PNE141 Unit 5 Exam
A nurse is discussing dietary needs with a client. The client states, "I usually eat one or meal meals per day from a drive-through restaurant. I know it's not the best diet, but I take a vitamin every day." What response should the nurse make?
"A vitamin won't replace poor eating habits. Let's find ways to improve your overall diet."
adults' expected urinary output
0.5 mL/kg/hr
A healthy weight-loss plan consists of losing ____________ per week.
1-2 lbs
daily protein required range
2 and 6½ ounces
A healthy adult should consume no more than _________________________ of salt, per day.
2,300 mg of sodium, or a teaspoon
How many calories a day does the average person consume.
2000
For example, suppose a client is 5 feet 4 inches (64 inches total) and weighs 170 lb. Based on the client's height and weight, the BMI is______________________-
29.17, which puts this person in the overweight category.
Angle at which the bed should be elevated for tube feedings
30o to 45o
Carbohydrates should make up __________ of total daily calories
45% to 65%
% daily value low vs high
5% or less is low, 20% or more is high
a weight loss of just _________________________can improve blood pressure, blood glucose, and cholesterol levels.
5% to 10% of total body weight
BPH is so common that it is thought to occur in ______ of males older than _____ years of age.
90%; 80
saturated fats
A fat that is solid at room temperature and found in animal fats, lards, and dairy products.
urinary urgency
A strong desire to urinate.
fiber
A tough complex carbohydrate that the body cannot digest; improves bowel movements, lowers cholesterol, improves blood glucose levels, and decreases caloric intake
foods and beverage, which are known to increase the risk of diarrhea
Alcohol Caffeinated beverages and foods Dairy (milk, cheese, cream, and ice cream) Foods that are high in fat or are highly greasy Beverages that contain fructose Spicy foods Apples, peaches, and pears Products that contain sweeteners, such as sorbitol, mannitol, xylitol, and maltitol
Silent aspiration
Aspirating food or fluids without coughing or choking and later developing pneumonia or other conditions
What can occur due to high cholesterol
Blockages in arteries and veins
Vitamin K
Blood clotting and bone health; Spinach, liver, butter, kale, parsley
Fluoride
Bone and teeth development
Vitamin D
Bone and teeth development, absorption and metabolism of calcium and phosphorus; Fish oil, milk, eggs, dairy products, *sunlight
Electromyography
Calculates electrical impulses of the nerves and muscles of the bladder and sphincters
Vitamins
Carbon-based organic micronutrients that promote health and support optimal functioning of the body.
Thiazide diuretics
Chlorthalidone Hydrochlorothiazide Metolazone Indapamide
Chin-tuck position
Client holds the chin down to the chest while swallowing Narrows the airway's entrance to decrease aspiration risk
Stress incontinence
Coughing, sneezing, laughing, or physical activity that increases pressure on the bladder, resulting in urine leakage.
Selenium
Defense against oxidative damage
Upper GI series
Evaluates for nausea and vomiting, abdominal pain, difficulties with swallowing, unexplained weight loss, cancerous growths, and injuries to the esophagus, reflux, hernias, scarring, or ulcers
Potassium
Fluid balance, muscle function, and nerve transmission; Bananas, fruit, legumes, whole grains
Sodium
Fluid balance, nerve transmission, muscle contraction; Salt, soy sauce, processed foods, meats
glycemic index
Food's ability to raise the blood glucose level
Phosphorus
Healthy bones and teeth, assists with acid-base balance; Eggs, fish, poultry, milk
Overflow incontinence
Incomplete bladder emptying that results in the bladder overfilling when full, leading to urine leakage.
A nurse is caring for a client who is scheduled for an upcoming procedure with sedation. Which of the diets should the nurse expect the provider to prescribe?
NPO
Bladder Scanning
Noninvasive technique used to measure residual volume. Uses an ultrasound device to determine the volume.
Zinc
Normal growth, wound healing, and immune function
Nutritional Supplements
Not FDA regulated While vitamins are readily available, some supplements contain herbs, amino acids, minerals, enzymes, and other components. Supplements are also available in many forms, such as capsules, gummies, powders, drinks, food, and tablets.
Parenteral nutrition
Nutritional intake through the veins, given when a client's GI system does not function.
Stomach
Organ that holds food and uses acids and enzymes to digest food
rectum
Storage area for feces at the end of the large intestine.
calorie density
The number of calories a food contains related to its volume or weight.
Loop diuretics
Torsemide (Demadex) Furosemide (Lasix) Bumetanide
Water-soluble vitamins
Vitamins that are carried to the tissues of the body but are not stored in the body Ex: vitamin C and vitamin B complex
dark yellow or amber color urine can indicate
a need to increase fluid intake
clean catch urine specimen
a urine specimen obtained by cleaning the genitalia and then capturing a midstream urine sample for laboratory analysis
After change-of-shift report, which patient should the nurse assess first? a. Patient with a urethral stricture who has not voided for 12 hours b. Patient who has cloudy urine after orthotopic bladder reconstruction c. Patient with polycystic kidney disease whose blood pressure is 186/98 mm Hg d. Patient who voided bright red urine immediately after returning from lithotripsy
a. Patient with a urethral stricture who has not voided for 12 hours
diverticulitis
an inflamed pouch or sac forms as a result of stool becoming trapped.
Macrominerals
any of the minerals that people require daily in amounts over 100 mg
Common times to check blood glucose levels
before or after meals or exercise, prior to going to bed, during times of illness, with the start of new medications, or when the client's daily routine changes.
body's primary fuel source
carbohydrates
Rectal Tube
devices placed into the rectum to prevent incontinent clients from soiling themselves
peritoneal dialysis
dialysis in which the lining of the peritoneal cavity acts as the filter to remove waste from the blood
esophagus
hollow tubular organ located in the neck and chest that connects the mouth to the stomach
Manifestations of Crohn's disease
iarrhea, abdominal pain or cramping, weight loss, anemia, fatigue, fever, joint pain, nausea, and painful bumps under the skin
In a healthy person, urine is...
ight-yellow color, clear, and without cloudiness
peritonitis
inflammation of the peritoneum
What is the primary function of the urinary tract
primary function is to convert and remove excess waste and fluids from the body in the form of urine
Vitamins aid in
promoting healthy vision, bones, and skin
Bristol Stool Chart diarrhea
types 5 to 7
If not addressed, urinary retention can cause
urinary tract infections, bladder damage, kidney damage, and urinary incontinence.
