Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
175 Cards in this Set
- Front
- Back
- 3rd side (hint)
|
Potential to become malnourished:
_________ is an inadequate intake of nutrients ______ is caused by disease & iatrogenic effects. |
-Primary
-Secondary |
|
|
|
Capacity for recovery from illness or disease
Depends on _________ |
nutritional status
|
|
|
|
___________: delays/prevents recovery, while _________ Promotes healing/recovery
|
-Poor nutritional status
-Good nutritional status |
|
|
|
Nutritional Therapy (NT) is provided by ______
|
registered dietitians (RDs)
|
|
|
|
True or False:
Psychologic and physiologic elements occurring during hospitalization can put patients at nutritional risk |
True
|
|
|
|
during nutritional screening, one should identify characteristics associated with ___________.
|
nutritional problems
|
|
|
|
All patients admitted to hospitals
Must be screened within ___ hours of admission |
48
|
|
|
|
the act or process of nourishing or being nourished;specifically : the sum of the processes by which an animal or plant takes in and utilizes food substances.
|
nutrition
|
|
|
|
True or False:
screening may be completed in any setting. |
true
|
|
|
|
Screening helps complete ______ goals
|
early intervention
|
|
|
|
Screening includes collection of: (2)
|
1.Relevant data on risk factors
2.Interpretation of data for intervention/treatment |
|
|
|
Nutritional Screening helps determine the need for a ______ and is cost effective.
|
nutrition assessment
|
|
|
|
The nutritional care process begins when a patient is identified as being at ______ and needs extra support to promote his/her nutritional status.
|
nutritional risk
|
|
|
|
The nutritional care process involves :
1. 2. 3. 4. |
1.Nutrition assessment
2.Nutrition diagnosis 3.Nutrition intervention 4.Nutrition monitoring and evaluation |
|
|
|
______is conducted to determine appropriate nutrition therapy
based on identified needs of patient. |
Nutritional Assesment
|
|
|
|
Nutritional Assesment Uses data collected from:
(4) |
1.Anthropometric data
2.Biochemical data 3.Clinical observations 4.Diet evaluations |
|
|
|
True or false:
In Nutritional assesment, they use one tool to measure nutritional status and determine nutritional problems and needs. |
FALSE:
There is no one parameter that: Measures nutritional status Determines nutritional problems/needs |
|
|
|
A combination of parameters must be used to interpret overall nutritional picture
within context of: ____,_____,and ______ backgrounds |
Personal
Social Economic |
|
|
|
Noninvasive Anthropometric Assessment techniques that measure are :(4)
|
Height
Weight Head circumference Skinfold thicknesses |
|
|
|
In ampotheric assesment, _______ are more useful than noninvasive measuring techniques (Height, weight, head circumference, skinfold thicknesses)
|
Serial measurements
|
|
|
|
Evaluation of Anthropometric Data involves comparison of data collected with:
______ and _________to identify type and severity of malnutrition |
-Predetermined reference limits
-cutoff points |
|
|
|
the ampotheric measurement of assesing height in children evaluates _____ and ______. In adults it is needed to assess _____ and _______.
|
-growth and nutritional status
-weight and body size |
|
|
|
_______ is important when measuring height becuase calculations used to determine energy requirements and needs are based on weight and height.
|
accuracy
|
|
|
|
Measuring _____ is a simple, gross estimate of body composition and is the most important measurement in assessing nutritional status.
