ch 45. Clinical Nursing Nutrition and Dietary Management

What are the six major categories of nutrients required by the human body?

Carbohydrates, proteins, fats, water, vitamins, and minerals.

Into what two main categories are vitamins classified?

Fat-soluble vitamins and water-soluble vitamins.

Which digestive organ primary functions to breakdown food particles and assist in producing spoken language?

Mouth

What enzyme present in saliva begins the digestion of carbohydrates?

Amylase

What is the primary function of the esophagus in digestion?

Transporting food from the pharynx to the stomach.

What role does hydrochloric acid (HCl) play in the stomach?

HCl activates digestive enzymes, breaks down food, and kills germs.

How does the stomach wall protect itself from acid digestion?

A protective mucus lining covers and shields the stomach wall.

What digestive fluid produced by the liver aids in the digestion of fats?

Bile

What is the primary organ responsible for storing and concentrating bile?

Gallbladder

How does the pancreas prevent stomach acid from damaging the intestine?

It secretes bicarbonates to neutralize acidic stomach chyme.

In which segment of the gastrointestinal tract does the majority of nutrient and water absorption occur?

Small intestine

What are the primary reabsorptive functions of the large intestine?

Reabsorbing water, ions, and vitamins, while forming and storing feces.

What are the four primary phase components of gastrointestinal processing?

1. Digestion

2. Absorption

3. Metabolism and nutrient storage

4. Elimination

What five food groups make up a balanced plate layout?

Fruits, Vegetables, Grains, Protein, and Dairy.

What standard dietary guidelines define nutrient intake levels necessary to meet the needs of healthy individuals?

Dietary Reference Intakes (DRIs)

What foods are consumed in an ovolactovegetarian diet?

Plant foods, eggs, and dairy products (avoiding meat, poultry, and fish).

How does a lactovegetarian diet differ from an ovolactovegetarian diet?

Lactovegetarians include milk and dairy products but exclude eggs.

What foods are strictly excluded in a vegan diet?

All animal-derived foods, including meat, poultry, fish, eggs, and dairy

What key physiological states during young and middle adulthood require significant increases in nutritional intake?

Pregnancy and lactation.

What is the definition of anthropometry in a nutritional assessment?

The measurement of human body size, weight, and proportions (e.g., height, weight, BMI).

In assessing dysphagia, what anatomical structure normally folds down to protect the airway during swallowing?

The epiglottis, which blocks the larynx to direct food into the esophagus.

Failure of the epiglottis to block the larynx during swallowing directly increases the risk for _____

Aspiration (and aspiration pneumonia)

What nursing diagnosis applies to a patient with impaired oral food transfer or swallowing dysfunction?

Impaired Swallowing

What nursing diagnosis is indicated when a patient is unable to independently bring food to their mouth?

Impaired Self Feeding

A nurse is feeding a patient with dysphagia a pureed diet when the patient suddenly begins choking. What is the priority nursing intervention?

Stop feeding the patient immediately.

What nursing intervention helps promote appetite in hospitalized patients during mealtime?

Removing noxious odors, keeping environment clean, providing oral hygiene, and presenting small, appealing portions.

What type of enteral access device is pictured in container A below?

A small-bore enteral feeding tube (e.g., Dobbhoff tube).

Why is it vital to use ENFit connectors for all enteral nutrition sets, syringes, and feeding tubes?

To prevent accidental misconnections between enteral lines and IV lines or other non-enteral devices.

What position should a patient receiving enteral tube feeding maintain unless medically contraindicated?

Upright position or with the head of bed (HOB) elevated at least 30 to 45 degrees.

Why should food coloring or dye never be added to enteral nutrition (EN) formulas?

It can cause severe adverse effects (including dye toxicity) and is ineffective/unsafe for detecting aspiration.

What safety rule regarding safety verification must a nurse practice prior to administering enteral feeding?

"Right patient, right formula, right tube, right ENFit adapter."

Why is line tracing essential prior to administering enteral infusions?

To physically trace all lines back to the patient and confirm only enteral-to-enteral connections exist.

What is Parenteral Nutrition (PN)?

The intravenous administration of complex nutritional solutions directly into the bloodstream.

What technique must nurses maintain when manipulating parenteral nutrition (PN) IV infusion components?

Standard Aseptic Non-Touch Technique (ANTT®) and strict aseptic technique.

A patient receiving both Parenteral Nutrition (PN) and Enteral Nutrition (EN) is progressing well. At what threshold of EN intake should the nurse collaborate with the provider to discontinue PN?

When 75% of the patient's nutritional needs are met by the tube feedings (EN).

Why should continuous enteral feedings and PN always be administered using an infusion pump?

To maintain accurate flow rates, prevent sudden fluid overload, and minimize glycemic instability.

Why do anticoagulation therapy and bleeding disorders increase risk during nasal tube insertion?

They significantly elevate the patient's risk for severe epistaxis (nosebleeds).

What are four potential complications associated with nasogastric or nasointestinal tubes?

1. Sinusitis

2. Otitis

3. Vocal cord paralysis

4. Medical device-related pressure injuries to the nose

What is Medical Nutrition Therapy (MNT)?

The use of specific nutritional therapies and dietary modifications to treat or manage diseases or clinical conditions.

What key medical conditions commonly utilize Medical Nutrition Therapy (MNT) as part of treatment?

Gastrointestinal diseases, Diabetes Mellitus, Cardiovascular diseases, Cancer, and HIV/AIDS.

When evaluating nursing care for a patient receiving nutritional support, evaluation should focus on _____ and the patient's perspective.

Patient outcomes (e.g., weight stabilization, target biochemical markers, absence of aspiration).