1430 Exam 3

Front 1

This is needed for DNA synthesis

Back 1

Folic Acid

Front 2

This is needed for growth of Red Blood Cells

Back 2

Folic Acid

Front 3

If lack of Folic Acid/Red Blood Cell concentration-what kind of birth defects

occur

Back 3

Neural Tube Defects such as

Spina Bifida

Anacephaly

Front 4

When Red Blood Cells don't form correctly during fetal development

Back 4

Maternal Megaloblastic Anemia (inhibition of DNA synthesis during RBC production)

Front 5

Basal Metabolic Rate (BMR)

Back 5

Rate at which body uses energy when resting to keep vital functions going

Front 6

Body Mass Index (BMI)

Back 6

person's weight in Kg divided by height in meters squared,

determines ideal body weight

Front 7

Role of Cognition in Nutrition

Back 7

Confusion causes patient to forget to eat, eat spoiled food, not sure what time of day it is/what mealtime it is, Cannot get food from store to home

Front 8

Role of Depression on Nutrition

Back 8

Patient doesn't care to eat, or eats too much,

Depression affects metabolism.

Weigh patient regularly, provide opportunities for patient to eat with social interaction (family,friends, nurse etc)

Front 9

Essential nutrient for patients in wound healing

Back 9

Albumin- a serum protein (promotes proper blood circulation and metabolism of compounds in body)

Front 10

"Protein Only" Diets can cause these negative consequences:

Back 10

Constipation, Ketones, pH imbalance, nitrogen imbalance, gout, kidney failure

Front 11

Positive Nitrogen Balance

Back 11

*MORE* nitrogen intake than output (good)

Front 12

Iron Anemia

Back 12

check Hemoglobin/Hematocrit for adequate #of healthy Red Blood Cells, which carry oxygen to body's tissues

Front 13

Electrolytes include:

Back 13

Sodium (Na+)

Postassium (K+)

Calcium (Ca2+)

Magnesium(Mg2+)

Bicarbonate (HCO3-)

Chloride (CI-)

Phosphate (HPO4-)

Front 14

For Growth and Tissue Repair, these are needed:

Back 14

Good nutrition

Exercise

Rest

Front 15

Malnourishment includes

Back 15

Obesity and Underweight

Front 16

What type of foods should be chosen?

Back 16

High Density Nutrient foods

(instead of Low Density Nutrient foods)

Front 17

Elderly can become dehydrated easily because

Back 17

They lose their sense of thirst

(a normal physiological effect of aging)

Front 18

Result of Dehydration in elderly-

Back 18

Urine output is low, allows for bacteria to build up in bladder,

causes UTI (urinary tract infection)

(can cause confusion in elderly)

Front 19

Oral Hygiene and hydration necessary for good nutrition because:

Back 19

*dry mouth causes reduced appetite, poor nutrition

*Keep mouth clean (toothpaste etc) to prevent mouth sores and yeast growth so patient can eat

Front 20

Low Energy/Fatigue/Depression can affect nutrition by:

Back 20

Patient may refuse to eat, or state they don't want to get better.

*Encourage patient to discuss what is bothering them, sit and talk with them while they eat/ change of scenery suggest eating outdoors

Front 21

G-tubes and Feeding tubes

Back 21

Temporary means of nutrition in order to regain strength

Front 22

Do not force a patient to eat, instead...

Back 22

encourage them

Front 23

Medications can affect nutrition by

Back 23

changing taste buds, increase appetite, causing nausea

Front 24

HIV Patients & nutrition:

Back 24

Cannot taste, need extra spice

Front 25

Cerebral Palsy patients & nutrition

Back 25

Prefer salty and spicy, (cannot taste well)

Front 26

Lifestyle behaviors

in expectations and goals, allow patient to be involved

example:

Back 26

Overweight- patient may not be concerned about weight.

explain health risks to the heart

Front 27

Age, Gender and Ethnicity affect nutrition

allow patients to bring in food for example:

Back 27

Kosher food for Jewish patient

Front 28

Economic Status can affect nutrition

example:

Back 28

Patients who receive help from food pantries have a lot of packaged/canned food with high sodium and preservatives

Front 29

Affect of cow's milk on an infant:

Back 29

Intestinal bleeding, their body lack enzymes to break it down

(If blood in infant's diaper, ask if they have had cow's milk)