Urine Culture
used to evaluate urine for the presence of bacteria and yeast that may cause a UTI
Naturally occurring carbohydrates can be found in
vegetables, fruits, milk, nuts, grains, legumes, and seeds
starches occur naturally occur in
vegetables, grains, and beans
ureteroscopy
visual examination of the ureter
Bacteria within the large intestine continue to break down any remaining nutrients and produce
vitamin K
Placement of the NG tube must be verified by _______________ prior to its use.
x-ray
Inadequate Nutrition Indicators
○ weight○ teeth○ hair○ skin○ brain○ digestion○ immune system
The maximum amount of urine the bladder can hold
2 cups
Food remains in the stomach for...
2 to 8 hours
Nutritional labels
A product label that shows serving size and nutritional value
Eppiglottis
A small flap of cartilage; prevents food and liquid from entering the airway, but allows them to continue into the esophagus
Urge incontinence
A strong need or urge to urinate, but leaking occurs before the client gets to the toilet.
factors that can increase the risk of altered urinary and bowel elimination patterns
Age, sex, medications, and psychological stress due to lack of privacy
Vitamin A
Bone formation, vision, tooth formation, immune function, cellular function; Fish liver oil, beef liver, dairy products, green leafy vegetables, sweet potatoes
Supraglottic swallow
Client swallows food/liquid while holding the breath, which protects the airway, and then coughs immediately after to remove any residual food Steps include holding the breath, putting food/liquid in the mouth, swallowing up to three times while holding the breath until the food/liquid is mostly cleared, then coughing any residual out
Tilting of the head to the strong side
Client tilts the head to the strong side to push food down that side
Rotation of the head to the affected side
Client turns the head to the affected side, which directs the food to the strong side
Endoscopic retrograde cholangiopancreatography (ERCP)
Diagnoses problems associated with pancreatic and bile ducts such as gallstones, infections, pancreatitis, and pancreatic masses
clear liquid diet
Diet consisting of only liquids that are clear and offers little daily calories and nutrients. Foods that can be seen through, such as gelatin, can be included on a clear liquid diet, as well as foods that partly or completely melt at room temperature
soft diet
Diet containing foods that are soft, easy to digest, low in fiber, and easy to swallow without difficulty.
Renal Diet
Diet for individuals with kidney disease that limits intake of sodium, potassium, and phosphorus.
dysphagia
Difficulty swallowing.
_______________ are more likely to develop urinary retention (why)
Males; due to an enlarged prostate
Cystometric test
Measures bladder capacity, or the amount of fluid or pressure inside the bladder as it is filling, and its final capacity when the urge to urinate begins
Leak point pressure measurement
Measures bladder pressure when the bladder begins to leak
Postvoid residual measurement
Measures the amount of urine left in the bladder after voiding
Uroflowmetry
Measures urine speed and volume
warfarin
Medicine that thins the blood to prevent blood clots.
Identify the correct order in which food or liquid contents are transported through the gastrointestinal tract.
Mouth esophagus stomach small intestine large intestine anus
S/S IBS
abdominal pain, bloating, mucus in the stool, and incomplete bowel emptying.
A female patient with a suspected urinary tract infection (UTI) is to provide a clean-catch urine specimen for culture and sensitivity testing. To obtain the specimen, the nurse will a. have the patient empty the bladder completely; then obtain the next urine specimen that the patient is able to void. b. teach the patient to clean the urethral area, void a small amount into the toilet, and then void into a sterile specimen cup. c. insert a short sterile "mini" catheter attached to a collecting container into the urethra and bladder to obtain the specimen. d. clean the area around the meatus with a povidone-iodine (Betadine) swab and then have the patient void into a sterile container
b. teach the patient to clean the urethral area, void a small amount into the toilet, and then void into a sterile specimen cup.
LDL cholesterol
bad. low density lipoprotein. low protein, high fat
Sources of protein
beans, soy, nuts, meats, eggs, and fish.
Nocturnal enuresis
bedwetting Common in children but may occur in adults who have consumed too much alcohol, who consume caffeine at night, or who take certain medications.
The large intestine contains billions of ________________________
beneficial bacteria
insulin is made in
beta cells in the islets of Langerhans, which are located in the pancreas
Urinary Tract Infections
bladder infections caused by bacteria entering the urinary tract.
High phosphorus levels can increase the risk for
bone disease, as calcium is pulled from the bones. This increases a client's risk for fractures.
When a patient's urine dipstick test indicates a small amount of protein, the nurse's next action should be to a. send a urine specimen to the laboratory to test for ketones. b. obtain a clean-catch urine for culture and sensitivity testing. c. inquire about which medications the patient is currently taking. d. ask the patient about any family history of chronic renal failure
c. inquire about which medications the patient is currently taking. (dipstick evalustion-reagent strip, that contains several chemical colors for testing. is quickly placed into the urine, then removed and placed on its side on a clean surface and observed for changes in the various chemical colors; used to determine the acidity or pH level of the urine. They may also assess for urine concentration and the presence of protein, glucose, ketones, bilirubin, leukocytes, nitrites, and blood.)
