- Information
- AI Chat
Exam 4 Study Guide
Nutrition in Healthcare (NURS232)
Bryant & Stratton College
Preview text
Exam 4 Study Guide
Exam Breakdown
44 Multiple Choice 6 Select All that Apply
Definition, Signs/Symptoms, Causes and Nutritional Considerations (Including food choices) for the Following Conditions: o GERD Gastroesophageal reflux disease (heart burn) Extreme chest/epigastric pain Burning sensation in esophagus, Asthma, chronic cough, other ears slash nose and throat ailments Avoid foods high in fat that increased sphincter relaxation and potential reflux. chocolate, alcohol, peppermint, spearmint, caffeine, and high acid foods can irritate esophagus. o Cushing’s Body makes too much cortisol Weight gain (abdomen), moon face, buffalo hump, pink/purple striae, thinning skin, slow healing cuts/infections, acne CAUSES: oral corticosteroid meds, pituitary glands, adrenal gland disease Diet rich in calcium and vitamin d, decrease sodium intake, maintain protein balance o Addison’s Disease Too little cortisol Extreme fatigue, weight loss, decreased appetite, Darkening of your skin, low blood pressure, fainting, salt craving, low blood sugar, N/V/D, abdominal pain, muscle and joint pain, irritability, depression, body hair loss, sexual dysfunction in women CAUSES: Damage to the adrenal glands, cancer high sodium diet, corticosteroids needed to increase calcium and vitamin D, increased fluids o Hiatal Hernia chronic reflux results in inflammation of the lower esophagus. Stomach pushes up through diaphragm. Respiratory symptoms such as pneumonitis, chronic bronchitis, and asthma Avoid foods high in fat o Depression Changes in neural transmitters because of a mix of genetics and environmental stress. Develops between the ages of 25 and 44
deficiency of brain serotonin, moderate type of depression expressed as poor appetite or overeating common insomnia, over sleeping, will energy, fatigue, irritability, high stress. Mix of protein and carbohydrate for adequate amounts of tryptophan. Magnesium, calcium, selenium, zinc omega-3 polyunsaturated fatty acids, antioxidants o Schizophrenia Manifested by disordered thinking, hallucinations, delusions, apathy, social withdrawal, and mood or behavioral disturbances answered between ages 16 and 30 Strong genetic component Diet= antioxidant rich foods, vitamin D, omega-3, folic acid, vitamin B12, calorie control may be needed o Nephrotic Syndrome o Ulcerative Colitis Limited to large intestine Continuous inflamed areas Ulcers penetrate inner lining Bleeding is common with bowel movements Abdominal pain, diarrhea, intestinal bleeding, protein loss increase risk for malabsorption. Think mouth to anus Replace lost nutrients, correct deficits. Provide adequate nutrition to achieve and maintain energy and obtain nitrogen, fluid and electrolyte balance. Surgery is curative for ulcerative colitis, Crohn's disease tends to reoccur. o Crohn’s Disease Abdominal pain, diarrhea, intestinal bleeding, protein loss increase risk for malabsorption. Think mouth to anus Replace lost nutrients, correct deficits. Provide adequate nutrition to achieve and maintain energy and obtain nitrogen, fluid and electrolyte balance. Surgery is curative for ulcerative colitis, Crohn's disease tends to reoccur. o Anorexia Eating disorder, patient severely rejects food, extreme weight loss, low basal metabolic rate and exhaustion low serotonin levels common relentless pursuit of thinness, misperception of body image, restrained eating, binge eating, or purging. High calorie diets started on admission and lead to faster weight gains and shorter hospital stays. Enteral nutrition. o Bulimia Eating order where food addiction is the primary coping mechanism. We current episodes. Sense of lack of control period self-evaluation unduly influenced by weight or body shape.
