Nursing 114 Test 2 Prep Questions And Answers All Correct

Why is food important in the body? - correct answers •We have to have it to survive • keeps our energy level up • it is our energy/fuel • food provides our body with the nutrients it needs to survive Helps to sustain life Why is fluid important in the body? - correct answers • without fluid, our cells would shrink • we become dehydrated •lubricates our organs Sustains life Assessing Nutritional Status: what constitutes a well nourished patient? - correct answers • alert, oriented • vital signs in normal limits • do they have adequate muscle tone? • are they eliminating properly? • do they have normal elimination patterns? Assessing Nutritional Status: how does the patient get adequate fluid and how much is needed? - correct answers • some patient's are on fluid restrictions but most of the time we get adequate fluid intake by drinking fluid and eating (some foods have water content) • fluid makes up 60-70% of body weight in patient • average fluid intake is around 2,300 ML per day What tells us there is a issue with nourishment? - correct answers • decreases in weight • confusion/ change in mental status • change or decrease in appetite (is it because they didn't like the food, maybe it's because they can't chew properly) • change in their elimination. What assessment findings would make the nurse document and report to the HCP regarding the patient's nutritional status? - correct answers Any time there is a change in nutritional stats the nurse should thoroughly assess and determine the cause, see if you can fix it, document and report to HCP. • wounds may not heal properly if there is poor nutrition Water- basic nutrients - correct answers Makes up 60-70% of total body weight • often as people age their thirst receptors decrease so they may not know they need more fluids. Carbohydrates - basic nutrients - correct answers Main source of energy in diet, "fuel" Rice, potatoes, and bread Proteins - basic nutrients - correct answers Essential for tissue growth, maintenance, and repair. Meat, poultry, fish, eggs Fats- basic nutrients - correct answers Body's form of stored energy Vitamins - basic nutrients - correct answers Water soluble- not able to be stored by the body. (Vitamin C and B complex) Fat soluble- can be stored by body (A,D,E,K) Minerals - basic nutrients - correct answers Calcium and phosphorus are essential for formation of bones and teeth, iron for formation of HGB (hemoglobin)- oxygen carrier of the blood Fluids - correct answers • can be obtained by mouth or parenteral- such as IV or NG • need balance between intake and output (unless you are correcting an output). Ex- If they were dehydrated they would need more intake than output. Output- anything that comes out- urinary, vomiting, drainage/drainage tube measure using the collection device, sweating, burns(can't maintain temperature), excessive diarrhea. Fluids exit the body through the intestines, lungs, skin and kidneys, which is the main source through urination. Who is most at risk for problems with fluid problems? - correct answers Anybody can be but it is usually the very young and very old. Young- won't have enough reserve to be able to combat a drastic change. Problems associated with body fluid - correct answers Dehydration- when the body doesn't have enough fluid. Skin is try, sunken eyes, "tenting" skin when pulled up, normally little to no energy. Edema- when the body retains too much fluid and causes swelling in the extremities, often lower extremities such as legs and feet. During assessment of a bed ridden pt always check sacrum for edema A change in 2.2 lbs/or 1kg - correct answers Is equal to 1 liter of fluid. This is why we weigh our patients daily with fluid issues. Weigh at the same type of day, same scale and same clothing What should we be eating? - correct answers Review food pyramid Types of hospital diets - correct answers •Regular-nutritionally adequate, uses food pyramid as guide. (No restrictions other than allergies) • Soft- easily digestible (avoiding gassy foods) • clear liquids- anything you can see through (tea,coffee,water,broth/bouillon, clear juices, jello and popsicles. • full liquids- all liquids including smooth textured dairy products, cooked cereals and vegetable juices and pudding. • mechanical soft- includes finely ground chopped meats (people with poor dentition) • diet for age- whatever is appropriate for the patients age Ex- infants only consuming breast milk or baby food Vegetarian- diet consists of plant food only and some may allow eggs or milk in diet. Other- high fiber, diabetic, low sodium, low residue etc Religious and cultural practices that may affect diet - correct answers •The nurse should ask what foods the patient must avoid for religious restrictions. • do they need help cutting up food? • must they be prepared differently? (Such as Kosher diet) • some religious and cultural groups are opposed to some proteins such as pork or beef How does illness affect dietary intake? - correct answers Must consider medications the patient is on and how they feel. The medication may be making the patient nauseous or they may not feel like eating because of the illness. - how long have they been on the medication - does it affect their taste? •Short term- most of the time not eating short term won't hurt the patient because most people have "reserves" and will be ok with missing a meal. (Not normally a problem) •Long term illness- extended periods of decreased intake may effect wound healing. The patient may need different forms of intake. They may need a dietary supplement such as a protein shake(must be prescribed by the HCP). They may need IV fluids or and NG tube it they still cannot tolerate