WOC nurses
certified through the Wound Ostomy and Continuous Nurses Society (WOCN) post graduate certification
Fecal Occult Blood Test
checks stool for the presence of blood
retention enema
client to retain the fluid for a minimum of 15 to 30 minutes depending on the type of solution instilled before being expelled by the client
To support brain health
clients should consume a diet with adequate omega-3 fatty acids. Eating flax seed, walnuts, fish oil, and wild salmon increases omega-3 intake and can help prevent feelings of fatigue and loss of memory or concentration
Starch and fiber are both___________________
complex carbohydrates
Diverticulitis
condition in which small sacs or pouches form in the colon
pureed diet
consists of foods that are soft and smooth and do not need to be chewed
igh-calorie-dense foods
consumes more calories with a smaller or equal portion size of that of a low-calorie-dense food. For example, French fries are a high-calorie-dense food: More calories are consumed per serving
A hospitalized patient with possible renal insufficiency after coronary artery bypass surgery is scheduled for a 24-hour urine test. Which item will the nurse need to obtain? a. Urinary catheter c. Cleansing towelettes b. Sterile specimen cup d. Large urine container
d. Large urine container (urine is collected over a 24-hour period, placed in a special container, and refrigerated)
Expected urine production tends to ___________with age
decrease
Urine
extra fluid and waste the body no longer needs
urinary tract consists of t
he kidneys, ureters, bladder, and urethra.
regular diet
healthy foods coming from all of the food groups, such as fruits, vegetables, grains, protein, and dairy sources
Interventions to treat constipation
high-fiber diet, staying well hydrated, exercise, bowel training, and medications to soften stools
Urostomy
ileal conduit; a surgically created diversion that uses part of the small intestine. Once a section of the small intestine is removed from the GI tract, it is repositioned with one end attached to the ureters, and the other attached to the wall of the abdomen, where a stoma is created to allow urine to pass into a pouch attached to the abdominal wall cutaneous ureterostomy; ureters are attached directly to the stoma.
continent cutaneous reservoir
imilar to the neobladder, but is placed in the abdomen rather than the pelvis
changes in lifestyle that are often linked to aging that can affect bowel movements
inactivity, decreased fluid and fiber intake, and ingestion of medications such as some antihypertensive and antacids.
Common digestive issues
include diarrhea, constipation, nausea, vomiting, abdominal pain, gas, and bloating
pyelonephritis
inflammation of the kidney and renal pelvis
Older clients may need _______ calories depending on their activity level
less
laxatives
medications or foods given to stimulate bowel movements
Glucose
primary sugar found in the blood. It comes from food ingested by the individual and is the body's major source of energy.
Fats to avoid
saturated and trans fat
Rapid-acting insulin
starts to work in 15 minutes, peaks in 1 to 2 hours, and has effects that last 2 to 4 hours.
stool culture
test for microorganisms present in feces
Digestion
the act of the body breaking down food into simple substances that are either absorbed by the bloodstream as nutrients or eliminated by the body as waste
gain weight in a healthy manner
the client should aim at increasing muscle or bone mass. While attempting to gain weight, nutrient-rich foods should be preferred over empty-calorie ones. As with weight loss, gaining weight should be a steady process to avoid unnecessary complications.
nutritional value is determined by
the impact it has on the body
Kidney Failure
the loss of 15% of expected kidney function. Risk factors for kidney failure include diabetes, hypertension, cardiac disease, and a family history of kidney problems.
cystoscopy
the visual examination of the urinary bladder using a cystoscope
A nurse is instructing a client how to collect a fecal occult blood test. Which of the following responses by the client indicates understanding? "I will make sure to hold my Vitamin C supplements." "I will collect a sample that has a little blood." "I will smear the stool with a cotton swab." "I will collect three samples and then call the nurse."
"I will make sure to hold my Vitamin C supplements." False positive fecal occult blood results occur due to a client's intake of certain foods (red meat, broccoli, turnip greens), medications (ibuprofen and aspirin), and vitamins (vitamin C). If the client informs the nurse they will avoid vitamin C supplements when collecting a sample, that is an indication of understanding the nurse's instruction. Waiting to collect a stool sample with blood is not the proper procedure. Occult blood, by definition, is "hidden" blood. The client will be given two separate tongue blades to smear the stool samples to avoid contamination. Cotton tip applicators should not be used. Unless otherwise indicated, the client should inform the nurse when the test is collected to ensure transport to testing location.
A client asks a nurse why a fecal occult blood test is necessary when they have not experienced any bleeding when they have a bowel movement. Which of the following responses from the nurse best answers the client? "I will need to check your chart again." "This is a test we do on all clients your age." "The physician ordered it based on your recent blood work." "Sometimes we can't see blood in the stool."
"Sometimes we can't see blood in the stool." The fecal occult blood test is a diagnostic tool used to identify the presence of unseen blood in stool. The testing reagent reacts with the stool yielding a positive (blue color) or negative reaction. The nurse can check the chart again; however, it is not the best answer given the choices, and it would diminish the client's trust in the nurse's care. FOBT are not used as a screening tool at this time. While blood work such as blood count and hematocrit may be factors, this answer does not answer the client's question as to why the test is necessary if they have not experienced bleeding with a bowel movement.
USDA, daily dietary intake for adults
2 cups of fruit, 2½ cups of vegetables, 6 ounces of grains, 5½ ounces of protein, and 3 cups of dairy products.(varies based on age, gender, and activity level)
How many units are needed to prime an insulin pen
2 units
A nurse is calculating total calories for a client. The client ate two servings of chips at 150 calories per serving. The client also ate half a serving of a turkey sandwich, with one serving being 600 calories. How many calories has this client consumed?
600 calories
Constipation
A condition in which the client has infrequent bowel movements and the stool is hard, lumpy, and difficult to pass. Common causes of constipation are immobility, a lack of fluid intake, some medications (e.g., opioid drugs), and impaired neurologic functioning.
Mendelsohn maneuver
A form of the supraglottic swallow Client swallows, holds the swallow for 2-3 seconds, completes the swallow, and then relaxes
Insulin
A hormone produced by the pancreas or taken as a medication by many diabetics
A nurse is caring for a client who is at risk for aspiration. Which of the following actions should the nurse take to prevent aspiration during meals?
