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Flashcards in week six Deck (192)
1

Anorexia

a prolonged disorder of eating due to loss of appetite

2

Anthropometry

measurement and study of the human body and its parts and capacities

3

Basal Metabolic Rate (BMR)

the rate at which the body metabolizes food to maintain the energy requirements of a person who is awake and at rest. It is the rate at which the body spends energy to keep all of the life-sustaining processes going.

4

Calorie

unit of heat defined as the quantity of heat required to raise the temperature of 1 gram of water by 1 degree centigrade at atmospheric pressure

5

Malnutrition

the results in the body of poor nutrition; undernutrition, overnutrition, or any nutrient deficiency

6

MyPlate

Visual representation of the relative daily portions of various food groups; replaced MyPyramid in 2011.

7

Nausea

A subjective, unpleasant, wavelike sensation in the back of the throat, epigastrium, or the abdomen that may lead to the urge or the need to vomit

8

Negative Nitrogen Balance

Occurs when more nitrogen is excreted from the body than is retained from dietary protein sources. Occurs during the aging process, starvation, and extreme stress.

9

Nutrient

Organic and inorganic substances found in foods that are required for body functioning

10

What are the nutrient categories?

Carbohydrates, proteins, fats, water, vitamins, minerals

11

What are essential nutrients?

Must be supplied by our diet

12

What are non-essential nutrients

Can be made in the body

13

Calories in protein

4

14

Calories in carbs

4

15

Calories in fat

9

16

Calories in alcohol

7

17

What factors influence caloric requirement?

age/growth, gender, climate, activity, fever, illness, trauma, surgery

18

What are the important functions of proteins?

growth, repair and maintenance of body structures and tissues. Involved in the manufacture of hormones such as insulin. Act as enzymes to help bring about some chemical reactions such as digestion.

19

What is a complete protein?

A complete protein contains all 9 of the essential amino acids in the correct proportions to maintain tissues and support body structures. Includes most animal proteins, cheese, and eggs

20

What is an incomplete protein?

An incomplete protein lacks one or more of the essential amino acids. Usually vegetables.

21

What is a complementary protein?

Two proteins that when combined provide adequate amounts and proportions of all essential amino acids. Black beans and rice. Peanut butter and bread.

22

Nitrogen

The element that distinguishes proteins from lipids and carbohydrates.

23

Positive Nitrogen Balance

Occurs when more nitrogen is retained in the body than is excreted. This may occur in infancy, childhood, pregnancy and during lactation.

24

Nitrogen Balance

Studies that are helpful in determining the protein requirement of the body throughout the life cycle. Nitrogen balance occurs when the intake of nitrogen is equal to the output of nitrogen.

25

Sources of protein

whole grains, oatmeal, crackers, dark green and deep yellow vegetables, cottage cheese, yogurt, hard cheese, chicken, steak, dry beans, peanut butter

26

Protein deficiency problems

stunted growth, muscle wasting, decreased reflexes, swollen limbs and face, abnormal weight, swollen gums, cracked lips, swollen tongue, red, eyes pale and dry, brittle pale nails, patchy scaly skin, bruises, non-healing sores, mental apathy, tired

27

Stages of life when protein intake needs to be increased

pregnancy, breast feeding, infancy to childhood, emotional stress, physical stress, infection, higher environmental temperature

28

Carbohydrates

Organic compounds of carbon, hydrogen, and oxygen that are stored in the muscles and liver. CHO are also sugar compounds made by plants when they are exposed to light.

29

Functions of CHO

provides a quick source of energy in the form of glucose, spares break-down of protein for energy, aids in normal functioning of intestines (as CHO in fiber form), excesses of glucose stored as fast so it can later be convered to fuel if needed

30

Simple carbohydrates

sugars with a simple structure. One or two sugar units.

