NURS 3003 Exam 4 (45-50)

dietary guidelines for americans 2020-2025

• Follow a healthy dietary pattern at every life stage

• Customize and enjoy food and beverage choices to reflect personal preferences, cultural traditions, and budgetary considerations

• Focus on meeting food group needs with nutrient-dense foods and beverages, and stay within calorie limits

• Limit foods and beverages higher in added sugars, saturated fat, and sodium, and limit alcoholic beverages

The basal metabolic rate

is the energy needed at rest to maintain life-sustaining activities (breathing, circulation, heart rate, and temperature) for a specific amount of time.

what is energy expenditure

is measured by calculating kilocalories (kcal) of ingested foods.

• When food intake meets energy requirements, body weight is stable

• Weight gain occurs when the kilocalories exceed energy demands

• Decreasing kilocalories below energy requirements results in weight loss.

Water-soluble fiber

Water-soluble fiber sources are barley, cereal grains, and oats.

Positive nitrogen balance

Positive nitrogen balance is required for growth, normal pregnancy, maintenance of lean muscle mass and vital organs, and wound healing

Negative nitrogen balance

Negative nitrogen balance occurs when the body loses more nitrogen than it gains (e.g., with infection, burns, fever, starvation, head injury, and trauma)

fat-soluble vitamins

(A, D, E, and K) are stored in the fatty compartments of the body

water-soluble vitamins

are vitamins C and B comple

functions of digestive system

ingestion, mech. digestion, chem. digestion, absorption, elimination

MyPlate dietary guidelines, and Healthy People 2030

provide guidelines to assess and maintain patients’ nutritional status.

Enteral nutrition (EN)

provides nutrients to the GI tract.

• nasoenteral route (nasogastric, nasoduodenal, and nasojejunal

• gastric tubes inserted into the stomach (gastrostomy)

• jejunum (jejunostomy).

Parenteral nutrition (PN)

• is a form of specialized nutritional support provided intravenously.

Patients in highly stressed physiological states such as sepsis, head injury, or burns are candidates for PN therapy

environmental factors

Environmental factors can limit a person’s likelihood of healthy eating and participation in exercise or other activities of healthy living.

= causes obesity

overweight

is defined as having a body mass index (BMI) of 25 kg/m2 to below 30 kg/m2

obesity

is defined as a BMI of 30 kg/m2 or greater

Breastfeeding

Breastfeeding is recommended for a newborn’s first 6 months of life and breastfeeding with complementary foods from 6 months to 2 years

kids under 1 shouldnt get what?

children under 1 year of age should never ingest honey and corn syrup products because they are potential sources of the botulism toxin

muslims

no pork, fasting ramadan

christianity

minimal or no alcohol, meatless days during lent

hinduism

All meats

Fish, shellfish with some restrictions

Alcohol

judaism

kosher food, no pork, shellfish, blood, no mixing milk w/ meat

Church of Jesus Christ of Latter-Day Saints (Mormons)

Alcohol

Tobacco

Caffeine such as in teas, coffees, and sodas

Seventh-Day Adventists Church

Pork

Shellfish

Fish

Alcohol

Caffeine

Vegetarian or ovolactovegetarian diets encouraged

Albumin

Albumin: long term malnutrition

Prealbumin

Prealbumin: malnutrition in short term

no protein unable to maintain what

fluids

Dysphagia

Dysphagia or difficulty swallowing, refers to a sensation of food or liquid being delayed or hindered in its passage from the mouth to the stomach

Silent aspiration

silent aspiration is aspiration that occurs in patients with neurological problems that lead to decreased sensation

gastric residuals

Check gastric volume residual: how much liquid is left

Greater than 500mL = non-functioning GI Tract, peristalsis isn’t working

Medical nutrition therapy (MNT)

Medical nutrition therapy (MNT) is the use of specific nutritional therapies to treat an illness, injury, or condition.

Total PN (TPN),

Total PN (TPN), administered through a central line, is a 2-in-1 formula in which administration of fat emulsions occurs separately from the protein and dextrose solution

intravenous fat emulsion

intravenous fat emulsion to PN supports a patient’s need for supplemental kilocalories to prevent essential fatty-acid deficiencies and help control hyperglycemia during periods of stress

refeeding syndrome

complications when nutrition is introduced too rapidly to extremely malnourished patients

signs: hypokalemia, hyponatremia, hypophosphate, elevated blood sugar, elevated temp

whats the expected urine output

1-2liters per day

minimum 30mls per hour

Transient Incontinence

Incontinence caused by medical conditions

Functional Incontinence

Loss of continence because of causes outside the urinary tract

Overflow Urinary Incontinence

Involuntary loss of urine caused by an overdistended bladder often related to bladder outlet obstruction or incomplete bladder emptying

Stress Urinary Incontinence

Involuntary leakage of small volumes of urine associated with increased intraabdominal pressure related to either urethral hypermobility or an incompetent urinary sphincter

Urge or Urgency Urinary Incontinence

Involuntary passage of urine often associated with a strong sense of urgency related to an overactive bladder

Reflex Urinary Incontinence

Involuntary loss of urine occurring at somewhat predictable intervals

factors influencing urination

growth & development

sociocultural factors

psychological factors

personal habits

fluid intake

pathological conditions

surgical procedures

medications

diagnostic exams

Urinary retention

is the inability to empty the bladder partially or completely

acute/chronic = urinary retention stretches the bladder, causing feelings of pressure, discomfort/pain, tenderness

Chronic urinary retention = may experience a decrease in voiding volumes, straining to void, frequency, urgency, incontinence, and sensations of incomplete emptying

Urinary incontinence

Urinary incontinence (UI) is defined as the “complaint of any involuntary loss of urine

signs of a urinary tract infection in older adults

delirium, confusion, fatigue, loss of appetite, functional decline, mental status changes, incontinence, falls, or subnormal temperature

urinary diversions

patients who’ve undergone bladder removal due to cancer or severe bladder dysfunction

stoma through the urinary wall

continent urinary reservoir

(Fig. 46.2A), which is created from a distal part of the ileum and proximal part of the colon

orthotopic neobladder,

which uses an ileal pouch to replace the bladder

ureterostomy or ileal conduit

is a permanent incontinent urinary diversion created by transplanting the ureters into a closed-off part of the intestinal ileum and bringing the other end out onto the abdominal wall

Nephrostomy

tubes are small tubes that are tunneled through the skin into the renal pelvis

bladder training & pelvic muscle exercise

• effective in treating stress urinary incontinence

• reestablish voluntary control over micturition

stoma (bowel diversions)

colostomy or ileostomy

Fecal Incontinence

Fecal Incontinence is the inability to control the passage of feces and gas from the anus.

• Clostridium difficile (C. difficile)

bowel training

attempting to defecate at the same time each day and using measures that promote defecation

how to prepare for a fecal occult blood test

no red meat for 3 days before testing

no aspirin or ibprofhen any NSAIDS

avoid vitamin c and citrus fruits

• colorectal cancer and GI conditions