D440 NUT 2024 LATEST Q UESTIONS & ANSWERS VERIFIED
100% CORRECT!!
Role of RN (Registered Nurse) - Correct Answer - assess pt for clinical manesfestations of fluid and electrolyte disturbance -determine if ordered IV therapy is appropriate
- choose appropriate catheters/ infusion devices
- METHODS OF NUTRITIONAL SUPPORT - Correct Answer -regular, enteral, parenteral nutrition
Role of LPN/LVN - Correct Answer -administer IV fluids and meds to stable pts -adjust the flow rate for stable pts according to HCP orders -Insert IV catheters -monitor clinical manisfestations of adverse reactions to IV fluids or meds Role of Unlicensed Assistive Personnel (UAP) - Correct Answer -Measure and record oral intake and output -report swelling or redness at the IV site -report pt complaints of discomfort at IV site to the RN General Dietary Management - Correct Answer -MNT will depend on pt nutrition status when they arrive, the metabolic results of condition, the pt ability to eat food -routine IV fluids are used to supply hydration needs and electrolytes but CANT sustain energy and nutrient balance. PT would need 10x the amount.-for pt only recieving IV fluids, they should return to regular eating and maintain as tolerated intake and output (I&O) - Correct Answer used to evaluate fluid balance whereby intake and output are measured and documented
enteral nutrition - Correct Answer Indications:
-impaired nutrient INGESTION (inadequate eating/malnutrition) -wasting 1 / 4
-GI is functioning -allows gut preservation (the gut is functioning normal and we want to prevent it from declining) -prevents atrophy of the stomach
TYPES:
-NG TUBES: less than 4 weeks (ends in stomach)
-duodenal/jujenum (ends there) -PEG and PEJ (nurse don't put this in) (long term)
Administration types: cyclic, intermittent, bolus, continuous
Aspiration precautions: sit HOB 30-45 Degrees before and after feedings
Immediate measures to take: NEX, make a mark
Verify placement via chest XR before administration
Conditions that require it:
-dysphasia, conditions preventing oral nutrition, coma, hyperemesis gravidarum, severe anorexia nervousa, malnutrition Nurse considerations: s/s diarrhea, vomiting, abdominal distention, overall gastric motility -you can give meds through the NG and PEG tubes you are going to crush them, make sure to flush with water (document intake) Parenteral Nutrition - Correct Answer administration of nutrients intravenously TYPES: Peripheral (PICC into arm into vena cava.. some nurses can insert this) , central line (TPN...inserted by surgeon)
Indications:
-GI incompetence 2 / 4
-critical illness -last resort
Nurse considerations:
-If bag goes dry and need a refill, without pt special prescribed formula, you will need to give 10- 20% of Dextrose until it arrives to prevent a HYPOGLYCEMIC CRISIS -formula can consist of eggs for fat so need to do a comprehensive allergy assessment just in case they're allergic -monitor their blood glucose
COMPLICATIONS:
-Pneumothorax.. still do chest XR -air embolism -aspiration- stop feeding when laying flat, raise the HOB -hyper/hypoglycemia -infection r/t IV
LOOK AT CH 70 SAUNDERS
Ch 22 Williams textbook PKU (phenylketonuria) - Correct Answer a condition that makes it impossible for babies to metabolize certain proteins
-S/S: CNS damage, mental retardation, decreased melanin
- formulas that are safe for an infant with PKU is: lofenalac, phenex
-foods to avoid: high protein foods like meat, fish, poultry, dairy, soy, legumes (dried beans), eggs, nuts Type 1 diabetes mellitus/ DIABETES GENERAL - Correct Answer -S/S: 3 Ps: polydipsia, polyphasia, polyuria 3 / 4
-wt loss -warm and dry skin -dehydration (weak pulse, decreased skin turgor) -fruity breath odor -diabetes caused by a total lack of insulin production; usually develops in childhood, and patients require insulin replacement therapy to control the disorder -calorie count to consider -they do have diet restrictions but they can eat like normal 15/15 rule - Correct Answer -low BG is when it drops below target level
S/S: nausea, dizziness, seizures if severe
-15 grams of fast-acting carbohydrates (simple sugar) -Repeat in 15 minutes if blood glucose is <60 mg/DL or still symptomatic -Follow with snack that contains complex carbohydrates
FOODS:
-6-7 hard candies (life savers) -8 oz of milk (15 g of carbs) -4 oz of regular not DIET soda
HYPOGLYCEMIA
S/S - Correct Answer BG<70 mg/dL -caused by too much insulin in the blood , decreased food intake w inadequate food intake, excercise, excess alcohol
-S/S:
-hunger, irritability, confusion, cool and clammy skin, pale/coldclammy—> seizure/ coma
- / 4