Nutrition - ATI Proctor

Practice A & B General Info

Manifestations of Tube Feeding Intolerance

N&V

Indications of Hypervolemia (6)

• Tachycardia

• Hypertension

• Hyponatremia

• Crackles

• Bounding peripheral pulse

• Pitting edema

Infant Growth (4)

• Infant should triple their birth weight by 1 year

• Infant should weigh about 20 pounds by 1 year

• Infant should increase by length by 50% (around 27 inches) by 1 year

• Infant returns to birth weight by 2 weeks of age

Toddler - Choking Hazards

Celery

Peanut butter

Whole grapes

Popcorn (until 4 y/o)

Hard pretzels (until 4 y/o)

Milk - Pediatrics (2)

• Whole milk - Provides fat for neurological development for children up to 2

• After 2 y/o - Children should consume low-fat or skim milk

TPN - Consideration

TPN flow must remain consistent to reduce risk of inadequate nutrition & metabolic complications

TPN contains high concentrations of nutrients never infuse NS as it can cause rapid shifts in levels of some substances

Delayed TPN - Administer D10W or D20W until next TPN arrives as TPN contains high amounts of dextrose & proteins to avoid hypoglycemia

Never abruptly stop a TPN infusion, leads to metabolic complications

Ramadan (3)

• Clients consume meals before dawn and after sunset

• Can eat during nighttime hours & fast during daytime hours

• Islam Diet Laws - Caffeine prohibited & beverages consumed after not with meals

Crohn’s Disease - Nutrition (4)

• Follow a high calorie, high protein diet to prevent malnutrition & promote healing

• Reduce fat intake during acute episodes, as they increase diarrhea & steatorrhea

• Low fiber diet to minimize bowel stimulation during acute episodes, high fiber during remission

• Eat small, frequent meals

Lutein (3)

• A carotenoid found in vitamin A

• Slows the progression of age-related macular degeneration

• Found in kale, spinach, collards, & mustard greens.

Niacin

Aids in lowering LDL & triglycerides

Age Related Vision Loss - Prevention (Nutrition) (4)

• Antioxidants

• Lutein

• Vitamin E & B12

• Slow age-related vision loss

Low-Glycemic Index Foods

Aid clients who have diabetes mellitus in managing postprandial hyperglycemia,

Ways to Increase Dietary Fiber Intake (4)

• Replace meat-based meals with dried peas or beans

• Add a small amount of bran to daily diet, working up to 3 Tbsp daily (less than ¼ cup)

• Leave skin on fruits & veggies

• Increase fluid intake to at least 8 glasses of water daily (240 mL)

Calcium Rich Foods

½ cup of roasted almonds (185 mg)

Manifestations of Malnutrition

Dry Skin

Dry conjunctiva & corneal vascularization

Paresthesia

Weak hand grasps

Lower extremity edema (malnutrition & protein deficiency)

Breastfeeding (4)

• Plan 5 min feedings on each breast on the 1st day after birth to promote milk production

• Breastfeed on demand when newborn shows indications of hunger (8-12x/day)

• Avoid giving fluids other than breastmilk to newborns

• Avoid using supplemental formula with artificial nipples to decrease risk of nipple confusion

Cancer Treatment - Nutrition (4)

• Avoid aromatic foods as they can cause nausea & increasing anorexia (odor sensitivity)

• Serve cold foods rather than hot

• Eat small frequent meals every 2 hours

• Add extra calories & protein to every meal

Cleft Lip Feedings (4)

• Burp infant after each oz of feeding or at least 2-3 times during feeding

• Swallowing air increase risk of vomiting & aspiration

• Use a one-way valve bottle with a high-flow rate nipple

• Squeeze infants cheeks together to decrease width of cleft & allow infant to achieve a better seal

PN with Lipids - Contraindication (3)

• Egg allergy

• Lipid emulsions are isotonic & composed of soybean or safflower plus soybean oil with egg phospholipid used as an emulsifier

• Can have reaction to emulsifier

Hemodialysis - Nutrition (3)

• Limit fluid intake to maintain fluid balance

• Restrict sodium

• Increase protein intake

Dumping Syndrome - Interventions (4)

• Apply pectin (fiber) to food to help delay gastric emptying

• Avoid drinking liquids with meals & wait 30 mins before & after meals to drink liquids

• Lie down & rest at least 15 mins after eating

• Avoid simple sugars (honey, sugar, syrups)

Inflammatory Bowel Disease (Impaired Digestion) Formula (2)

• Hydrolyzed or elemental formula provides protein & other nutrients in their simplest form

• Require little or no digestion & decrease stimulation of the bowel.

Modular Product Supplement Formula

Increase intake of a specific nutrient without increasing volume

Manifestations of Hypoglycemia (7)

• Diaphoresis

• Irritability

• Tremor

• Tachycardia

• Hunger

• Cold

• Confusion

Total 25-Hydroxy D

Vitamin D

Low vitamin D increases risk of osteoporosis

Prealbumin

Low levels indicate malnutrition & delay wound healing

Delayed Wound Healing Lab Indicators (3)

• Low iron level

• Low prealbumin

• Elevated blood glucose