WGU Nutrition D440 Competed Study Guide
Test with Questions and answers
What is the recommended fluid intake for breastfeeding mothers?
3L/day
What considerations do you need to take when doing nutritional education to clients
of differing religions and cultures?
Consider food restrictions on certain days, certain foods, liquids (alcohol and caffeine),
how the food is prepared (certain foods mixed and how the food is cooked)
What is dysphagia and where is it typically seen?
Difficulty swallowing - chronic, common among patients with Alzheimer's, Parkinson's,
and stroke complications, head and neck cancer, tooth loss, xerostomia,
neurodegenerative, neuromuscular disorders, post-intubation trauma, muscular
weakness of the larynx
What are some behaviors seen in patients with dysphagia?
Reluctance to eat certain food consistencies or any food at all.
-Very slow chewing or eating
-fatigue from eating
-frequent throat clearing
-complaints of food “sticking” in the throat, pockets of food held in the cheeks
-painful swallowing, regurgitation, coughing or choking ---
-silent aspirations.
Adapt the diet to individual needs in stages of thickened liquids and pureed foods
Which consults would you do with a patient with dysphagia?
Registered dietician nutritionist (RDN), Speech-lang`1uage pathologist, Occupational
therapist
TPN
total parenteral nutrition (IV feeding)
,Continuous PN
Infused continuously over 24 hours, most used in a hospital setting
Intermittent or cyclic PN
Nutrient solution infusion regimen varies and is commonly administered overnight.
Allows clients requiring PN on a long-term basis to participate in activities of daily living
during the day without the inconvenience of an IV bag and pump set. Monitor glucose
levels closely to avoid hypoglycemia
Who must assess nutritional status before PN is discontinued?
Evaluation of nutritional status by a nutritionist is done before PN is discontinued
What must be done in order to prevent hypoglycemia when discontinuing PN?
If PN discontinued, gradually decrease the flow rate for 1-2 hours while increasing oral
intake (helps prevent hypoglycemia)
What must you do to site of IV catheter in order to lower the risk of infection?
After removal of IV catheter, daily dressing change until insertion site heals. Being left
in increases risk of infection
What must you do for a patient who had PN removed?
Encourage oral nutrition
Record oral intake, body weight, and laboratory results of serum electrolyte and
glucose levels
What are some complications of PN?
Pneumothorax and air embolism associated with central line placement: air embolism
also associated with tubing changes
Other complications include infection (catheter-related), hypervolemia, and metabolic
alterations such as hyperglycemia and hypoglycemia (usually caused by PN solution)
PEG
percutaneous endoscopic gastrostomy (feeding tube)
Why is a feeding tube needed?
Used when the gastrointestinal tract is functional but oral intake is not meeting
estimated nutrient needs
,What conditions might a client have that will require a feeding tube?
Used for clients with swallowing problems, burns, major trauma, liver, or other organ
failure, or severe malnutrition
When is a PEG tube used?
Placed into stomach by surgeon if patient is not at risk for aspiration
Enteral
Provides liquefied foods into the gastrointestinal tract via a tube
When is enteral used?
Used when the gastrointestinal tract is functional but oral intake is not meeting
estimated nutrient needs
Used for clients with swallowing problems, burns, major trauma, liver, or other organ
failure, or severe malnutrition
___________ feedings preserve gut function and are less invasive and less expensive
than parenteral nutrition. Maintaining some level of gut function helps to prevent
atrophy of the GI tract.
Enteral tube
Types of enteral tubes
nasogastric and nasaljejunal/nasalduodenal
When is a nasal gastric tube used?
If is required for less than 4 weeks, tube is usually inserted into the stomach through
the nose
When is a nasojejunal/nasoduodenal tube used?
If at risk for aspiration, reflux, or continual vomiting.
How is a nasojejunal/nasoduedenal tube placed?
Tube passes through the nose, down the esophagus, through the stomach, and into
the proper location of the small intestine by peristaltic activity, endoscopic, or
fluoroscopic guidance. Use of X-ray to verify placement
What is stomatitis?
, Inflammation of the oral mucous lining of the mouth
What is the treatment/diet for stomatitis?
Eat foods that are soft and east to chew and swallow
Moisten foods with gravy, broth, or sauces
Avoid alcohol and known irritants such as acidic, spicy, salty, and coarse-textured
foods (crunchy foods)
Cook foods until they are soft and tender, or cut foods into small bites
Eat foods at room temperature
Supplement meals with high-calories, high-protein milkshakes or smoothies
Maintain good oral hygiene
Numb the mouth with ice chips or flavored ice pops
Radiation of the head, neck or esophagus
disturbs the oral mucosa and salivary secretions, thereby affecting taste sensations and
sensitivity to food texture and temperature. Resultant anorexia and nausea may
exacerbate malnutrition.
Radiation to the abdominal area
compromises the intestinal mucosa, causing a loss of villi and possibly nutrient
malabsorption. Tissue breakdown may cause ulcers, inflammation, obstructions, or
fistulas, and these conditions interfere with the normal function of the involved tissue.
Dietary choices and physical activity
are the most modifiable risk factors for cancer prevention
What does the American cancer society suggest about your weight in order to prevent
cancer?
Be as lean as possible within normal range of body weight throughout life. Balance
caloric intake with physical activity. Avoid excessive weight gain at all ages.
What does the American Cancer Society suggest about exercise for children and
adolescents in order to prevent cancer?
participate in at least 60 minutes every day of moderate to vigorous physical activity,
with vigorous physical activity included at least 3 days per week.