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Intervention Ch. 44
Nutrition-ATI 39
| Question | Answer |
|---|---|
| What is enteral nutrition? | nutrients given in the GI tract |
| What kind of clients get formula from nasogastric, jejunal, or gastric tubes? | enterally fed clients |
| How many types of enternal formula are there? | 4 |
| What are the four types of enternal formula? | polymeric, modular formulas (added to other food), elemental formulas (predigested nutrients), specialty formulas (certain illness needs) |
| Tube feeding are usually started? | at full strength at slow rates |
| You should increase rate? | every 8 to 12 hours |
| Enternal feeding reduces? | sepsis, response to trauma, and maintains intestinal structure and function |
| What do enternal feeding provide? | fluid, electrolytes, and nutritional support |
| What is a serious complication with enteral feeding? | aspiration of formula into the tracheobronchial tree |
| What does aspiration do? | irritates the bronchial mucosa, resulting in decreased blood dupply that leads to nectrotizing infection, pnemonia, and abcess |
| What does high glucose cause? | bacterial medium for growth, promoting infection |
| What is also associated with pulmonary aspiration? | ARDS |
| What are common conditions that increase aspiration? | coughing, nasotracheal suctioning, an artificial airway, decreased level of consciousness, and lying flat |
| What meds decrease the risk of aspiration? | prokinetic meds (metoclopramide, erythromycin, or cisapride |
| How much should you elevate the bed? | 30 degrees |
| Measure what every 4-6 hrs? | GRV |
| Stop feeding immediately when? | aspiration occurs |
| Withold feeding and reasses client tolerance if the GRV is? | over 200 ml |
| When do you use an enteral tube? | when a client cannot eat, but still absorbs the nutrients from food |
| Feeding tubes are inserted through? | the nose, surgically, or endoscopically |
| What are used for feeding of 4 weeks? | nasogastric or nasojejunal |
| What is used for long term feeding? | surgical or endoscopically |
| For adults, most tubes are? | 8-12 Fr, and 36 to 44 in long |
| What is often used during insertion? | a stylet |
| Don't use nasoenteric tubes when? | pt's had nose surgery, facial trauma, nosebleeds, and those given anticoagulation therapy |
| Advance a tube as? | the client swallows |
| If you hear air after you insert the tube the tube may be? | in the respiratory tract |
| What are early signs of aspiration? | abnormal lung sounds |
| What do you record? | size of tube, location, client's tolerance, ph value, and confiration of tube position by x ray exam |
| Plan pH testing when? | feeding is withheld |
| Before aspirating you should? | put in 30 ml of air into the tube |
| Fasted pH is? | 1-4 |
| Fluid pH from nasointestinal tube is? | greater than 6 |
| pt's with continuous feeding pH? | 5 or higher |
| What should you check the feeding container for? | expiration date and integrity |
| Have tube feeding at? | room temp |
| What causes skin breakdown? | infection, pressure from tube, or drainage of gastric secretions |
| What does absent bowl sounds mean? | inability for nutrients to be absorbed |
| Cold formula causes? | gastric cramping |
| Usually clients recieve enteral feeding continuously to ensure what? | proper absorption |
| Tube feeding are given with? | feeding pumps |
| Putting a cap on formula prevents? | air from entering stomach |
| Change bag and use a new administration every? | 24 hrs |
| Measure aspirate every? | 4-6 hrs |
| Measure glucose every? | 6 hrs |
| Measure I & O every? | 8 hrs |
| Weigh clients? | 3x a week |
| How do nurses verify tube placement? | injects air through the tube while auscultating the stomach for a gurgling or bubbling sound |
| The most reliable method to verify tube placement is? | x ray |
| How much gastric fluid is needed for testing? | 5-10 ml |
| The stopped using what to see if aspirate is in the lung? | blue food coloring |
| What is parenteral nutrition? | a form of specialized nutrition support in which nutrients are proveded IV |
| Who benefits from Parenteral nutrition? | people who are unable to digest or absob enteral nutrition |
| What have disuse of the GI tract been associated with? | villus atrophy and generalized cell shrinkage |
| What do lipid emulsions provide? | supplemental kcalories and prevent essential fatty acid defiencies |
| What is the adding of lipid emulsion to the PH solution called? | 3 in 1 admixture |
| do not use admixture if? | the is oil on the top |
| Lipid emulsions are? | white or opaque |
| What are complications of PN? | catheter related prob and metabolic alterations |
| Pnemunothorax is accompanied by? | symptoms of sudden sharp chest pain, dyspnea, and coughing |
| When does an air embolus occur? | during insterion of the catheter or when changing the tubing or cap |