Used to predict _______ and recognize changes that are representative/suggestive of serious health problems. |
-weight
-energy needs |
|
|
|
______Measures weight corrected for height
|
Body Mass Index (BMI)
|
|
|
|
The desired BMI for adults is ______ while _____ is concidered underweight.
|
-18.5 to 24.9 kg/m2
-less than 18.5 kg/m2 |
|
|
|
__________estimates subcutaneous fat stores
|
Skinfold thicknesses
|
|
|
|
True or False:
Skinfold Thickness can be measured by anyone. |
FALSE:
Proper training in the technique is essential. |
|
|
|
True or False:
Skinfold thickness should be used alone. Do not use any other techniques while using this tool. |
FALSE:
it should be used in conjunction with other parameters |
|
|
|
True or False:
There is no single Biochemical assesment test available. |
True
|
|
|
|
In Biochemical Assessment one should evaluate _____ response to nutrition therapy
|
short-term
|
|
|
|
Biochemical Assesment Should be used in conjunction with:
(3) |
Anthropometric data
Clinical data Dietary intake assessment |
|
|
|
True or false:
Biochemical assesment tests work for everyone. |
FALSE:
Some tests inappropriate for certain patients |
|
|
|
A ______ test is one of the more useful assesment tests.
|
Serial
|
|
|
|
The most important blood tests are__________ and _______
|
visceral protein status and immune function
|
|
|
|
T*LT
|
tail light
|
|
|
|
Serum Albumin assess ______ status
|
visceral protein
|
|
|
|
When using Serum Albumin, a Compromised protein status
is _______ and a Possible protein malnutrition is _________. |
-2.8 to 3.5 mg/dL
-less than 2.8 mg/dL |
|
|
|
when using serum albumin, it is most useful when measuring ______nutrition changes (dehydrated patients would have normal serum albumin initially)
|
-long-term
|
|
|
|
_____ is your Visceral protein status assessment
|
Prealbumin
|
|
|
|
Prealbumin:
Normal values ________ Compromised protein status _________ Possible protein malnutrition _______ |
-20 to 50 mg/dL
-10 to 15 g/dL -less than 10 g/dL |
|
|
|
Prealbumin is useful in monitoring ______changes in visceral protein status
|
short-term
|
|
|
|
PR-FT
|
period of time
|
phrase
|
|
|
_________ is Information regarding actual and habitual dietary intake
|
Dietary Intake Assessment
|
|
|
|
Dietary Intake Assessment :
______-Diet/food recall ______-Diet/food records |
-Retrospective
-Prospective |
|
|
|
True or False:
24 hour diet-recall requires a trained interviewer |
true
|
|
|
|
A _______ is when the patient is asked to report all foods and beverages consumed during the past 24 hours
|
24-Hour Diet Recall
|
|
|
|
A 24 hour diet recall requires a detailed description of:
__________(5) |
1.All foods and beverages
2.Cooking methods 3.Brand names 4.Condiments 5.Supplements |
|
|
|
_______ are given in common household measures
|
Portion sizes
|
|
|
|
Advantages of a 24 hour diet recall are ____,_____,and _____
|
-Quick
-Can be used with most age-groups -Patient does not modify his/her actual intake |
|
|
|
Limitations of a 24 hour diet recall relies on:
_____,_____,and _____. It may not be representative of the patient’s actual diet. |
Memory
Motivation Awareness of the patient |
|
|
|
All foods, beverages, snacks, and supplements are recorded by the patient, usually over _____days using ______ measures
|
-1 to 7
-household |
|
|
|
Cooking methods, recipe ingredients, and descriptions need to be recorded as _____ and _____as possible
|
completely and accurately
|
|
|
|
to make a food record, one should identify behavioral patterns by assesing : _____
_______ _______ and ______ |
Locations
Times Events Feelings |
|
|
|
True or false:
A 7-day food record is considered optimal and does tend to be tedious. |
TRUE
|
|
|
|
3-day record (including __ weekdays and __ weekend day) can be acceptable
|
-2
-1 |
|
|
|
The patient must be ____ _____ and _____ to create a food record.
|
Literate
Nurmerate Well motivated |
|
|
|
_________ may influence recorder's standard food choices
|
Record keeping
|
|
|
|
True or False:
In Actual practice, all nutrients can be assessed. |
true
|
|
|
|
Kcal and protein intakes are parameters usually ______
|
quantified
|
|
|
|
Kcal counts are used to:
(2) |
-Determine adequacy of patient’s daily oral intake
-Document need for nutritional support |
|
|
|
_________ are essential to Kcal counts.
|
Nursing observations
|
|
|
|
For Kcal counts, Recording of intake must be _______.
