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nutrition Flashcards

(65 cards)

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1
Q

3 Main Functions of Gastrointestinal System

A

Transportation, Digestion, & Absorption

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2
Q

Patients who are malnourished upon admission are a greater risk of what 6 complications

A 
Dysrhythmias
Skin breakdown
Sepsis
Hemorrhage
Increase length of stay
Delayed surgical healing
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3
Q

what are food guidelines

A

Provides average daily consumption of five food groups

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4
Q

5 dietary guidelines

A
  1. Follow a healthy eating pattern across the lifespan.
  2. Focus on variety, nutrient density, & amount.
  3. Limit calories from added sugars & saturated fats & reduce sodium intake.
  4. Shift to healthier food & beverage choices
  5. Support healthy eating patterns for all
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5
Q

7 factors influencing nutrition

A 
Appetite
Negative Experiences
Disease & Illness
Medications
Environmental Factors
- Income
-Education level
-Physical function level
-Transportation
-Availability of foods
Developmental Needs
Alternative Food Patterns
-Religion
-Cultural background
-Health beliefs
-Personal preferences
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6
Q

What must nurses consider during older adult nutritioin

A

Presence of chronic illnesses

Medications

Gastrointestinal changes

Slower metabolic rate

Cognitive impairments

Available transportation

Functional ability

Fixed income

Many need calcium
supplementation

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7
Q

Name 4 nutrition screening tools

A

Subjective screening

Objective measures

Identify risk factors of

malnutrition

Standardized tools

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8
Q

Name 3 standardized tools for screening

A

Subjective Global

Assessment (SGA)
Mini-nutritional

Assessment (MNA)
Malnutrition Screening Tools (MST)

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9
Q

Anthropometry Assessment

A

Measure of size and make up of body:

Height & Weight

Ideal Body Weight

Body Mass Index

Skin Fold Measures

Fat Percentage

Registered Dieticians can assist

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10
Q

Factors that affect lab results

A

Fluid balance
Liver & kidney function
Presence of disease

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11
Q

Common labs discussed in FUNDAMENTALS

A

Total Protein
Albumin
Prealbumin
Hemoglobin

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12
Q

Total Protein

A

Combination of albumin & globulin constitute

Normal: 6.4-8.3 g/dL (UKHC 6.3-7.9 g/dL)

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13
Q

Albumin

A 
Makes up 60% of total PRO
Better indicator of chronic illnesses
Synthesized in the liver
Half-life- 21 days
Normal: 3.5-5.0 g/dL (UKHC 3.3-4.6
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14
Q

prealbumin

A

Preferred for acute conditions
Half-life- 2 days
Normal: 15-36 mg/dL (UKHC 20-41)

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15
Q

what is Hemoglobin

A

Protein responsible for transporting oxygen in the blood

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16
Q

Normal levels of hemoglobin

A

Male 14-18g/dL (UKHC 13.7-17.5)

Female 12-16g/dL (UKHC 11.2-15.7)

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17
Q

If hemoglobin is low what may a patient benefit from?

A

Eating foods rich in iron

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18
Q

Factors of Diet History (8)

A 
Dietary intake
Food preferences
intolerances
Unpleasant symptoms
Allergies
Taste, chewing, swallowing
Appetite
Weight
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19
Q

Factors of health history (4)

A

Illness
Activity level
Health status
Medications:

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20
Q

factors of other history in nutrition history

A 
Age
Socioeconomic status
Cultural background
Religious beliefs
Transportation
Psychological factors
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21
Q

8 nutrition nursing problems

A

Imbalanced Nutrition: Less than body requirements – or simply poor nutrition or the like

Imbalanced Nutrition: More than body requirements – or Overweight/Obesity

Impaired swallowing

Risk for aspiration

Diarrhea, Constipation, Nausea

Impaired Dentition

Fatigue

Risk of unstable blood glucose

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22
Q

4 categories of Planning

A

INDIVIDUALIZED approach

Goals & Outcomes

Setting priorities

Teamwork & Collaboration

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23
Q

5 categories of assessment of nutritional status

A

Screening

Anthropometry

Laboratory & Biochemical Tests

Diet & Health
History

Physical
Examination

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24
Q

6 areas of nutritional nursing implementation

A

Health Promotion

Diet Selection

Advancing Diet

Care of Common Nutritional Issues

Measuring Intake & Output (I&O)

