RNSG 1216 Exam #1 Questions & Answers

Vitamin B12 deficiency - ANSWERScan occur because of low gastric acid Normal BMI - ANSWERS18.5-24.9 Northern heritage health risk - ANSWERS-celiac -type 1 diabetes Feeding the patient key points (7) - ANSWERS1) Food allergies 2) ID patients diet 3) elevate head of bed 4) oral & hand hygiene 5) observe for dysphagia 6) record meal 7) record liquid Diet as tolerated - ANSWERSsolid/balanced diet -normal/ regular diet Clear liquid - ANSWERS-inadequate in energy -DON'T use more than 24 hrs -usually given after surgeries -coffee (NO cream NO milk) -broth (NO noodles) -tea -fruit juice -gelatin - 7up/ sprite -popsicles Full liquid - ANSWERS-these diets are HIGH in fat and HIGH in cholesterol -they are liquid a room temperature -used for patients having difficulty swallowing/chewing solid foods OR patients w/gastrointestinal problems -CAN supply adequate nutrition -milk, butter, yogurt, strained soup, Ensure, honey, juices w/pulp, ice cream, all sodas. Mechanical soft - ANSWERS-varies based on type of dysphagia -patients w/ difficulty chewing/ swallowing -ground meats, soft cooked veggies, anything chopped/ground/mashed, butter, honey, cream Diabetic diet - ANSWERS-controls type and amount of calories - eat foods like; beans, high fiber foods, wheat pasta, nuts. - *avoid* starch, sugar, simple carbs Cardiac diet - ANSWERS-low in sodium -low in cholesterol -eat foods like: almonds, fish, chicken, veggies, walnuts, fruit - *avoid* high cholesterol, animal products, soups, pickles, lunch meats Renal Diet - ANSWERS-kidney friendly -foods like: grapes, cherries, red bell peppers, salmond, any berry fruit, olive oil, cauliflower - *avoid* : potassium, sodium, protein, phosphorus Pureed Diet - ANSWERS-blenderized food - mostly food for the elderly - usually long term - *avoid* : nuts, seeds, eggs Thickened Liquids - ANSWERS- for patients likely to aspirate *Consistency* Nectar: straw, drunk Honey: no straw, drunk Pudding: no straw, not drunk The nurse enters the patient's room w/ the patient's soft diet. The first action the nurse should do is: - ANSWERSCheck the patient's arm band When the patient is finished with meal time the nurse should: - ANSWERS-Record the patient's fluid intake, and % of meal eaten The nurse knows an example of foods allowable on a Full liquid diet would be: - ANSWERS- Jell-O, Boost, and chocolate ice cream The nurse knows the best diet for a patient with chronic kidney disease is: - ANSWERS-Salmon patties cooked in olive oil, steamed cauliflower, and cranberry juice Common Intake - ANSWERSFoods: -juice, soup, ice cream, popsicle, jell-O, ice chips (is 1/2 of what water is measured) Medical: -IV fluids, IVPB's, Unit of Blood, liquid meds Common Output - ANSWERS-urine, stool, perspiration, vomitus, NG suction, colostomy, urostomy, jackson pratt, chest tube, dialysis, surgery, bleeding, dressings, venipunctures Nursing I&O - ANSWERSIntake - Output = Excess *needs to be mL* in 24 hrs or 30 mL per hr Risk factors of Poor Nutritional Status - ANSWERS-weight that's 20% higher or 10% lower than normal -Cancer, diarrhea, inflammation, postOP, infection/ draining wound, burns, major trauma -alterations in chewing, swallowing, taste, smell -Body temp more than 37C for more than 2 days -NPO for more than 3 days/ IV feedings Assisting at Mealtime (before) - ANSWERS-ask about allergies -identify patient/ check meal ticket make sure its for the correct patient -position patient in bed at 90 degrees or have them sit in a chair -ask if patient has passed gas w/o nausea. Listen to all 4 quadrants of the abdomen for bowel sounds. -assist with dentures/hand hygiene/ mouth hygiene -make patient tuck chin and swallow - inspect mouth for abrasions/ redness -have them sip water see if they have no trouble *NOTE* thicker liquids are easier to swallow *if patients are at a HIGH risk for aspirating use a pulse oximeter. *Avoid mixing textures* *place 1/2 to 1 teaspoon of food in mouth with it touching tongue Assisting at mealtime (during) - ANSWERS-feed slow - coach on chewing skills "chew, swallow, take your time" -if has one sided weakness be sure to place the spoon in their stronger side -assess for pocketing in cheeks -give liquids throughout meal -make sure to minimize distractions (turn down tv) *NOTE* if patient has vision problems visualize the plate as a clock (ex. fish is at 3 o'clock, potatoes are at 9 o'clock) Assisting at mealtime (after) - ANSWERS-have patient remain at 45 degrees for at least 30 minutes after a meal -help with oral/hand hygiene -assess the amount of meal eaten as a % for intake (0, 25, 50, 75, 100) -also record their beverage intake in mL Medical asepsis - ANSWERS-perform hand hygiene -keep table surfaces clean and dry - keep solutions tightly capped -Don't leave bottled solutions opened for prolonged periods of time -Discard any item that touches the floor -Use personal care items for each patient