Basal metabolic rate (BMR) - ANSWER Energy needed at rest to maintain life-
sustaining activities for a specific amount of time. Older adults have a slower BMR
Resting energy expenditure (REE) - ANSWER Amount of energy needed to consume
over 24-hour period for the body to maintain internal working activities while at rest
Carbohydrates - ANSWER Main source of energy in the diet. composed of carbon,
hydrogen, and oxygen. produces 4 kcal/g and serves as the main source of fuel
(glucose) for the brain, skeletal muscles during exercise, erythrocyte and leukocyte
production, and cell function of the renal medulla.
Protein - ANSWER made up of amino acids. Necessary for nitrogen balance. Proteins
provide a source of energy (4 kcal/g), and they are essential for the growth,
maintenance and repair of body tissue. Consist of oxygen, carbon, hydrogen, and
nitrogen.
Fats (lipids) - ANSWER Fats (lipids) are the most calorie-dense nutrient, providing 9
kcal/g.
Fats are composed of triglycerides and fatty acids.
Water - ANSWER makes up 60-70% of body weight.
Infants have greatest percentage of total body water
Vitamins - ANSWER organic substances present in small amounts in foods that are
essential to normal metabolism. They are chemicals that act as catalysts in biochemical
reactions.
Minerals - ANSWER inorganic elements essential to the body as catalysts in
biochemical reactions.
normal BMI - ANSWER 18.5-24.9
overweight BMI - ANSWER 25-29.9
obese BMI - ANSWER >30
Mini Nutritional Assessment (MNA) - ANSWER If a patient scores 11 or less on the
screening part, the health care provider completes the assessment part. A total score of
less than 17 indicates protein-energy malnutrition.
Calculate nitrogen balance - ANSWER by dividing 6.25 into the total grams of protein
ingested in a day
,Serum Laboratory Values - ANSWER Albumin
Prealbumin
Hemoglobin
Metabolic half-life - ANSWER Albumin- 21 days (long term)
Transferrin- 8 days
Prealbumin- 2 days (acute term)
Albumin - ANSWER Normal Value (adult): 3.5-5.0 g/dl
<2.8 associated with edema
21 days half life (long term)
Synthesized in the liver from amino acids; indicator of prolonged protein depletion
Prealbumin - ANSWER Normal value 15-36mg/dl
<10.7 is severe nutritional deficiency
acute term 2 days
Determines protein depletion in acute conditions
Hemoglobin - ANSWER 12-16 g/dl in females
14-18 g/dl in males
the iron-containing pigment of the Red blood cells; assists with O2 and CO2 transport.
Fruitarian - ANSWER consumes fruit, nuts, honey, and olive oil
vegan - ANSWER consumes only plant food
Lactovegetarian - ANSWER drinks milk but avoids eggs
Ovolactovegetarian - ANSWER avoids meat, fish, and poultry, but eats eggs and milk
Dysphagia - ANSWER Difficulty swallowing, at risk for aspiration. Need a speech and
language consult. Most common dysphagia is silent and occurs without a cough.
patients eat with a chin tuck and food goes on strong side of the mouth
NPO Diet - ANSWER nothing by mouth. Rest the GI tract or for patients with swallowing
problems.require enternal if NPO >5 days
Pureed Diet - ANSWER clients with dysphagia or wired jaws; foods that have been
blenderized to smooth consistency
Soft/Low-residue diet - ANSWER reduces volume and frequency of stools includes
easily digested foods that are easy to chew and swallow
Dysphagia diets- 4 levels - ANSWER Dysphagia puree- pudding like
Dysphagia mechanically altered-soft texture
Dysphagia advanced- no hard, sticky or crunchy foods
, Regular
These levels are determined by a swallow test
4 levels of liquid for dysphagia patients - ANSWER Liquid thin (water),
Nectar-like (apricot, prune, tomato),
Honey-like (smoothies, yogurt),
Spoon-thick (pudding)
Enteral Nutrition - ANSWER nutrition may be provided with nasogastric, gastric, or
jejunal tubes. comes in cans or prefilled bags. Diarrhea can be caused by bacteria
being in the bag, bag only good for 24 hours. If nausea, cramping or diarrhea occurs
slow the tube feeding down
Nasogastric (NG) Tube - ANSWER inserted through the nose
is used short term 4 weeks or less
assess sputum before placing into the nose incase the sputum is deviated
Landmarks for inserting-Nose, ear, xiphoid process for stomach add 8-10 inches for
small intestine
Gastrostomy (G-tube) or jejunostomy (j-tube) - ANSWER inserted surgically MD; used
for long term
jejunostomy tube ( j-tube) - ANSWER is the only tube that is beyond the stomach and is
not contraindicated by facial trauma
Tubes places in the stomach - ANSWER The nasogastric tube and the PEG tube are
placed in the stomach, and placement could lead to aspiration
PEG tube - ANSWER long term; MD performs in endoscopy; does not require surgery
Meds per feeding tube - ANSWER Insert crushed med one at a time
Make sure meds can be crushed, if unsure contact pharmacy
Flush in between each med with water
Nursing Responsibilities
for NG Tubes - ANSWER X-ray is the only reliable method of placement verification for
initial feeding. Must check x-ray first.
Verify tube placement
HOB up at least 30 degrees
If laying flat turn tube feeding off put it on hold
Assess bowel sounds
Nursing Responsibilities for G-tube or PEG - ANSWER same as NG but
Administering and monitoring of tube and tube feeding; monitoring of I & O and labs