nutrition. •Malnutrition- if a patient is/becomes malnourished it will affect healing, their quality of life, the ability to do things on their own and ability to fight infection. They will have no energy, this is a viscous cycle. KNOW- May be given Megase or periactin as an appetite inhibitor Other things that may effect dietary intake. - correct answers •Do they have their dentures in? •Smells- are smells affecting their intake? Is the bedpan/urinal they just used bothering them to where they won't eat? • Promoting and managing patient's nutritional status regarding developmental level - correct answers •Infants- formal and breast milk, adding baby foods along the way. Should educate the parents on only trying 1 at a time and waiting 4-5 days before trying a new one. •Toddlers/preschooler- have more frequent "easy" meals toddlers can carry around and be sure to cut up food that may be a choking hazard. Avoid having more than 24oz of milk on a day. They will avoid other foods if they have too much milk. •school aged- make sure they are eating a nutritionally appropriate diet. Limit snack foods and sodas. •adolescences- this age is when most teens are worried about body image. This is when most eating disorders present (bulimia, anorexia, etc). This is when growth spurts occurs and they begin to eat more. •adult- regular diet unless they have restrictions on sodium or sugar • Pregnant women- should slightly increase calorie intake, and increase iron intake as well because their blood volume is off kilter. Also folic acid • lactation- increase calories • older adults- are they physically able to cook? Do they know how? Can they afford it? Are they able to chew properly? Often times they have decreased taste and don't want to eat because of that How to promote nutritional status - correct answers Patients with physical improvements: Blind patients- set up their food on plate at the pattern of a clock. Teach them independence. Immobilized patient- make sure they have adequate calcium and protein intake. When they are bed ridden calcium will pull from the bones and it will increase the risk for fractures. And prevent bed sores. Swallowing difficulties- increased risk of aspiration, might need speech pathologist to evaluate what type of diet may be appropriate. HOB I'm elevated position and patient sitting up. When they intake instruct to flex head down to close off the esophagus. Sometimes consistency may need to be changes Community resources for patients with decreased financial resources - correct answers •WIC • food stamps • churches • special groups- grocery delivery, soup kitchens • hospitals • consult with a private dietician Psychological significance and eating - correct answers • most people don't like to eat alone- maybe they aren't eating because nobody is there with them. Evaluation - correct answers • why is it important to evaluate pt nutritional status? Fluctuations may occur, we should always be evaluating because their needs can change at any time. • how do we get the patient involved in their care? Ask questions, look for cues See pg in Potter and Perry - correct answers Table on religious aspects- 1063 Table on mini nutritional assessment- 1065 Good sleep habits and rest promote - correct answers •Better health and well being • poor habits increase risk for depression, heart attack, hypertension HNT, and obesity Definition of rest - correct answers Physical and emotional state of decreased muscle and cognitive activity. • May involve total body relaxation or only part of the body • you remain awake and aware of your surroundings when we are "resting" Sleep - correct answers • the progression or repeated cycles of altered consciousness with different phases of body and brain activity •involves the whole body • you are unresponsive to surroundings Sleep is needed to: - correct answers Repair muscles Grow bones Manage hormones And sort memories- memory consolidation occurs during sleep Normal sleep requirements - correct answers Duration and quality vary among persons of all ages •Infants- require 16-18 hours a day to boost growth and development, especially the brain • school age and adolescents- 8-10 hrs a night • adults- 7-9 hrs a night, after the age of 60, nighttime sleep tends to be shorter, lighter, and interrupted by multiple awakenings. Sleep cycles - correct answers • 90 minutes per cycle, slightly increases as we progress • 2 types of sleep: Non-REM- quiet sleep and REM- active sleep • 3 stages of NREM, (80% of our total sleep are NREM) • we progress from N1 to N3 then back to N2 THEN into REM. *time varies over lifespan* Stage 1 NREM (non-rem) - correct answers Very light sleep, happens within the first 5-10 minutes. During this stage you are easily aroused and may have a relaxed and drowsy "floating sensation" Often referred to as the "hypnagogic" stage between wakefulness and sleep Stage 2 NREM - correct answers Light sleep stage: •Increased relaxation •We are still easily aroused and lasts 10-20 minutes • our vitals start to change- we have a decreased pulse, respiratory rate and temperature Thais state of sleep accounts for 50% of our total sleep Stage 3 NREM - correct answers Deepest (delta/slow wave) sleep: • Person is difficult to arouse. • rarely move. • muscles are completely relaxed • 1st episode lasts 45-90 minutes and decreases with subsequent cycles. • this is that stage that sleep walking, talking, snoring, night terrors, dreams and enuresis may occur. Regenerative period- body heals and repairs itself. REM sleep - correct answers Last stage is the sleep cycle: •Very vivid and active dreaming and remembered • happens approx. 90-110 min after sleep has begun. • it is difficult to arouse or make awake spontaneously • durations incre