Allow extra time for the client to chew and swallow each bite of food Sit the client up at 90° prior to providing the meal
Potassium-sparing diuretics
Amiloride Triamterene Spironolactone eplerenone
Water
An essential nutrient that makes up more than half of the body weight and is required by systems in the body to function properly.
medications and other dietary supplements that can slow gastric motility and cause constipation
Antacids Anticholinergics and antispasmodics—medications used to treat muscle spasms Antiseizure medications Calcium channel blockers—medications used to primarily treat elevated blood pressure Diuretics—which increase urine production Iron supplements—used to treat certain forms of anemia Anti-Parkinson disease medications Narcotic pain medications—used to treat pain Antidepressants
full liquid diet
Diet of liquids, foods that are considered liquids, and foods that turn into liquids at room temperature.
Before getting clients positioned to eat consider the following questions
Do they need to use the restroom? Have they washed their hands? Are their dentures in place? Are their hearing aids in place and turned on? Are the surroundings free of clutter?
assistive devices
Equipment or tools that help a client perform daily tasks easier.
Fats
Essential nutrient that help the body absorb vitamins while providing energy.
Lower GI series
Evaluates for bleeding, changes in bowel habits, chronic diarrhea, unexplained weight loss, abdominal pain, cancer, diverticula, fistulas, polyps, or ulcers.
Upper GI endoscopy
Evaluates the esophagus, stomach, and upper intestine after unexpected findings such as persistent heartburn, bleeding, nausea and vomiting, pain, issues with swallowing, unexplained weight loss, ulcers, cancer, precancerous conditions, celiac disease, narrowing of the esophagus, or blockages.
Flexible sigmoidoscopy
Evaluates tissue that may be swollen or irritated for ulcers, polyps, or cancer
How often placement of a feeding tube should be checked
Every 4 hours
anus
External opening of the rectum where feces is removed from the body.
Vitamin E
Fight infection, healthy red blood cells; Almonds, wheat germ, sunflower seeds, spinach
Findings associated with urinary retention
Findings associated with urinary retention
signs that can indicate a person is not getting proper nutrition in their daily diet
Fluctuations in a person's weight, teeth, hair, skin, brain, digestion, and immune system can all be driven by poor nutrition.
Chloride
Fluid balance and stomach acid; Salt, meats, soy sauce, processed foods
A nurse is caring for a client who has a percutaneous endoscopic gastrostomy (PEG) tube, and the enteral feeding has completed infusion. Which of the following actions should the nurse take?
Flush the tubing with 30 mL of water. All enteral tubes must be flushed at the end of the feeding (bolus or infusion). This is to be sure the enteral feeding formula does not remain in the tube. Enteral feeding formula that remains in the tube may harden or congeal to the tubing and cause clogging or occlusion of the tube for administration of additional feedings or medications. In addition, the water is used to maintain the client's fluid and electrolyte balance.
A nurse is caring for a client who is scheduled to receive a bolus feeding via the nasogastric (NG) tube. The nurse checks the pH of the gastric contents and the result is a 6.5. Which of the following actions should the nurse take?
Gastric pH is a reliable method to verify the placement of the NG tube. A result of 6.0 pH or above may indicate that the NG tube is not in the stomach. To reduce the risk of aspiration to the client, the nurse should hold the feeding and recheck the gastric pH. If the pH is higher than 6.5 again, the feeding should be held, the provider notified, and an X-ray done to confirm NG placement.
Which type of infection can result if a urinary tract infection is left untreated? What are the manifestations of this common urinary system infection? How is it commonly treated? Who is more likely to develop this infection?
If left untreated for too long, a urinary tract infection (UTI) can result in a kidney infection or pyelonephritis. Symptoms of a UTI include burning or painful urination and frequent urgency or need to urinate, despite not having a lot of urine to excrete. UTIs are commonly treated with antibiotics. Females are more likely to develop UTIs.
total parenteral nutrition
Intravenous liquid nutrition that makes up all of a client's nutritional intake.
peristalsis
Involuntary muscle contractions that occur throughout the digestive system that move food along the pathway to be digested.
Copper
Iron metabolism; Legumes, whole grains, organ meats, water
nephrolithiasis
Kidney stones, also called renal calculi, nephrolithiasis, or urolithiasis, are hard formations of minerals that collect in the kidneys. Stones that become stuck cause severe pain and bleeding, and can obstruct the flow of urine. Kidney stones are more likely to develop in males than in females, as well as in clients who have had kidney stones in the past or who have a family history of kidney stones.
Place the following organs in the correct order in which they produce and transport urine along the urinary tract. Ureters urethra kidneys bladder
Kidneys ureters bladder urethra Understanding the order of stops along the urinary tract will help the nurse comprehend all its major components, and critically think about how a disease process can affect each part along the urinary tract.
Thickened liquids
Liquids that are thickened using powder or gel to help prevent aspiration for those with dysphagia. can be mildly thick, like nectar; moderately thick, like honey; or extremely thick, with a pudding consistency
Sulfur
Located in protein molecules; Eggs, meat, fish, legumes
_______________________ may lead to issues such as urinary leakage, urinary incontinence, or urinary retention, which is expected with ageing
Loss of tone of the bladder
carbohydrates
Macronutrient that provides the body's cells, organs, and tissues with the energy they need to function.
Magnesium
Muscle contraction, immune system health, nerve transmission; Legumes, green vegetables, seafood
Special diets
NPO (an abbreviation of a Latin term meaning "nothing by mouth"), regular, soft, pureed, liquid, cardiovascular, and renal.
Magnesium
Part of several enzymes; Nuts, some fish, brown rice, avocado, spinach, and bananas
Nasogastric Decompression
Patients w/intestinal obstruction. Suction is applied to relieve abdominal distention. Obstruction can be mechanical (tumors, adhesions, fecal impaction) or functional (paralytic ileus) Assess Bowel sounds, tube placement, ab girth.
Functional incontinence
Physical inability to reach the toilet in time. This may be due to a physical impairment such as being wheelchair bound or having arthritis of the hands, which can hinder the fine motor skills needed to unbutton clothing.
A nurse is reviewing a client's diet. The client states they eat potatoes with most meals. What information should the nurse provide the client about the glycemic index?
