Nutrition ATI Proctor Focus Review 2019
1) Dysphagia Diet – Nursing Actions
a. Place pt. in high fowler’s or upright position
b. High risk for aspiration
c. Give pt. oral care prior to eating
d. Allow adequate time
...
Nutrition ATI Proctor Focus Review 2019
1) Dysphagia Diet – Nursing Actions
a. Place pt. in high fowler’s or upright position
b. High risk for aspiration
c. Give pt. oral care prior to eating
d. Allow adequate time to eat/chew and use assistive devices
e. Give/encourage small bites
2) Water intoxication/excess (Hyponatremia)
a. Risk factors
i. Compromised regulatory system - Heart failure, kidney
disease, cirrhosis
ii. Overdose of fluids – IV, oral, enteral
iii. Burns
iv. Prolonged use of corticosteroids
v. Severe stress
vi. Hyperaldosteronism - endocrine disorder that involves one
or both of your adrenal glands creating too much of a
hormone called aldosterone. This causes your body to lose
too much potassium and retain too much sodium, which
increases water retention, blood volume, and blood
pressure.
b. S&S
i. Tachycardia, bounding pulse, Hypertension, Tachypnea,
*Increased central venous pressure
ii. Crackles, Cough, Dyspnea
iii. Liver enlargement
iv. Seizures, Weakness, Visual changes, Altered LOC,
Paresthesia
c. Lab Test
i. Decreased – Hct & Hgb, BUN, urine sodium & specific
gravity, blood osmolarity
3) Fluid volume deficit - Dehydration/Hypovolemia
a. Risk factors
i. Excessive GI loss – vomiting, diarrhea, nasogastric
suctioning
ii. Excessive skin loss – diaphoresis (sweating) without sodium
& water replacement
iii. Excessive renal system loss – diuretic therapy, kidney
disease, adrenal insufficiency
iv. Third spacing burns
v. Hemorrhage (blood loss) or plasma loss
vi. Altered intake – nausea, anorexia, impaired swallowing,
confusion, nothing by mouth (NPO)
b. Causes
:00
i. Hyperventilation or excessive perspiration without water
treatment
ii. Prolonged fever
iii. DKA – Diabetic ketoacidosis
iv. Insufficient water intake
v. Diabetes insipidus
vi. Osmotic diuresis
vii. Excessive salt intake, salt tablets, hypertonic IV fluids
c. S&S
i. Hyperthermia, tachycardia, thread pulse, hypotension,
orthostatic hypotension, decreased central venous
pressure, tachypnea, hypoxia
ii. Dizziness, syncope, confusion, weakness, fatigue
iii. Thirst, dry furrowed tongue, nausea, vomiting, anorexia,
acute weight loss
iv. Oliguria
v. Diminished capillary refill, cool clammy skin, diaphoresis,
sunken eyeballs, flattened neck veins, skin turgor,
hyperthermia, seizures
d. Lab test
i. Increased – HCT, BUN, urine specific gravity, sodium
(hypernatremia), blood osmolality
4) Atorvastatin – priority assessment
a. Negative nitrogen balance causes
i. Use of alcohol, caffeine, nicotine
b. S&S
i. Hepatotoxicity
1. Avoid alcohol
2. Obtain LFTs
ii. Myopathy
1. Obtain creatine kinase (CK) level
2. Can progress to myositis or rhabdomyolysis
c. Nursing Interventions
i. Give with evening meal
ii.
5) Foods with high water content
a. Lettuce, gelatin, soup, melons
b. 2.7 L for females & 3.7 for males
6) Vegan deficiencies
a. Iron
b. Zinc
c. Calcium
d. Vitamin D
e. Omega-3 fatty acids
f. Vit. B12
7) Osteoporosis prevention food sources - calcium
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