Nutrition Exam 3

Question 1

factors influencing nutrition

Answer 1

appetite, negative experiences, disease, illness, medications, environmental factors (income, education, physical function level, transportation, availability of foods), developmental needs, alternative food patterns (religion, cultural background, health beliefs, personal preferences)

Question 2

what is considered in anthropometry

Answer 2

size and makeup of body
height & weight 
ideal body weight 
BMI: kg/m^2 OR 703 x lb/in^2
skin fold measures 
fat percentage

Question 3

what is total protein

Answer 3

combination of albumin and globulin constitute

normal: 6.4-8.3 g/dL

Question 4

albumin

Answer 4

makes up 60% of total protein 
better indicator of chronic illnesses 
synthesized in the liver 
half-life 21 days 
normal: 3.5-5 g/dL

if someone has liver problems their albumin may be low

Question 5

prealbumin

Answer 5

preferred for acute conditions
half life 2 days
normal: 15-36 mg/dL

Question 6

hemoglobin

Answer 6

protein responsible for transporting oxygen in the blood
Male: 14-18 g/dL
female: 12-16 g/dL

if low may benefit from eating foods rich in iron

Question 7

what is a regular diet

Answer 7

no restrictions and no signs of intolerances
PT has no comorbidities
regular consistency
aim to provide a well-balanced diet to meet nutritional needs

Question 8

what is a mechanical soft diet

Answer 8

softer, smaller in size
no raw fruits or veggies
no nuts or seeds

Question 9

what is a pureed diet

Answer 9

no chewing at all

smooth like pudding

Question 10

what is a minced diet

Answer 10

food chopped up teeny tiny, 1/8in big

Question 11

what is a ground diet

Answer 11

like rice

1/4 in

Question 12

what is a chopped diet

Answer 12

1/2 in

Question 13

what is a clear liquid diet

Answer 13

leaving little residue or fiber in the GI tract
could be going for medical procedure
may be associated with acute illness

anything liquid that you can see through
-broth

Question 14

what is a full liquid diet

Answer 14

often transition from clear liquid

-everything from clear and then any other measured in mL

Question 15

what is a fluid restriction

Answer 15

limiting number of fluids per day

anyone retaining excessive water

• heart failure and kidney failure
• pt. with low serum sodium

Question 16

what is a consistent carb diet

Answer 16

balances carbs, fats, proteins

recommended for diabetics

Question 17

what is a cardiac diet

Answer 17

low salt
low saturated fat
low cholesterol

Question 18

what is a low residue

Answer 18

limit foods that are easily digested (high fiber foods)
limit dairy

chrons disease will use low residue

reduce hyperactive diet

Question 19

what is a high fiber

Answer 19

grains, fruits, veggies, nuts, beans

Question 20

what is a gluten free

Answer 20

wheat barley rye oats

Question 21

what is a lactose free

Answer 21

not being able to digest sugars and lactose

Question 22

what is a bland diet

Answer 22

designed to avoid irritation in GI tract
decrease parastalsis
gastric reflux

Question 23

anorexia

Answer 23

lack or loss of appetite

causes

• pain
• fatigue
• effects of medications

Question 24

nursing care to increase appetite

Answer 24

treat cause
creative approaches 
environment 
smaller means more frequent meals 
allow for food preferences
seasonings to improve taste 
provide oral hygiene 
ensure patient is comfortable 
medications for appetite simulation

Question 25

dysphagia

Answer 25

difficulty swallowing

complications:

• aspiration pneumonia
• dehydration
• malnutrition s/t decreased intake
• weight loss

Question 26

silent aspiration

Answer 26

typically with dysphagia patients

when food goes into airway instead of stomach

Question 27

dont’s for dysphagia patients

Answer 27

DON’T feed when altered LOC
DON’T leave unattended
DON’T administer sedatives or hypnotics
DON’T use straw

Question 28

enteral vs parental nutrition

Answer 28

enteral - provides nutrients in GI tract, preferred method if patient cannot swallow & gut is functioning

parenteral - form of specialized nutrition support provided intravenously

Question 29

how does enteral nutrition work

Answer 29

receive formula through nasogastric tubes, jejunal or gastric tubes
delivered to gastric or jejunum
risk for gastric reflux –> jejunum feedings

ALWAYS CONFORM PLACEMENT

Question 30

why might someone get enteral nutrition

Answer 30

prolonged anorexia (pt. will simply not eat)
severe protein-energy malnutrition 
coma
impaired swallowing 
critical illnesses

Question 31

why is enteral better than parenteral

Answer 31

reduce sepsis
minimizes the hypermetabolic response to trauma
decreases hospital mortality
maintains intestinal structure and function

Question 32

signs of intolerance for tube feeding

Answer 32

high gastric residuals 
nausea
cramping
vomiting
diarrhea

Question 33

complications of tube feeding

Answer 33

pulmonary aspiration 
diarrhea
constipation
cramping, nausea, vomiting
tube occlusion or displacement 
delayed gastric emptying 
serum electrolyte imbalance
fluid overload
hyperosmolar dehydration

Question 34

what is the only 100% way of confirming tube is in correct place?

Answer 34

X-ray

Question 35

what is gastric residual

Answer 35

checking the amount of stuff in the stomach at any point in time

continuous - q 4-6 hours
intermittent - immediately before bolus

> 500 mL hold and notify HCP
250 mL hold for 1 hour and recheck
-always replace what is taken out