31

Monosaccharides (define)

one sugar unit

32

Disaccharide (define)

two sugar units

33

Monosaccharides

Glucose, Fructose, Galactose

34

Glucose

simple sugars

35

Fructose

fruit and honey

36

Galactose

sugar derived from digesting lactose

37

Disaccharides

Sucrose, Maltose, Lactose

38

Sucrose

table sugar

39

Maltose

not found naturally in foods but occurs in starch digestion

40

Lactose

CHO found naturally in milk

41

Complex Carbohydrates (define)

Composed of long chains of carbohydrates

42

Polysaccharide (define)

Chain of multiple molecules, many sugar units

43

Polysaccharides

Starch, Glycogen, Fiber

44

Complex Carbohydrates

Starch, Glycogen, Fiber

45

Starch

Major source of CHO in our diets. Rice, pasta. Non-sweet form of CHO

46

Glycogen

no dietary source

47

Fiber

Supply roughage as it can't be digested. Not a source of energy

48

Sources of Carbohydrates

pasta, bread, legumes, beans, fruits

49

Fats (lipids)

Organic substances that are greasy and insoluble in water but are soluble in alcohol. They are composed of carbon, hydrogen and oxygen but with a higher proportion of hydrogen

50

What are fats composed of?

carbon, hydrogen, oxygen. higher proportion of hydrogen

51

What are carbohydrates composed of?

carbon, hydrogen, and oxygen.

52

What are proteins composed of?

carbon, hydrogen, oxygen, nitrogen

53

Proteins

the building blocks of the body's tissues and organs

54

Fats

Lipids that are solid at room temperature

55

Oils

Lipids that are liquid at room temperature

56

What are the functions of fats?

provides energy and fuel, supports and protects internal organs, regulates body temperature, provides palatability, provides feeling of fullness

57

What are the three classifications of fats?

Triglycerides, phospholipids, sterols

58

Triglycerides

three fatty acids, may be saturated or unsaturated

59

Phospholipids

lipids containing phosphorus

60

Sterols

cholesterol. fat-like substances produced within the body and found in animal products

61

What are the three types of fats?

saturated fats, unsaturated fats, trans fats

62

Saturated Fats

saturation occurs when all 4 potential binding sites of a carbon atom are full with hydrogen atoms. Meat, poultry, full-fat products, and tropical oils

63

Unsaturated Fats

A fatty acid not completely filled with all of the hydrogen ions it can hold. Olive oil, peanuts, and canola oil.

64

Trans Fats

Fatty acids with unusual double bond structures caused by hydrogenated unsaturated oils. Baked goods.

65

Hydrogenation

The process of adding hydrogen a fat. This process extends the shelf life of a product. baked good, microwave popcorn.

66

Sources of fat

prepared foods, doughnuts, cookies, pies, avocado, coconut, yogurt, milk, cheese, shellfish, crab, untrimmed meats

67

Vitamins

organic compounds not manufactured by the body and are required in small amounts

68

Functions of vitamins

do not provide energy but necessary for metabolism of energy, vital for life, help regulate body processes such as growth and metabolism

69

Two classifications of vitamins

Water soluble and fat soluble

70

Water soluble

dissolves or disperses in water. Easily absorbed in the small intestine, excessive amounts excreted in the urine

71

Fat soluble

dissolves in fat, excess not excreted, rather stored, can be toxic and cause kidney damage, hair loss, double vision

72

Water soluble vitamins

Vitamin C, B complex vitamins, folate, choline

73

Fat soluble vitamins

vitamin A, D, E, K

74

B Complex Vitamins

B1, B2, B3, B6, folate, B12, panthothenic acid and biotin

75

What do the B Complex vitamins do?

functions in energy metabolism, blood cell formation, promotes normal nervous system functioning

76

Sources of B Complex vitamins

meat, fish, eggs, milk

77

What does vitamin C do?

promotes formation of connective tissues and plays a role in immune system functioning

78

Sources of vitamin C

citrus fruits, vegetables

79

What does vitamin A do?

involved in normal growth and development of bones and teeth, enable eyes to adapt to dim light

80

Sources of vitamin A

liver, milk, fish, green leafy vegetables

81

Sources of vitamin D

sunlight on skin, liver, egg yolks, fortified milk

82

What does vitamin D do?

necessary for normal bones and development of teeth

83

What does vitamin E do?

linked to prevention of cardiovascular disease and cancers

84

Sources of vitamin E

leafy vegetables, whole grains, wheat germ, vegetable oils

85

What does vitamin K do?

plays a role in normal blood clotting

86

Sources of vitamin K

green leafy vegetables, yogurt

87

Minerals

Inorganic elements that originate from the earth's crust, not from plants or animals

88

Function of minerals

play a role in structure of teeth and bones, assist in the regulation of the fluid balance of the body, involved in normal muscle relaxation and functioning

89

What are the two mineral categories?

macro mineral (major) and micromineral (trace)

