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Nur 333 Fun 2 > Nutrition (Exam 2) > Flashcards

Nutrition (Exam 2) Flashcards

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1
Q

Enteral Nutrition

A

Nutrition by the way of the GI tract

Feeding tube

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2
Q

Parenteral Nutrition

A

Feeding someone outside of the GI tract. IV or TPN feedings

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3
Q

3 main functions of the GI System

A

Transportation, Digestion, Absorption

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4
Q

Importance of good nutrition

A

Helps use reach and maintain a healthy weight

reduce risk of chronic disease (CVD, HTN)

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5
Q

Importance of Nutrition

A

-Early recognition of someone who is malnourished is key

-Patients who are malnourished upon admission are at greater risk of complications

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6
Q

Dietary Guidelines

A

-Provides average daily consumption of five food groups

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7
Q

Factors influencing Nutrition

A

-Appetite
-Negative experiences
-Illness
-Medications
-Environmental Factors (Income. Education level. Physical function level. transportation. availability of food.
-Developmental needs
-Alternative food patterns

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8
Q

Nutrition: Older Adults

A

-Older adults need the same amount of Vit. Minerals as younger adults

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9
Q

Older Adult Nutrition: What the nurse must consider

A

-Presence of chronic illnesses

-Medications

-Gastrointestinal changes

-Slower metabolic rate

-Cognitive impairments

-Available transporation

-Functional

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10
Q

Cultural Considerations

A

-Be considerate of pt.’s cultural and ethnic backgrounds

-consider dietary restrictions secondary to religious belief’s

-Don’t assume a each individual in each culture is the same

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11
Q

Nursing Assessment: Screening

A

-Essential part of nursing assessment

-Nutrition screening tools. Subjective and objective measures

-Identify risk factors of malnutrition

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12
Q

Nursing Assessment: Anthropometry

A

-A form of assessment. Study of measurments and porportions of the human body

-Heigh and Weight

-Ideal body weight

-BMI (Weight that they are taking into account their height)

-Registered dieticians

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13
Q

Nursing Assessment: Laboratory and Biochemical test

A

-No single lab test to meet standards

-facotrs that affect lab results:
-Fluid balance
-Liver and kidney problems
-presence of disease

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14
Q

Common nutritional labs in fundamentals

A

-Total Protein
-Albumin
-Prealbumin
-Hemoglobin

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15
Q

Total Protein

A

-Combination of albumin and globulin constitute

-Normal: 6.4-8.3

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16
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

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17
Q

Prealbumin

A

-Preferred for acute conditions

-Half-life-2days

-Normal: 15-36

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18
Q

Albumin is a colloid

A

Colloid creates pulling power in intravascular system. Keeps fluid inside intravascular space

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19
Q

Nutrition Labs: Hemoglobin

A

-Protein responsible for transporting O2 in blood

-Normal: 14-18 male. 12-16 Female

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20
Q

If Hg is low then patients might benefit from eating what kinds of food

A

Food that are rich in iron

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21
Q

Nutrition Assessment: History

A

Diet History
Health History
Other History

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22
Q

Health Nutrition vs Malnutrition chart

A
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23
Q

Cachectic

A

Very gout and skinny

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24
Q

Nutrition Nursing Problems

A

-Poor Nutrition
-Imbalanced Nutrition
-Impaired swallowing
-Risk for Aspiration
-DCN
-Impaired Dentition
-fatigue
-risk of unstable blood glucose

