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test 3

malnutrition a lack of proper nutrition in the diet
calories one way to express the energy value of food
healthy adults require how many daily calories 1800-3000 a day
proteins are composed of amino acids
how many essential amino acids are there? nine
essential amino acids cannot be produced by the body; must be obtained from food sources
non essential amino acids produced by the body
two sources for proteins animal and plant
how many essential proteins do animal sources provide? all nine
how many essential amino acids do plant sources provide? they contain only some of the nine, so they are considered incomplete protein sources.
fat soluble vitamins A,D,E, and K
sources for fats/lipids butter, oils, salad dressing, whole milk, beef and pork...etc.
Cholesterol comes in two types. Tell the types and which one is good and bad. LDL (lethal) is bad and HDL (healthy) is good.
ideal HDL 70-88
ideal LDL less than 30 mg/dl
types of fats or triglycerides and which is better for you? saturated and unsaturated (better)
saturated fat solid at room temp
unsaturated liquid at room temp
water soluble vitamins B complex and C vitamins---must replenish daily because they are eliminated with body fluids
megadoses overdose of vitamins--can cause some side effects
catabolism breaking down
anabolism constructive/ building up
two parts to metabolism catabolism and anabolism
basal metabolic rate rate at which the body metabolizes food to maintain the energy requirements of person at rest.
three systems involved in metabolism disorders GI, endocrine and reproductive
Pancreas has two organ functions endocrine- making insulin and exocrine- secreting pancreatic juices for digestion
Health history for digestive and metabolism GI surgeries, unexplained weight loss/gain, regular bowel pattern, normal diet, history of GI disease and activity level
Medication history for GI GI disorder meds, laxatives, aspirin, or NSAIDS, vitamins, antacids, narcotics, weight-loss meds
Nutritional assessment normal food and fluid intake, food allergies, appetite patterns, any nutritional supplements (ensure).
include diet history in nutritional assessment age, gender, who preps meals, when do they eat, frequency of meals, food likes/dislikes, chewing/swallowing difficulty (dysphagia), level of activity, use of alcohol, special diets, desire to improve nutritional intake.
Physical Nutritional assessment genreal appearance, ability to chew/swallow, vitality/attention/concentration, psychosocial factors, anthropometric data, abdomen, lab data
nursing diagnosis related to metabolism and nutrition altered nutrition: ,ore than body requirements and less than, nausea,R/F aspiration, impaired swallowing, self-care deficit: feeding, risk for fluid volume deficit (vomiting/diarrhea)
altered nutrition: more than body requirements assess daily weights, food/fluid intake diary, increase activity, teach small frequent meals, teach table eating
altered nutrition:less than body requirements teach good eating habits, assess weight, food intake, stimulate appetite by good oral hygiene/decreasing pain/familiar foods, small frequent meals, nutrient dense foods, rest before meals, meals in groups, right temp.
nausea assess for odors or visuals, distraction, avoid abrupt movements, limit intake temporarily, cool cloth
vomiting always document the amount, color, appearance, and unusual odor
impaired swallowing and risk for aspiration keep suction nearby, sit up 90 deg. during meals, place food on unaffected side, teach small bites/chew well, check for pocketing
self care deficit: feeding appropriate equipment, assistance feeding
Diagnostic GI tests Flat plat of the abd., upper GI series(barium swallow), CT scan of abd., UGI(endoscopy)/EGD(gastroscopy), ERCP, Gastric analysis, MRI, oral cholecystography, ultrasound gallbladder/liver/pancreas/biliary, HIDA scan, liver scan/biopsy
special care when prepping for GI study NPO after midnight, no smoking morning of. POST test- increase fluids, laxative, teach stool will be light
CT special care assess for allergies to shellfish/iodine, inform of burning upon injection, NPO POST test- increase fluids
UGI/EGD and ERCP special care NPO, informed consent, POST test- no eating or drinking until gag reflex returns, monitor for any abnormal pain, tenderness, guarding or melena(dark tarry stool)**report melena immediately
Gastric analysis special care NPO, no smoking prior, no anti-cholinergics 24 hrs prior
MRI special care MUST assess for any metal in the body, assess for claustrophobia, inform of loud noises during
oral cholecystography special care check for iodine allergies, take radioactive tablets night before, NPO after midnight
HIDA scan special care and liver scan NPO POST test- increase fluids
liver biopsy special care informed consent, make sure Pt, PTT and bleeding times assess ahead of time, NPO, baseline vitals, POST test- bandage applied and lie on rt. side, bed rest, monitor for bleeding
Lab tests for GI serum bilirubin, liver enzymes, serum protein, serum ammonia, serum amylase, serum lipase
temporary therapeutic measures nasogastric and nasoenteric tubes
long-term therapeutic measures gastrostomy and jejunostomy
purposes of therepuetic GI intubation decompression, obtain gastric secretions, relieve obstructions, gavage (feeding), lavage(pumping), promote healing after GI surgery
tube feedings use what type of nutrition commercially prepared formulas such as ensure--doctor determines amount and type
when tube feedings are used you should monitor daily water intake
methods for tube feedings bolus, intermittent continuous
TPN Total Parenteral Nutrition
Created by: laceynickie