Obtaining Height & Weight

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25
4 areas of Diet selection
Amt needed Ability to eat GI alterations? Any special consideration based on health status
26
5 Types of Diets
Regular Liquid Diets & Special Considerations Modified Texture diets Therapeutic Diets Modified for Nutrients Supplements
27
What is a Regular Diet and it's aim?
No restrictions & no signs of intolerances Pt. has no comorbidities Encourage healthy choices Regular consistency Aim is to provide a well-balanced diet to meet nutritional needs
28
5 types of modified texture diets
Mechanical Soft Pureed Minced Ground Chopped
29
What is the differences between clear and full liquid diet
Clear liquid diet is any liquid you can see through Full liquid diet is anything liquid
30
What are the 2 special considerateions for liquid diet
fluid restriction Modified consistency of liquid
31
Purpose of clear liquid diet
surgery digestive problems acute illness leave little fiber in GI tract
32
full liquid diet is usually used for what?
Transition to regular diet
33
3 types of patients on fluid restriction
heart failure renal failure low serum sodium
34
Best indicator of patient fluid status
weight of patient everyday at same time in same clothes
35
6 types of therapeutic diet orders
Consistent Carbohydrate Cardiac Diet or Heart Healthy Diet Low residue High Fiber Gluten Free Lactose Free Bland
36
who would have low residue diet
ulcerative colitis | chrons disease
37
who would have a high fiber diet
improving cholesterol prevent colon cancer constipation
38
NPO means
Nothing by mouth
39
T/F Being NPO for more than 5-7 days are high nutritional risk
True
40
What are 4 common nutritional issues
Anorexia Inability to feed self Dysphagia Nausea & Vomiting
41
what does anorexia mean
lack or loss of appetite
42
causes of anorexia
pain fatigue effects of medications
43
9 approaches to increase appetite
Treat the cause Use creative approaches to stimulate appetite Environment Smaller meals, more frequent meals Allow for food preferences Seasonings to improve taste Provide oral hygiene Ensure patient is comfortable Medications for appetite stimulation
44
6 steps to assisting patients with oral feedings
Protect safety, independence & dignity Make sure tray is within reach Assess risk of aspiration Does patient need to be supervised Any visual deficits? Decreased motor skills
45
Dysphagia complications
Aspiration pneumonia Dehydration Malnutrition s/t decreased intake Weight loss
46
If dysphagia is suspected
Make referrals to Speech Language Pathologist (SLP) & Registered Dietician (RD) Perform swallow evaluations
47
The Do's of Dysphagia (11)
``` Sit in high fowlers Minimize environmental distractions Allow for time in between bites and drinks Check for oral pocketing Chin tuck Double swallowing Have suction available Perform oral care Monitor for choking and coughing ```
48
The Don'ts of Dysphagia (4)
Feed when altered LOC Leave unattended Administer sedatives or hypnotics Use a straw
49
7 stages of Dysphagia diet
``` 0 - Thin 1sligtly thick 2midly thick 3moderately thick/liquidised 4exremely thick/pureed 5minced 6 soft 7- regular/easy chew ```
50
Strick I&O
Measurement of all intake and all output Record in patient medical record Can measure in amount (mls) or in occurrences
51
who needs strict I&Os
``` Critical care patients Unstable patients Post-Operative patients Pt.’s who have catheters, lines, drains, tubes Patient’s with history of/ or current Heart failure, liver failure, renal failure Malnourished or patients who are NPO Receiving medications such as diuretics Changes in weight ```
52
what is considered intake 5
``` Oral intake IV Fluids Blood products Tube feeding Flushes ```
53
what is considered output 4
Urine Bowel movements Emesis Drainage tubes
54
What is enteral nutrition
Provides nutrients in GI tract | Preferred method if patient cannot swallow & gut is functioning
55
what is parenteral nutrition
Form of specialized nutrition support provided intravenously
56
Characteristics of enteral nutrition
Receive formula through nasogastric tubes, jejunal or gastric tubes Delivered to gastric or jejunum Risk for gastric reflux_ jejunum feedings When placed MUST CONFIRM PLACEMENT
57
indications of EN
``` Prolonged anorexia Some patients simply WILL NOT eat Severe protein-energy malnutrition Coma Impaired swallowing Critical illnesses ```
58
Benefits of EN vs PN
Reduce sepsis Minimizes the hypermetabolic response to trauma Decreases hospital mortality Maintains intestinal structure & function
59
Signs of Tube feeding intolerance
``` High gastric residuals Nausea Cramping Vomiting Diarrhea ```
60
complications of tube feeding
``` Pulmonary aspiration Diarrhea Constipation Abd cramping, nausea, vomiting Tube occlusion or displacement Delayed gastric emptying Serum electrolyte imbalance Fluid overload Hyperosmolar dehydration ```
61
placement of feeding tubes
Through the nose Nasogastric or nasointestinal (duodenal) Surgically Gastronomy Jejunostomy Endoscopically Percutaneous Endoscopic Gastronomy (PEG) Percutaneous Endoscopic Jejunostomy (PEJ)
62
nurse role in tube placement
Insert NG tube using water soluble lubricant Landmarks (gastric)- nose_ ear_ xiphoid process Add 8-10 inches for jejenum
63
Nasogastric or Nasojejunal | characteristics
Typically for EN < 4 weeks Large bore & small bore Typical for adults: 8-12 Fr, 36-44 inches long Come with a stylet Connectors are not standard for EN feeding tubes
64
surgically or endo tube characteristics
Preferred long-term feeding | More than 6 weeks
65
checking gastric residual
Continuous- Every 4-6 hours Intermittent- immediately before High gastric residual can indicate delayed gastric emptying How much is too much? Know hospital policy as well as KNOW your patient > 250 ml_ hold for 1 hour and recheck > 500 mls_ hold and notify HCP

Fundamentals 2 (5 decks)

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