Nutrition

Question 1

This is the energy needed at rest to maintain life-sustaining activities such as breathing, circulation, maintaining temperature.

Answer 1

Basal metabolic rate

Question 2

This is the amount of energy you need to consume over a 24-hour period for the body to maintain internal working activities.

Answer 2

Resting energy expenditure or Resting metabolic rate

Question 3

How much energy does 1 g of each of the following produce?
Carbohydrates
Proteins
Fats

Answer 3

Carbohydrates and Proteins - 4kcal/g
Fats - 9kcal/g

Question 4

Proteins that contain all essential amino acids in quantities that are sufficient to support growth and maintain nitrogen balance.

Answer 4

Complete proteins or high-quality protein e.g. those from animal sources

Question 5

When the intake of nitrogen is greater than output; this is required for when there is increased nutritional needs i.e. growth, normal pregnancy, wound healing, this is called:

Answer 5

Positive nitrogen balance

Question 6

This occurs when the body loses more nitrogen than it gains i.e. infection, burns, fever.

Answer 6

Negative nitrogen balance

Question 7

The only essential fatty acid in humans, meaning they cannot be synthesised by the body and have to come from food sources.

Answer 7

Linoleic acid

Question 8

A health infant from birth to 1 year requires how many kcal per day?

Answer 8

100 kcal/kg of body weight per day and 100 to 120 ml/kg/day of fluid because a large part of total body weight is water

Question 9

What are typically the first semi-solid food to be introduced to infants?

Answer 9

Iron-fortified cereals

Question 10

What and how would you feed a toddler?

Answer 10

Small, frequent meals consisting of breakfast, lunch, and dinner with three high-nutrient-dense snacks in between.
Toddlers need fewer kilocalories but have an increased protein requirement

Question 11

What foods would you avoid for toddlers?

Answer 11

Candy, nuts, frapes, raw vegetables and popcorn – choking hazards

Question 12

Intense fear of gaining weight or becoming fat, restriction of energy intake in relation to requirements, and disturbance in the way one’s body weight, size, or shape is experienced is called:

Answer 12

Anorexia Nervosa – onset is typically during adolescence

Question 13

An eating disorder characterised by recurrent episodes of binge eating and compensatory behaviours to prevent weight gain, such as purging or use of laxatives

Answer 13

Bulimia nervosa

Question 14

What is the recommended protein intake during pregnancy?

Answer 14

Increased to 60 g daily

Question 15

What nutrient is specifically important during pregnancy for DNA synthesis and growth of red blood cells?

Answer 15

Folic acid

Question 16

Inadequate folic acid intake can lead to which complications/defects for the mother and newborn?

Answer 16

Fetal neural tube defects, anencephaly, maternal megaloblastic anemia

Question 17

What is the recommend daily intake of folic acid for pregnant women?

Answer 17

600 mcg daily

Question 18

What are the dietary restrictions for Muslims?

Answer 18

Pork

Alcohol

Fasting during Ramadan from sunrise to sunset for a month

Foods need to be halal – ritualised method of animal slaughter that is required for Muslims to be able to eat meat

Question 19

What are the dietary restrictions for those belonging to the Judaism religion>

Answer 19

Pork, shellfish, blood, mixing of milk or dairy products with meat dishes

Kosher food preparation – animals must be slaughtered according to religious guidelines i.e. quick, humane cut to throat to minimise suffering

24 hour of fasting on Yom Kippur or day of atonement

No leavened bread during Passover
No cooking on the Sabbath from sundown Friday to sundown Saturday

Question 20

These need to be eliminated in a gluten free diet.

Answer 20

BROW
Barley
Rye
Oat
Wheat

Question 21

Give at least five ways that you can maintain aspiration precautions. HINT: ALLERT

Answer 21

Assess: assess swallowing, observe for throat clearing, coughing, choking

Liquids in between solids

Low to High Fowler’s: remain sitting upright for at least 30 to 60 minutes after a meal

Environment: minimise distractions, do not talk

Rest periods during meals

Textures: avoid mixing foods of different texture

Question 22

What method can be used to support oral feeding for patients with visual deficits to maintain independence?

Answer 22

Arrange food in clock position and identify food location on meal plate i.e. rice at 3 o’clock

Orient the patient to where everything is located i.e. where are the beverages located in relation to the plate

Question 23

What type of tube would be used for patients expected to receive enteral feedings for less than 4 weeks?

Answer 23

Nasogastric tube

Question 24

What size and length of nasogastric tube that is typically used for adults?

Answer 24

8 to 12 Fr tube that is 36 to 44 inches long

Question 25

What is the purpose of the stylet in a nasogastric tube?

Answer 25

A stylet helps to make the tube stiffer during insertion, but is removed after correct tube location is confirmed. It should already have been removed before feeding is started AND SHOULD NEVER BE REINSERTED.

Question 26

What method can be used at bedside to confirm tube location on an ongoing basis?

Answer 26

Aspiration of gastric contents to measure pH

Question 27

What position should the patient be in for NGT insertion and why?

Answer 27

Upright position either Fowler’s and semi-Fowler’s with forward head position. This reduces the risk of aspiration and promotes effective swallowing. Forward head position helps with closure of airway and passage of tube into esophagus.

Question 28

How would you measure the correct length of an NGT for an adult?

Answer 28

Measure distance from tip of nose to earlobe to xyphoid process (NEX)

Question 29

How would you measure the correct length of NGT for a child?

Answer 29

Nose to earlobe to mid-umbilicus (NEMU)

Question 30

True or false: if the patient starts coughing during NGT insertion, the tube needs to be advanced quickly to minimise risk of aspiration.

Answer 30

False. The tube should not be advanced if the patient is coughing or during inspiration because then it is more likely to enter the respiratory tract.

Question 31

What nursing action can help lubricate the tube and facilitate passage of the NG tube into the esophagus?

Answer 31

Encourage the patient to swallow small sips of water and advancing tube each time the patient swallows.

Question 32

What is the most accurate way of confirming tube placement?

Answer 32

X-ray

Question 33

What position should the patient be placed in when administering enteral feedings?

Answer 33

Upright with head of bed elevated 30 to 45 degrees

Question 34

What is an alternative position for patients who require NGT feeding but are forced to remain supine?

Answer 34

Trendelenburg

Question 35

For manual gravity bolus feeding, how would you position the syringe if you want a faster flow of feeding?

Answer 35

Move the syringe higher

Question 36

If an institution recommends measurement of gastric residual volume, what does a GRV between 250 to 500 ml indicate?

Answer 36

Delayed gastric emptying and increased risk of aspiration GRV measurement is not routinely done unless policy states it.