Potatoes have a high glycemic index. Potatoes, white bread, and processed snack foods have a high glycemic index. This means that they increase the body's amount of blood glucose quickly compared to foods with a low glycemic index causing the blood sugar to spike. This can cause grogginess as the provided energy is not sustainable/ long acting.
heart-healthy diet
Promotes cardiovascular health through controlling portion, eating a varied diet, and watching sodium intake.
Vitamin C (ascorbic acid)
Promotes iron absorption, wound healing, bone formation, and immune function; found in Brussels sprouts, citrus fruits, spinach, berries, tomatoes, potatoes
Calcium
Proper function and structure of teeth and bones, muscle function, blood pressure regulation; Milk, milk products, broccoli, leafy greens, legumes
Diet modifications that can help prevent aspiration in the client who has dysphagia
Providers may prescribe thickening of liquids with gels or powders, as thinner liquids are easier to aspirate
Blood glucose
Provides energy to the cells in the body, primary sugar in the body that is made from foods eaten.
A nurse is caring for a client who has a prescription for a clear liquid diet prior to having a colon exam the following morning. The client requests red gelatin with the next meal. The nurse tells the client they cannot have red gelatin but offers gelatin of other colors. What is the nurse's reasoning for responding this way?
Red-colored foods can be confused with a postprocedure bleed and should be avoided prior to procedures. Avoiding red-colored foods before any procedure is important so that the nurse can distinguish between a bleed and the food coloring after the procedure. This decreases any confusion during the procedure and postprocedural care.
liver
Removes toxins from the blood and produces bile, which breaks down carbohydrates, proteins, and fats
Colonoscopy
Screening procedure for colon or rectal cancer; can also be used to evaluate for causes of GI bleeding, changes in bowel habits, abdominal pain, and unexplained weight loss
pelvic floor muscles
Separate the pelvic cavity from the perineum. Support organs of pelvis; helps to support the urethra
vaginal pessary
Soft, removable device that goes in your vagina that supports/protects areas
Examples of supplement interactions with medications include
St. John's wort can decrease the effectiveness of medications including birth control, cardiac medications, and antidepressants. Vitamin K reduces the effectiveness of warfarin, an anticoagulant, which can increase the risk of blood clots. Antioxidant supplements, including vitamin C and E, can reduce the effectiveness of chemotherapy.
Partial parenteral nutrition
Supplies a client with part of their nutritional requirements allowing for supplemental oral intake.
Why is susceptibility testing so important for the proper treatment of a UTI?
Susceptibility testing is used to determine which specific antibiotic can eradicate the infectious organism causing the UTI. This also prevents antibiotic resistance by ensuring the right treatment for the right organism.
Video urodynamic test
Takes pictures and video of the bladder while it is filling and emptying
net carbs
The amount of carbs counted toward consumption after taking away the amount of fiber and sugar alcohols in a food.
urination
The process of the elimination of urine through the urethra and out of the body
gastrointestinal tract
The stomach and intestine as a functional unit.
trans fat
The type of fat produced when manufacturers add hydrogen to the fat molecules in vegetable oils.
Urinary Catheterization
This flexible tube can be placed into the bladder through the urethra or through a surgically created opening in the lower abdomen to allow urine to drain
Iodine
Thyroid regulation
food frequency questionnaire
Tool used to determine a client's typical food consumption based on a list of foods.
A nurse is reviewing how to calculate net carbohydrates using a food label with a client who has diabetes mellitus and is starting to use an insulin pump. What should the nurse include in this review of calculating net carbohydrates?
Total carbs per serving alcohol sugars dietary fiber
_____________ can also occur if supplements are taken in excess.
Toxicity; For example, increased levels of iron can lead to nausea and vomiting while risking damage to the liver. Excess vitamin A can cause headaches, lead to birth defects, and decrease bone strength.
Potential complications of urinary diversions
UTIs, as well as kidney infections and skin complications; may cause depression and raise concerns about what life will be like after the placement
Briefly explain the difference between urinary incontinence and urinary retention.
Urinary incontinence (UI) is a common bladder control problem that affects the retention, or holding, and releasing of urine from the bladder. In clients with a vagina, it can occur as a result of pregnancy, with increasing pressure on the pelvic floor, or it can occur later in life as a result of the loss of pelvic floor muscle tone. In clients with a penis, it can occur as a result of an enlarging prostate constricting the flow of urine from the bladder, which then causes incomplete bladder emptying and later urinary leaking asucite. Urinary retention is a condition in which the bladder is not able to fully empty. Health problems such as prostate enlargement or a cystocele (prolapsed bladder) can prevent urine from leaving the bladder fully. This condition can be acute or sudden, or it can develop over time and be a chronic problem asucite. Clients with a penis are more likely to develop urinary retention due to an enlarged prostate.
Reflex incontinence
Urinary leakage as a result of nerve damage.
To protect clients from tube feeding aspiration nurses should perform
Verify the initial tube placement with an x-ray before initial use. Check the tube placement every 4 hours by checking the pH of the gastric contents. Check the client's tube feeding tolerance every 4 hours by measuring the residual.Follow the facility policy for residuals greater than 250 mL. Maintain the head of the bed at 30° to 45° during feeding. Maintain the head of the bed at 30° to 45° for at least 1 hour following bolus feedings.
Trace Mineral
Vital to health, required in the diet in amounts >100 mg per day
Iron
Vital to the transport of oxygen throughout the body; Organ meats, red meats, leafy green vegetables, iron-fortified foods
fat-soluble vitamins
Vitamins that do not dissolve in water but instead are dissolved in fats; after consumption, are stored in the liver and fatty tissues for later use.
unintentional weight loss
Weight loss of 5% of body weight over a 6-12 month period that is not intentional; the cause should be identified, as the client may have an undiagnosed health issue that requires treatment
Aspiration
When solids or liquids enter the lungs during inhalation.
small intestine
Where food is broken down and the majority of the nutrients are absorbed
fasting blood glucose
a blood glucose level that is taken after a client has been NPO for at least 8 hours. the expected reference for a fasting blood glucose level for a client who does not have diabetes is less than 100 mg/dL. A blood glucose level of less than 140 mg/dL after eating 2 hours prior is considered within the expected reference range.
