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NUR 333: > Nutrition > Flashcards

Nutrition Flashcards

(67 cards)

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1
Q

3 main functions of GI system

A
  • transportation
  • digestion
  • absorption
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2
Q

importance of good nutrition

A
  • helps maintain healthy weight
  • reduces risk of chronic disease
  • promotes overall health
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3
Q

risks of malnourishment

A

greater risk of disease
- dysrhythmias
- skin breakdown
- sepsis
- hemorrhage
- inc length of stay
- delay surgical healing

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4
Q

dietary guideline

A

consume the proper daily values (myplate)

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5
Q

healthy eating patterns

A
  1. follow a healthy eating pattern across a lifespan
  2. focus on variety, nutrient dense foods, amount
  3. limit calories w added sugars, sat fats, reduce Na
  4. shit to healthier food and beverage choice
  5. support healthy eating patterns
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6
Q

factors influencing nutrition

A
  • appetite
  • negative experience
  • disease, illness
  • medications
  • env factors (income, edu, physical function, transportation, food cost)
  • developmental needs
  • alternative food patterns (religion, culture, health beliefs, personal preference)
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7
Q

older adults diet

A
  • need the same amount of vitamins and minerals of younger adults
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8
Q

nursing considerations for older adults

A
  • presence of chronic illnesses
  • meds
  • GI changes (dec HCl)
  • dec metabolic rate
  • cognitive impairments
  • available transportation
  • functional ability
  • fixed income
  • Ca supplements
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9
Q

cultural considerations

A
  • considerate of cultural and ethnic backgrounds
  • dietary restrictions secondary to religious beliefs
  • dont assume q culture is the same
  • habits often customs of their family
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10
Q

assessment of pt nutrition

A

sub/obj data
- risk of malnutrition
- standardized tools

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11
Q

assessment: anthropometry

A

-measure size and make of body
- ht and wt
- ideal body line
- BMI
- skin fold measure
- fat percentage
- RD can assist

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12
Q

nutrition lab test

A

no lab tests

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13
Q

factors that affect nutrition labs

A
  • fluid balance
  • liver and kidney function
  • presence of disease
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14
Q

total protein

A

combination of albumin and globulin
- normal 6.4- 8.3

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15
Q

albumin

A

makes up 60% of total PRO
- better indication of chronic disease
- synthesized in the liver
- half life 21 days
- normal (3.5-5.0)

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16
Q

prealbumin

A

preferred for acute conditions
- half life 2 days
- normal 15-36

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17
Q

hemoglobin

A

protein responsible for transporting o2 in the blood
- normal male (14-18 g/dL)
- normal female (12-16 g/dL)
if low may benefit from eating foods with Fe

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18
Q

assessment of nutrition history

A

-diet history (intake preference, allergies, etc)
- health history (illness, activity level, meds, etc)
- other history (age, socioeconomic, etc)

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19
Q

healthy nutrition physical exam

A
  • alert, erect
  • normal BMI
  • EMV: 15, 2+ reflexes
  • cardio: stable VS
  • GI: no problems
  • muscoskeletal: strong
  • moist skin, good color
  • nails are firm and pink
  • no swelling in face
  • mouth and teeth pink w no decay
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20
Q

malnutrition physical exam

A
  • fatigue, apathetic, sagging shoulders
  • obese, underweight
  • EMV: inattentive, irritable, confused, dec reflexes
  • cardio: stable VS
  • GI: anorexia, indigestion, constipation, diarrhea
  • muscoskeletal: weak, poor tone, wasted appearance, bowlegged, visible ribs
  • rough dry scaly pale skin
  • spoon shaped brittle nails
  • swollen face and sucken eyes
  • pale conjunctiva
  • red swollen dry lips
  • spongy receding, easily bleeding gums
  • welling tongue, teeth are missing and broken, oral mucosa swollen
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21
Q

nutritional nursing problems

A
  • imbalances nutrition: low nutrients, high nutrients
  • impaired swallowing
  • risk for aspiration
  • D/C/N
  • impaired dentition
  • fatigue
  • risk of unstable glucose
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22
Q

planning nutrition

A
  • individualized approach
  • goals and outcomes reasonable and reachable
  • setting priorities w pt understanding
  • teamwork and collaboration
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23
Q

nursing implementation

A
  • health promotion
  • advancing diet
  • measuring i and os
  • diet selection
  • care of common nutritional
  • obtaining ht and wt
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24
Q