| Catheter occlusion is present where there is? | a sluggis or no flow through the catheter |
| Suspect cathater sepsis if? | pt has fever, chills, glucose intolerance, and has a positive blood culture |
| Clean a port with? | alcohol |
| the PN solution contains most of what? | electrolytes, vitamins, and minerals |
| too rapid administration of hyertonic dextroce cancause? | osmotic diuresis and dehydration |
| pt's who move from PN to oral feedings? | have loss of appetite |
| When 75% of needs are being met by reliable dietary needs PN is? | discontinued |
| Optimal nutrition is important in? | health and illness |
| Medical Nutrition Thereapy is the use? | of specific nutritional therapies to treat an illness, injury or condition |
| MNT is necessary to assit the body's ability to? | metabolize certain nutrients, corrent nutritional deficiencies related to the disease, and elinimate foods that may exacerbate disease symptoms |
| How are peptic ulcers controlled? | with regular meals and meds |
| What bacteria causes peptic ulcers? | H. Pylori |
| To prevent peptic ulcers tell clients to avoid what kind of foods? | that increase stomach acidity and pain (caffeine, decaffeinated coffee, milk, juices, and seasonings) |
| Tell them not to do what to prevent peptic ulcers? | smoking, alcohol, aspirin, and NSAIDS |
| Nutrition therapy is usually the major treatment for? | disease control |
| All nutrition related objectives include? | baseline data, from which progress is measured |
| What is the basal metabolic rate? | the energy needed to maintain life sustaining activities for a specific period of time at rest |
| What affects energy requirements? | age, body mass, gender, fever, starvation, mestruation, illness, injury |
| What is the resting energy expenditure? | the amount of energy and individual needs to consume over a 24 period for the body to |
| Energy requirements are completely met by? | kilocalorie food |
| What are nutrients? | elements necessary for body processes and function |
| Foods are sometimes described according to their? | nutrient density |
| What are the main source of energy? | Carbs |
| Carbs also give what to the brain? | glucose |
| Carbs are classified according to their carb unit or? | saccharides |
| What has received attention as a dietary factor in disease prevention and treatment? | fiber |
| What are the insoluble fibers that cannot be digested? | cellulose, hemicellulose and lignin |
| What is made of DNA? | collagen, hormones, enzymes, immune cells, DNA and RNA |
| What is simplest form of protein? | amino acid |
| Nutrients provide? | energy for cellular metabolism and for repain, organ function, growth, and physical activity |
| Carbs provide? | energy and fiber |
| How many kcal is in 1 carb? | 4 |
| Fats are used? | for energy and provide vitamins |
| How many kcal in 1 fat? | 9 |
| What are sources of carbs? | grain bread, potatoes, and brown rice |
| Proteins contribute to? | the growth and repair of body tissues |
| How many kcal are in 1 protein? | 4 |
| Vitamins must be consumed daily for? | growth and repair of body tissues |
| What are fat solluble Vitamins? | A D E K |
| What are water soluble vitamins? | Vit B and C |
| Minerals complete essential? | biochemical reaction in the body system |
| Infants have? | high energy requirements |
| Toddlers need increased? | protein, Ca and phosphorus for bone growth |
| School aged children need adequate? | protein Vit C and A |
| Adolescents need? | protein, Ca, iron, iodine, folic acid and vit B |
| Women need? | Ca and iron |
| What is anorexia nervosa? | Fear of being fat |
| What is bulimia? | a cycle of binge eating followed by purging |
| BMI >30= | obese |
| How do you calculate BMI? | weight divided by height |
| What is a clear liquid diet? | liquids that leave little residue |
| What is full liquid diet? | liquid dairy product |
| What is pureed diet? | pureed meats, fruits, and scrambled eggs |
| What is mchanical soft diet? | diced or ground foods |
| What is soft/low residue diet? | foos low in fiber that are easy to digest |
| What is high fiber? | whole grain, raw and dried fruits |
| What is low cholesterol diet? | less than 300 mg/day |
| What is diabetic diet? | balanced intake of protein, fats, and carbohydrates |
| What is dysphagia? | pureed food and thickened liquids |
| What are types of nutrients given parenterally? | lipids, electrolytes,minerals, vitamins, dextrose, and amino acids |
| What are enzymes? | speed up chemical reactions |
| Digestion and absorption occur mainly in? | small intestine |
| Dietary change means you have? | redced fat, saturated fat, sodium, refind sugar and cholesterol |
| Tube feedings are for clients who? | are unable to ingest food but are able to digest and absorb food |
| Enteral nutrition? | protects intestinal structure and function and enhances immunity |
Created by:
alicia.rennaker
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