Exam (elaborations)
ATI NUTRITION CHAPTER 10, 11, 13, 14, 16, 17
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ATI NUTRITION CHAPTER 10, 11, 13, 14, 16, 17
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ATI NUTRITION CHAPTER 10, 11, 13, 14, 16, 17When is parenteral nutrition used? - Answers-when the GI tract is non-functional or
patient cannot consume sufficient nutrients orally or enterally.
total parenteral nutrition (TPN) - Answers-- nutritionally complete solution
- used for pt w/ high caloric needs (burns, cancer, bowel disorders, critically ill)
-long term therapy
-administered via a central vein
-hypertonic solution >10% dextrose
How do you know that PN is being effective? - Answers-Pt. weight gain up to 1kg/day
BUN is 10-20 mg/dL
albumin levels increase 15-36mg/dL
How does a cracked TPN solution look like? - Answers-oily appearance or layer of fat at
the top of the solution, increase in calcium and phosphorus
-Discard or return to the pharmacy
-DON'T USE!!!!
What happens if the infusion rate is too fast? - Answers-- diarrhea
-dehydration
-hypovolemic shock
-seizures, coma, death
What should the nurse do when it comes to PN bag? - Answers-- allow it to cool at room
temp for 1 hr before administering
- change bag and tubing every 24 hours
-maintain sterile technique when changing central line
- use pump to prevent overload of solution
-make sure there is no CRACKING!!!
What are some potential complications to PN? - Answers-- infection and sepsis (fever,
inc WBC)
- fluid overload (weight gain > 1kg/day)
-dehydration
-hypo/hyperglycemia
-refeeding syndrome
What is refeeding syndrome? - Answers-body rapidly changes from catabolic
(starvation) to anabolic
this leads to electrolytes imbalances (seizures, confusion, shallow resp, cardiac
dysrhythmias)
When transitioning back to eating, what diet should the patient start off with? - Answers-
clear liquids that are low in fat or do not cause GI irritation
, What if a bag for TPN is not available, what do you do? - Answers-Administer 20%
dextrose in water IV until the next bag is available
How is poor nutrition a barrier to dentition? - Answers-- cavities, teeth loss which make it
difficult to chew
-difficult to adjust to dentures
peripheral parenteral nutrition (PPN) - Answers--nutritionally incomplete
-short term therapy
-fewer calories/day
-isotonic solution
-client is unable to consume enough calories to meet metabolic needs or nutritional
support is needed for a short time
-<10% dextrose and <5% a.a.
What allergies should you be concerned about for PN? - Answers-soybean, safflower,
eggs
What is included in Parenteral nutrition? - Answers-electrolytes, trace minerals, amino
acids, dextrose, vitamins
Electrolytes, lipids, vitamins, and trace elements can be added... - Answers-depending
on clients blood chemistry
Nursing care for poor dentition - Answers--use fluoridated toothpaste
-school screenings to help with referral process
-limit processed carbs because they stick to the teeth and can cause plaque build up
How is low socioeconomic status a barrier to adequate nutrition? - Answers-- lack of
money to buy food or no transportation
- tend to buy more processed foods, canned and boxed foods
-can lead to obesity or malnutrition
processed foods, canned and boxed foods are high in... - Answers--fat, sodium, and
simple carbs
nursing care for low socioeconomic barrier - Answers-- educate patient on how to read
nutrition labels
-contact social worker about food assistance programs
-frozen fruits and veggies are an affordable option
How do cognitive disorders (Dementia, Alzheimer's) cause a barrier to nutrition? -
Answers-- impaired memory and judgment
- may forget to eat, refuse to eat, or not eat enough
- food shopping, food selection, and food preparation are difficult
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