|
accurate
|
|
|
|
Record foods and beverages consumed in measurable amounts like Cups, ounces, teaspoons, tablespoons, and mL or _________ like 50% baked chicken, 75% bread, & 25% green beans.
|
-percentage of amount eaten
|
|
|
|
adults ______ are at nutritional risk. Children _____ are at nutritional risk.
|
-75 years of age or older
-5 years or younger |
|
|
|
there is a moderate nutritional risk for Adults ________years of age Children ____ years of age
|
-65 to 75
->5 (less than 5) |
|
|
|
_________ may be nutritional risk factor; depends on cause.
|
Weight loss
|
|
|
|
Percentage of body weight lost + evaluation or cause of the loss determines __________.
|
-the possible level of risk
|
|
|
|
Laboratory test results:
_____,______,and ______ levels provide an assessment of nutritional risk |
Albumin, TLC, and prealbumin
|
|
|
|
Conditions of various body systems that present either moderate or high nutritional risk:
Moderate nutritional risk: ________ because of its effects on dietary intake. High nutritional risk: _____ and _______ |
-Chemotherapy
-Eating disorders and Diabetes when pregnant |
|
|
|
Moderate nutritional risk is associated with
-the transition from _____ to _____ -modified diets that can cause ______ |
-from restrictive therapeutic intervention to a regular dietary intake.
-nutrient deficiencies |
|
|
|
There is a High nutritional risk
for feeding modalities such as : _____ _____ _____ ______ |
Parental feeding
Tube feeding NPO (i.e. nouthing by mouth) Clear liquids for more than 3 days |
|
|
|
____ is Designed to attain or maintain optimal nutritional status in those who do not require modified or therapeutic diets
|
Regular/general diet
|
|
|
|
A _____ is used to promote health and reduce risks for developing chronic diet-related diseases
|
Regular/general diet
|
|
|
|
Qualitative diet modifications:
______ ______ and _________ (ex. _______) |
-Consistency
-Texture -Nutrients (Example: clear-liquid or full-liquid diets) |
|
|
|
Quantitative diet modifications:
-_____ or _____of meals served -_____ of specific nutrients (Six small feedings and Kcal-controlled diets which are used in the treatment of ____). |
-Number or size
-Amounts -diabetes mellitus |
|
|
|
A Clear-liquid diet consists of foods clear and liquid at _____ temperature.
Used to help prevent ______ and keep colon contents to a minimum. |
-room/body
-dehydration |
|
|
|
A _____ diet is a good source of fluids and water
|
Clear-liquid diet
|
|
|
|
A Clear-liquid diet is inadequate in:
____ _____ _____ and _____ |
Protein
Fat Energy fiber |
|
|
|
A clear-liquid diet should not be used for more than ____ hours
|
24
|
|
|
|
A Clear-liquid diet can be ____,_____,_____, and ______.
|
Apple juice, broth, coffee, kool-aid
|
|
|
|
Foods liquid at _____temperature
|
room or body
|
|
|
|
A _____ diet is used to provide oral nourishment for patients who may have difficulty chewing and swallowing solid foods.
|
Full-liquid diet
|
|
|
|
Full-liquid diet:
Commercial nutritional supplements are often used to supply adequate amounts of _____ and _____to make it nutritionally complete |
energy and nutrients
|
|
|
|
In addition to clear liquids for a full liquid diet, add _____,_____,and _____supplements.
|
ice cream, pudding, milk,
|
|
|
|
Consistency of food can be varied according to the patient’s ability to ____ and ____ (Foods chopped, ground, mashed, or pureed)
|
chew and swallow
|
|
|
|
In a mechanically altered diet, Patient’s needs should be evaluated, modifying _____ according to ______.
