Exam #2 Flashcards by JANETH Martinez

A calculation with an answer resulting in a number less than 1 must have?

A leading 0, ex. 0.35 mg

How well did you know this?

Not at all

Perfectly

A calculation with a number greater than 1 must

Not have a trailing 0

How well did you know this?

Not at all

Perfectly

8 Aging and digestive changes
5 decreases and 3 others

Decreased taste and smell
Dry mouth (Xerostomia)
Chewing and swallowing (dysphasia) issues
Early satiety (feeling full faster)
Decreased thirst (risk of dehydration
Decreased HCl- acid secretion
Decreased absorption of nutrients
Decreased peristalsis (constipation)

How well did you know this?

Not at all

Perfectly

Can liquid and fluid meds be drawn up to the 100ths place?

Yes

How well did you know this?

Not at all

Perfectly

Makes food smaller by chewing, tongue movements, and mixing food with saliva to prepare food for digestion

Mechanical Digestion

How well did you know this?

Not at all

Perfectly

Digestive juices combining with food to make an acidic “soup” called “chyme”

Mechanical digestion

How well did you know this?

Not at all

Perfectly

Chyme travels to the__________ where localized contraction occur to mix contents and facilitate absorption
What kind of digestion is this?

Small intestine
Mechanical Digestion

How well did you know this?

Not at all

Perfectly

This enzyme digests carbohydrates in the mouth pancreas and small intestine
Part of which kind of digestion?

Salivary amylase
Chemical digestion

How well did you know this?

Not at all

Perfectly

This enzyme digests amino acids in the stomach but needs ____ to activate this protein

Pepsin, HCl- acid in the stomach
Chemical digestion

How well did you know this?

Not at all

Perfectly

This enzyme digests facts into fatty acids and is found in the mouth, stomach and pancreas

Lipase
Chemical Digestion

How well did you know this?

Not at all

Perfectly

Role of nutrition in wound healing and illness:
Maintenance of skin and mucous membranes

Vitamin A

How well did you know this?

Not at all

Perfectly

Role of Nutrition in Wound Healing and illness:
Promotes immunity and migration of macrophages

Vitamin A

How well did you know this?

Not at all

Perfectly

Role of Nutrition in Wound Healing and illness:
Tissue repair, granulation tissue and energy boost

Vitamin B12

How well did you know this?

Not at all

Perfectly

Role of Nutrition in Wound Healing and illness:
Enhances tensile wound strength (builds collagen), and blood vessels formation

Vitamin C

How well did you know this?

Not at all

Perfectly

Role of Nutrition in Wound Healing and illness:
Anti-inflammatory properties

Vitamin E

How well did you know this?

Not at all

Perfectly

Role of Nutrition in Wound Healing and illness:
Blood clotting (2)

Vitamin K and Ca+

How well did you know this?

Not at all

Perfectly

Role of Nutrition in Wound Healing and illness:
Builds and repairs skin and tissues, fights infection, balances fluids

Protein

How well did you know this?

Not at all

Perfectly

What the differences between caloric, protein, carbohydrate, and fat nutritional requirements between adults and older adults

Caloric: Geriatric need less
Protein: Geriatric need more to prevent age related muscle loss
Carbohydrates: Same (45-65% of total energy intake)
Fats: same (20-35%) of total energy intake

How well did you know this?

Not at all

Perfectly

What are the vitamin differences in adults vs geriatric patients for Vitamin D, Calcium, Iron and B12?

Vitamin D: Geriatric need more because they are not exposed to the sun as much
Calcium: Geriatric need more to prevent osteoporosis
Iron: Same, decreases after menopause for women, same all around for men
B12: same for both

How well did you know this?

Not at all

Perfectly

Nursing Interventions to Promote Nutrition 8

Good oral hygiene
Small frequent meals
Environment
Position (HOB elevated)
Favorite foods
Pain control
-Collaborate with dietician *swallow assessment
Promote a balanced diet

How well did you know this?

Not at all

Perfectly

What are the recommended servings for the 5 food groups according to my plate?
Fruits and veggies
Grains and proteins
Dairy
And how many times a day should a person consume a full food group a day

Fruits and veggies: 1/2 plate
Grains and proteins: 1/2 plate
One dairy helping

Eat at least 1 full food group per day

How well did you know this?

Not at all

Perfectly

What are the 4 vitamins/ electrolytes included on a food label

Vitamin D
Calcium
Iron
Potassium

How well did you know this?

Not at all

Perfectly

When calculating deliverable doses for both adult and pediatric patients results will be rounded to the

100ths place

How well did you know this?

Not at all

Perfectly

Weight calculations:
For Adults round to:
For Pediatric round to:

10th
100th

How well did you know this?

