* avoid sugar and restrict ___ intake
* Suggest the client does a ___ diet (consume liquids 1 hr before or after eating instead of during meals)
* instruct client to lie down for 20 to 30 mins after meals to delay ____ ______
* if reflux is a problem, assume a _____ position.
* Monitor clients who are receiving _____ ____ feedings and report symptoms of this.
* monitor client for iron & b12 deficits.
```
small
protein and fat
lactose
dry
gastric emptying
reclining
enteral tube
```
55
_____ occurs as the result of the abnormal reflex of gastric secretions in the esophagus. leads to ____ and heart burn
*long term can cause adenocarcinoma of the esophagus and _____ esophagus
GERD (gastroesophageal reflux disease)
indigestion
Barrett's
56
Clinical symptoms of GERD include _____, retrosternal bleeding (esophageal), painful _____, Dyspepsia (______).
* pain may be mistaken for _____ ________
heartburn
swallowing
indigestion
myocardial infarction
57
Nursing interventions for GERD include:
* avoid abdominal pressure (tight clothing)
* avoid eating __ hr or less before laying down.
* elevate the body on _____ instead of lying flat
* avoid trigger food (citrus fruit, juice, spicy, carbonated drinks)
* avoid items that reduce lower ______ _____(LES) pressure. what are some examples?
2
pillows
esophageal sphincter
fatty foods, caffeine, chocolate, alcohol, cig smoke
58
_______ is inflam. of the gastric mucosa congested with blood and fluid
* there is a ______in acid produced and an overabundance of _______, superficial _____ occur, sometimes leading to hemorrhages
gastritis
decrease
mucus
ulcers
59
_____ gastritis occurs with excessive use of NSAIDS, bile ____, ingestion of strong acid/alkali substance, complication of radiation, and trauma (burns, food poisoning, severe infection, liver, kidney, respiratory failure, major surgery)
acute
| reflux
60
chronic gastritis occurs in the presence of ______(benign or malignant), helicobactor pylori, autoimmune disease (pernicious anemia)
ulcers
61
clinical symptoms of gastritis includes: abdominal pain/discomfort (relieved by eating), ______, nausea, anorexia, sour taste in mouth, ________ (vomiting of blood)
headache
| hematemesis
62
Nursing interventions for gastritis include:
* avoid eating frequent meals and snacks, as they promote increased _____ acid secretion
* tell to avoid alcohol, cigs, ______ and other Nsaids (nonsteroidal anti-inflam drugs, coffee
* monitor for Vit ___ deficiency.
gastric
aspirin
b12
63
Acute recovery for gastritis usually occurs in ___ day, the client should eat a ____ diet when able to tolerate food. ___ fluid may be required.
* when the condition occurs due to ingestion of strong acids of alkalis, _______ and _________ of the casual agent is needed. avoid _____ and emetics due to potential perforation and esophageal damage.
* chronic mgmt: modify diet, reduce stress, avoid alcohol and _____. if condition is persistent, the provider will prescribe an ____-receptor antagonist such as ranitidine (zantac)
```
1
bland
IV
dilution
neutralization
lavage
nsaids
H2
```
64
_____ ulcer disease is characterized by an erosion of the mucosal layer of the stomach or duodenum
* may be caused by a bacterial infection (H. Pylori-use ______ therapy) or the chronic use of _____
* some clients who have this are _________. others report anemia, tarry stools due to intestinal bleeding, epigastic pain (gnawing or burning)
* Eating may temporarily relieve pain, anemia can occur due to blood loss.
```
peptic
triple-combo of antibiotics and acid reducting meds takin for 14 days
nsaids (aspirin &ibprofen)
aymptomatic
burning
```
65
Lactose intolerance results from an inadequate supply of ______ in the intestine, the enzyme that digests lactose.
* the enzyme that converts lactose into _____ and ______ is absent or insufficient.
* symptoms include distention, ______, flatus, and osmotic diarrhea.
* monitor client for vit__ and _____ deficiency
```
lactase
glucose
galactose
cramps
D
Calcium
```
66
An ______is a surgically created opening on the surface of the abdomen from either the end of the small intestine (_____) or from the colon (colostomy).
* _____ and ______ maintenance is the primary concern
* The colon absorbs large amounts of fluid, ____ and _______
* nutriton therapy is a diet high in fluids and soluble fiber
* increase intake of calories and protein to promote _______ of stoma site.
* emotional support
```
ostomy
ileostomy
fluid
electrolyte
sodium
potassium
healing
```
67
_______are pouches protruding through the muscle of the intestinal wall, usually from increased intraluminal pressure. usually occur in the _____ colon, cause no problem unless infection
* diverticulosis is a condition characterized by presence of diverticular.
* diverticulitis is inflam. that occurs when fecal matter becomes _____ in the diverticula. (clear liquid diet until inflam decreases, then a high fiber, low fat diet
* avoid foods with seeds, husks (corn, berries)
diverticula
sigmoid
trapped
*abdominal pain, nausea, vomit, constipation/diarrhea, fever with chills/tachycardia.
68
```
_____ disease (regional enteritis) and ulcerative colitis are are chronic, inflam. ____ diseases characterized by periods of exacerbation and remission
* diets are low in _____
```
Crohn's
bowel
fiber
69
What kind of diet is prescribed to a pt with inflam bowel disease?
*____ _______ nutrition (TPN) is indicated for clients who are severely ill during acute phase of illness.
a low residue, high protein, high calorie diet with vit and min. supplementation. fluid and electrolytes with iv or oral fluids
Total parenteral
70
______ is inflam. of the gall bladder
*the gallbladder stores and releases _____ that aids in the digestion of _____.
