-
Rate of energy untilization required for essential activities
Basal metabolic rate (BMR)
-
Iron can interfere with
Some abx
-
Physical features of assessments scored as
- 0 normal
- 1 mild
- 2 moderate
- 3 severe
-
Simple substances, build up to complex
Anabolism
-
3 parental nutrition
TPN, lipid emulsions, total nutrient admixture
-
Lab values reveal anemia and dehydration
CBC
-
Female creatinine level
0.5-1.1 mg/dl
-
Some of all processes by which living things are formed
Metabolism
-
Physiological considerations to promote nutrition
Oral care, increase activity, decrease stress, good environment
-
Biologic catalysts speed up chemical reactions
Enzymes
-
Clear liquid examples
Room temp, water, tea, broths, clear gelatins
-
Tube feedings, do what to head of bed
Elevate
-
Kozier 4 nutritional status
Ideal, borderline, malnutrition, over nutrition
-
Kozier over nutrition
Obese
-
Bony tissue covers root of tooth, imbedded in jaw
Cementum
-
BUN increases with (5)
High protein, dehydration, burns, CHF, MI
-
Urea is formed..
in liver, end product of protein metabolism
-
Formed in liver, end product of protein metabolism
Urea
-
Normal value BUN
10-20 mg/dl
-
Normal serum albumin
3.5-5.0 g/dl
-
Causes of decreased BUN (2)
Malnutriton, liver failure
-
Why do bedridden pts develop hyperkalemia
Bone demineralization
-
How are vitamins absorbed?
Through intestinal wall directly into bloodstream.
-
Vitamins are classified as?
Water or fat soluble
-
Vegetable fats are
Unsaturated
-
What do you offer first, solid or liquid foods?
Alternate, ask pt what they want next.
-
How full should the spoon be?
1/3
-
TPN, when should you be concerned of thrombosis?
Pain/swelling at or near catheter or ext that side.
-
Check 4 before TPN administration.
- Label w/med order
- Rate w/med order
- Inspect for junk
- Use infusion pump
-
Stop feeding tube if residual...
>100
-
Who should recieve parenteral fat emulsions?
Those with high calcium needs or cant tolerate glucose.
Sick infants
-
Poached egg good for what diet?
Low residual diet
-
TPN, changing tube, instruct pt to....
Valsalva maneuver and clamp so to prevent air embolism
-
Earliest sign of catheter related sepsis?
Increased temp
-
3 psychosocial fatctors affecting food habits
Culture, religion, tradition
-
Vegetarian can eat what for calcium
Collard greens
-
3 phsysiologic factors affecting food habits
Health, hunger, development
-
3 physical factors affecting food habits
Geography, food tech, income
-
Water accounts for what % of body weight
50-60
-
Can lead to vit B deficiency and peripheral neuropathy
Alcoholism
-
Most common cause of hypomagnesium
Alcoholism
-
What 2 levels oppose each other?
Ca and phosphorous
-
2/3 body water locate where?
Inside cells
-
Feeding tube, best way to check placement?
X ray
-
Position pt who is aspiration risk while feeding...
90 degree, keep that way 45-60 min after meal
-
TPN, central, % glucose
up to 35
-
TPN, vitals every...
4 hours
-
Glycogen catablosim back to glucose in liver
Glycogenolysis
-
Explain positive nitrogen balance
Anabolism build up greater than catabolism, nitrogen intake exceeds excretion
-
TPN, infusion to fast =
Hyperosmolar diuresis and dehydration
-
Explain nitrogen negative balance
Catabolism breakdown greater than anabolism, excretion exceeds intake
-
What happens to glucose tolerance as people age?
Decreases
-
TPN, most common complication
Infection
-
TPN, change IV line every
24 hrs
-
95% lipids in diet are
Triglycerides
-
Talk to pt while eating?
Yes, provides pleasent and social environment
-
Where do you stand when feeding pt?
Sit, eye level
-
TPN, peripheral % glucose
Up to 10%
-
TPN, monitor weight....
Daily, after voiding, same time, same scale.
-
TPN, tachypnea may indicate?
Increase carbs, increasing CO2
-
What confirms venous thrombosis?
Venogram
-
TPN, monitor blood glucose....
Q 6 hrs initially, then daily
-
TPN, pts could also require
Insulin due to glucose in TPN
-
TPN, reasonable weight gain goal
1 lb/wk, no more than 3 lb/wk
-
Diff b/t complete, incomplete proteins
- Complete, animal, high quality
- Incomplete, plants, low quality
- Based on amino acids
-
BMR of women
0.9 cal/kg per hr
-
BMR of males
1 cal/kg per hour
-
Tube feeding, monitor gastric emptying every
4 hours
-
Formation of glucose from noncarb molecules
Gluconeogenesis
-
Glycogenesis
Glycogen anabolism from glucose in liver
-
Storage form of carbs in body
- Glycogen, in liver.
- Excess stored as fat
-
Why fewer calories needed in adulthood
Decreased BMR
-
Dyshpagia
Diff swallowing
-
Tube feeding, flush every
4 hours
-
Typical amount/time of tube feedings
200-350 ml over 15-30 min
-
Most common cause aspiration in adults during oral feedings
Dysphagia
-
4 signs of dysphagia
- Multiple attempts at swallowing
- Food stuck
- Poor lip/tounge control
- Cough/gasps
-
More diff to swallow, thick or thin fluids
Thin
-
TPN rate to slow =
Little benefit
-
Animal fats are
Saturated
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