Not at all

Perfectly

What is the purpose of a nutritional history and screening? What 6 things are we looking for

Purpose: collect data about eating behaviors and identifying possible nutritional risks or deficiencies - Eating habits and appetite - Food allergies - Medical conditions - Dentition/ chewing or swallowing difficulties - Weightloss - BMI

What are the ranges for BMI Underweight Normal Overweight Obese Extreme Obesity

Underweight: less than or equal to 18.5 Normal: 18.5- 24.9 Overweight: 25.0- <30 Obese: >30 Extreme obesity: >40

Signs and symptoms of nutritional deficiencies Poor skin turgor or edema

Fluids imbalance/ electrolyte imbalance

Signs and symptoms of nutritional deficiencies: Poor skin turgor or edema

Fluids imbalance/ electrolyte imbalance

Signs and Symptoms of Nutritional deficiencies: Pallor, spoon shaped nails

Iron

Signs and Symptoms of Nutritional deficiencies: Bleeding abnormalities

Vitamin K

Signs and Symptoms of Nutritional deficiencies: Brittle and fragile nails, hair loss, poor wound healing

Protein

Signs and Symptoms of Nutritional deficiencies: Low energy, headache

Glucose

What to observe for a swallowing evaluation? 5 Orientation? Position? History? Etc…

Alertness, ability to sit upright, managing secretions, cough strength, history of aspiration pneumonia

This type of diet includes broth, clear juices (apple cranberry), water, black coffee, carbonated beverages and gelatin

Clear liquid diet

This diet includes juices with pulp, soups, milk, milkshakes, ice cream, cream soups, puddings, custards, pain yogurt, nutritional supplements and thinned hit cereal (no fruit chunks)

Full liquid

This diet is recommended for restarting oral feeding after surgery or an abdominal procedure Also used for electrolyte replacement in people with severe diarrhea

Clear liquid diet

This diet is used as a second step to restarting oral seeing once clear liquids are tolerated. It should be used for people who cannot tolerate a mechanical soft diet and should not be used for extended periods

Full liquid diets

This diet should be used for those with problems chewing and swallowing (for poor dental conditions, missing teeth, or a condition known as dysphasia)

Mechanically altered or soft diet

This diet should be used when a petite has a wired jaw, extremely poor definition or any other instance where chewing is inadequate (it can pass through a straw)

Puréed diet

The study or science of drugs

Pharmacology

Preparing and dispensing drugs, includes dosage form design (form determines rate of drug disruption and absorption)

Pharmaceutics

What is the order of fastest to slowest drug absorption? Liquids, syrups Tablets Enteric coated Bucal and sublingual Capsules

Buccal and cublingual (SL) Liquids and syrups Capsules Tablets Enteric coated

The study of drug movement throughout the body?

Pharmacokinetics

What are the 4 processes of pharmacokinetics

ADME Absorption Distribution Metabolism Excretion

Medications passing through the oral and GI route Does it bypass first effect?

Enteral NO

Medications that include IM. IV and Subcutaneous Bypass first effect?

Parenteral YES

Medications that include ointments, gels, patches, drops, inhalers, creams and lotions Bypass first pass effect?

Topical YES

The extend of drug absorption (how much medication is actually used and absorbed by the body) Ex. Oral drug absorption via stomach or intestine

Bioavailability

Why is knowing about 1st pass effect and bioavailability for medications

For emergent situation and. Dosing medications Oral meds have less than 100% bioavailability meaning that not all of the dose is absorbed and used by the body

Liver changes drug into less active metabolites after being absorbed through the intestinal tract Some medication is inactivated by the liver

First pass effect

When a medication is being distributed does it transport to the heart, liver, kidney, and brain more rapidly or the muscle skin and fat?

Heart, liver, Kidney and brain, (they are more vascular)

Bio transformation occurs in the _____ in which drug molecules are converted into _____ _____ molecules to prepare for excretion though the______

Liver, water soluble, kidney

A______ is a drug that goes to the_____ to be activated instead of inactivated like most oral drugs are This type of drug is activated by ______ enzyme

Prodrug, liver P450

What organ is responsible for excretion of medications After it passes what?

Kidneys, after it passes through the liver and is metabolized into water soluble molecules

What disease affect the excretion of medications and can lead to possible toxicity?

Kidney disease

First pass effect or not? IV?

Not

First pass effect or not? Inhaled meds

Not

First pass effect or not? Oral

Yes

First pass effect or not? Sublingual

Not

First pass effect or not? Intranasal

Not

First pass effect or not? IM and SubQ

Not

First pass effect or not? Transdermal

Not

First pass effect or not? Rectal

Yes and no It may be considered enteral or topical Mixed first pass and non first pass absorption and metabolism

First pass effect or not? Orally disintegrating tablets, oral soluble films

Not, oral cavity is highly vascularized and does not undergo first pass effect

The use of drugs to prevent or treat diseases

Pharmacotherapy

Food drug interactions: Intake of leafy green veggies may decrease anticoagulant effect of this medication

Warfarin

Food drug interactions: Grapefruit juice Which medication categories causes problems with enzymes and transporters resulting in too much or too little of the drug when combined with grapefruit juice (4 types)

Cardiac medications Anti-seizure medication Anti- cholesterol Anti-anxiety

Which medication class can increase drowsiness and sedation which consumed with valerian root

CNS depressants

Therapeutic vs pharmacological classifications

Therapeutic: how a drug is used clinically to treat a specific disease or condition Pharmacological: how a drug works at a molecular level based on its mechanism of action

What is polypharmacy and what are the risks

Many drugs, greater possibility of experiencing adverse effects and drug drug interactions

What are some dosing recommendations for medications? Dosage? Pace?

1/2- 2/3 of standard adult dose Start low and go slow Look at geriatric dosing recommendations in drug guide before administering

Aging effects on pharmacokinetics: Decreased cardiac output, and blood flow

Decreased absorption and distribution

Aging effects on pharmacokinetics Increased alkaline gastric secretions and peristalsis

Altered absorption and delayed gastric emptying

Aging effects on pharmacokinetics: Decreases enzyme production

Decreased metabolism

Aging effects on pharmacokinetics Decreased blood flow, renal function and glomerular filtration rate

Decreased, metabolism and excretion 2x

Exam #2 Flashcards

(75 cards)