Nutrition and Elimination quiz

soluble fiber

mixes with water and forms a gel-like substance, which results in slower digestion

insoluble fiber

does not retain water but allows formation of bulk, resulting in the accelerated passage of the end products of food through the intestines and a slowing of starch absorption

vitamin A

increase the resistance to infection, promote night vision, normal function of epithelial tissue, and aid in the development of normal bones and teeth

Vitamin A deficiency

night blindness

vitamin A foods

liver, milk, egg yolk, and dark, leafy green vegetables. Yellow and orange vegetables and fruits (such as sweet potatoes, pumpkin, carrots, and apricots)

vitamin D

strengthens bones

vitamin D deficiency

rickets, osteomalacia

vitamin D foods

dairy products, eggs, fortified food products, liver, and fatty fish (salmon and mackerel)

vitamin K

essential for the synthesis of proteins that promote the clotting, or coagulation, of blood

vitamin K deficiency

hemorrhage, bleeding

vitamin K foods

dark-green leafy vegetables such as broccoli, spinach, Brussels sprouts, and cabbage

vitamin C

immunity

Vitamin C deficiency

scurvy (bleeding gums), hemorrhagic diathesis, poor wound healing

vitamin C foods

fresh yellow and orange fruits, papaya, kiwi, broccoli, and sweet and white potatoes

vitamin B1 (thiamine)

essential for the metabolism of protein, fat, and carbohydrates, including sugar to produce energy for the body's cells

Vitamin B2 (Riboflavin)

assists in the metabolism of protein and the function of other B vitamins, visual adaptation to light, and maintaining healthy skin

Vitamin B3 (Niacin)

referred to as nicotinic acid or nicotinamide, is a coenzyme for energy production. It also has a critical role in the formation of fatty acids

Vitamin B6 (pyridoxine)

assists as a coenzyme in the synthesis and catabolism of amino acids

vitamin B12

essential for the production of red blood cells

Vitamin B9 (folic acid)

needed in pregnant women

vitamin B9 foods

leafy green vegetables (kale, spinach, Brussels sprouts), oranges, strawberries, dried beans, peas and nuts, and enriched breads and cereals and other fortified grain products

magnesium

combined with calcium regulates blood pressure and maintains a regular heartbeat and nerve and muscle function

ways to get food intake

24 hour recall and food diary

nutritional assessment components

dentition

food/fluid intake

skin

weight/BMI

ability to feed self

meds, history

DETERMINE

disease, eating poorly, tooth loss/mouth pain, economic hardship, reduced social contact, multiple medications, involuntary weight loss/gain, needs assistance in self-care, and elderly years above age 80

important lab values

prealbumin, albumin, transferrin

prealbumin

below 11 indicated malnutrition

albumin

below 3.5 indicates malnutrition

transferrin

<200 indicates malnutrition

nursing diagnoses for alteration in nutrition

lack of knowledge

impaired swallowing

impaired self-feeding

clear liquid diet

limited nutrients and is used only for a short period of time. Clear juices that do not contain pulp (such as apple or cranberry juice, gelatin, popsicles, and clear broths); most commonly are ordered for patients with GI problems, before surgery and after surgery, and before some diagnostic tests

full liquid diet

foods that are or may become liquid at room or body temperature; include juices with and without pulp, milk and milk products, yogurt, strained cream soups, and liquid dietary supplements; often ordered for patients who have GI disturbances, dental work, or unable to tolerate solid food when they do not need to be NPO or limited to a clear liquid diet

puree diet

consist of food that is placed into a blender and made into a pulplike mixture. This type of diet is used for individuals who cannot safely chew or swallow solid food (ex: dysphagia); The addition of raw eggs, nuts, and seeds should be avoided

mechanical soft diet

include food consistencies that have been modified, such as ground meat or soft-cooked foods. They are used for those who have difficulty chewing effectively.

thickened liquids

used for patients who have difficulty swallowing and are at risk for aspiration Liquids can be thickened by adding a commercially prepared thickening agent; Nuts, seeds, and other hard or raw foods should be avoided to decrease the risk of aspiration

diabetic diets

usually 4 or 5 C cap

avoid simple carbs, sugars, starchy foods

cardiac diets

restrict sodium, animal products with cholesterol, no pickles or lunch meat

renal diets

restrict potassium, sodium, protein, and phosphorus; no bananas, limited meat

healthy amount of urine

30-60 mL per hour, 1400 mL daily

polyuria

excessive urination; greater than 2500 mL in 24 hrs

anuria

50-100 mL in 24 hrs

oliguria

100-400 mL in 24 hours

nocturia

excessive urination at night

hematuria

blood in the urine

urinary retention

inability to empty the bladder

urinary incontinence

inability to control urination

less muscle tone impact on urination

increased possibility or incontinence; kegel exercises help

urinary assessment

color, clarity, odor, amount, frequency

high specific gravity

indicates dehydration

protein in urine indicates

glomerulus problem

glucose in urine

indicates diabetes

ketones in urine indicates

DKA, Fat broken down for energy

high creatinine indicates

AKI, kidney failure, dehydration

urinary elimination nursing diagnoses

urinary incontinence

urinary retention

urinary tract infection

impaired urination

impaired kidney function

risk for impaired skin integrity

risk for urinary infection

disturbed body image

cystoscopy

Scope looks at urethra, bladder, etc.

NPO for 8-12 hours in case they need anesthesia

Shows cause of hematuria, dysuria, incontinence

Looks at things that don't show up on x ray or CT

ultrasound

Blood flow, size, shape, location of kidneys

Bladder has to be full before this is performed

KUB

X ray of kidneys urinary and bladder

Can show kidney stones

intravenous pyelogram

Use contrast and do x ray at certain intervals

X ray of kidneys, bladder, ureters, urethra

Tumors, kidney stones, infection, injury

NPO 8-12 hours before

diarrhea causes

C. diff

Medication

Foodborne pathogens

Lactose intolerance

Valsalva maneuver

straining too hard can stimulate vagus nerve slowing heart rate, can cause pt. to pass out; avoid straining with CV problems

constipation causes

Medication

Blockages

Poor diet and fluid intake

Immobility

IBS

Surgery

why do we document flatulence?

Documented after surgical procedures - so we know bowels are waking up and peristalsis is happening before giving them food or drinks

stoma should be...

pink/red and moist

sigmoid and descending ostomy have ___ stool

solid

transverse ostomy has ___ stool

semi-solid or liquid

ascending ostomy and ileostomy has ___ stool

liquid

fecal occult blood test

Shows if there's blood in the stool

3 small stool samples taken a day apart

Special diet 48-72 hours before test; NO beets, broccoli, carrots, fish, red meat

loop colostomy is usually created when?

during emergency

loop colostomy consists of ...

one stoma with two openings

The proximal end of the stoma is stool

The distal end may discharge mucus

double-barrel colostomy consist of

two ends of bowel are brought out onto the abdominal wall, resulting in two distinct stomas

temporary incontinence

constipation impacts bladder mechanisms and stops the bladder from emptying completely

stress incontinence

the inability to control the voiding of urine under physical stress such as running, sneezing, laughing, or coughing

urge incontinence

rapid bladder contractions that result in sudden strong urge to void

mixed incontinence

combination of stress and urge incontinence

renal calculi (kidney stones)

urinary obstruction that prevents flow of urine

which organ synthesizes vitamin D

kidneys

pt has only voided 50-100 mL every 2 to 3 hours with foley catheter, what is priority action?

check for bladder distention

is irrigation of indwelling catheter recommended?

no, backflow of contaminated urine can cause infection

peritoneal dialysis

abdominal cavity functions as a dialyzing membrane

hemodialysis

dialysate fluid is pumped through one side of the artificial semipermeable membrane and blood pumped through the other side

a pt carries the foley catheter at their waste when ambulating, which condition are they at risk for?

infection

reflux of urine

what is the most probable cause of large proteins in the urine?

glomerulonephritis

erythropoietin is administered b/c of dysfunction with which organ?

kidney

metronidazole urine

makes urine brown

what makes urine blue-green

asparagus

cimetidine

what complication does a nurse expect after surgery?

urine retention

nurse finds that pt has deep amber color urine, BUN of 25, and urine specific gravity is high, what does this indicate?

dehydration

sweet fruity urine

diabetes

priority when preparing for intravenous pyelogram

note any allergies

pt. has difficulty voiding postop, which action will nurse implement first?

turn on bathroom faucet as pt tries to void

which question is a priority when taking health history of pt with diagnosis of rule out bowel obstruction

when was the last time you moved your bowels?

why is salem sump the right tool for gastric decompression

it has 2 lumens

what question should you ask a pt with C. diff to obtain relevant info about the cause

are you taking any antibiotics

who is more at risk for c diff

patients who have been receiving large doses of antibiotics or taken antibiotics over a long period of time

which foods can alter fecal occult blood test

carrots, red meat, grapefruit

normal stoma

moist, reddish-pink, budding slightly above skin

abnormal stoma

rashes, whitish area around it

max about of fluid given when a cleansing enema is ordered for 55 year old patient

1000 mL

nurse responds with what nursing action if pt reports abdominal pain during admin of an enema

slow down rate of instillation

condition for pt. with black, tarry stools

iron ingestion

GI bleeding