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Fund - Module 8
Fundamentals Exam 3 - Nutrition
| Question | Answer |
|---|---|
| principles of nursing | energy balance, energy nutrients, regulatory nutrients, digestion, adequate diet selection |
| which nutrients contain calories? | carbohydrates, protein, fat |
| which nutrients do not contain calories? | vitamins, minerals, water |
| how many calories do carbohydrates have? | 4 kcal/gram |
| how many calories does protein have? | 4 kcal/gram |
| how many calories does fats have? | 9 kcal/gram |
| total daily energy expenditure | sum of all calories used to perform physical activity, maintain basal metabolism, digest, absorb, and metabolize food |
| basal metabolism | energy required to carry on involuntary activities of body at rest |
| what activities require basal metabolism? | maintaining body temperature and muscle tone, producing and releasing secretions, propelling food through GI tract, inflating lungs, contracting heart muscle |
| what is basal metabolism affected by? | age, biological sex, growth, meal frequency, physical and emotional health, environmental temperature, hormones, sleep |
| ideal body weight | estimate of optimal weight for optimal health |
| body mass index | ratio of weight to height |
| waist circumference | measurement of waist at level of umbilicus (good indicator of abdominal fat) |
| how many calories is 1 lb of body fat? | 3500 calories |
| how many calories do you need to increase/decrease to gain/lose 1 lb of body fat? | increase/decrease daily calorie intake by 500 calories |
| what is the primary function and recommendation for carbohydrates? | supply energy; 45-65% of total caloric intake |
| what is the primary function and recommendation for protein? | maintain body tissues, support growth of new tissue; 10-35% of total caloric intake |
| what is the primary function and recommendation for fats? | most concentrated source of energy; absorption of fat-soluble vitamins; provide insulation, structure, and temperature control; 20-35% of total caloric intake |
| what percentage of fats should be saturated fats? | less than 10% |
| what is the metabolism of carbohydrates? | converted to glucose |
| what is the metabolism of protein? | broken down into amino acids particles, nitrogen balance |
| what is the metabolism of fats? | bole acts as fat emulsifier |
| what are sources of carbohydrates? | fruits, vegetables, grains, whole wheat flour and wheat bran, oatmeal, dried peas and beans, mil, sugars |
| what are sources of proteins? | mils and milk products, eggs, meat, poultry, fish, dried peas and beans, nuts, soy, grains, legumes, vegetables |
| what are sources of fats? | butter, oils, margarine, lard, mayonnaise, whole milk and whole milk products, high-fat meats, nuts, salad dressings |
| vitamins | needed for metabolism of carbs, proteins, and fats; most not synthesized in body or made in insufficient quantities; water soluble (C, B) or fat soluble (A, D, E, K) |
| minerals | provide structure within body and help regulate body processes; found in all body fluids and tissues: salts or combined with organic compounds |
| water | 50-60% of adult total body weight; necessary for chemical reactions (solvent); balance between input and output |
| digested nutrients | transferred into circulation for transportation throughout body |
| undigested waste | continue through GI tract and eliminated |
| goals of MyPlate food guide | balanced calories, avoid oversized portions, increase intake of nutrients and water, adequate physical activity |
| adult considerations for nutrition | decline in basal metabolic rate with each decade, nutritional needs level off, fewer calories requires, wight gain common If adjustments in caloric intake are not made |
| older adult considerations for nutrition | energy expenditure decreases, loss of lean body mass; decreased caloric needs but need for nutrients increases; intake, digestion, absorption, metabolism , or excretion may be altered due to physiologic changes of aging |
| male considerations for nutrition | larger muscle mass with high caloric and protein requirements |
| female considerations for nutrition | more adipose tissue with lower caloric and protein requirements, higher iron requirements due to menstruation |
| how does alcohol affect nutrition? | interferes with normal nutrient absorption, need for vitamin B increases, impairment of nutrient storage and increased nutrient excretion; liver damage affects metabolism |