90

Macromineral

needed in daily amounts of 100mg or more per mineral

91

Examples of macrominerals

magnesium, phosphorus, sodium, chloride, sulfur, calcium

92

Calcium function

provides structure to bones and teeth, stimulates muscle to contract

93

Sources of calcium

dairy products, shellfish, sardines

94

Micromineral

needed daily in amounts of less than 100mg

95

Examples of microminerals

Iron, zinc, iodine, selenium, copper, manganese, fluoride, and chromium

96

Function of iron

responsible for distribution of oxygen throughout the body

97

Sources of iron

red meat, organ meat, chick peas, raisins, liver

98

Function of iodine

regulates growth and development (r/t thyroid hormone)

99

Sources of iodine

Iodized salt and seafood

100

Water

the largest single constituent of the human body. It is the medium in which all biochemical reactions occur.

101

Function of water

provide shape and structure to the cells, regulates body temperature, aids in digestion

102

Dietican

designs therapeutic diets based upon individual needs, supervises meal preparation, educates, may hold advanced certification to teach clients about specific disease conditions

103

Nurse's role in nutrition

nutritional assessments, education, may hold advanced certifications, assists client to adhere to prescribed diet

104

What is therapeutic nutrition?

A modified diet or special diet prescribed to promote, maintain, or restore the client to an optimal level of health

105

Why would a diet modification be necessary?

hypertension, cardiac, renal disease, dysphagia, edentulous, obesity, trauma

106

Dysphagia

difficulty swallowing

107

Edentulous

toothless

108

Nursing role in therapeutic nutrition

reinforce instructions, evaluate response, assist in planning changes, provide nursing interventions to help stimulate appetite, assist incapacitated clients, refer to various community programs

109

Nursing interventions for managing nausea

avoid movement, distraction, odor free setting, limit oral intake, small meals, offer fluids between meals, avoid certain foods, bland foods, lower stress, anti-emetic drug, relaxation, fresh air, crackers at the bedside

110

Nursing interventions for managing vomiting

change position, promote skin integrity, prevent aspiration, provide emesis basin, offer prn medications, sip cool liquids, assess urine output / I & O, provide reassurance, daily weights, frequent oral hygiene, IV fluids, assess electrolyte status, rest/safety

111

Emesis

vomiting

112

What are the types of modified diets?

low sodium, low fat, clear liquid, full liquid, soft diet

113

Low Sodium Diet

used for those with HTN risk or actual heart and or renal disease. Omit table salt and processed foods

114

Low Fat Diet

used to lower weight and cholesterol, for those with increase risk of stoke, heart disease and diabetes. eat less meat, remove fat from meat, keep total fat intake within 20-35% of total calories, decrease saturated fats to less than 10% of total daily calories

115

Clear Liquid Diet

used for surgical prep, post-op period, or with GI disorders. Foods that are clear at room temperature, requires minimal digestions and leaves minimal residue, inadequate in calories in nutrients, short term use only (24-36 hours), includes tea, clear juice, ginger ale, water, popsicles.

116

How long may a clear liquid diet be used?

Short term. 24-36 hours

117

What are appropriate examples of foods for a clear liquid diet?

tea, clear juice, ginger ale, water, popsicles

118

Full Liquid Diet

Used with GI disturbance or inability to tolerate solid/semisolid foods. liquids or foods that liquefy at room temperature. not suitable for long term use, can be supplemented with ensure. yogurt, ice cream, vegetable juice, pudding, custard

119

What are appropriate examples of foods for a full liquid diet?

milk, yogurt, ice cream, vegetable juice, pudding, custard

120

Soft Diet

those with difficulty chewing or swallowing. lower fiber, easily chewed and digested. mashed potatoes, applesauce, and bread pudding

121

What are appropriate examples of foods for a soft diet?

potatoes, applesauce, and bread pudding

122

What is important to remember about a soft diet?

Low in fiber. May cause constipation.