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25
Nutrition Planning
-Make it an individualized approach -Create Goals and Outcome -Set priorities -Teamwork and Collaboration
26
Nursing Implementation: Health Promotion
-Patient Educations -early identifications of nutritional concerns -Assisting with meal planning for all nutritional needs
27
Nursing Implementation: Diet Selection
-Amount needed -Ability to eat -Any alterations in their GI system -Any special considerations based on their health statues
28
Types of Diets (P/P Box)
-regular -Liquid -modified texture -therapeutic -supplements
29
Regular Diet
No restrictions and encourage healthy choices Aim to provide a well-balanced diet to meet nutritional needs
30
Modified Texture Diets
-Mechanical Soft Diet (soft and small in size. Easier to eat and soft in texture) (Blended or Chopped) -Pureed Diet: Smooth like pudding that their is no chewing -Minced Diet: Chopped up to 1/8 inch big which is similar to a sesame seed Ground diet: Like rice 1/4 inches Chopped diet: 1/2 inch
31
Clear and Full Liquid Diet
Clear: Before medical procedure or need to rest gut. Associated with acute illness and you are trying to leave little residue in the GI tract. Anything that you can see through. Broth, Juice, Pulp free Orange juice, black coffee, popsicle, gelatin Full: Typically transition from clear to regular diet. Any juice, milk, frozen yogurt, everything on clear and things measured in mL
32
Fluid Restriction Diet
Limiting amount of fluid per day Patients who have heart failure or kidney failure. They are retaining water. Patients who have lower serum sodium. Hyponatremic
33
Modified Consistency of Liquid
-Any who has Dysphagia patient. Someone who has stroke and cant swallow like normal
34
Best way to measure fluid volume statues in a patient
Weighing them daily is better that keep tract of I/O's
35
NO DIFFERENT TYPES OF LIQUDS
36
Therapeutic Diet Orders
-Consistent Carbohydrate (DM) -Cardiac Diet or Heart Healthy Diet (Low salt, Low Sat, Low Chol) -Low Residue (low ruffage) (low fiber)(Limit dairy)(People with Ulcertivie colitlts. Chrons.) -High fiber: Improve Chol levels. -Gluten Free: Celica's disease -Lactose Free: People who dont digest sugar in dairy products well -Bland Diet: Avoid irritation and decrease peristalsis
37
NPO Diet
Nothing by mouth -Before procedure or coming back from procedure. Medical problems NPO after midnight except meds
38
NPO risk
Nutritional risk if it last more than 5-7 days. TPN (Central Line)
39
Advance Diet as Tolerated
Clear Liquid. full liquid. Low residue. Regular diet -Only if patient is tolerating. Do assessments first
40
Common Nutritional Issues
Anorexia Inability to feed self dysphagia nausea and vomiting
41
Anorexia
Loss or lack of appetite Pain fatigue Effects of medications
42
Increasing Anorexia Appetite
-Treat cause -Use creative approaches t stimulate appetite -Environment -Smaller meals and more frequent -Allow for food preferences -Season -Oral hygiene -Ensure comfort -Provide medication
43
Assisting Patient With Oral Feedinds
-Protect Safety, Independence and Dignity? -Make Sure tray in reach? -Assess risk of aspiration -Supervision? -Motor or visual deficits? -PLATE AS A CLOCK
44
Dysphagia
-Nurses should screen for this -G means swallowing -Treat causes
45
Dysphagia Warning Signs
-Slow weak speech -Non gag reflex -delay swallowing
46
Silent Aspiration
food in airway and not stomach. Can lead to PNA
47
Dysphagia Complications
-Aspiration pneumonia -Dehydration -Malnutrition -Weight loss
48
WTD if Dysphagia is suspected
Refer to SLP or RD Preform swallow evaluatons
49
Nursing care Dysphagia: Do's
-Sit in high fowlers -Minimize environmental distractions -Allow for time in between bites and drinks -Check for oral pocketing -Chin tuck -Double swallowing -Suction -Oral Care -Monitor for choking and coughing
50
Nursing care dysphagia: Don't
-Feed when altered LOC -Leave Unattended -Administer sedatives or hypnotics -Use a straw
51
Dysphagia Diet
-SLP recommends -Stages -Position of patient -Aspiration precautions chart in PP
52
Intervention: Strict I/O
-Measuring of all intake and all output -Mls or Occurrences
53
Who needs strict I/O
Critical Care patients Unstable patients Post-opp Heart, liver, or kidney failure Pt's with tubes malnourished or npo pt's on diuretics changes in weight issues
54
Intake
Oral Fluids IV Blood Products Tube feeding Flushes anything in mL's
55
Output
Urine Bowel Movements Emesis Drainage tubes (JP or Chest)
56
Nurses Role I/O
Can be delegated Collaborate with NA Educate patient and family Communicate with everything Assess and monitor trends
57
Parenteral Nutrition
-Feeding outside of the GI tract. Intravenously, bypassing the usual process of eating and digestion
58
Enteral Nutrition
Liquid supplemental nutrition is either taken by mouth or is given via a feeding tube. Going to the GI tract
59
Look and understand the routes of enteral nutrition
60
Enteral Nutrition
Patient receive formula through nasogastric tubes, jejunal or gastric tubes Delivered to stomach or jejunum Risk for gastric reflux. MUST CONFIRM PLACEMENT.
61
Indications of EN
-Prolonged anorexia. (will not eat) -Severe protein energy malnutrition -Coma -Impaired swallowing -Critical Illnesses
62
Benefits of EN versus PN
-Reduces sepsis -Minimizes the hypermetabolic response to trauma -Decreases hospital mortality -Maintains intestinal structure and function
63
Nepro
For kidney issues
64
Administration Rate of Tube Feeding
-Started at full strength, slow rate -Increase per RD recommendation or HCP order (increase very 8-12 hours, amount of increases is set until reach goal rate, increase if no signs of intolerance) -Assess for signs of intolerance. (High gastric residuals, NCVD)
65
Administration of Tube Feeding
Bolus (Intermittent) vs Pump (continuous)
66
Compilations of Tube feedings (potter and perry)
-Pulmonary aspiration -Delayed gastric emptying -Serum electrolyte imbalance -Fluid overload
67
Placement of Feeding tubes
Through nose: Nasogastric or Nonintentional (doudenal) Surgically: gastronomy, jejunostomy Endoscopically: PEG (Percutaneous Endoscopic gastronomy) and PEJ (Percutaneous Endoscopic Jejunostomy)
68
Nursing Role in Placement
NG tube us a water soluble lubricant -landmarks (gastric) - nose- ear- xiphoid process. -Add 8-10 inches for jejunum
69
Feeding Tube: Conformation of Placement
-Historically: Insert air into tube and auscultate over stomach for bubbling -XRAY is the only 100% way to confirm -Once verified with x-ray, an ongoing placement verification ca be to test the pH
70
Nasogastric or Nasojejunal Tube
Typically for EN < 4 weeks Large bore and small bore Typically for adults; 8-13 Fr, 36-44 inches long Come with stylet Connectors are not standard for EN feeding tube
71
Surgically or endoscopically placed tubes
-Preferred long-term feeding -More than 6 weeks
72
Feeding Tube: Assessment and Monitoring
-Abd focused assessment -Check skin around tube for breakdown -Assess nutritional status -Assess for intolerance -Assess I&O -Assess and Monitor Labs
73
Decrease rick of aspiration in tube feeding
Elevate HOB to at least 30 degrees
74
Checking Gastric Residual
For continuous check every 4-6 hours. For intermittent check immediatley before High gastric residual can indicate delayed gastric emptying How much is to much?
75
> 250 ml gastric residual
Hold for an 1 hour and recheck
76
> 500 mls
Hold and notify HCP
77
Tube Feeding Administration of Medication
-Follow 5 rights of med administration -Ensure med can be administered via tube -Always verify placement -Flush with water before and after administration -Administer on med at a time

Nur 333 Fun 2 (19 decks)

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