Kilocalories= high to prevent catabolism (breakdown) 25-35 kcal/kg Sodium= 2000 mg, can be reduced to 1000mg Fluids= 1500 mL/day or 1000- Vitamins= water soluble (folate/B12/Thiamine), Fat soluble o Cholecystitis High fat diet, women multiparity, oral contraceptive or estrogen, obesity, sedentary lifestyle, rapid waste weight loss, very low-calorie diets, old age Pain, tenderness, fever, fat intolerance, nausea, heartburn, jaundice, steatorrhea after eating= epigastric pain o Cholelithiasis High fat diet, women multiparity, oral contraceptive or estrogen, obesity, sedentary lifestyle, rapid waste weight loss, very low-calorie diets, old age After eating= Mild pain in mid epigastrium, colic attack, pain radiating to upper right quadrant and right subscapular area Pain control: avoid foods that cause discomfort, follow low fat diet. Post operatively. Start with clear liquid and progress to regular diet. Many patients follow low fat diabetic individual tolerance varies. Avoid what causes pain. Fried foods are horrible o End-Stage Renal Disease-Also be familiar with Important Nursing interventions for ESRD kidneys have stopped working at full capacity. ESRD can accumulate over time or can present in a matter of days CAUSES: Chronic urinary tract infections and issues can lead to damage of the ureters and kidneys. Autoimmune diseases such as Lupus, which is the body attacking its own immune response cells. Hypertension over time, uncontrolled high blood pressure can cause arteries around the kidneys to weaken. Diabetes can harm the kidneys by causing damage to the blood vessels inside your kidneys. High sugar levels in the blood can cause these vessels to become clogged. Itching, Vomiting and nausea, Back cramping and abdominal pain, Forming too much urine or not enough, Lowered appetite, Difficulty sleeping, Diarrhea, Rash Avoid excessive sodium intake. Learn to read food labels: Pick foods that have less than 300 mg of sodium per serving size K+ can build up in the blood if the kidneys do not work properly On dialysis phosphorus can build in your blood Dash Diet: Lower in sodium, Fruits and Veggies, HIgh in protein Renal Diet: Low in protein, Low sodium, Fresh foods (no prepackaged) Hemodialysis Diet: Safe fluid intake, Low Potassium, Low Sodium, Low Phosphorus
Peritoneal Diet: Safe fluid intake, Low Potassium, Low Sodium, Low Phosphorus o Pancreatitis Inflammatory process characterized by decreased production of digestive enzymes and bicarbonate CAUSES: excess alcohol consumption, gallbladder disease, genetics auto digestion of pancreas by enzymes, severe pain and elevated serum enzyme levels, malabsorption of fats and proteins Troubles digesting food. NPO for few days upon diagnosis. Protein in fat malabsorption, nutritional support is needed. A low fat elemental formula is recommended. TPN through central line may be used for those who are NPO longer than five to seven days. TPN is good for people that cannot digest food. Fat= western 50 grams per day Mct= oils can be used Protein= about 1 grams per day Carbohydrates= remainder of kilo calories Meals are better in 6 small throughout the day instead of 3 main o Dumping Syndrome CAUSED by partial or total gastrectomy or removal of Pyloric sphincter. Early phase 10 to 20 minutes after meal. Fullness, cramps, nausea, diarrhea. Vasomotor symptoms: tachycardia comma hypo comma sweating comma weakness comma flushing comma Late phase 1-3 hours after meal Hypoglycemia, perspiration, hunger, nausea, anxiety, tremors, weakness Liquid should be consumed between meals, protein, fat, in complex carbohydrates are better tolerated, older patients should be evaluated for iron, vitamin B12, protein and, vitamin D deficiencies o Celiac Disease Gluten sensitivity. Chronic disease that damages mucosa of the small intestine. diarrhea, abdominal distention, fat malabsorption, weight loss. Remove gluten from diet, lifelong avoidance of gluten, read Food labels, alternative foods such as rice, potato, buckwheat. possible nutritional deficiencies= osteopenia, osteoporosis, inadequate blood coagulation and easy bruising due to lack of vitamin K, iron deficiency anemia, pernicious anemia type, idiopathic steatorrhea in early stages o Lactose Intolerance Most common disaccharidase disorder. Deficiency of lactose abdominal cramping, flatulence, diarrhea