123

What are factors that influence a person's eating patterns?

development, ethnicity/culture, personal beliefs, lifestyle, health, psychological factors, gender, food beliefs, religious beliefs, medications, alcohol, personal preferences, age, economics, advertising

124

What are examples of anthopometric data?

height, weight, ideal body weight, usual body weight, tricep skin-fold measurement, body mass index

125

What are the components of a nutritional assessment?

anthropometric data, biochemical data, dietary/health history, clinical data

126

Biochemical data

Lab tests used to provide objective information

127

Examples of biochemical data

hemoglobin, electrolytes, total lymphocyte count, urine specific gravity, serum transferrin level, serum albumin, serum pre-albumin level

128

If the total lymphocyte count is low, than protein is?

low

129

What does serum transferrin do?

binds and transfers iron

130

Examples of dietary/health history

gender, age, weigh changes, problems related to eating, living arrangements, difficulty with food prep, culture, education, appetite changes, activity level, medical history, 24 hour food recall, food diary

131

Examples of clinical data

assessment of skin, eyes, hair, nails, mucous membranes, activity level

132

Albumin

a blood test used to assess protein levels in the body

133

Normal albumin level

3.5-5.0 gm/dl

134

Prealbumin

a blood test to assess protein levels in the body but it is more sensitive than the albumin test because of its short half-life. It is more expensive.

135

Normal prealbumin level

17-40 mg/dl

136

Underweight

not eating enough food to take in all of the necessary essential nutrients

137

Underweight criteria

15-20% below weigh standards or BMI is 19 or lower

138

Overweight criteria

BMI between 25 and 29.9

139

Obese criteria

BMI over 30

140

Vegetarian

loosely defined as the abstinence from animal products

141

Ovolacto

eats dairy and eggs

142

Lacto

eats dairy

143

Ovo

eats eggs

144

Vegan

does not eat meat, fish, poultry, dairy, or eggs

145

Reasons for vegetarian diet

health, religion, ethical, ecological, financial

146

Fad Diets

Widespread but short-lived interest or practice of a specific diet followed with considerable zeal

147

Examples of fad diets

grapefruit diet, atkins diet, south beach diet, zone diet

148

% Daily Value

The % of nutrients that one serving contributes to a 2,000 calorie diet

149

Three basic messages of US dietary guidelines

aim for fitness, build a healthy base, choose sensibly

150

MyPlate guidelines

half of your plate fruits and vegetables, half of your grains whole, fat-free or low-fat milk, vary your protein choices, cut back on sodium and empty calories from solid fats and added sugars, enjoy food but eat less, be physically active your way

151

Defining characteristics of Nausea

aversion to food, gagging sensation, increased salivation, increased swallowing, report of nausea, sour taste in mouth

152

Define Nutrition imbalanced, less than body requirements

Intake of nutrients insufficient to meet metabolic needs

153

Defining characteristics of Nutrition imbalanced, less than body requirements

abdominal cramping, abdominal pain aversion to eating, body weight 20% or more under ideal, capillary fragility, diarrhea, excessive loss of hair, hyperactive bowel sounds, lack of food, lack of information, lack of interest in food, loss of weight with adequate food intake, misconceptions, misinformation, pale mucous membranes, perceived inability to ingest food, poor muscle tone, reported altered taste sensation, reported food intake less than RDA, satiety immediately after ingesting food, sore buccal cavity, steatorrhea, weakness of muscles required for swallowing or mastication

154

Define Nutrition imbalanced, more than body reqirements

Intake of nutrients that exceeds metabolic needs

155

Defining characteristics of Nutrition imbalanced, more than body requirements

concentrating food intake at the end of the day, dysfunctional eating pattern, eating in response to external cues, eating in response to internal cues other than hunger, sedentary activity level, triceps skin fold >25mm in women and >15mm in men, weight 20% over ideal for height and frame

156

Define Nutrition imbalanced, risk for more than body requirements

At risk for intake of nutrients that exceeds metabolic needs

157

Risk factors for Nutrition imbalanced, risk for more than body requirements

concentrating food at the end of the day, dysfunctional eating patterns, eating in response to external cues, higher baseline weight at the beginning of each pregnancy, observed use of food as comfort measure, observed use of food as reward, pairing foods with other activities, parental obesity, rapid transition across growth percentiles in children, reported use of solid food as major food source before 5 months of age

158

Gauge

Diameter of the shaft of the needle. The gauge varies from #18-#30. The larger the gauge number, the smaller the diameter of the shaft.

159

Vial

a small bottle that contains a drug (especially a sealed sterile container for injection by needle)

160

Which is a thicker needle, #18 or #30?

#18

161

Ampule

a small glass container for individual doses of liquid medications

162

More than 1 ml syringe

Tenths. Never trailing 0.

163

Less than 1 ml syringe

Hundredths. Never trailing 0.

