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NUR242 / NUR 242 Exam 2 Study Guide
Medical-Surgical Nursing Concepts
100% Correct | Grade A Galen
Nutrition Module
Carbohydrates: first substance body uses for energy production and the ONLY source of energy production for
the brain Protein: second source of energy. Lack of protein intake leads to muscle breakdown to use as source
of protein. A byproduct of protein metabolism are amino acids. Protein assists with on optic pressure and
therefore helps hold fluid in vascular space.
Fats: the last to be broken down. A byproduct are ketone bodies which are acidic
Diets:
Clear Liquid: broth, gelatin, popsicle, tea with lemon, fruit juice without pulp, ginger-
ale Prohibited: anything that is not a clear liquid at room temperature
Purpose: maintain hydration and fluid balance
Uses: postoperative, acute vomiting or
diarrhea
Full Liquid Diet: custard, milkshakes, soups, all clear liquids
Prohibited: solid foods, nuts, james, fruit
Purpose: nutrition without chewing
Uses: GI upset, progressing diet after surgery
Low-Fat, Low-Cholesterol Diet: vegetables, lean meats, fruits,
cereals Prohibited: marbled meats, avocados, milk, bacon,
egg, yolks, butter Purpose: reduce calories from fat, minimize
cholesterol intake
Uses: atherosclerosis, cystic fibrosis, cardiac disease
Sodium-Restricted Diet: cold baked chicken, salad (no dressing), fruit, raw vegetables
Prohibited: cold cut meat s, cheese, fried food, milk products, canned food, table salt added to food
Purpose: lower body water and promote excretion
Uses: heart failure, hypertension, cirrhosis
High-Roughage, High-Fiber Diet: cracked wheat bread, minestrone soup, fiber fortified cereal, fruits,
vegetables Prohibited: white bread, baked goods made with white flour
Purpose: maximize bulk in stool
Uses: constipation, bowel
disorders
,Low-Residue Diet: meats, buttered rice, white bread, baked goods, processed foods with white
flour Prohibited: whole what flour breads and baked goods corn, bran
Purpose: minimized intestinal activity
Uses: GI/elimination problems, lower bowel surgery
High-Protein Diet: skim milk, eggs, learn meats, nuts, nut
butters Prohibited: soft drinks, junk food
Purpose: re-establish anabolism or raise albumin
levels Uses: burns, infection, hyperthyroidism
Renal Diet: unsalted vegetables, white rice, canned fruits, sweets
Prohibited: beans, cereal, citrus fruits, table salt added to food, canned vegetables
Purpose: keep protein, potassium and sodium low
Uses: renal failure
Low Phenylalanine Diet: fats, fruits, jams, low-phenylalanine
milk Prohibited: meat, eggs, beans and bread
Purpose: low-protein diet to prevent brain damage from amino acid
imbalance Uses: Phenylketonuria (PKU)
, Enteral Feeding: liquid food delivered to the stomach or lower GI tract via a tune inserted into the stomach,
duodenum or jejunum
Conditions:
-need for additional nutritional support
-GI problems (crohn’s disease, ulcerative colitis, malabsorption)
-side effects of oncology treatments
-head and neck disorders or traumas
-depression
-eating disorders
-alcoholism
Complications:
-tube displacements
-aspirations
-GI cramping, vomiting, diarrhea
-hypersomolar nonketotic coma
-glucose intolerance
TPN: total parenteral nutrition: provides all of pts calorics and nutrient requirements except for lipids which can
be admin separately; due to high dextrose and osmolarity, this infusion MUST be infused in a CENTRAL
LINE
PPN: partial or peripheral parenteral nutrition: provides some of pts caloric and nutrients requirements; this
infusions has lower dextrose and osmolarity so it can be infused through peripheral access; both TPN and
PPN require a specific rate to ensure the pt is not exposed to too many solutes at a given time, a medication
error related into infusion rate of a TPN or PPN infusion is potentially fatal to the pt
Keeping pts on TPN or PPN Safe:
-inside at only the ordered rate
-change IV tubing/filter every 24 hours
-keep refrigerated until needed then bring to room temperature
-gradually taper off TPN according to orders
-lumber used for TPN should not be used for any other types of infusion
Required monitoring for pts receiving TPN/PPN:
-daily monitoring: daily weights, adequate I/O, glucose, temperature and electrolytes (initially)
-at least 3 times a week: BUN, Electrolytes
-weekly: CBC, albumin levels, platelets, PT, liver function tests
Impact of Nutrition on the body
Sodium: the major electrolyte found in extracellular fluid space; sodium is important in conduction of nerve
impulses and muscle movement.
-Because sodium is important in nerve and muscle functionality (making things move) then we will see signs
and symptoms that related to movement
-Sodium is also important in relation to water balances; if the body has a high level of sodium, then the body
tries to retain water to maintain homeostasis
•Hyponatremia: condition when sodium levels are below normal limits; sodium values are obtained from a
normal blood test; nutrition and electrolyte restoration can help with hyponatremia, food to suggest:
-cheese, milk (high in calcium and in sodium)
-celery, pre-made meals such as canned or frozen dinners, condiments like ketchup, salted nuts,
bacon
, shrimp, ham, bread, tofu or soy products
*S/S of Hyponatremia: Hypotension, Muscle weakness, Thready pulse, Anorexia
NUR242 / NUR 242 Exam 2 Study Guide
Medical-Surgical Nursing Concepts
100% Correct | Grade A Galen
Nutrition Module
Carbohydrates: first substance body uses for energy production and the ONLY source of energy production for
the brain Protein: second source of energy. Lack of protein intake leads to muscle breakdown to use as source
of protein. A byproduct of protein metabolism are amino acids. Protein assists with on optic pressure and
therefore helps hold fluid in vascular space.
