NSG 232 SOLVED EXAM CORRECT VERIFIED

A nurse is working within the managed care delivery model. Which of the following is true regarding managed care? A-All plans have the same values underlying the delivery of care. B-Their values are not reflected in the decision making. C-All systems reflect the values of efficiency and effectiveness. D-There are no conflicts between cost-effectiveness and respectful care. - -*A-All systems in the managed care delivery model reflect the values of efficiency and effectiveness* Different plans may have different values underlying the delivery of care. However, they all reflect the business plan values of efficiency and effectiveness. Their values are reflected in the decision making and the policy development of the organization. Value conflicts between cost-effectiveness and respectful care may be seen. A nurse in the infection prevention and control program is conducting an assessment of infection control practices. The nurse is evaluating the infection control actions taken on the unit for a client with a decreased white blood cell count. Which of the following infection control practices does the nurse consider most important for this client? A-Diligent adherence to aseptic technique B-Using antimicrobial soap when providing care C-Requesting prophylactic antibiotic treatment D-Implementing respiratory isolation procedures - -The client in this scenario is neutropenic, which places the client at risk for contracting an infection. All measures of aseptic technique must be used to protect the client. The other options do not provide complete protection for the client. Basal metabolic rate (BMR) - -the energy needed to maintain life-sustaining activities for a specific period of time at rest Resting energy expenditure (REE) (aka resting metabolic rate) - -amount of energy that an individual needs to consume over a 24-hour period for the body to maintain all of its internal working activities while at rest Where is glucose stored? How? What is glycogenolysis? - -liver and skeletal muscle Glycogen Breakdown of glycogen to glucose NSG 232 NSG 232 Carbs Improve absorption of ___ and excretion of __ - -Na; Ca term used when the body forms glucose from non-carbohydrate sources - gluconeogenesis Main issue with proteins being used for energy: - -Not available for tissue breakdown, growth and repair What happens when fats are converted to glucose? - -Ketones When Amino acids are metabolized, the _______ containing part is converted to _________ _and excreted in the urine as _______ - -Nitrogen; ammonia; urea Nitrogen balance reflects - -how well the body tissues are being maintained Proteins are vital to metabolism bc they are precursors to digestive______ and __________ - -digestive enzymes; hormones Proteins act as fluid balance by attracting ______ and regulating fluid balance in the bloodstream - -water Three types of lipids: - -Glycerides, Sterols, Phospholipds Glycerides are considered ______ fats and ____glycerides are most common in food. - -true; tri Cholesterol is Necessary for_______membrane, vitamin ___, _________, and testosterone formation - -cell; D; estrogen Low Density Lipoprotein (LDL), known as ______ fats, Transports ________ to body cells, and are found in diets high in ________fats - -Bad; cholesterol; saturated High density lipoproteins (HDL), known as ______fats, remove ________ from the bloodstream to liver where it is used to produce_____ - good; cholesterol; bile Decreased ability to excrete fluids leads to - -fluid restriction _________ are _______substances present in small amounts in food that are essential to normal________ and in regulating body functions - -Vitamins, organic, metabolism Fat soluble vitamins __,__,__, AND __ are Stored primarily in the _______and adipose tissue. Vitamin ____ can be found in all body tissues - -K, A, D, E. Liver E NSG 232 NSG 232 Functions of minerals include: Help balance _____ - -pH _________is primary source of absorption - -Small Intestine Metabolism - -Metabolism All biochemical reactions within the cells Factors that influence nutrition include - -Developmental stage From infants to elders Includes lactating women Educational level Knowledge of nutrition Socioeconomic Status Ethnicity/culture Religious practices Nursing Process for Nutrition: ASSESSMENT includes, plus physical examination to determine signs of ______or _______ nutrition - -Screening Mini Nutritional Assessment Anthropometry Specific measurements of IBW & BMI Laboratory and Biochemical Tests Albumin, Pre-albumin, Transferrin Dietary History and Health History Drug-Nutrient Interactions GOOD; POOR Nursing Process for Nutrition: PRIORITIES - -Diarrhea, Dysphagia, Lack of education Nursing Process for Nutrition: INTERVENTION; it is most important to identify the ________ of the imbalance, and then provide teaching for pt and families, as well as Check food ________ based on __________ - -etiology; security; income If pt can not have food p.o., options include _________ Nutrition: Deliver liquid nutrition via a tube into the G.I. tract. and ___________ Nutrition: Deliver of nutrition intravenously - -enteral, parenteral Enteral nutrition is the __________ method. Risks include: - -Enteral; aspiration, infection, diarrhea, metabolic disturbances, alteration in drug absorption and metabolism. NSG 232 NSG 232 Enteral feeding tubes include the NG, or _______ and NE, or ______. Less than ___ weeks preferred. - -Nasogastric, nasoenteric. 4 weeks. Enteric Feedings greater than 4 weeks ___________ gastrostomy tube (PEG) ____________ tube - -Percutaneous, jejunostomy Lab values to be tracked with Enteral feedings - -Lab values (glucose, BUN, & electrolytes) For parenteral feedings, there are two options: _______________ or (PPN) Can take some of their nutritional intake orally IV nutrition is supplemental AND _________________ or (TPN) Require total resting of GI tract Extensive burns or trauma, severely malnourished... - -Partial Parenteral Nutrition; Total Parenteral Nutrition With TPN, ______ _______ labs are monitored because most contain insulin. They must be prepared under strict _________ techniques bc they are ideal mediums for bacterial growth. Change frequently bc of this. - -Blood Sugar Aseptic TPN is 10% - ____% concentration of ________ in water along with amino acids and vitamins. - -50%, dextrose In evaluating a client's response to nutrition therapy, whic