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Test four

Terms in this set (90)

Priority Patients
Patients who need immediate care and transport.
Priority Patients
#1 airway #2 breathing #3 circulation
Stoma Care for Clients with an Ostomy
-Normal stoma should appear red and may bleed slightly when touched
-Assess the peristomal skin for irritation each time the appliance is changed
-Treat any irritation or skin breakdown immediately
-Keep skin clean by washing off any excretion and drying thoroughly
-Protect skin, collect stool, and control odor with an ostomy appliance
When do you alert dr if stoma is abnormal?
Necrotic tissue (blue or black skin)
Total parental nutrition
The intravenous feeding of all necessary nutrients, including the most basic forms of protein, carbohydrates, lipids, vitamins, minerals, and electrolytes.
Who should receive TPN?
Critically ill, cancer patients, malnourished
Where is TPN located?
Central Vein (within the neck)
Should the TPN ever be stopped?
No, it runs 24 hours. DO NOT STOP. Call dr before stopping
anorexia nervosa
an eating disorder in which an irrational fear of weight gain leads people to starve themselves
bowel-training program
A program of timing bowel movements and then scheduling toileting to promote a regular evacuation time
How to train bowel movements?
When they need to go, take them ASAP. Before and after meals. Q2 hours
Why do we use TPN?
To deliver total nutrition to people who cannot get nutrition by eating (aids, cancer, IBD, terminally ill, burn pts)
Who is most susceptible to UTIs
Elderly
urinary output
1500 mL/day
Osteoporosis
a condition in which the bones become fragile and break easily
diarrhea
frequent passage of loose, watery stools
Stoma Care for Clients with an Ostomy
-Normal stoma should appear red and may bleed slightly when touched
-Assess the peristomal skin for irritation each time the appliance is changed
-Treat any irritation or skin breakdown immediately
-Keep skin clean by washing off any excretion and drying thoroughly
-Protect skin, collect stool, and control odor with an ostomy appliance
Probiotic uses
Promotes healthy gut bacteria, can be taken in conjunction with antibiotics
Folic Acid Food Sources
meats, legumes, leafy green vegetables FOCUS ON GREEN VEGGIES
Post op surgery
Focus on GI/GU
GI assessment- presence of gas (ask pt if they're passing gas), listen for active bowel sounds

NPO- nothing by mouth
Swallow study/ food tolerated/ introduce food in stages
What is patient given first after surgery?
Clear liquid
What is a clear liquid diet?
anything that is clear or see through.
ex. Bouillon, fat-free broth, grape, apple, cranberry juice. fruit drinks, popsickles, gelatin, tea, coffee, ginger ale, lemon-lime soda, supplemental formulas. and HARD CANDY
full liquid diet
Anything with dairy
Oatmeal, milk, ice cream ect
Soft diet and mechanical soft diet
soft in texture and consists of soft or chopped foods that are easier to chew and swallow

Mac and cheese, potatoes, oatmeal
full diet/regular diet
Any foods (not many restrictions)
What is the purpose of dietary fat?
Heat, protection, increases flavor, helps make food appetizing
risks of diarrhea?
dehydration & electrolyte imbalance
3 way foley
3rd port used for irrigation of bladder after TURP
Why do we use 3 way Foley's?
Getting rid of blood clots (men-enlarged prostates)
What vitamin is missing when someone has anemia?
Lacking b12
diet for heart disease
Low sodium& low fat (also called heart healthy)
Diet for diabetic
Consistent carbs (too many will increase blood glucose and too little will drop blood glucose)
Why would someone have a reduced protein diet?
Liver or kidney failure
Fat soluable vitamins?
A, D, E, K
Water solvable vitamins
B and C
What is BMI?
body mass index
Underweight BMI
<18.5
Overweight BMI
25-29.9
Obese BMI
over 30
Morbidly Obese BMI
greater than 40
nasogastic tube
a feeding tube that is inserted through the nose and into the stomach
NG tube interventions
Liquid meds, liquid diet
How to check NG tube placement
X-ray
NG tube placement
xray to confirm proper placement, monitor NG output (color and amt), monitor nasal skin around tube, monitor tubing for kinks & "plugs", continue to assess BS's and abdominal girth, pain, **aspirate contents & irrigate the tube w/ 30 mL of NS q 4 hrs or as ordered by hcp


