1. hand hygiene, AIDET, etc 2. position pt 3. ask pt preferences 4. offer drinks 5. allow pt enough time to chew/ swallow 6. leave pt upright when done for digestion 7. document percentage of food/drink eaten

Feeding, Elimination, Intake/Output, Specimen Collection Flashcards by Allison Wessel

What do you use a clear liquid diet for? (How long? What’s it for?)

Acute (short-term) diet (24-36 hours)

to relieve thirst, prevent dehydration, and minimize stimulation of the GI tract

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What does a clear liquid diet consist of?

water
tea
coffee
clear broths
ginger ale or other clear carbonated beverages
strained and clear juices
plain gelatin

(must be able to see through)

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What do you use a full liquid diet for? (How long? What’s it for?)

Acute (short-term) diet

For people unable to tolerate solid or semisolid foods

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What does a full liquid diet consist of?

All liquids in clear liquid diet
Milk products (including ice cream)

Anything that is liquefied at room temp

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What do you use a soft diet for?

People who have difficulty chewing and swallowing

People with jaw issues (ex: after wisdom teeth surgery)

Food is easily chewed and digested (low fiber diet)

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What does a regular diet provide?

balanced diet that supplies the METABOLIC requirements of a sedentary person, standard or house diet

for hospital clients who do not have special dietary needs

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What does an ADA diet consist of?

calorie restricted diet

sugar in moderation (splenda)

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What does ADA stand for?

American Diabetic Association

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What does a renal diet restrict?

could have fluid restriction (IV, oral)
modifying sodium intake
avoid processed foods

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What does a heart healthy diet restrict?

no caffeine (in some patients)
limiting fats and sodium intake

helps fight against heart disease
lowers cholesterol

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What does a pureed diet consist of? And what is it used for?

liquid and items that have been blended into liquid

chewing and swallowing difficulties

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Arab Heritage Diet Considerations

bread is served at every meal
no pork, meats cooked well done
food is eaten with right hand
beverages are drunk after the meal not during

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Jewish Heritage Diet Considerations

dietary laws govern the killing, preparation, and eating of foods
meat and animal milk are not eaten at the same time; dairy substitutes are permitted
pork is forbidden
all blood must be drained from meats
always wash hands before eating

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Mexican Heritage Diet Considerations

rice, beans, and tortillas are core, essential foods
being overweight may be viewed as positive
the main meal of the day is at NOONTIME

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What is thickening liquid used for? What are the consistencies?

prevents likelihood of aspiration (aspiration could cause pneumonia)

honey, nectar, pudding

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Feeding Assessments

ability to swallow
feed themselves
may need to provide assistance
stir food to help with heat
appetite
diets
preferences
likes/dislikes

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Feeding Position

High Fowler’s
towel on chest to catch food

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Privacy for Feeding

depends on patient

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When do you assess blood sugar when ordered?

before the patient eats

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Feeding Procedure

hand hygiene, AIDET, etc
position pt
ask pt preferences
offer drinks
allow pt enough time to chew/ swallow
leave pt upright when done for digestion
document percentage of food/drink eaten

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Intake

everything liquid

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Output

everything that comes out

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When do you document the amount of fluid intake for a cup?

after taking the cup away

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30 mL = ? oz

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cc =

What is the minimum urine output requirement for adults?

30 mL/ hr

What is a fecal impaction?

hardened feces in rectum (impacted) preventing bm (constipation but worse)

How is a fecal impaction assessed?

by digital (finger) exam

How is a fecal impaction relieved?

double glove pt in sims line bed w/ bed pads may have bed pan nearby water soluble lubricant pull away at impaction w/ finger when enough is taken out the rest will follow

What are potential complications for the digital removal of a fecal impaction?

vagus nerve may be stimulated = pt will pass out (dizziness, sweaty) be mindful of cardiac pt

What is an ostomy?

opening on the abdominal wall for the elimination of feces or urine

What does normal skin look like?

pink, dry, intact, warm

What is a stoma?

the opening created in the abdominal wall by an ostomy

What should the peri-stomal skin look like?

normal (pink, dry, intact, warm)

What should the stoma look like?

pink/beefy, moist

How often should you change an ostomy appliance?

change weekly unless signs of skin breakdown are noted

When does the ostomy bag need emptied?

at about half full

What may stool specimens be collected for?

to test for: bacteria C. diff blood worms ova and parasites may analyze dietary products and digestive enzymes

When a stool specimen needs to be taken, what communication do you need to have?

signage on the door communication with patient and family members

How many samples do you need for ova (worms)? Why?

3 separate samples to capture entire lifetime

When obtaining a stool specimen do you wear gloves?

YES

What should a stool label contain?

2 pt identifiers: name and DOB

Where should you apply the label for the specimen?

at pt bedside after they confirm name and DOB

Nursing Considerations for Stool Specimen

clean bed pan/Texas hat do NOT contaminate w/ urine no toilet paper on specimen use tongue depressor to move specimen amount depends on test (typically 1" or 15-30 mL for liquidy stool) include abnormal in sample

What does hemoccult mean?

hidden blood

Who performs a hemoccult test?

depends on agency policies

Routine Specimen (urine)

no time frame around it EX: pregnancy test, drug test

Clean catch for C & S

sterile sample to figure out what bacteria it is (specifically) midstream peri-care before may do straight catheter if pt cannot stop midstream

What does C & S stand for?

culture: growth on petri dish sensitivity: identify what grew in culture so we can figure out what it is sensitive to

Foley Catheter Urine Specimen

only collect specimen right when placed in pt use blue port to collect after bag is inserted do NOT take sample from bag

Timed Urine Sample

over a period of time large sample = more accurate ex: 24 hr urine if a sample is missed you have to restart every dop needs to be collected sample collection bag is on ice to keep it cold

How much urine do you need for a culture?

3 mL

How much urine do you need for a urine analysis (UA)?

10 mL

What is sputum?

comes from lungs, thick, mucous

What is the purpose of sputum specimen?

identify microorganisms, lung cancer, TB

What is the procedure for a sputum specimen?

pt expectorates into container requires 1-2 tsp (5-10 mL) can use suction if needed

What is the purpose for throat specimens?

test for microorganisms, strep

What is the procedure for throat specimens?

visualize throat move tongue out of way quickly do it swab the abnormal

Nursing Considerations for throat specimen

if you take too long pt may gag/vomit

Nasopharyngeal specimens (purpose, procedure, considerations)

COVID-19 test pt head back, wear gloves be quick