* pain in the _____ right abdomen, can also have referred pain in the right shoulder
* limit fat
* diet modifications are not needed for healthy people with asymptomatic gallstones.
cholecystitis
bile
fats
upper
71
The pancreas is responsible for secreting ______ needed to digest fats, carbs, and protein.
* pancreatitis
* acute: prescribed NPO, nasogastric tube to suction gastric contents.
* chronic pancreatitis: low ___, high protein, high carb. Vit C & b complex
enzymes
| fat
72
the _____ is involved in the metabolism of almost all nutrients.
* disorders include cirrhosis, hepatitis, and cancer
* increased protein to promote ____ nitrogen balance
* B, C & K vitamins
liver
73
Celiac disease is also known as ______-sensitive enteropathy (GSE), celiac sprue, and gluten intolerance.
* chronic, ______, genetic
* lack enzyme DPP-IV
* eliminate gluten-found in wheat, rye and barley.
* gluten free options include: milk, cheese, _____, corn eggs, potatoes
*symptoms: steatorrhea, anemia, diarrhea, pain, bloating, osteomalacia.
glucose
| inherited
74
the kidneys have 2 basic functions: 1.) maintain normal ____ _____ and 2.) excreting _____ products
*profound effect on nutritional state
*_____ is a waste by product of protein metabolism, and these levels rise with renal disease
*short term disease requires _____ support rather than dietary restrictions. dependent on stage.
blood volume
waste
urea
nutritional
75
Pre-stage chronic kidney disease (CKD) is distinguished by an increase in serum ______.
*symptoms include fatigue, _____ pain, and appetite changes.
creatine
| back
76
End-state kidney disease (ESKD) or CKD symptoms include fatigue, decrease ______, anemia, decreased urination, headache, weight loss.
alertness
77
Acute kidney injury symptoms include a decrease in ______, decreased sensation in _____ extremities and flank pain
* characterized by rising blood levels of _____ and other nitrogenous wastes
urination
lower
urea
78
Nephrotic syndrome's most pronounced symptoms is ______ and high _________.
edema
| proteinuria
79
Kidney stones have sudden _____pain. Symptoms of diaphoresis, nausea, and vomiting, and there can be _____ in the urine.
*80% of stones contain ______
intense
blood
calcium
80
Nurses should monitor _____ daily for general renal considerations since it is an indicator of fluid status and is a primary concern.
* monitor fluid _____ & encourage compliance with fluid restrictions.
* monitor urine output
* monitor _____
weight
intake
constipation
81
Pre-state CKD, or ________ kidney reserve/insufficiency, characterized by a increase in serum _______
* * control blood glucose and ______, which are risk factors
* * help preserve remaining kidney function by limiting the intake of ______ & _______ (slows progression)
```
diminished
creatinine
hypertension
calcium
phosphorus
```
82
what are dietary restrictions for pre stage CKD?
* the daily protein intake is __ to ___ g/kg of ideal body weight.
* ______ restrictions are decreased as disease progresses to end stage.
restrict sodium to maintain blood pressure
.6-1.0
protein
83
High ______value proteins are recommended for clients who have kidney failure to prevent _____of muscle tissue. these proteins include _____, meats (5-6 oz men/4 for female), poultry, game, fish, soy, and dairy (1/2 cup).
* limit high ______ foods (peanut butter, dried peas beans, beer
biologic
catabolism
eggs
phosphorus
84
End-state kidney disease or CKD occurs when the ______ _____ rate is less than 29 ml/min, the serum creatine level steadily rises, or _____ or transplantation is necessary.
glomerular filtration
85
What kind of diet for End stage kidney disease?
* once dialysis begins, ____ intake will be increased
* vit d and calcium are nutrients of concern
-high protein
-low phosphorus and potassium, sodium, fl restricted
protein
86
foods high in phosphorus include _____, beef liver, chocolate, nuts and lugumes
* phosphate _____ (ca carbonate, ca acetate) must be taken with all meals and snacks
milk
| binders
87
Vit _ deficiency occurs b/c kidneys cannot convert into the active form.
*this alters the metabolism of ______, _____ and _______ leading to hyper levels of all three.
*____ supplements will likely be required b/c foods high in phosphorus (which are restricted) are also high in calcium
```
D
Calcium
Phosphorus
Magnesium
calcium
```
88
Acute kidney _____ is an abrupt, rapid decline in kidney _____ causes by trauma, sepsis, poor perfusion, or medications and is usually ______
*can cause Hyper-Na/K/Ca/phos.
*_____is a complication and is leading cause of death in these clients
*three phases of AKI are?
```
abrupt
function
reversible
infection
oliguric, diuretic, recovery
```
89
Potassium is restricted to ___ to ____ meq/day when on dialysis
60-70
90
______ is restricted to 1 to 3 g/day is not receiving dialysis, if they are increases from 1-__ g/day
sodium
| 4
91
______ requirements are of less than 2000 mg daily if on hemodialysis or peritoneal dialysis
calcium
92
______ syndrome results in the increased excretion of serum proteins in the urine
nephrotic
| results in hypoalbuminemia, edema, hyperlipidemia. watch for prolonged protein loss
93
____ _____, kidney damage due to meds/ chemicals, autoimmune, and infections can cause nephrotic syndrome.
diabetes mellitus
94
recommendation for calcium _______stone formation is to limit animal protein, excess sodium, alcohol, and caffeine. low K may also be a factor
*foods high in oxalate include spinach, rhubarb, beets, nuts should be limited, also mega doses of Vit C, which increases the amount of exalate excreted.
Oxalate
95
for prevention of ____ acid stones, limit foods high in purines
uric