health promotion for implementation of health promotion

A
  • pt education
  • early identification of concerns
  • assist w meals for all nutritional needs
  • educate food safety
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25
implementation: diet selection
- amount needed - ability to eat - any alterations in GI system - special considerations based on health status
26
types of diets
- regular - liquid - modifies texture - therapeutic diets and modified nutrition - supplements
27
regular diet
no restrictions or signs of intolerance - regular consistency - aim to provide well balanced meal
28
modified texture
used for pt w choking issues (dysphagia, weakness chewing) - mechanical soft: foods soft and easy to eat (no fruits, veggies) - pureed: no chewing like pudding - minced: chopped small (1/8th in) - ground: 1/4 in (rice) - chopped: 1/2 in (elbow macaroni)
29
clear liquid diet
usually for medical procedure or to rest the gut - water, coffee/tea (nothing added), broth, jello, popsicles, sport drinks, lemonade (no pulp) - no residuals in them
30
liquid diet foods
transition back to reg diet - juice, milk, coffee, tea, sports drinks, broth and soup, sorbet, yogurt
31
liquid diet, fluid retention
limit amount of fluid/day often for ppl retaining excess water (heart and kidney failure) - strict i and os - better measurement is weigh every day in am - watch for low serum Na
32
modified consistency of liquid
- thin liquid - thickened liquid (often for person who has had stroke)
33
thickness of liquids
- thin - nectar - honey - spoon
34
therapuetic diet orders
- consistent carb - cardiac or heart healthy - low residual - high fiber - gluten free - lactose free - bland
35
NPO diet
nothing to eat/drink by mouth - ordered for medical procedures or pt condition like resting gut or need it to wake up after med procedure - can be after midnight or after midnight except meds - NPO for more than 5-7 days risk nutritional health
36
advancing diets
common is to have advance as tolerated - tolerated = no nausea, vomiting, distention, active bowel sounds - typical progression: clear --> full --> low residue if needed --> regular
37
common nutritional issues
- anorexia - inability to feed self - dysphagia - nausea and vomiting
38
anorexia
lack or loss of appetite - caused by pain, fatigue, effects of medication, emotional stress
39
treatment of anorexia
-treat the cause - use creative ways to stimulate appetite - good env to eat in - smaller more frequent meals - have preferences available - oral hygiene - plus others
40
assisting pt w oral feeding
- protect, safety, independence, dignity - make sure tray is in reach - assess risk of aspiration - do they need to be supervised - any visual deficits - decreased motor skills - special utensils that OT helps w, use plate as a clock
41
dysphagia
difficulty swallowing - pts should be screened by nurse for risk - typically cause by stroke - warning signs like drooling, pocketing - silent aspiration
42
silent aspiration
food or fluid goes into airway and can cause things like pneumonia
43
complications of dysphagia
- aspiration pneumonia - dehydration - malnutrition - wt loss - if suspected refer to speech path and RD to preform swallowing eval
44
do for pt w dysphagia
- high fowlers, minimize distractions, allow time bw bites - check for pocketing, chin tuck, double swallowing - have suction available, oral care, monitor for chocking/coughing
45
dont for pt w dysphagia
feed when altered LOC - leave unattended - administer sedatives or hypnotics - use a straw
46
diet for dysphagia
recommended by speech path - stages like slightly thicken etc - position of pt - aspiration precaution
47
strict i and os
measure of all intake and output - recorded in medical record - measured in ml or occurrences - incontinence would need catheter for i and os
48
who needs strict i and os
critical care, unstable pt, post op, catheters/lines/drains/tubes, history of heart/kidney/renal failure, malnourished who are NPO, receiving diuretics, changes in wt
49
what counts as intake
- oral intake - IV fluids - blood products - tube feeding - flushes
50
what counts as output
- urine - bowel movements - emesis - drainage tubes (JP, chest tubes)
51
interventions for obtaining ht and wt
- must have accurate info - weight should be the same and accurate - ht - assess trend
52
enteral
provide nutrients via GI. tract - preferred method if pt cant swallow and gut is functioning - received through nasogastric, jejunal, gastric tube that deliver to gastric of jejunum - risk for gastric reflux --> jejunum feedings - must confirm placement
53
parenteral
form of specialized nutrition support provided IV
54
indications for enteral nutrition
- prolonged anorexia - severe protein energy malnutrition - coma - impaired swallowing - critical illness
55
benefits of EN over PN
- reduces sepsis - minimizes the hyper-metabolic response to trauma - decreases hospital mortality - maintains intestinal structure and function
56
administration of tube feeding
- start at full strength, slow rate - inc per RD and HCP recommendations like inc q 8-12 hrs, inc until goal reached, inc w no intolerance
57
signs of tube feeding intolerance
- high gastric residual - nausea - cramping - vomiting - diarrhea
58
types of tube feeding
bolus --> intermittent pump --> continuous
59
complications of tube feeding
- pulmonary aspiration - diarrhea - constipation - cramping, nausea - tube occlusion - delayed gastric emptying - serum electrolyte imbalance - fluid overload - hyperosmolar dehydration
60
tube feeding placement
- through the nose (nasogastric/nasointestinal) - surgically (gastronomy/jejunostomy) - endoscopically (PEG/PEJ)
61
nurses role in feeding tube placement
- insert NG tube using water soluble lubricant - landmarks: nose, ear, xiphoid process
62
confirming tube placement
- xray - ongoing placement verified w pH test
63
nasogastric or nasojejunal
typically for less than 4 wks - large and small bore - come w stylet - connectors are not standard for EN feeding tubes
64
surgically or endoscopically placed tubes
- preferred for long term feeding - more than 6 wks
65
nursing care for feeding tubes
- abd focused assessment - check skin for breakdown - assess nutritional status, intolerance, i and os, monitor labs - head og bed greater than 45
66
checking residual
- for continuous: q 4-6 hours - for intermittent: immediately before - high gastric residual can indicate delayed gastric emptying - more than 250 then hold for an hr and recheck - more than 500 notify HCP
67
feeding tube administration
- follow 5 rights for med administration - ensure med can be administered - always verify placement - flush w water before and after - administer one med at a time

NUR 333: (10 decks)

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