NR228 Final Exam Study Guide: December 2020

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1. Post Liver Transplant Nutritional Considerations

• Correct Nutritional Considerations:
  • Total parenteral nutrition or tube feeding may be necessary.
    • This is often required in the early post-transplant period due to the patient’s inability to take in adequate nutrition orally.
  • Other Options:
    • Nutrition is not a concern because the client is overweight - Incorrect; nutrition is crucial regardless of weight status.
    • Fats and carbohydrates are not a concern long term after transplant - Incorrect; both macronutrients need to be carefully managed.
    • A dietary consult would not be necessary for the client - Incorrect; a dietary consult is often essential.

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2. Nursing Interventions for Enteral Feeding (Multiple Trauma Patient)

• Appropriate Nursing Interventions:
  • Maintain head of bed elevation to prevent aspiration.
  • Monitor for signs of tube feeding intolerance, such as bloating, diarrhea, or vomiting.
  • Check gastric residual volumes regularly to ensure the feeding is being absorbed.
  • Flush the feeding tube with water before and after medications to prevent clogging.
  • Monitor fluid balance, including input and output.
• Remember:
  • Always ensure the tube is in the correct position and assess the patient for signs of discomfort or complications.

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3. Nutritional Needs Increase with Infection

• Energy/Nutrient Increase:
  • Typically, energy needs increase by 20-30% during infection to support the immune response and healing process.
  • Specific percentages might vary based on the severity of the infection and patient condition.

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4. Additional Functions of the GI Tract (Beyond Digestion and Absorption)

• Functions Include:
  • Immune system support by serving as a barrier to pathogens.
  • Production of hormones that regulate appetite and digestion.
  • Maintenance of fluid and electrolyte balance.
  • Production of vitamins by gut bacteria, such as vitamin K.

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5. Fluid Restriction in Cirrhosis

• Incorrect Client Statement:
  • “I can only drink 1200ml of fluid a day, but I can have all the jello I want.”
    • Jello, along with ice cream, pudding, and milk, are considered fluids and should be included in the fluid restriction.
  • Other Statements:
    • The other statements, such as understanding fluid limitations and the effect of fluid buildup, are correct.

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6. Appropriate Oral Feeding for Acute Hepatitis B

• Oral Feeding Recommendations:
  • Small, frequent meals that are low in fat and high in carbohydrates.
  • Avoidance of alcohol and foods that can irritate the liver.
  • Encouraging adequate hydration with fluids that are easy on the liver.

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7. Heart Disease Death Rates

• True or False:
  • True. Deaths from heart disease have declined, largely due to better management and prevention strategies.

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8. Change in Nutritional Advice

• Best Statement:
  • “Healthy fats and moderate portions via the Mediterranean diet are being promoted.”
    • This diet focuses on healthy fats (like olive oil), whole grains, fruits, vegetables, and moderate protein portions.

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9. Chronic Lung Disease

• Chronic Lung Disease Example:
  • Emphysema is a chronic obstructive pulmonary disease (COPD) that affects the lungs and causes breathing difficulties.

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10. Cancer Cachexia Description

• Best Description:
  • Cancer cachexia is a syndrome characterized by weight loss, muscle wasting, and loss of appetite, often seen in patients with advanced cancer.
  • This condition is not simply malnutrition; it is a metabolic syndrome that leads to severe physical decline.

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