Cystostomy
a catheter is inserted directly into the bladder and attached to a drainage bag outside the client's abdomen.
encopresis
a childhood disorder characterized by repeated defecating in inappropriate places, such as one's clothing
Crohn's disease
a chronic disease that causes inflammation in the GI tract, but it also commonly affects the small intestine
The balance maintained between caloric intake and energy expenditure directly affects...
a client's ability to lose or gain weight.
nutritional assessment includes
a collection and review of the client's dietary habits to determine if all of the necessary nutrients are being consumed and if there are any health issues related to the client's nutritional intake.
BS with mixed bowel habits (IBS-M)
a combination of both diarrhea and constipation elimination throughout the day
bladder
a hollow, balloon-shaped muscle that stores urine
Urinalysis
a lab test commonly used by health care providers to evaluate for a variety of disorders, including bladder infections or UTIs, kidney infections, kidney disease, and diabetes; includes visual examination of the urine, dipstick testing, and microscopic examination
Parenteral nutrition, in the form of IV fluid, is administered into
a large vein through a venous access device
body mass index (BMI)
a measure of body weight relative to height; The client's weight is first divided by their height, and then this calculation is repeated once more. This number is then multiplied by 703 to obtain the client's BMI.
Adequate nutrition is evident by
a person's physical appearance, weight, and other measurements such as blood pressure and cholesterol levels.
Ileostomy
a temporary or permanent fecal diversion that uses the terminal end of the small intestine, called the ileum.
Irritable bowel syndrome (IBS)
a term used to describe abdominal pain and changes to bowel elimination patterns that can include diarrhea, constipation, or a mixture of both
nasogastric (NG) tube
a thin plastic tube that is inserted into the nostril and down the esophagus, with the end placed in the stomach. It is primarily used to provide nutrition and medication to a client, but can also be used to remove contents from the stomach in the event of a client ingesting a harmful substance, poison, or too much medication.
nasojejunal (NJ) tube
a thin, soft tube that is inserted through the nostril and stomach, ending in the jejunum of the small intestine. NJ tubes are used for clients who are unable to consume enough nutrition, cannot tolerate foods and liquids in their stomach, or have delayed gastric emptying.
fecal impaction solution
a warm mineral oil enema can be used to loosen the stool and allow for its manual removal. If a complete obstruction has occurred that cannot be cleared, surgery may be needed.
A patient is admitted to the emergency department with possible renal trauma after an automobile accident. Which prescribed intervention will the nurse implement first? a. Check blood pressure and heart rate. b. Administer morphine sulfate 4 mg IV. c. Transport to radiology for an intravenous pyelogram. d. Insert a urethral catheter and obtain a urine specimen.
a. Check blood pressure and heart rate.
Which medication taken at home by a patient with decreased renal function will be of most concern to the nurse? a. ibuprofen (Motrin) c. folic acid (vitamin B9) b. warfarin (Coumadin) d. penicillin (Bicillin C-R)
a. ibuprofen (Motrin)
Findings that may indicate the need for medical intervention for altered bowel elimination
abdominal pain and cramping with the inability to pass stool or only passing liquid or very thin segments of stool that are able to move around the impaction.
urinary retention
abnormal accumulation of urine in the bladder because of an inability to urinate
added sugars
added to foods during processing, packaged as sweeteners, sugars from concentrate, and syrups or honey; are included in the total sugars count
Clients who have dysphagia or are at risk for aspiration should receive a referral for
an evaluation by a speech therapist. for a swallowing evaluation
J-Pouch
an internal pouch formed with the ileum. This internal reservoir connects to the anus after removal of the rectum and colon; instead of passing through the colon and rectum, it directly passes through the anus during a bowel movement
Urodynamic testing
any procedure that evaluates how the bladder, sphincters, and urethra are holding and releasing urine
Effective urine production in adults
approximately 1.5 to 1.8 liters daily
Calories
are the energy that is stored in food; they are used to support processes of the body such as walking, breathing, and running
Maintaining NPO status prior to surgery or procedures helps to protect the client from _______________ while under sedation
aspirating
the pancreas, liver, and gallbladder secrete digestive enzymes into the small intestine to
assist with the breakdown of carbohydrates, fats, proteins, and vitamins
The nurse completing a physical assessment for a newly admitted patient is unable to feel either kidney on palpation. Which action should the nurse take? a. Obtain a urine specimen to check for hematuria. b. Document the information on the assessment form. c. Ask the patient about any history of recent sore throat. d. Ask the health care provider about scheduling a renal ultrasound
b. Document the information on the assessment form.
A 79-yr-old patient has been admitted with BPH. What is most appropriate to include in the nursing plan of care? a. Limit fluid intake to no more than 1000 mL/day. b. Leave a light on in the bathroom during the night. c. Ask the patient to use a urinal so that urine can be measured. d. Pad the patient's bed to accommodate overflow incontinence
b. Leave a light on in the bathroom during the night. benign prostatic hyperplasia-noncancerous condition that causes constriction to the urethra, increasing urinary retention.; more likely to develop impaired urinary patterns
Water promotes
brain function, hydrates and flushes out wastes from the body, regulates body temperature, and acts as a lubricant in the body
A diet with adequate protein intake helps prevent
brittle hair and hair loss. Assessing the condition of a person's hair and skin can give an indication of their nutritional status.
A patient passing bloody urine is scheduled for a cystoscopy with cystogram. Which description of the procedure by the nurse is accurate? a. "Your doctor will place a catheter into an artery in your groin and inject a dye to visualize the blood supply to the kidneys." b. "Your doctor will insert a lighted tube into the bladder, and little catheters will be inserted through the tube into your kidney." c. "Your doctor will insert a lighted tube in the bladder through your urethra, inspect the bladder, and instill dye that will outline your bladder on x-ray." d. "Your doctor will inject a radioactive solution into a vein in your arm, then the distribution of the isotope in your kidneys and bladder will be visible."
c. "Your doctor will insert a lighted tube in the bladder through your urethra, inspect the bladder, and instill dye that will outline your bladder on x-ray."