Front 30

No Honey/Corn Syrup for infants 12 months and younger, it can cause:

Back 30

Botulism

Front 31

Toddlers who drink excessive amount of milk may be deficient in:

Back 31

Iron (they drink too much milk, not enough solid food with nutrients that they need)

Front 32

Where to direct patients to teach them about nutrition

Back 32

myplate.gov

Front 33

Nutritional needs specific to Down Syndrome patients:

Back 33

They have a high heart rate, High Metabolism and need more calories & protein

Front 34

Hyperosmolar definition

Back 34

a hyperglycemic state, a complication of Diabetes in which high blood sugars cause severe dehydration

(could lead to coma or death)

Front 35

Feeding tube formula- some tolerate, some don't

if it causes diarrhea:

Back 35

intolerant to the formula, dilute it

Front 36

feeding tube formula, if it causes cramping:

Back 36

it's too fast, slow down the feeding

Front 37

Pregnancy nutrition- must increase:

Back 37

Calcium for bones- yogurt, dark greens, fish with bones such as sardines,

Omega3 Fatty Acids- for brain development

Front 38

Young Adult nutrition challenges:

Back 38

high stress levels, no regular routine

Front 39

Middle Age nutrition challenges:

Back 39

Blood pressure, cardiovascular issues, time constraints, metabolism slows, life stress

Front 40

Recommended intake of fat in diet:

and what is too low:

Back 40

15-20% fat intake required

Less than 10% malnutrition-fat deficiency

Front 41

What type of fat should be decreased in the diet?

Back 41

Saturated Fats (animal sources)

Front 42

The good fats and their sources:

Back 42

Polyunsaturated Fats (vegetable fats such as avocado, nuts)

Front 43

Linoleic Acids-

Back 43

The only essential fatty acid found in humans- in breastmilk

(Essential means the body cannot synthesize it, is must be consumed from food sources such as: seed, nut and olive oils)

Front 44

older adults nutrition challenge-

Back 44

decrease in taste buds, they prefer sugary foods

they eat smaller portions

Front 45

dysphagia

Back 45

diificulty swallowing foods or liquids

can cause aspiration

Front 46

neurogenic cause of dysphagia

Back 46

stroke

Front 47

myogenic cause of dysphagia

Back 47

myasthenia gravis

muscular dystrophy

Front 48

keeps food in esophagus, stays closed unless food is going down

Back 48

epiglottis

Front 49

if epiglottis doesn't function properly, it opens and

Back 49

food can come back up, or food can enter trachea and then the lungs

Front 50

for patients with dysphagia, prepare foods by

Back 50

thickening fluids,

thin or soften foods

Front 51

how to check for aspiration

Back 51

xray

Front 52

if patient aspirates, doctor may prescribe:

Back 52

antibiotics to prevent pneumonia

Front 53

Infants may have reflux because-

Back 53

muscle not developed well, usually resolves by 5/6 months of age

Front 54

Soft Food diet includes:

Back 54

Eggs, oatmeal, applesauce

Front 55

Clear diet definition

Back 55

Any food clear AT ROOM/BODY temperature

Front 56

Clear diet list:

Back 56

gelatin

broth

bullion

popsicles/ice pops

juice

carbonated beverage (any, even coke)

Regular/Decaf coffee (no creamer)

Tea

Front 57

Full Liquid Diet includes

Back 57

All "clear" items, plus:

milk

dairy

custard

pudding

frozen dessert

veggie juice

pureed veggies in broth

yogurt

sherbert/ice cream

at hospital-orange cup with added nutrients

Front 58

Anesthesia causes

Back 58

Smooth Muscle falls asleep, bowels have to slowly wake up

Front 59

After surgery, how do you know if bowels are waking:

Back 59

Listen for sounds, usually about 2 hours after surgery

Front 60

After surgery with anesthesia, what diet is prescribed for patient

Back 60

start with Clear, advance to Full Liquid, once bowel sounds are heard, gradually introduce more foods until regular diet is resumed

Front 61

normal urinary output per hour adult

Back 61

30-50 mL/hr

Front 62

normal urinary output per hour for child

Back 62

1-2 ml per Kilo per Hour

Front 63

polyuria

Back 63

production of abnormally large volumes of urine

(2500-3000ml per day, 2.5-3 Liters)