| how is absorption altered by medications? | change pH of GI tract, increase GI motility, damage intestinal mucosa, bind with nutrients |
| how is metabolism altered by medications? | act as nutrient antagonist, alter enzyme systems that metabolize nutrients, alter nutrient degradation |
| what are economic factors affecting nutrition? | ability to purchase sufficient food or food of high nutritional value; increasing cost of food and limited purchasing power |
| how does religion affect nutrition? | dietary restrictions; avoidance of certain types of food products and special food preparation techniques |
| how does culture influence nutrition? | nutritional diversity; influences what is eaten or considered edible, food preparation, and what combinations of foods are permitted |
| what BMI is considered underweight? | less than 18.5 |
| what are possible causes of limited food intake? | anorexia, illnesses, difficulty chewing or swallowing, surgical procedures, inadequate food budgets |
| what BMI is considered obese? | greater than or equal to 30 |
| nutritional screening | identifies cues associated with nutrition problems to determine presence or risk of malnutrition ex: Mini Nutritional Assessment tool |
| 24 hour recall | all foods and beverages consumed during average day |
| food diaries/counting calories | documentation of intake for specified time period |
| food frequency record | average number of times certain foods/food groups consumed in given time period |
| diet history | interview questions on food intake habits along with other tools |
| anthropometric data | height, weight, triceps, skin fold, midarm muscle circumference |
| biochemical tests | hemoglobin, prealbumin, transferrin, glucose, cholesterol, creatine |
| what are clinical manifestations of malnutrition? | N/V/D or Constipations, flaccid muscles, mental status changes, loss of appetite, dry and brittle hair and nails, dry scaly skin, inflammation and bleeding of gums, leaking/fatigue, changes in weight |
| what are food safety tips you should teach your patient | safe handling of foods, food storage, and prevention of food borne illnesses |
| what can malnourishment cause? | slower healing and development of complications |
| diet progression | medical orders written to begin one diet and advance to another diet as tolerated |
| what does advancing the diet depend on? | return of GI function, absence of symptoms related to disease, resolution of need for dietary restriction |
| how is the tolerance of died assessed? | absence of N/V/D, feelings of fullness, abdominal pain, distention, presence of feeling of hunger, ability to consume 50-75% of meal |
| what are measures to stimulate appetite? | small frequent meals that include meal preferences, provide encouragement, do not schedule procedures/medications that will interfere with mealtime, control pain, nausea, and depression, good oral hygiene, food easily reachable and pt properly positioned |
| therapeutic diets | control intake of certain foods or nutrients; part of treatment plan for medical condition |
| modified consistency diet | liquid diets or mechanically altered diets (modified texture) |
| NPO diet indications | surgery/tests, severe N/V, inability to chew/swallow, GI abnormalities, comatose |
| NPO diet nursing interventions | oral hygiene, mouth moisture, avoid watching others eat; nutritional challenge if lasts extended period |
| clear liquid diet | clear fluids or foods that become fluid at body temperature; requires minimal digestion and leaves minimal residue |
| indications for clear liquid diet | prep for bowel surgery and lower endoscopy, acute GI disorders, initial postoperative diet |
| pureed diet | foods blenderized to liquid form; all foods allowed |
| pureed diet indications | after oral or facial surgery; chewing and swallowing difficulties |
| mechanically altered diet | regular diet with modifications for texture; excluded raw fruits & veggies, foods with seeds, nuts, dried fruits; foods are chopped, ground, mashed, or soft |
| mechanically altered diet indications | chewing and swallowing difficulties; after surgery to the head, neck, or mouth |
| consistant carbohydrate diet | total daily carbohydrate content is consistent; calories based on attaining and maintaining healthy weight; high fiber and heart healthy fats encourages; sodium and saturated fats are limited |
