COMPREHENSIVE STUDY GUIDE FOR INTRODUCTION TO CRITICAL CARE NURSING- EDITION 7

COMPREHENSIVE STUDY GUIDE FOR
INTRODUCTION TO CRITICAL CARE
NURSING- EDITION 7
- ANS>>Chapter06:NutritionalTherapy

b. Fluidandelectrolyteimbalancesandsepsis -
ANS>>1.ApatientishavingcomplicationsfromabdominalsurgeryandremainsNPO.Because
enteraltubefeedingsarenotpossible,thedecisionistoinitiateparenteralfeedings.Whatarethe
majorcomplicationsforthistherapy

d. Topreventaspirationofthefeedings -
ANS>>.Apatientisbeingventilatedandhasbeenstartedonenteralfeedingswithanasogastric
small-
borefeedingtube.Whatistheprimaryreasonthenursemustfrequentlyassesstubeplacement
?

d. Subclavianvein -
ANS>>3.Thepatientistostartparenteralnutrition.Thenurseknowstopreparewhichsiteforcat
heterinsertion?

c. Obtainachestradiograph. -
ANS>>4.Apatienthasbeenadmittedtothecriticalcareunitafterastroke.Afterfailingaswallows
tudy,thepatientisplacedonenteralfeedings.Followingplacementofanasogastrictubefortube
feeding,whatisthenextcriticalstep?

c. theintestinalmucosanormallyreceivesnutrientsfromthestomachinperistalticwaves -
ANS>>5.Apatientsfeedingtubehasbeensuccessfullyplacedinthesmallintestinewithcontinu
ousflowtubefeeding.Thenurseknowsthatthisapproachwaschosenbecause:

Elevatetheheadofthebed30degrees. -
ANS>>6.Apatientisbeingfedthroughanasogastrictubeplacedinhisstomach.Thenursewoul
dcarryoutwhichinterventiontominimizeaspirationrisk?

d. tube feeding intolerance. -
ANS>>7.Apatientwhoisreceivingcontinuousenteralfeedingshasjustvomited250mLofmilky
greenfluid.Thisisaconcernbecausethismostlikelydemonstratesthatthepatienthas:

d. recheck the residual in 2hours -
ANS>>8.Apatientisreceivingenteralfeedingsandhasjustvomited250mLofmilkygreenliquid.
Thenurseholdsthetubefeeding,whichhadbeeninfusingat100mL/
hr.Thenurseknowsthatthenextactionshouldbe:

,a. Abdominal distention -
ANS>>9.Inadditiontoresidualstomachvolume,whatotherevidencesuggestsfeedingintolera
nce?

a. Clostridium difficile -
ANS>>10.Approximately5daysafterstartingtubefeedings,apatientdevelopsextremediarrh
ea.Astoolspecimeniscollectedtocheckforwhichpossiblecause?

b. Infuseantibioticsthroughtheintravenousline. -
ANS>>11.Apatientwithacutepancreatitisisstartedonparenteralnutrition.Thestudentnurseli
stedpossibleinterventionsforthispatient.Whichinterventionneedscorrectionbeforefinalizin
gtheplanofcare?

c. Prealbumin -
ANS>>12.Inevaluatingapatientsnutrition,thenursewouldmonitorwhichbloodtestasthemost
sensitiveindicatorofproteinsynthesisandcatabolism?

d. Phenytoin - ANS>>13.Apatientisreceivingenteraltubefeedingsandhasdevelopeddrug-
nutrientinteractions.Thenurserecognizeswhichdrugashavingthepotentialforcausingdrug-
nutrientreactions?

d. Without nutritional stimulation, mucosal villi atrophy. -
ANS>>14.Whichstatementistrueaboutnormalfunctionofthegastrointestinal(GI)tract?

c. potential for drug-nutrient interaction related to polypharmacy. - ANS>>15.An
important nutritional consideration in the elderly population is:

d. weight loss, elevated glucose, and dehydration -
ANS>>16.Objectivedatadesignatingthatthenutritiongoalsarenotbeingmetinclude:

a. 24hours - ANS>>17.In trauma patients ,enteral nutrition via nasogastric tube feedings
into the small bowel is best initiated within what time frame following the injury?

b. Fiber-addedformula -
ANS>>18.Apatientwithahistoryofemphysema,diabetes,andhyperlipidemiaisinthecriticalc
areunitonaventilator.Thenutritionassessmentnotesthatthepatienthasaproteinandvitamind
eficiencyandisunderweight.Whichformulafornutritionalassessmentismostappropriate?

d. Gut mucosa is preserved. -
ANS>>19.Selectthephysiologicalreasoningbehindenteraltherapyasthepreferredsourceof
nutritionaltherapy

b. The patient with ileitis -
ANS>>20.Thenurseidentifieswhichpatientatgreatestriskformalabsorptionofprotein?

, b. flushthetubeevery4hourswith20to30mLoftapwater. -
ANS>>21.Thebestnursingapproachtopreventfeedingtubeobstructionis:

c. 35kcal/kg/day -
ANS>>22.Patientsexperiencingseverephysiologicalstressincreasetheirnutritionalrequire
mentsto:

b. impairing immune function - ANS>>23.Malnutritioncontributestoinfectionriskby

d. stopsfeedings10to15minutesbeforeplacingflattoobtaintheradiograph. -
ANS>>24.Apatient,whohasatubefeeding,requiresachestx-
raystudyforevaluationofacough.Toreducetheriskofaspiration,thenurse:

a.
Assessingfluidvolumestatusandpreventinginfectionareimportantnursingconsiderations.b.
Fingerstickglucoselevelsareassessedevery6hoursandprn.
d.
Totalparenteralnutrition,withaddedlipids,providesadequatelevelsofprotein,carbohydrates,
andfats. - ANS>>1.Whichstatement(s)abouttotalparenteralnutritionis(are)true?
(Selectallthatapply.)

b. Changethetubingevery24hours.
d. Monitortriglyceridelevels. -
ANS>>2.Whichintervention(s)is(are)criticalduringintravenouslipidadministration?
(Selectallthatapply).

a. are most useful in heart failure and liver disease. - ANS>>3.Calorie-densefeedings:
(Selectallthatapply.)

b. elevatedbloodsugar.
c. infectionatthecathetersite.
d. volumeoverload. - ANS>>4.Risksoftotalparenteralnutritioninclude:(Selectallthatapply.)

a. Amountofparenteralinsulinisadjustedbasedontheprevious24-hourlaboratoryvalues.
b. Insulinmaybeaddedtoaparenteralnutritionsolution.
c. Subcutaneousinsulinisusedonaslidingscaleduringparenteralnutrition. -
ANS>>5.Whichofthefollowingstatementsistrueaboutinsulinandparenteralnutrition?
(Selectallthatapply.)

A.Initiatetubefeeding. B.Insertfeedingtube. C.Flushtubetoverifypatency.
D.Obtainchestradiograph. E.Assessresiduals. ANS: B,D,C,A,E -
ANS>>Thecorrectorderofactionsforapatientstartingenteralnutritionwithafeedingtubeis:__

d. Uncompensated
respiratory
acidosis;