Study Guide - Chapter 37

Nutrition

What are the major nutrients we need?

• Essential (not made by the body in sufficient #s, provided thru diet/supplements)

• Macro (carbs, proteins, fats)

• Micro (vitamins, minerals)

Which nutrients supply energy?

macronutrients (carbs, proteins, fats)

Which nutrients regulate body processes?

micronutrients (vitamins, minerals) and water

What are the functions of carbs?

• provide energy

• absorb water to increase fecal bulk

• slow gastric emptying

What are the functions of proteins?

• tissue growth and repair

• regulation of fluid balance

• regulation of acid-base balance

• detox of harmful substances

• formation of antibodies

• transportation of fat and other substances

• provide energy when carb intake is low

What are the functions of fats?

• provides energy and structure

• insulates body

• cushions internal organs

• needed for absorption of fat-soluble vitamins

What assessments should you make before feeding a patient?

• confirm pts diet

• food allergies, religious or cultural preferences

• pt should not have any lab or diagnostics scheduled

• swallowing difficulties

  • abdominal distention and tenderness

What are aspiration precautions? Why is it important for pts with dysphagia?

• assess risk and obtain S&S consult prior to feeding

• ensure alert prior to feeding

• HOB at 90 degrees during meals, 30 degrees after eating

• o2 and suction equipment nearby

• check for pocketing

• offer proper consistency

• avoid thin liquids

Pts with dysphagia are at high risk for aspiration

What are alternate methods of nutritional intake?

Enteral - tube feedings!!

• ng tube

• gastronomy tube

Parenteral

• IV/catheters

• central line

What can a nasogastric tube do?

Indications:

• deliver nutrition

• remove unwanted fluid/air/substances

• help monitor bleeding in the GI

• help treat intestinal obstruction

How do you verify NGT placement?

• x-ray (gold standard)

• measure aspiration (should be acidic pH)

• measure tube length and marking

• CO2 monitoring/capnography

What is the difference b/w parenteral nutrition and enteral nutrition?

Parenteral - bypasses GI, goes directly to bloodstream

Enteral - uses GI

What are some complications of Total Parenteral Nutrition (TPN)?

• insertion problems

• infection and sepsis/phlebitis

• metabolic alterations

• refeeding syndrome (b/c body has adapted to much less)

• fluid, electrolyte, and acid-base imbalances

• hyperglycemia

• hyperlipidemia

• liver + gallbladder disease

Difference b/w enteral and parenteral feedings + give example of each

Parenteral - bypasses GI, goes thru bloodstream (ex: central line)

Enteral - goes thru GI (NG tube)

Why is water or hydration important?

• provides medium necessary for all chemical reactions in the body

• acts as solvent

• aids w/ digestion, absorption, circulation, and excretion

What vitamin is found in carrots?

Vitamin A

In what foods can you find vitamin B?

asparagus, avocado, eggs, almonds, black beans, and mushrooms

In what foods can you find vitamin C?

oranges and citrus fruits

Salmon is high in what vitamin?

vitamin D

Sunflower seeds are high in what vitamin?

Vitamin E

Cheese is high in _____

calcium

Kale is high in ____

magnesium

Pumpkin is high in ___

phosphorus

Brazil nuts are high in ____

selenium

Bananas, avocado, and leafy greens are high in

potassium

Pumpkin seeds are high in ___

zinc

Brown rice is high in ____

manganese

Briefly describe what each fat soluble vitamin is mainly responsible for

A - visual acuity in dim light, skin maintenance, immune function

D - bone health, immune support, absorbs calcium and phosphorus

E - cell membrane protection

K - blood clotting

What minerals are vital in our neuro and cardiac cycle?

potassium, sodium, calcium, and magnesium

List values for dehydration vs overhydration

Dehydration

• increased hematocrit (over 52%)

• increased blood urea nitrogen (over 20 mg/dL)

• increased serum creatine (over 1.2 mg/dL

• increased serum pre-albumin (over 38 mg/dL)

Overhydration

• decreased blood urea nitrogen (less than 6 mg/dL)

What diet is indicated for pts w/ diabetes?

consistent-carb diet

What diet is indicated for pts w/ diverticulosis, IBS, or constipation?

high fiber diet

What diet is indicated for pts w/ diverticulitis, crohns disease, and before surgery

low fiber diet

What diet is indicated for pts w/ nephrotic syndrome, chronic kidney disease

renal diet