|
-consistency
-food preferences |
|
|
|
True or False:
The more often you alter your food consistency, the better it is. |
FALSE:
Food consistency should be altered only to the degree necessary |
|
|
|
_____ are used during transition from liquid diets to regular or general diets.
|
soft diets
|
|
|
|
In a soft diet, Foods are _____and only lightly seasoned.
|
low in fiber
|
|
|
|
A soft diet is not appropriate for patients requiring ________
|
mechanical soft diets
|
|
|
|
____ is the basis for almost all modified diets
|
Regular/General Diets
|
|
|
|
A _____ diet is used for those who do not need dietary restrictions or modifications.
|
Regular/General Diet
|
|
|
|
True or False:
Hopitals only offer self-select menus for regular diets. |
FALSE:
Most hospitals offer self-select menus for regular diets and often for many modified diets |
|
|
|
It is common for this diet (“Diet as Tolerated”) to be ordered ________.
|
postoperatively
|
|
|
|
______Permits patient’s preferences and situations to be taken into consideration
|
“Diet as Tolerated”
|
|
|
|
"diet as tolerated" also allows for __________at the patient’s tolerance
|
postoperative diet progression
|
|
|
|
_____ is used when patients unable or unwilling to orally consume adequate nutrients and kcal .
|
Enteral Feeding by Tube
|
|
|
|
True or False:
Enteral Feeding by tube is preferred over parenteral nutrition |
true
|
|
|
|
Enteral Feeding by Tube is physiologically beneficial in maintaining the integrity and function of the ____.
|
gut
|
|
|
|
Types of Enteral Formulas:
_______: Intact nutrients that require a functioning GI tract for digestion and absorption of nutrients |
Standard-intact formulas (Polymeric formulas)
|
|
|
|
Standard-intact formula (Polymeric formula) Categories include:
|
-1 to 2 kcal/mL formulas
-Blenderized food products -Milk-based formulas -High-kcal lactose-free formulas -Normocaloric lactose-free formulas |
|
|
|
Types of Enteral Formulas:
______(ex___):Can be used for patients with a partially functioning GI tract |
Elemental formulas (predigested or hydrolyzed formulas) (ex. Optimental, Elecare)
|
|
|
|
Elemental formulas are those who have impaired capacity to ______,______,or ______.
|
-digest foods or absorb nutrients, pancreatic insufficiency, or bile salt deficiency
|
|
|
|
True or False:
Elemental formulas are palatable. |
False: Elemental formulas are not palatable
(Best suited for administration by tube) |
|
|
|
Elemental formulas are _____ and usually ________.
|
-Lactose-free
-hyperosmolar |
|
|
|
Types of Enteral Formulas:
______: which are very high in calories. |
Modular formulas
|
|
|
|
Modular formulas are ______ kcal/mL
|
-3.8 to 4
|
|
|
|
True or False:
Modular formulas are nutritionally complete. |
False: they are not nutritionally complete by themselves
|
|
|
|
Modular formulas are single macronutrients: _____ _______ _______
|
Glucose polymers
Protein Lipids |
|
|
|
______ are added to foods or other enteral products
|
Modular formulas
|
|
|
|
Change the composition of modular formulas when ________.
|
nutritional needs cannot otherwise be met
|
|
|
|
Specialty formulas contain ____kcal/mL. (examples:Glucerna, Juven, Nepro, Pulmocare)
|
1 to 2
|
|
|
|
Specialty formulas meet nutrient demands for specific disease states such as :
|
Diabetes
Renal failure Liver failure Pulmonary disease Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) |
|
|
|
Specialty formulas may require supplementation with ____,_____,or ____.
|
vitamins, minerals, or trace elements
|
|
|
|
True or flase:
all specialty formulas are platable. |
false: some specialty formulas are unplatable
|
|
|
|
Most specialty formulas are _____.
|
expensive
|
|
|
|
Formula Selection is based on:
-Patient’s ____ and ______ capabilities -Whether patient’s_________ -Whether patient has ________ |
-digestive and absorptive
-patient's fluids need to be restricted -high metabolic requirements |
|
|
|
_____ is when the Tube is passed through nose to stomach
|
Nasogastric
|
|
|
|
______ is when the Tube is passed from nose to duodenum
|
Nasoduodenal
|
|
|
|
____ is when the Tube is passed through nose to jejunum
|
Nasojejunal
|
|
|
|
_____ is when the Tube surgically inserted into the neck and extends to stomach
|
Esophagostomy
|
|
|
|
____ is when the Tube surgically inserted into stomach
|
Gastrostomy
|
|
|
|
____ is when the Tube surgically inserted into small intestine
|
Jejunostomy
|
|
|
|
_____ is Generally the preferred method of feeding
|
Continuous infusion
|
|
|
|
________ Provides controlled delivery of a prescribed volume of formula at a constant rate over a continuous period using an infusion pump
(Similar to ______) |
-Continuous infusion
-typical gastric emptying |
|
|
|
________ is Delivering the total quantity of formulas needed for a 24-hour period in three to six equal feedings.
|
Intermittent infusion
|
|
|
|
When using Intermittent infusion, each feeding is usually delivered by gravity during a _____minute period
|
30- to 90
|
|
|
|
Intermittent infusion represents a more _____feeding pattern
|
normal
|
|
|
|
Patients often do not tolerate Intermittent infusion if the ____is too rapid
|
rate
|
|
|
|
Intermittent infusion is ______ and Feedings must be closely monitored to ensure proper delivery rate
|
time consuming
|
|
|
|
______:Infusing volumes of formula by gravity or syringe over a short period
|
Bolus feedings
|
|
|
|
True or false:
Bolus feedings requires minimal equipment and time |
true
|
|
|
|
Bolus feedings is associated with ____ potential
-Aspiration -Regurgitation -GI side effects |
increased
|
|
|
|
Bolus feedings should not be used for ______
|
intestinal feedings
|
|
|
|
Possible tube feeding complications: GI problems:
|
Diarrhea
Nausea and vomiting Cramping Distention Constipation |
|
|
|
Possible tube feeding complications: Mechanical complications:
|
Tube displacement
Tube obstruction Pulmonary aspiration Mucosal damage |
|
|
|
Possible tube feeding complications :Metabolic complications:
|
-Hyperosmolar dehydration
-Overhydration -Abnormal blood concentration levels (Sodium, Potassium, Phosphorus, Magnesium) -Hyperglycemia -Respiratory insufficiency -Rapid weight gain |
|
|
|
Parenteral Nutrition provides nutrients when: (2)
|
-Patients can’t or won’t eat
-Tube feedings are contraindicated |
|
|
|
In parenteral nutrition, energy and nutrients provided ______.
|
intravenously
|
|
|
|
_______ is infused into a large-diameter vein (Superior vena cava, Subclavian)
|
Total parenteral nutrition (TPN)
|
|
|
|
______ is when a smaller, peripheral vein is used
(Usually in the forearm) |
Peripheral parenteral nutrition (PPN)
|
|
|
|
Parenteral Nutrition should be ______.