| consistant carbohydrate diet indications | diabetes, gestational diabetes, impaired glucose tolerance |
| fat restricted diet | lower the patient's total intake of fat |
| fat restricted diet indications | chronic cholecystitis, CV disease, prevent atherosclerosis |
| high fiber diet | increased intake of foods high in fiber |
| high fiber diet indications | prevent or treat constipation; irritable bowel syndrome, diverticulosis |
| low fiber diet | fiber limited to less than 10g a day |
| low fiber diet indications | before surgery, ulcerative colitis, diverticulitis, Crohn's disease |
| sodium restricted diet | sodium limit may be set at 500-3,000 mg/day |
| sodium restricted diet indications | hypertension, heart failure, acute and chronic renal disease, liver disease |
| renal diet | protein restriction of 0.6-1 g/kg/day; sodium restriction 1,000-3,000 mg/day; potassium and fluid restrictions |
| renal diet indications | nephrotic syndrome, chronic kidney disease, diabetic kidney disease |
| enteral nutrition | passing a time into GI tract to administer nutrient rich formula |
| what factors help identify the feeding tube needed? | risk of aspiration, function of GI tract, ethical implications, anticipated duration of feeding tube, conditions and prognosis |
| what routes are used for short teem nutritional support (less than 4 weeks)? | nasogastric and nasointestinal |
| what is the main risk of a NG tube? | aspiration |
| what are examples of short term nutritional support tubes? | Levin tube (single lumen), Salem sump tube (double lumen), dobbhoff tube (jejunum) |
| what is used to verify initial placement of an enteral feeding tube? | x-ray |
| what do you do to ensure the tube stays in the right place? | measure the length of exposed tube after insertion and document measurement; mark tube with an indelible marker at the nostril |
| if your tube is in the lungs what pH reading will you get? | >7 |
| what does it mean if you have a positive reading for CO2? | the tube is in the lungs |
| if the aspirate is green, what does that mean? | this is stomach aspirate, the tube is in the correct place |
| what is used for long term enteral feeding? | enterostomal tube |
| What is a PEG tube? | a gastrostomy tube surgically placed or percutaneous endoscopic gastrostomy |
| what is a PEG/J tube? | jejunostomy tube surgically placed |
| continuous feeding | gradual introduction of formula into GI tract to promote minimal absorption; enteral feeding pump |
| intermittent feeding | formula delivered at regular intervals in equal portions over a set period of time; gravity or enteral feeding pump |
| bolus intermittent feeding | formula delivered quickly into stomach; gravity via syringe |
| cyclic feeding | continuous formula amount administered for portion of 24-hour period (12-16 hour overnight) |
| standard formula | intact molecules of protein, carbs, and fats |
| hydrolyzed formula | proteins and other nutrients in simple forms |
| what os the rate of feeding infusions? | 10-40 mL/hour |
| what is the correct way to advance the rate of feeding infusions? | based on patient's tolerance by 10-20 mL/hour every 8-12 hours until desired rate is achieved |
| what is the criteria to determine the patient's tolerance of the rate of feeding infusions? | absence of abdominal pain and GI complications, minimal or no gastric residual, presence of bowel sounds within acceptable limits |
| parenteral nutrition | intravenous administration of nutritional support |
| total parenteral nutrition (TPN) | highly concentrated, hypertonic solution administered through central venous access device; provide calories and restores nitrogen balance |
| peripheral parenteral nutrition (PPN) | less concentrated, isotonic solution administered through peripheral venous access divide; not as nutrient dense as TPN; short term (less and 2 weeks) |
| advantages of TPN | promotes healing and metabolic function, provides bowel a chance to heal, reduces activity in the gallbladder, pancreas, and small intestine |
| advantages of PPN | supplements inadequate oral intake; contains less than 10% glucose |
| what complications are important to know about TPN? | pneumothorax, thromboembolism, phlebitis, infection & sepsis, metabolic alterations (glucose levels), fluid, electrolyte, acid-base imbalances, hyperlipidemia, liver & gallbladder disease |
Created by:
ballen9519
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