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Intervention Ch. 44

Nutrition-ATI 39

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