|
preserved
|
|
|
|
Parenteral Nutrition:
Severely malnourished patients are ______ patients and patients who have _________ |
-chemotherapy
-Major surgery |
|
|
|
Factors that should be considered before initiating TPN (total parenteral nutrition):
|
Nature of the patient’s GI dysfunction
Severity of malnutrition Degree of hypercatabolism Medical prognosis Patient’s wishes |
|
|
|
Components of Parenteral Nutrition Solutions: ______ _______ and _______
|
Carbohydrate
Protein IV lipid emulsions |
|
|
|
Components of Parenteral Nutrition Solutions :
Carbohydrate: -Dextrose monohydrate -Yields____kcal/g because of its hydrated form -Dextrose solutions (available in initial concentrations of ______%) |
- 3.4 kcal/g
-5% to 70% |
|
|
|
The________component of Parenteral Nutrition Solutions are mixed with amino acids and other nutrients to form the final solution
|
carbohydrate
|
|
|
|
The _____ component of parenteral solutions is a mixture of_____ and ______
|
-essential and nonessential crystalline amino acids
|
|
|
|
True or False:
essential and nonessential crystalline amino acids (protein component of parenteral solutions) is only available if you add electrolytes. |
FALSE:Available with or without added electrolytes
|
|
|
|
the _________ component of parenteral solutions should not be considered part of the solution’s kcal source
|
Protein
|
|
|
|
The protein component of parenteral solutions are available in different ________ as well as in different ______ of amino acids
|
-concentrations
-compositions |
|
|
|
the protein component of parenteral solutions is available for specialized protein needs such as_____,_____,____,and _____ but their efficacy is controversial
|
renal failure, liver failure, stress, and trauma
|
|
|
|
IV lipid emulsions are components of parenteral nutrition solutions that are formulations of safflower oil, soybean oil, or a combination of the two, with ______ added for isotonicity and _______added as an emulsifying agent
|
-glycerol
-egg phospholipid |
|
|
|
Kcal density of lipid solutions is useful when _______ is necessary
|
volume restriction
|
|
|
|
IV lipid emulsions :
10% fat emulsion yields _____kcal/mL or _____ kcal per 500-mL bottle |
-1.1 kcal/mL
-550 |
|
|
|
IV lipid emulsions :
20% solution yields___ kcal/mL or ____kcal per 500-mL bottle |
- 2 kcal/mL
-1000 |
|
|
|
A three in one mixture is ____+_____+_____
|
Lipid+Detrose+AA
|
|
|
|
Lipid is infused over ____period
|
24hr
|
|
|
|
Lipids decrease _____ production
|
-carbon dioxide
|
|
|
|
Lipids reduce accumulation of ____ in ____(as a result of long-term glucose use)
|
fat in liver
|
|
|
|
_____ _____ and _____ are added to all TPN composition
|
Electrolytes, Vitamins & Trace Elements
|
|
|
|
Technical complications of Parenteral Nutrition is ______ which is a _________
|
Pneumothorax – collapsed lung
|
|
|
|
Septic complications of Parenteral Nutrition can be ____ or _____–infections from sterilization issues
|
Local or systemic
|
|
|
|
Metabolic complications of Parenteral Nutrition is the most common, especially _____
|
hyperglycemia
|
|
|
|
Parenteral to oral or tube feeding requires assesment of ______
|
GI function
|
|
|
|
Assessment of GI function is recommended to prevent problems:
|
Delayed gastric emptying
Nausea Vomiting Diarrhea |
|
|
|
As Parenteral Nutrition (PN) is tapered, _______ increases
|
Oral or tube feeding intake
|
|
|
|
When switching from parenteral to oral or tube feeding it isiImportant to document ______, including ______
|
-actual enteral intake, including fluids
|
|
|
|
When going from Tube to oral feeding:
Before offering oral feedings: -Intake ____ and _____ must be documented -Important to assess the patient’s _______ |
-per tube and orally
-swallowing ability |
|
|
|
When going from Tube to oral feeding _____are usually offered firstfFollowed by ____ or _____ foods
|
-full liquids
-pureed or soft foods |
|
|
|
Tube feedings should be stopped at least _______mealtime to promote appetite
|
1 hour before and after
|
|
|
|
As oral intake increases from tube to oral feeding, Tube feeding volume should be _____
|
decreased
|
|
|
|
Tube feedings can be discontinued when ______
|
oral intake consistently exceeds two thirds of energy requirements
|
|
|
|
Noninvasive measurments of height, weight, circumferences, and skinfold thickness are known as
______ |
Anthropometric data
|
|