Modified Diets- Indication for each and examples of foods o Clear liquids Indications include acute illness, reduction with fecal material prior to certain diagnosis tests in procedures, post op recovery Examples: Tea, water, coffee- without sugar/cream, fat free broth, carbonated beverages, clear juices, ginger ale, and gelatin Can be used for patients who have nausea and vomiting o Full Liquids Foods that are liquid at room temperature Swallowing difficulties indications include transition from liquid to soft diets post op recovery, acute gastritis, feed dry conditions and intolerance of solid foods Examples: ice cream, strained soups and cereals, cooked eggs, oral supplements, and milkshakes o Dysphagia Diets (Mechanical soft and Thickened liquids) Prescribed when swallowing is limited usually following a stroke Manifestations of dysphasia or drooling, pocketing food, choking or gagging LEVEL 1= Pureed, baby food consistency. Pudding-like, all foods are blended LEVEL 2=Mechanical. Soft textured, moist, semi solid foods that are easily chewed and swallowed. Ground up meats and gravy, chicken, tuna salad, well moistened pancakes with syrup, poached eggs, soft canned or cooked fruit. LEVEL 3=Advanced. Near normal texture food that are moist. Moist tender needs or casseroles can move Brad got is not crusty, moist potatoes, soups, ways. Harsh/ sticky foods are eliminated. LIQUID TYPES= Thin liquids. Non-restricted, can have un-thickened liquids. Nectar. Thin enough to sip straw but thicker than water. Consistency of heavy syrup, nectars, cream soups, buttermilk, thin milkshakes. Honey. Liquid does not maintain shape, can be eaten with a spoon and can be sipped through straw. Honey, tomato sauce, yogurt. Pudding. Thickened to maintain shape and need to be eaten with a spoon. Pudding, custard, hot cereals. o Soft diets sometimes ordered after surgery, transition from liquid diets to regular diets, mild GI problems EXAMPLE: most cooked or canned foods Omit chewy, string, tough foods Good Food Sources for Protein o Meat
o Poultry o Seafood o Eggs o Nuts and seeds o Beans and peas Dietary recommendations for patients with Ostomies
o Eat small meals often. ... o Eat slowly and chew your food well. o Drink 8 to 10 (8-ounce) glasses (about 2 liters) of liquids every day. o Eat mostly bland, low-fiber foods. ... o When you add foods back into your diet, introduce them one at a time. o Avoid raw fruits and vegetables. o Cook fruits and vegetables until fork tender, chew well and eat small to moderate quantities at each meal. o Avoid fruit skins and seeds, and dried fruit. o Avoid nuts, seeds (unless in a processed form like smooth butters) and popcorn. Signs and Symptoms of hypoglycemia and Hyperglycemia o Hypoglycemia:
Decrease BS sweating trembling dizziness mood changes hunger headaches blurred vision extreme tiredness and paleness o Hyperglycemia:
Increase BS dry mouth extreme thirst frequent urge to urinate drowsiness frequent bed wetting stomach pain Nutritional Practices/Considerations for the Chinese Patient-See ATI book o Causes of dehydration
o Not drinking enough fluid o Losing more fluid than you take in o Fluid is lost through sweat, tears, vomiting, urine or diarrhea Rationale for checking Residuals when administering tube feedings
o FORMULA Can be used in place of breastfeeding as an occasional supplement to breastfeeding or when exclusively breast-fed infants are weaned before 12 months of age alternative to breast milk. Modified from cows’ milk to provide comparable nutrients iron fortified formula is recommended for at least the first 12 months Fluoride supplements can be required if an adequate level is not supplied by the water supply follow manufacturers mixing directions bottles of formula require refrigeration. Do not use if formula has been left at room temperature for two hours or longer. Do not reuse partially emptied bottled formula. Infant should not drink more than 32 ounces per 24-hour period o BOTTLE FEEDING Hold infant with head slightly elevated to facilitate passage of formula or breast milk into stomach tilt battle to maintain liquid in nipple and prevents swallowing of air do not prop the bottle or put an infant to bed with a bottle. Promotes tooth decay. Diabetes and Exercise o Exercises helps lower glucose o Assists in maintaining normal lipid levels o Increases circulation o Helps reduce therapeutic level of insulin if consistent o Self-monitor BS before/during/after exercise My Plate food and serving guidelines o Fruits- 2 cups o Veggies- 2 ½ cups o Grains- 6 oz o Dairy- 3 cups o Protein- 5 ½ oz
Exam 4 Study Guide
Course: Nutrition in Healthcare (NURS232)
University: Bryant & Stratton College
- Discover more from:
