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NUR151-Nutrition2
Nutrition - Part 2
| Question | Answer |
|---|---|
| Act as catalysts in biochemical reactions | minerals |
| Grains | 6 oz every day |
| Vegetables | 2 ½ cups each day |
| Fruits | 2 cups every day |
| Milk | 3 cups every day |
| Meat and Beans | Eat 5 ½ oz every day |
| Vegan, Zen macrobiotic | brown rice, grains, herb tea only |
| Islam | no pork, alcohol, caffeine |
| Hindu | no meat, alcohol |
| Judaism (orthodox) | no pork, predatory fowl, shellfish, require kosher food preparation, no milk w/ meat |
| LDS (Mormon) | no alcohol, tobacco, caffeine |
| 3-5 day food diary more accurate than recall Why? | more accurate and give actual picture of what they eat. |
| Anthropometry | a measurement system of the size and makeup of the body - measurements that help in identifying nutritional problems include the ratio of height to wrist circumference, mid-upper arm circumference |
| A client is considered overweight if the BMI is | 25 to 30 |
| Metabolic half-life of albumin is __ days | 21 |
| Metabolic half-life of transferring is __ days | 8 |
| Metabolic half-life of prealbumin is __ days | 2 |
| Metabolic half-life of retinol binding protein is __ hours | 12 |
| Common lab rests used to study nutritional status | plasma proteins (albumin), transferring, prealbumin, retinol binding protein, total iron-binding capacity, and hemoglobin. |
| Factors that affect serum albumin levels include | hydration, hemorrhage, renal or hepatic disease, drainiage from wounds, drains, burns, GI |
| Albumin level is a better indicator for | chronic illness |
| Prealbumin level study is preferred for | acute conditions |
| Nitrogen balance is important to establishing | serum protein status |
| A positive ___g nitrogen balance is necessary for anabolism. | 2-3 g |
| Negative nitrogen balance is present when __ states exist. | catabolic |
| BMI over __considered obese | 30 |
| When should you weigh patients? | In the morning after they have voided to do a “dry weight” |
| I & O is often inaccurate – Why? | because the measurement is somewhat subjective and open to numerous errors of measurement. Inaccurate readings, insensible water loss, forgetting to record intake and output. |
| Who might require fluid restriction? | renal patients, liver patients, SIADH |
| Minimum fluid output should be half a ml/kg/hour | means their kidneys are adequately perfusing |
| What might cause an increased fluid output? | diuretics, diabetes insipidus, diarrhea, shock |
| What are 5 s/sx you may see in someone who’s nutritionally impaired | basic signs like – pale, underweight, anorexic, tired, dry skin, constipated, confused, irritable, nails (spoon shaped for iron deficiency). |
| RUMBA | Realistic, Understandable, Measurable, Believable, and Achievable. |
| Diabetic diet (ADA) | calories per MD – Recommended food exchanges by the American Diabetic Association - around 1800 calories. The diet needs to include a balanced intake of carbohydrates, fats, and proteins. |
| Low cholesterol | common with cardiac patients, ordered by physician, foods low in cholesterol - less than 300 mg/day cholesterol, in keeping with American Heart Association guidelines for serum lipid reduction. |
| Soft, low residue diet | Addition of low-fiber, easily digested foods, such as pastas, casseroles, moist tender meats, and canned cooked fruits and vegetables. Desserts, cakes, and cookies without nuts or coconut. – food is soft and easy to chew. |
| Full liquid | liquid with addition of smooth-textured dairy products (e.g., ice cream), custards, refined cooked cereals, vegetable juice, pureed vegetables, all fruit juices. |
| Diet to enhance immune system | Protein, vitamins A, C, B12, B6, folic acid, thiamin, biotin, riboflavin, niacin, etc |
| Enteral nutrition (EN) used for | clients with a functional GI tract who are unable to safely swallow due to cancer of head or neck; trauma, Neuro or Muscular disorders |
| TPN (Total Parenteral Nutrition) or PPN (Partial Parenteral Nutrition) | are needed for pts. with a non- functioning GI tract or someone that needs to rest GI tract. |
| NG tube(nasogastric) | Most common tube - small bore tube used because it is less traumatic - inserted down nose into stomach or intestine (nasojejunal) - low risk of gastric reflux receive gastric feedings; however, if there is a risk of gastric reflux, which leads to aspirati |
| G-tube(gastrostomy) | tube inserted through stoma into stomach, changed periodically – surgically created hole in stomach. |
| Button | appliance flush with skin, attach extension to feed - often with kids – no external tubes for kids to pull. |
| Jejunostomy tube | tube inserted into jejunum by surgeon. Used for pts. With gastroparesis, reflux or aspiration risk. – lost peristalsis. |
| PEG or PEJ tube | percutaneously inserted G-tube - permanent tube inserted by surgeon endoscopically |
| Bolus | you stand there the whole time – rapid delivery feeding – poured into tube – about 20 minutes or so. |
| Intermittent Drip | feeding pump “kangaroo pump”, may last 30 – 45 minutes ex: ever 4 – 6 hours. Periodic feeding. |
| Continuous | receiving feeding 24 hours a day – hooked up to the pump. |
| Draw back on syringe, and obtain __ mL of gastric aspirate. | 5 to 10 |
| Histimine H2 antagonists | decrease acid production by inhibiting acid production in the stomach – on parietal cells – histamine directly inhibit histamine action and decreases stomach acid – histamine is located on parietal cells in the stomach. Administered before meals. |