Glucose monitoring
can be done at the bedside by obtaining a capillary blood sample and testing it using a glucose meter. This skill can be performed by an RN, PN, or trained AP, according to facility policy
low-calorie-dense foods
can consume a larger amount of the food without adding calories while still feeling full. Fruits and vegetables are good examples of such foods: They are low in calories but have a high volume, so more can be eaten without adding unnecessary calories
tap water enemas
cause a shift of fluids in the body and can cause water toxicity and circulatory overload. Therefore, tap water enemas should not be used more than once in adults. Tap water enemas should not be used in infants and children.
IBS with constipation (IBS-C)
ccurs when most of the daily bowel movements are hard or lumpy
Food is broken down into smaller, easy-to-digest parts by
chewing and mixing digestive enzymes
Ulcerative colitis (UC)
chronic disease that causes inflammation and ulcerations of the large intestine or colon; Manifestations of UC include diarrhea with blood or pus, abdominal discomfort, fatigue, nausea, fever, and anemia.
Diarrhea
condition in the client experiences frequent loose, watery stools throughout the day. It can be acute, lasting about 1 to 2 days; persistent, lasting longer than 2 weeks but less than 4 weeks; or chronic, lasting longer than 4 weeks
Protein
considered the major building block of the body, as it provides amino acids that the body needs to build and repair muscle.
bladder neck
consists of an internal sphincter (the second muscle), which holds urine inside the bladder
To assess whether there is any improvement in a patient's dysuria, which question will the nurse ask? a. "Do you have to urinate at night?" b. "Do you have blood in your urine?" c. "Do you have to urinate frequently?" d. "Do you have pain when you urinate?"
d. "Do you have pain when you urinate?" (dysuria-Pain or discomfort with urination often due to infection or injury)
The nurse assessing the urinary system of a 45-yr-old patient would use palpation to a. determine kidney function. c. check for ureteral peristalsis. b. identify renal artery bruits. d. assess for bladder distention
d. assess for bladder distention
Common manifestations of not getting enough water
dehydration; dark urine, feeling thirsty, dry skin, and headaches
Enteral nutrition
dietary intake via a medical device such as a feeding tube. Enteral feedings are prescribed for clients who do not have adequate oral intake or nutrition that can meet their metabolic needs.
What does the human digestive system enable
enables the organs and tissues in the body to receive the nutrients they need to function
CONDOM CATHETER
external catheter that has an attachment on the end that fits over the penis; also called a Texas catheter
Risk factors for IBS
family history, female gender, stressful events, infection within the GI tract, digestive disorders, anxiety, depression, and fibromyalgia.
UTIs are more common in __________
females (at higher risk due to having shorter urethras than males)
Daily intake of fiber
females should be 25 g per day, while men should aim to get 38 g per day
In adults, diarrhea symptoms that require medical follow-up
fever of 102°F or higher, diarrhea lasting longer than 2 days or six or more bowel movements a day, abdominal pain, or the presence of blood or black feces.
List unhealthy foods to avoid and/or limit.
foods with added sugar and salt, and those with trans fats
serving size
found on the nutritional label indicates the number of servings in the package; The serving size represents the amount of the food or drink that people usually consume; it is not a recommendation of how much people should consume
signs of dehydration
frequency of urination, urine that is very concentrated or dark colored, sunken or recessed eyes, or depressed fontanelles (soft spots on the head) in children. Decreased skin turgor
Commonly encountered simple carbohydrates
fructose (fruit sugar), sucrose (table sugar), and lactose (milk sugar)
Fiber is found in
fruits, vegetables, beans, and whole grains
Nutrient requirements are based on
gender, age, and activity level
HDL cholesterol
good. high density lipoprotein. high protein, low fat
Kock Pouch
he surgeon forms an internal pouch with a valve, so that intestinal contents do not escape the ileostomy. To empty the pouch, a catheter is placed through the ileostomy stoma, and the contents are drained
Nutrients are vital to
help disease prevention, promote growth and health, and provide nourishment
Why should Clients who have kidney disease limit their intake of potassium
high potassium levels can lead to heart dysrhythmias and increase the risk of myocardial infarction
Macronutrients
include protein, carbohydrates, and fat, and are eaten in large amounts. They provide the body with the energy it needs to function and are the primary building blocks of any diet.
Micronutrients
include vitamins and minerals; only small amounts of these nutrients are required in the diet.
Which organs are included in the process of digestion
includes the mouth, esophagus, stomach, liver, gallbladder, pancreas, small intestine, large intestine, rectum, and anus
If a client is experiencing hypoglycemia, the goal of treatment is
increase the blood glucose level back to the expected reference range. This is accomplished by providing the client with food that contains at least 15 g of carbohydrates—for example, 4 ounces of soda or juice, 1 tablespoon of honey, or 5 to 6 hard candies. The client's blood glucose level should then be rechecked 15 minutes later, and this process repeated until the blood glucose level is above 70 mg/dL. The provider should be notified if the interventions to increase the client's blood glucose level are unsuccessful.
Foods with a high glycemic index
increase the body's blood glucose level rapidly Ex:potatoes, white bread, and processed snack foods
Foods that have a lower glycemic index
increase the body's blood glucose level slowly, without spiking it, leading to stabilized energy without a feeling of sluggishness. Ex: legumes, vegetable, fruits, and whole grains
diuretics Affects on Urine Production
increase urination by increasing urine production in the kidneys. These medications work to rid the body of excess fluid and salt, primarily to reduce blood pressure, but also to treat conditions such as heart failure and edema. Three categories of diuretics are widely used: thiazide diuretics, loop diuretics, and potassium-sparing diuretics.
risk of peptic ulcer disease, especially in clients who take aspirin or other nonsteroidal anti-inflammatory (NSAID) drugs is _____________________ with age
increased
nasoduodenal tube
inserted into the nasal passage, with the tip placed past the stomach and in the duodenum. Nasoduodenal tubes are used primarily for feedings—namely, for clients needing long-term enteral feedings or who require total or supplementary feedings and for whom gastric feeding is not appropriate.
