Assessment
Correct order of abdominal assessment
inspect, auscultate, palpate
Test that determines if there is blood in stool
Fecal occult, or guaic test
Organs in the RUQ
Liver, gallbladder, duodenum, head of pancreas, hepatic flexure of the colon, part of ascending and transverse colon.
These medication contribute to weight gain. (list at least 3)
Corticosteroids, estrogen, NSAIDS, antihypertensives, antidepressants, antiepileptics, some oral antidiabetics
When should the initial nutritional assessment be completed?
within 24 hours of admission
High-pitched bowel sounds that are proximal to an obstruction
Borborygmus
Labs that determine pancreatic dysfunction. (there are 2)
Lipase and amylase
Labs that indicate a problem with the pancreas, and the name of the disease process
Amylase/Lipase=pancreatitis
Elevated blood glucose=diabetes
Acronym for assessment of obese patients
RESPECT: Create Rapport in an Environment that is Safe. Ensure their safety and Privacy, Encourage them to set realistic goals, provide Compassion and use Tact in conversation
Signs and symptoms of nutritional deficiencies. (need a minimum of 4)
Hair, eyes, GI tract, Skin, Musculoskeletal, Hematologic, Neurologic, Cardiovascular
Socioeconomic influences on nutrition (need at least three)
limited budget, lack of access to fresh foods and vegetables, lack of transportation, lack of education.
Labs that assess nutrition and their interpretation. (minimum of 3)
Hgb-Iron intake and absorption, oxygen carrying capacity, Electrolytes-Neuro and cellular function, Albumin-long-term protein, Cholesterol-cell wall building, HgbA1c-longterm glucose control, pre-albumin-short term nutrition
Action to be taken if a bruit is heard over the aorta
Notify the provide and DO NOT palpate or percuss
Non-surgical interventions for weight loss (minimum of 4)
Diet programs (fasting, low calorie, nutritionally balanced, unbalanced low-energy)
Nutrition therapy
Exercise programs
Drug therapy
Cryolipolysis
Behavioral management
Complementary and integrative health
Interventions for malnutrition. Include 4
Meal managment (environment, comfort, function, feeding schedule), Nutritional supplements, medications, total enteral nutrition, partial parenteral nutrition, total parenteral nutrition
Aging changes (need at least 3)
decreased peristalsis, decreased hydrochloric acid (absorption of Iron and B12), pancreatic duct change (decreased fat digestion), decreased liver function (drug toxicity), disrupted microbial balance (impairs immunity)
Priority assessments after endoscopy. Must include 2
Ability to swallow, vital signs, ability to take in adequate fluids
Central obesity is a major risk factor for these diseases. Must identify 3
CAD, brain attack (stroke or TIA), type 2 diabetes, colon/breast cancer, sleep apnea, early death
Post-operative priorities for surgical management of obesity
Airway management (vent semi-fowlers position), scd's, patient and staff safety, monitor for gastric anastamosis leak (signs of peritonitis), pain control, 1 ounce of clear liquids at a time.
Interventions for total enteral nutrition, (at least 5)
insert correct feeding tube, ensure placement prior to feeds, secure tube, check and document residual q6 hours, give correct solution at correct rate with correct water, label cans, keep head up 30 degrees, watch for complications, diarrhea , document, monitor weight
Questions for a GI health history. (must have at least 8 questions)
-food intake, n/v/d, appetite, weight change, vitamins/supplements, special diet, teeth/dentures, heartburn/gerd, GI surgeries, family history, smoking, chewing tobacco, elimination pattern, have you traveled, laxative use, bleeding with BM's, changes in BM pattern
Teaching priorities after colonoscopy. (Must include at least 3)
Don't drive, mild discomfort/cramping is to be expected, report severe abdominal pain, report dizziness, light-headedness, rest remainder of the day post-procedure
The names of the three common forms of protein-calorie malnutrition
Marasmus, Kwasihiorkor, Starvation
Dumping syndrome: signs and symptoms, interventions
S/SX: tachycardia, nausea, diarrhea, and abdominal cramping, needing to lay down.
Small meals, low fat, low sugar, no liquids with food
Interventions for TPN (at least 5)
Central line, watch for FVO, check electrolytes, monitor BGM and give sliding scale insulin, if bag runs out hang D10 or D20, change lines q24 hours, daily weight, change dressing q48-72 hours