ACSESS BOWEL SOUNDS AND LISTEN FOR WHOOSH AFTER AIR INSERTED
Residual FL during feeding (NG Tube)
Check contents with syringe, access bowel sounds, if more than 30cc hold feeding for 1 hr and call dr
Do NG tube (nasogastric) and Gtube (stomach) have the same interventions and feeding standards?
Yes- same interventions
Who is at risk for urinary retention?
Men with enlarged prostate
(Turks procedure-3 way foley )
What is the turks procedure?
3 way foley
What is the purpose of the 3 way foley?
Eliminate blood clots
Who is at risk for uti?
Elderly and patient with foleys
What to access with patients who have foleys?
The need for it EVERY single day
The ins/outs
Empty when half full
Inspect color and smell of urine
Anuric
not producing urine(water)
2 types of incontinence ?
Urge & stress
What is stress incontinence?
The loss or leaking of urine during exercise, sneezing, laughing, coughing, or when lifting something heavy.
What is urge urinary incontinence?
Leakage of large amounts of urine at unexpected time, including during sleep

LISTENING TO RUNNING WATER
What should be encouraged when someone is incontinent?
Encourage Kegals

In older adults- schedule bathroom breaks
What is the #1 effector or urinary problems?
Renal failure
How do I collect urine from a Catheter?
Place Needle( syringe) in aspiration port and pull back
bowel-training program
A program of timing bowel movements and then scheduling toileting to promote a regular evacuation time
What may be included in bowel training program?
Digitally remove stool, laxative daily
When someone appears to have bladder retention what should be done?
PVR
What causes constipation?
Meds(Narcotics)
Surgical procedures
Immobility
Lack of fiber
how to help with constipation
Stool softener, increase fiber and fluids
paralytic ileus
-causes bowel obstruction
What medication to give more diarrhea?
Imodium
Who's at risk for constipation OR bowel obstructions?
Surgical pt
Immobile pts
Elderly
ulcerative colitis
chronic inflammation of the colon with presence of ulcers
fecal impaction
the prolonged retention and buildup of feces in the rectum
Osteoporosis
A condition in which the body's bones become weak and break easily.
Osteoporosis treatment(dietary)
Calcium and vitamin D supplements
Increased weight-bearing exercise
Maramus
A widespread human protein deficiency disease caused by a diet low in calories and protein or imbalanced in essential amino acids.

FIRST YEAR OF LIFE
Kwashiorkor
protein deficiency
What is the most essential nutrient?
water
How much weight should infants gain by first year?
Double by 6 months triple by first year
What should infants diet consume of?
Breast milk or formula
Who is most at risk for inadequate nutrition?
Elderly
Why are the elderly most at risk for inadequate nutrition?
Loss of partner, diminished taste buds, ill fitting dentures, contractures
What does breast milk give babies that formula doesn't?
Antibodies
What vitamins are vegans lacking?
Vitamin D
What vitamin are alcoholics lacking?
Thiamine
Is a diet a drs order?
Yes
Goals of diet therapy
To treat and manage disease.
To prevent complications and restore health.
What should you access before feeding patient?
Are they safe? Are the positioned sitting straight and upwards?

-sit with pt to make their meal pleasant
Anorexia Bulimia
Binge eating followed by purging (throwing up) food
Why percent of patients aspirate with no signs?
More than 50%
Where is a gastronomy tube placed?
Stomach
signs of hyperglycemia (high blood sugar)
excessive thirst, excessive hunger, excessive urination
TPN patients are at risk for glucose instability
...
What should be checked on TPN patients first?
Blood glucose- finger stick
Fecal impaction treatment
digital rectal disimpaction
Increase fluids and fiber
Fiber
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