Enema
instillation of a liquid solution through the anus to relieve constipation or cleanse the bowel in preparation for diagnostic testing, procedure, or surgery
cleansing enema
instilled and retained for a few minutes and then expelled by the client
fecal incontinence
involuntary or inappropriate passing of stool or flatus
BMI categories
less than 18.5 is considered underweight, while a BMI of 18.5 to 24.9 is considered normal (or healthy). A BMI of 25 to 29.9 is overweight, and a BMI of 30 or greater is categorized as obese
Gastrointestinal Tract organs
liver, pancreas, gallbladder, the mouth, esophagus, stomach, small and large intestines, and anus, make up the gastrointestinal (GI) tract.
hypoglycemia
low blood sugar; occurs when the blood glucose level is less than 70 mg/dL
Healthy eating patterns include
maintaining a balanced diet daily, watching caloric intake, and consuming the necessary amounts of nutrients.
Dark brown color urine
may be a sign of dehydration and kidney or liver issues;
red tinted urine
may be caused by blood in the urine
Minerals
micronutrients that help the body develop and function normally; they include iron, zinc, and calcium
simple sugars
monosaccharides and disaccharides (rapidly change into sugars causing spike in blood sugar)
Which type of fat can lower cholesterol
monosaturated fats
Healthy fats
monounsaturated fats; nuts, olives, olive oil, seeds, and avocados. These types of fat can lower cholesterol while decreasing the risk for heart disease.
neobladder
new bladder; a reservoir surgically created from a piece of bowel;
IBS with diarrhea (IBS-D)
occurs when most of the daily bowel movements are loose and watery
Colostomy
part of the colon is used to form a stoma through the abdominal wall, allowing for the passage of body waste
24-hour recall
performed to see what the client has consumed in the last 24 hours, including different foods and portion sizes
If manifestations of aspiration are noted, nurses should....
place the client on NPO status and notify the provider immediately.
Before the meal arrives...
position the client upright in a chair, sitting at 90°, to prevent aspiration. If the client is unable to sit in a chair, raise the head of the bed to 90° and use pillows as support.
Constipation can affect all age groups, but is more common after
pregnancy, in older adults, in clients who consume little to no fiber, in clients who take certain medications, and in clients who have GI disorders.
Overt aspiration
presents with noticeable symptoms such as sudden cough, wheezing, trouble breathing, congestion, heartburn, throat clearing, or chest discomfort, as the body recognizes a foreign object going into the airway and attempts to clear it
pancreas
produces insulin, a hormone that regulates the metabolism of sugars
production of feces begins
production of feces begins
Understanding the physiology of digestion, the importance of healthy eating patterns, and the nutritional value of food allows the nurse to.....
promote appropriate nutritional intake for clients.
A balanced diet
provides the body with the nutrients that are needed for proper functioning
FEMALE EXTERNAL CATHETER
purewick; connected to wall suction to pull urine into a drainage canister.
Long-acting insulin
reaches the bloodstream several hours after injection and has effects that last up to 24 hours without a peak.
large intestine
responsible for removing water and electrolytes from the remaining food particles for the body's use and converting the rest into feces
NPO diets
restricts the client from eating or drinking anything until the diet is advanced; Nurses should clarify with the provider if the NPO status extends to medications as well
gallbladder
sac-like organ that stores the bile produced by the liver and releases it when needed
urinary incontinence and urinary retention can lead to other health problems, such as
skin breakdown.
Complications of Fecal Diversion
skin irritation; stoma issues such as hernias, prolapse, or narrowing; blockages; diarrhea; bleeding; electrolyte imbalances; infections; and leaking.
Where does food move to once done in the stomach
small intestine
Healthy bowel elimination
soft but formed stool that is easy to pass without straining.
Intermediate-acting insulin
starts to work in 1 to 4 hours, peaks at 4 to 12 hours, and has effects that last from 12 to 24 hours.
Colostomy irrigation
sterile water is inserted into the colon via the stoma site. This acts as a type of bowel training, helping to prevent passage of stool at other times and reducing the client's need to wear a colostomy pouch.
surgically created opening
stoma or ostomy
Medical conditions that put a client at increased risk for aspiration
stroke, acid reflux, mouth sores, and dental issues
The digestive system turns carbohydrates into
sugar
Regular or short-acting insulin
tarts working in 30 minutes, can peak from 1 to 5 hours, and has effects that last 3 to 7 hours.
hemodialysis
the process by which waste products are filtered directly from the patient's blood
fecal impaction
the prolonged retention and buildup of feces in the rectum; This extreme form of constipation happens more often in clients who are immobile or have a nervous system injury.
Older adult clients can also be prone to unintentional weight loss and dehydration due to changes in_______________
their senses of smell and taste or decreased appetite related to medications. Problems with chewing and swallowing food can also make it difficult for some older adults to eat a healthy diet.
ureters
thin tubes of muscle that carry urine from the kidneys to the bladder
Total sugars
those that naturally occur in foods
Ureteral Stent
to allow passage of urine when a ureter is blocked. This can happen for many reasons, such as obstruction from a stone or mass, postoperative scar tissue, or inflammation and swelling from an infection.
Nephrostomy
tube drains urine directly from the kidney into an external pouch; usually performed following the removal of kidney stones. This type of diversion is usually temporary and is removed once the kidney has healed.
Alterations in vital signs such as decreased oxygen saturation and increased heart rate, blood pressure, and respiratory rate, along with audible wheezing, are manifestations of
tube feeding aspiration
urethra
tube leading from the urinary bladder to the outside of the body
gastrostomy tube (G-tube)
tube placed through the abdomen directly into the stomach and used to provide nourishment
kidneys
two bean-shaped organs located below the ribcage, each adjacent to the spine. The kidneys are very efficient and can filter 120 to 150 quarts of blood daily. They also convert waste products and excess fluid into urine to be removed from the body. During this process, approximately 1 to 2 quarts of urine is produced each day.
Bristol Stool Chart constipation
types 1 and 2
Bristol Stool Chart ideal stools
types 3 and 4