NURS 1512 - Week 4 Exam Questions With Complete
Solutions
Communication and documentation
- Document in patient's electronic health record (EHR) or chart
the type of diet, amount of feeding assistance needed, tolerance
of diet and amount or percentage of the meal eaten (e.g., 25% of
food consumed at breakfast) and calorie count (if prescribed).
- If evaluating I&O, record fluid intake on appropriate form
- If patient is receiving oral nutritional supplements (e.g.,
Ensure, Boost), record the amount taken and patient's tolerance
(likes or dislikes, supplements to fill or replace meals) to the
health care team.
- Report any swallowing difficulties, food dislikes, refusal to eat.
Indigenous Peoples in Canada
- Traditional foods are high in animal protein, nutrient-rich, and
low in fat or high in marine sources of fat
- Hunting and gathering food provided an opportunity to
incorporate cultural values and practices
- Many indigenous communities face unique food security
considerations related to the consumption of traditional food
- One-third of Indigenous households located off-reserve are
food insecure due to limited economic opportunities
,Special considerations: pregnancy
- Cooked fish, limiting fish with mercury
- Multivitamin with folic acid and iron
- Dark green and orange vegetables
- Lower fat dairy products and alternatives
Special considerations: Paediatric
- Compare growth charts
- Human milk is preferred for first 6 months.
- As infant ages, provide additional nutrition.
- Do not mix solid foods in a bottle.
Special considerations: Care in the Community
- Instruct about safe handling, preparation, and storage of food
- Assess home environment
- Assess financial resources of patient and family.
- Help patient and family identify ways to make meals in the
home pleasant and enjoyable experiences.
Dysphagia
condition in which swallowing is difficult or painful
inability to coordinate the complex, sequential swallowing
mechanism shows eating, results in food being left in the mouth
and may lead to aspiration
Aspiration Precautions Skill 31-3
Aspiration (misdirection of oropharyngeal secretions or gastric
contents into the larynx and lower respiratory tract)
, Food, water, vomitus, or oral contents may be aspirated.
Aspiration pneumonia can be fatal, especially in older persons.
Assessment of a patient’s risk for aspiration and determination
of positioning cannot be delegated to UCP.
Silent Aspiration
The passage of foods or liquids into the trachea and lungs
without producing a productive cough or other signs consistent
with aspiration.
Symptoms include: lack of speech, depressed alertness, wet
quality to voice, drooling, difficulty controlling secretions, and
absence of gag reflex.
Criteria for dysphagia referral: before referral
If the answer is yes to either of the following two questions,
referral at this time is not appropriate:
- Is the patient unconscious or drowsy?
- Is the patient unable to sit in an upright position for a
reasonable length of time?
What are the next two questions to consider before making a
referral:
- Is the patient near end of life?
- Does the patient have an esophageal problem that requires
surgical intervention?
Solutions
Communication and documentation
- Document in patient's electronic health record (EHR) or chart
the type of diet, amount of feeding assistance needed, tolerance
of diet and amount or percentage of the meal eaten (e.g., 25% of
food consumed at breakfast) and calorie count (if prescribed).
- If evaluating I&O, record fluid intake on appropriate form
- If patient is receiving oral nutritional supplements (e.g.,
Ensure, Boost), record the amount taken and patient's tolerance
(likes or dislikes, supplements to fill or replace meals) to the
health care team.
- Report any swallowing difficulties, food dislikes, refusal to eat.
Indigenous Peoples in Canada
- Traditional foods are high in animal protein, nutrient-rich, and
low in fat or high in marine sources of fat
- Hunting and gathering food provided an opportunity to
incorporate cultural values and practices
- Many indigenous communities face unique food security
considerations related to the consumption of traditional food
- One-third of Indigenous households located off-reserve are
food insecure due to limited economic opportunities
,Special considerations: pregnancy
- Cooked fish, limiting fish with mercury
- Multivitamin with folic acid and iron
- Dark green and orange vegetables
- Lower fat dairy products and alternatives
Special considerations: Paediatric
- Compare growth charts
- Human milk is preferred for first 6 months.
- As infant ages, provide additional nutrition.
- Do not mix solid foods in a bottle.
Special considerations: Care in the Community
- Instruct about safe handling, preparation, and storage of food
- Assess home environment
- Assess financial resources of patient and family.
- Help patient and family identify ways to make meals in the
home pleasant and enjoyable experiences.
Dysphagia
condition in which swallowing is difficult or painful
inability to coordinate the complex, sequential swallowing
mechanism shows eating, results in food being left in the mouth
and may lead to aspiration
Aspiration Precautions Skill 31-3
Aspiration (misdirection of oropharyngeal secretions or gastric
contents into the larynx and lower respiratory tract)
, Food, water, vomitus, or oral contents may be aspirated.
Aspiration pneumonia can be fatal, especially in older persons.
Assessment of a patient’s risk for aspiration and determination
of positioning cannot be delegated to UCP.
Silent Aspiration
The passage of foods or liquids into the trachea and lungs
without producing a productive cough or other signs consistent
with aspiration.
Symptoms include: lack of speech, depressed alertness, wet
quality to voice, drooling, difficulty controlling secretions, and
absence of gag reflex.
Criteria for dysphagia referral: before referral
If the answer is yes to either of the following two questions,
referral at this time is not appropriate:
- Is the patient unconscious or drowsy?
- Is the patient unable to sit in an upright position for a
reasonable length of time?
What are the next two questions to consider before making a
referral:
- Is the patient near end of life?
- Does the patient have an esophageal problem that requires
surgical intervention?