Fats: the last to be broken down. A byproduct are ketone bodies which are acidic
Diets:
Clear Liquid: broth, gelatin, popsicle, tea with lemon, fruit juice without pulp, ginger-
ale Prohibited: anything that is not a clear liquid at room temperature
Purpose: maintain hydration and fluid balance
Uses: postoperative, acute vomiting or
diarrhea
Full Liquid Diet: custard, milkshakes, soups, all clear liquids
Prohibited: solid foods, nuts, james, fruit
Purpose: nutrition without chewing
Uses: GI upset, progressing diet after surgery
Low-Fat, Low-Cholesterol Diet: vegetables, lean meats, fruits,
cereals Prohibited: marbled meats, avocados, milk, bacon,
egg, yolks, butter Purpose: reduce calories from fat, minimize
cholesterol intake
Uses: atherosclerosis, cystic fibrosis, cardiac disease
Sodium-Restricted Diet: cold baked chicken, salad (no dressing), fruit, raw vegetables
Prohibited: cold cut meat s, cheese, fried food, milk products, canned food, table salt added to food
Purpose: lower body water and promote excretion
Uses: heart failure, hypertension, cirrhosis
High-Roughage, High-Fiber Diet: cracked wheat bread, minestrone soup, fiber fortified cereal, fruits,
vegetables Prohibited: white bread, baked goods made with white flour
Purpose: maximize bulk in stool
Uses: constipation, bowel
disorders
,Low-Residue Diet: meats, buttered rice, white bread, baked goods, processed foods with white
flour Prohibited: whole what flour breads and baked goods corn, bran
Purpose: minimized intestinal activity
Uses: GI/elimination problems, lower bowel surgery
High-Protein Diet: skim milk, eggs, learn meats, nuts, nut
butters Prohibited: soft drinks, junk food
Purpose: re-establish anabolism or raise albumin
levels Uses: burns, infection, hyperthyroidism
Renal Diet: unsalted vegetables, white rice, canned fruits, sweets
Prohibited: beans, cereal, citrus fruits, table salt added to food, canned vegetables
Purpose: keep protein, potassium and sodium low
Uses: renal failure
Low Phenylalanine Diet: fats, fruits, jams, low-phenylalanine
milk Prohibited: meat, eggs, beans and bread
Purpose: low-protein diet to prevent brain damage from amino acid
imbalance Uses: Phenylketonuria (PKU)
, Enteral Feeding: liquid food delivered to the stomach or lower GI tract via a tune inserted into the stomach,
duodenum or jejunum
Conditions:
-need for additional nutritional support
-GI problems (crohn’s disease, ulcerative colitis, malabsorption)
-side effects of oncology treatments
-head and neck disorders or traumas
-depression
-eating disorders
-alcoholism
Complications:
-tube displacements
-aspirations
-GI cramping, vomiting, diarrhea
-hypersomolar nonketotic coma
-glucose intolerance
TPN: total parenteral nutrition: provides all of pts calorics and nutrient requirements except for lipids which can
be admin separately; due to high dextrose and osmolarity, this infusion MUST be infused in a CENTRAL
LINE
PPN: partial or peripheral parenteral nutrition: provides some of pts caloric and nutrients requirements; this
infusions has lower dextrose and osmolarity so it can be infused through peripheral access; both TPN and
PPN require a specific rate to ensure the pt is not exposed to too many solutes at a given time, a medication
error related into infusion rate of a TPN or PPN infusion is potentially fatal to the pt
Keeping pts on TPN or PPN Safe:
-inside at only the ordered rate
-change IV tubing/filter every 24 hours
-keep refrigerated until needed then bring to room temperature
-gradually taper off TPN according to orders
-lumber used for TPN should not be used for any other types of infusion
Required monitoring for pts receiving TPN/PPN:
-daily monitoring: daily weights, adequate I/O, glucose, temperature and electrolytes (initially)
-at least 3 times a week: BUN, Electrolytes
-weekly: CBC, albumin levels, platelets, PT, liver function tests
Impact of Nutrition on the body
Sodium: the major electrolyte found in extracellular fluid space; sodium is important in conduction of nerve
impulses and muscle movement.
-Because sodium is important in nerve and muscle functionality (making things move) then we will see signs
and symptoms that related to movement
-Sodium is also important in relation to water balances; if the body has a high level of sodium, then the body
tries to retain water to maintain homeostasis
•Hyponatremia: condition when sodium levels are below normal limits; sodium values are obtained from a
normal blood test; nutrition and electrolyte restoration can help with hyponatremia, food to suggest:
-cheese, milk (high in calcium and in sodium)
-celery, pre-made meals such as canned or frozen dinners, condiments like ketchup, salted nuts,
bacon
, shrimp, ham, bread, tofu or soy products
*S/S of Hyponatremia: Hypotension, Muscle weakness, Thready pulse, Anorexia
