Nutrition PPT 2 Flashcards

Terms Definitions
Is the GI tract sterile?
No.
A fever indicates...
Infection of central line
Increased transferrin indicates...
iron deficiency, pregnancy, and estrogen therapy
A soft diet provides a transition point between a liquid and a regular diet. Are all the nutrients provided in a soft diet?
Yes
What causes diarrhea?
Infections to the GI
Lactose intolerance
Spoiled foods
Stress
Cyctic fibrosis and other malabsorptive diseases
What lab can be drawn to determine a clients protein status?
Serum albumin
A full liquid diet can be easily swallowed and provides oral nutrion. If your client is on a full liquid diet for more than three days, what must be provided?
Supplements
It is important to check your clients mouth daily. True or False?
True
When removing stomach contents what are you looking for?
COCA and aspirate
What is cheilosis?
cracks in the corners of the mouth
Although we consume a lot of meats (most of us), where do we get most of our iron?
Supplements (vitamins)
What are some types of sodium restrictive diets?
Strict: 500mg/d
Moderate: 1000mg/d
Mild: 2000mg/d
NAS: no food restrictions BUT do not add salt at the table or the stove
A low protein diet is used in clients with renal failure and liver dysfuntion. Proteins consumed must be of high quality. What is the perfect food that contains all of the essential amino acids?
Eggs
Is it okay to adjust the TPN rate without an order?
NO
Why are enteral feedings necessary?
Inability to consume adequate food
Increased nutritional requirements

Must bypass the mouthTumor
Dysphagia
decreased LOC
What are three uses for a NGT?
Gavage: feeding/nutrition
Lavage: removal of stomach contents for lab or washing out of toxins
Decompression: gastric rest, prevent N/V, reduce strain on suture line, and treatment of a bowel obstruction
Cholesterol is ingested and synthesized in the liver from dietary fats. Increased levels of cholesterol are due to_________ or ________.
increased fat intake or muscle breakdown
What are some things that might alter a clients nutritional intake while in the hospital?
meals are delayed
procedures
surgery
N/V
labs
diagnostic tests
PAIN
A soft diet should contain minimum fiber. What food items should be omitted from a soft diet?
Fried
highly seasoned
flatus causing foods
no bran or unrefined grains
no seeds, nuts, fresh fruit, and coconut
no spiced lunch meat
When assisting a client with dysphagia, what ar some things you should do?
have suction readily available
assist to sitting position
oral hygiene before feeding
smi solids with some texture
quarter size bites
observe for swallowing
tuck chin, remind to swallow 2-3 times
check mouth for food/fluids still in cavity
keep sitting, HOB up 30 degrees after meals for 30 minutes
watch for coughing and choking
always place food on unaffected side
What do use to irrigate with if your client has overdosed?
Activated charcoal
What are some causes of diarrhea? What are some interventions?

CausesAntibiotics
possible C-diff, hyperosmolar formula


InterventionsDecrease the volume/rate
dilute or change formula
keep clean
continuous feeding
lactose free formula
r/o fecal impaction
ADD FIBER
What are some nursing interventions for pyrosis (heartburn)?

Avoid certain drinks, foods, medications, and chemicals Alcohol
Acidic juices, Citrus fruits
Nicotine
Fatty/Spicey foods
Tomatoes
Chocolate
BCP, Sedatives, Antihistimines
What is the function of transferrin?
Transferrin is a protein that transfers (trans) iron (Fe) to be recycled
Transferrin's job is to regulate iron absorption
What are some foods that have hidden sodium?
soups
snacks
sauces (soy sauce, ketchup)
sauerkraut
smoked meats
seasonings
sweetners
sodium processed meats (kosher meats)
Explain a clear liquid diet.
Clear liquid diet is easily absorbed and does not overstimulate the digestive tract. They are liquid at room temperature. Decreases peristalsis. Clear liquid diets provide an oral source of fluids, small amounts of calories, and electrolytes, reduces colonic residue, and relieves thirst.
What are some ways that the nurse can help a client accept and participate in a therapeutic diet?
clarify misinformation
individualize the diet
help them understand the relation between their disease and diet
Client should be educated on the benefits and consequences of not following the diet!
Name one of two types of central lines.
Central Venous Catheter
Peripherally Inserted Central Catheter (PICC)
A client has N/V, what are some concerns you may have for this client?
Dehydration or self induced vomiting
After a feeding you would fluch the feeding tube except when your client has...
Renal failure, CHF, ...
One of the most annoying complications of tube feeding is tube occlusion. What are some interventions to prevent tube occlusion?
Use liquid medication
Irrigate tube with water before and after giving medication
DO NOT give medications that are "enteric coated" through the tube
Give only one medication at a time
Your client has a wound that is having difficulty healing. What are two things that you can give them to help the healing process?
Vitamin C and Zinc
When placing a client on a special diet what are some things you would discuss with the client?
allowed and prohibited foods
reasons why food labels are importanteducate them on how to read the labels
include significant others/familywho cooks/shops
refer to dietician or diet manual
EXPLAIN THE CONSEQUENCES AND APPEAL TO THE CLIENT
How can you check the placement of an NGT? Which is least reliable?