Front 64

olyguria

Back 64

Low urine output

less than 1 ml/Kg/h in infants

less than 0.5 ml/kg/h in children

less than 400-500 ml per day in Adults

Front 65

bladder distension

Back 65

distended, firm, tight bladder

(structural spinchter)

Front 66

bladder retention

Back 66

bladder full, can't empty it such as with UTI

Front 67

Nocturia

Back 67

having to urinate more than once during the night

(can be caused by medications or prostate/bladder tumors)

Front 68

If urine output is low, no urine within 2 hours, put catheter in to monitor intake/output

could indicate

Back 68

renal failure, let doctor know situation

Front 69

Peristalsis

Back 69

contraction of intestinal muscles which propel gastric contents along GI tract

Front 70

What to ask about bowel movements when assessing

Back 70

frequency, consistency, soft/firm, pain, amount, RECENT CHANGES, color, laxative use

Front 71

When assessing bowels, listen or palpate first?

Back 71

Auscultate first in all 4 quadrants, then palpate

(so as to not awaken bowels before listening)

Front 72

When assessing urinary system, what do we ask about?

Back 72

Color, Odor, Consistency, Amount

(also pain, burning or continent,incontinent?)

Front 73

What to increase if experiencing constipation?

Back 73

*Fiber- causes friction & absorbs more water

*Water- at least 1500 ml per day (1.5 L)

Front 74

Causes of constipation

Back 74

medications, immobility, depression, ignoring urge to defecate (slows peristalsis)

Front 75

Paralytic Ileus

Back 75

failure of appropriate forward movement of bowel contents, intestines not contracting

(can be caused by abdominal surgery, anesthesia, pain meds such as opioids)

Front 76

critical shunning

Back 76

all systems slow or stop in order to keep brain and heart alive

Front 77

How long after surgery before bowels awaken

Back 77

at 2 hours should begin to hear bowel sounds

Front 78

non invasive methods to encourage urination

Back 78

hand in warm water, listen to running water

Front 79

Most common bacteria responsible for UTI's?

Back 79

e Coli

Front 80

During catheterization, what causes infections?

Back 80

The bacteria introduced into the body, not the procedure itself

Front 81

Some causes of UTI

Back 81

poor hygiene

Catheterization

low urine output

Front 82

Ways to get rid of UTI

Back 82

Increase fluids to flush out system

Take meds prescribed

Vitamin C (acidic foods) and Juices such as cranberry

Front 83

how do acidic foods/juices help with UTI

Back 83

prevent bacteria from adhering to sides of bladder

Front 84

Stress Incontinence:

Back 84

Urinating while sneezing, coughing, laughing

Front 85

Urge incontinence

Back 85

sudden urge, no lead up to urge to urinate

Front 86

patient with urge incontinence is at risk for:

Back 86

increase risk for falls,

teach patient to go on a schedule, also Kiegel exercises

Front 87

Fecal incontinence complications

Back 87

rectal skin breakdown, dehydration from diarrhea
*may need rectal catheter

Front 88

what does a diuretic do?

Back 88

it converts extra fluid into urine (increase urine production

(DOES NOT stimulate urination)

Front 89

Hypokalemia is:

Back 89

Low Potassium (low K+)

Front 90

hypernatremia

Back 90

High sodium (high Na+)

Front 91

long term complications of laxatives

Back 91

*body becomes dependent (tolerance)

more laxatives needed in order to eliminate

* lowers absorption of fat and vitamins

Front 92

Teach a patient with constipation about nutrition:

Back 92

*Bulk Forming Fibers, fresh fruits/vegetables, whole grains,

*High Fat foods slow peristalsis-causes constipation

Front 93

spinal cord injury patients-elimination-training:

Back 93

can schedule times to go to bathroom, body will adapt

Front 94

encourage children and elderly with night time urination problems to -

Back 94

no more liquids 2 hours before bedtime

(don't take out of diet, just move it earlier)

Front 95

Stress affects elimination by causing:

Back 95

Diarrhea

Front 96

Depression affects elimination by causing

Back 96

constipation

Front 97

3 Signs of Nephrotic Syndrome

Back 97

1/ proteinuria (protein in urine)

2/Hypoalbuminemia (low albumin in blood)

3/ Edema (means kidney not filtering correctly)

Front 98

urinalysis tests for:

Back 98

protein, glucose, pH, bacteria, WBC

Front 99

Test to check for blood in stool:

Back 99

Guaiac Test

Front 100

How many positives needed in Guaiac Test for a True positive?