164

What factors should be considered when selecting needle length and gauge when giving an injection?

client muscle development (condition and size), client weight (thin, obese), type of injection ordered, amount of adipose tissue, age of client, viscosity of medication (thicker med - smaller gauge # needle aka bigger needle), type of medication (insulin needs insulin needle and syringe

165

Maximum amount of solution that can be administered into one subcutaneous site on an adult

2 mL

166

Needle size for subcut injection

Need gauge #25-#30, Needle Length 1/2-5/8

167

Subcutaneous: Pinch or Flatten?

Pinch

168

Appropriate locations for an I.M. injection?

deltoid, dorsogluteal, vastus lateralis, ventrogluteal

169

Maximum amount of a solution that can be administered into one intramuscular site on an adult

3 mL

170

Maximum of solution that can be administered into an adult deltoid injection site

2 mL

171

Needle size for an I.M. injection

Needle Gauge #21-#23, Needle Length 1-1.5 inches

172

Preferred Pediatric IM sites?

vastus lateralis and ventrogluteal sites. Vastus lateralis is most used.

173

Hub of needle

Attaches to the syringe.

174

Barrel of syringe

part hold medication and has markings

175

Tip of syringe

Provides connecting site for the needle.

176

Plunger of syringe

Used to pull or push medication into or out of the barrel.

177

Bevel of needle

The angle of the needle on the tip

178

Shaft of needle

Long cylindrical portion

179

Lumen of needle

gauge, where the medication comes out

180

Parts of needle that must be kept sterile

all of it

181

Parts of syringe that must be kept sterile

tip, inside of barrel, shaft of plunger

182

Deltoid Site Landmarks

Acromial process, deltoid muscle, scapula, humerus, deep brachial artery, radial nerve

183

Vastis lateralis Site Landmarks

Femoral artery, greater trochanter of femur, vastus lateralis

184

Ventrogluteal Site Landmarks

Anterior superior iliac spine, iliac crest, gluteus medius, greater trochanter

185

Dorsogluteal Site Landmarks

posterior superior iliac spine, gluteus maximus, greater trochanter of femur, sciatic nerve

186

Dorsogluteal Site

position client in the prone position with toes pointed inward or side-lying position with upper knee flexed and upper leg in front of lower leg, palpate the posterior superior iliac spine, then draw an imaginary line to the greater trochanter of the femur, the injection site is lateral and superior to this line, it is located in the upper, outer area of the buttock

187

Ventrogluteal Site

client can be positioned on the back, prone, or side-lying position with knee and hip flexed but the side-lying position is the most common, place your heel of hand over the greater trochanter with fingers pointing towards client's head and thumb facing client's groin (right hand on client's left hip or left hand on client's right hip), put your index finger on the anterior superior iliac spine and stretch your middle finger dorsally palpating iliac crest and pressing below it, your fingers form a V and the injection is given in it's center

188

Vastis lateralis site

Thigh should be relaxed and client in side lying or sitting position, palpate the knee and greater trochanter of femur, client's toes should be pointed inward, located site by placing 1 hand width below the great trochanter, 1 hand width above the knee, the middle area between the hands at the anterior lateral aspect of the thigh is the site

189

Deltoid Site

arm should be relaxed at the side of the body, palpate the lower edge of the acromion process, with the other hand find the lateral aspect of the arm which is in line with the axilla, form an upside down triangle between these points for the injection site

190

What are the reasons why a nurse should rotate injection sites on a client that receives multiple injections?

minimize tissue damage, aid absorption, avoid discomfort, minimize tissue irritation

191

What can a nurse do to minimize discomfort of injections?

Select a needle of largest gauge number that is appropriate. select needle of correct length. be sure needle is free of medication that might irritate the tissue. inject medication into relaxed muscle. do not inject areas that feel hard on palpation or tender to client. insert the needle with a dart-like motion without hesitation, remove it quickly at the same angle. do not inject more solution than is recommended for the site. inject the medication slowly. massage the area after injecting unless contraindicated. allow the fearful client to talk about their fears. rotate sites. use z track from IMs. Distract the client before giving the injection. stabilize the syringe after inserting needle, hold syringe steady. allow alcohol to dry before inserting needle

192

Actions to take in the event of a needlestick injury

clean: clean wound immediately, complete incident report. contaminated: follow agency policy. mcc policy