Aspirate gastric contents
Air rush/insufflation (least reliable)
What are some precautions to take when dealing with a client that has refeeding syndrom?
Correct and monitor electrolyte levels
Start slow
Watch Pulse, I&O, and electrolytes
Avoid overfeeding
Nursing care of a client on alternative feeding includes...
Daily weight and I&O
BM's
Tolerance to feeding

Residuals 
Oral hygiene (lube lips, rinse mouth out)
Keep nostrils clear
Watch for c/o sore throat
Body image
What are some reasons for loss of appetite?
altered smell or taste
disease state (after surgery)
sore mouth or tooth pain (always check mouth daily)
food intolerance and allergies
dysphagia
indigestion
What are some things you want to do to maintain a controlled mineral or electrolyte (sodium) diet?
encourage fruits and vegetable
increase use of other seasonings and spices that do not contain sodium
be aware of foods that are hiding sodium
What is the purpose of a high residue/high fiber diet?
To create mechanical stimulation of the GI tract, treat constipation, hemorroids, and diverticulitis
What are some of the drug interactions that can cause nutritional problems?
Anticoagulants & Vit K- antagonist (avoid leafy greens)
Tetracycline & minerals- antagonist (minerals bind to AB)
Antacids & nearly everything- blocks absorption
Diuretics & Potassium- depletes K
MAOI & aged foods and wine- can be deadly
Antiparkinson meds & Vit B6- antagonist
Antitubercular meds & Vit B6- B6 reduces side effects
An altered consistency or mechanical soft diet are considered a regular diet. What are some reasons that a client would be placed in a altered consistency or mechanical soft diet?
It is for those clients who cannot chew or swallow well
Which one of these TPN complications can lead to brain damage? Hyperglycemia or Hypoglycemia?
HypoglycemiaThe brain is a sugar hog! Its only feul is glucose!
What are some ways to prevent Pulmonary Aspiration?
Always check placement
Keep the HOB up at all times during feeding and medication admistration
What is the definition of a nasogastric tube? Can a NGT be used for alternative feeding?
A NGT describes the entrance into the body
Yes, a NGT may be used for feeding but generally is not.
Who has more taste buds? Baby or Grandpa?
Baby. Your taste buds decrease with age so the baby has the most taste buds
What is the function of hemoglobin and what is polycythemia vera?
Hemoglobin carries iron and oxygen and returns CO2 to the lungs.Polycythemia vera- increased hemoglobin
When serving the meal, what are some things you can do to make the experience more pleasant?
SIT THEM UP!
let them void
glasses and dentures
wash hands, face, oral hygiene
CHECK TRAY AND DIET ORDER,check for utensils, condiments
make sure client is not NPO
check allergies and name band
serve hot foods hot and cold foods cold
fill bowls and glasses 3/4 full
be pleasant
check on client to make sure eating (if not find out why)
document amount consumed (food and liquid) in mL's
What are some reasons to place a client on a therapeutic diet?
Increase or decrease body weight  by manipulating kcals
Reduce or prevent edema by limiting fluids/salt (CHF)
Aid in digestion by avoiding foods that irritate the GI
Eliminating a food that the body is unable to tolerate (lactose intolerance)
What is hypoglycemia and what are some signs and symptoms?
low blood sugar due to excess insulin
S/S- cool, diaphoretic, tachycardia, anxious, weak, shaky, hunger, confusion
What are some interventions for an air emboli?
Clamp the infusion
Lay the client on the left side in the trendelenberg position
Provide Oxygen
Call the doctor immediately
What is BUN? What is it a waste product of? How is it filtered out?
Blood urea nitrogen, waste product of protein breakdown, kidneys filter it out
What are some items on the menu for a client on a full liquid diet?
any clear liquids
soups (creamed or strained)
milks, creams
sherbert, plain ice cream
custard, pudding, eggnog (yum)
all cooked cereals
vegetables and strained fruit juice
When a client is on alternate feeding a daily weight and I&O are not important. True or False?
False. A daily weight and I&O are extremley important
Why do old people have so much gas?
They do not chew their food as well and the body is unable to break down large chunks so the carbs are left undigested!
What is an air embolism and what are the s/s?
Air embolism is a large amount of air in the vascular system that will occlude circulation.
S/S- SOB and feeling of impending doom (the patient, not the nurse!)
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