Back 100

Two tests at separate times, wait 3 days after diet correction

Front 101

Foods or meds that will cause a False Positive in Guaiac Test:

Back 101

Red meat, raw veggies, Canteloupe, Broccoli, Radishes, Turnips

NSAIDs, or other meds

Front 102

Iron causes what kind of stool

Back 102

black stool that can smell like blood

Front 103

GI bleed causes what kind of stool

Back 103

black/tarry stool

Front 104

abnormal weight loss is defined as

Back 104

more than 2 lb a week

Front 105

abnormal weight loss can be caused by

Back 105

cancer, thyroid, depression, stress, eating disorders

Front 106

Digestion begins in:

Back 106

mouth

Front 107

2 types of dysphagia:

Back 107

1/neurologic- stroke, MS, Parkinson's,

2/Esophogeal

Front 108

Side Effects of dysphagia

Back 108

1/ aspiration

2/dehydration

3/malnutrition

4/weight loss

Front 109

signs/symptoms of dysphagia:

Back 109

coughing, clearing throat, gurgling voice, increase oral secretions, difficulty swallowing, chest pain/heart burn or tugging pain after swallowing

Front 110

Intervention for dysphagia:

Back 110

sit up, food on strong side of mouth, take your time, (swallow study can show bolus/liquid or food)

Front 111

Initial Placement of feeding tube, check if it's in correct position by:

Back 111

Xray

Front 112

Check for proper placement of an established feeding tube by:

Back 112

Aspirate for Gastric contents

Front 113

NG tube placement

Back 113

nose to ear, to xyphoid process

if it's too high patient aspirate

Front 114

feeding tube how many residuals would be a concern that needs to be reported to dr?

Back 114

two high residuals

Front 115

with feeding tube, if there is diarrhea:

Back 115

slow rate of food

Front 116

with feeding tube, if abdominal pain:

Back 116

solution is too cold

Front 117

Feeding intolerance happens within:

Back 117

2 hours

Front 118

anemia is:

Back 118

reduced # of RBC hemogobin

Front 119

signs/symptoms of anemia

Back 119

shortness of breath (low O2), headache, dry mouth, fatigue, abnormal bruising

Front 120

Iron supplements can cause

Back 120

black stool, constipation

Front 121

fish that are a good source of calcium

Back 121

sardines (because of bones)

Front 122

Adolescent obesity- teaching:

Back 122

don't restrict calories, increase exercise, better diet choices (direct them to myplate.gov)

Front 123

Teach patients about Grapefruit/grapefruit juice:

Back 123

in can interfere with medications

Front 124

the nurse is caring for a pt with dysphagia, which interventions help decrease the risk of aspiration?

Back 124

1/sit pt upright

2/provide 30 minute rest before feeding

3/place food in strong side of mouth

4/feed pt slowly allow time to chew

Front 125

to verify correct position of small bore feeding tube:

Back 125

place order for an xray

Front 126

peptic ulcer disease is caused by which bacteria?

Back 126

Helicobacter pylori

Front 127

when assessing a pt receiving enteral feedings via small bore nasogastric tube, which assessment needs further intervention?

Back 127

gastric residual aspirate of 350 ml for the Second consecutive time

Front 128

which patient is at risk for experiencing adequate nutrition

(from quiz)

Back 128

recently widowed 76 year old woman recovering from mild stroke

Front 129

Statement by parent of 2 month old that requires further education

Back 129

I'll start next month to alternate formula with whole milk

Front 130

Teaching healthy nutrition at senior living center:

Back 130

1/avoid grapefruit/and their juice

2/increase amount of carbs for energy

3/take a multivitamin w/ Vitamin D for bone health

4/Cheese and eggs are good sources of protein

Front 131

Patient receiving Total Parenteral Nutrition asks why his glucose needs to be checked since he doesn't have Diabetes. Nurse reply:

Back 131

TPN can cause hyperglycemia, it is important to keep blood glucose at acceptable range