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NUR114 Unit 1
Total Parenteral Nutrition (TPN)
Mechanism
Nutrition Given Outside GI
Side Effects
Hyperglycemia
Hyperlipidemia
Refeeding Syndrome
Nausea and Vomiting
Considerations
Slow IV Infusion
Use Large Central Vein
No Added Meds to TPN Line
2 mins
Bulimia Nervosa Assessment
Assessment
Normal Body Weight
Binge and Purge
Electrolyte Disturbances
Alkalosis
Hypokalemia
Parotitis
Enamel Erosion
Russell's Sign
Diagnosis
Once Weekly For 3 Months
2 mins
Anorexia Nervosa and Bulimia Nervosa Interventions
Interventions
Build Trust
Plan Caloric Intake
Supervise Meals
Supervise Elimination
Encourage Liquids
Daily Weights
Use Matter-of-Fact Statements
Give Feelings of Control
Considerations
Tube Feedings If Further Weight Loss
2 mins
Anorexia Nervosa Assessment
Adolescent Girls
Fear of Gaining Weight
Assessment
Excessive Dieting
Distorted Body Image
Decreased Bone Density
Stress Fractures
Lanugo
Amenorrhea
Anemia
Diagnostic Criteria
BMI < 18.5
3 mins
Refeeding Syndrome
Seen in anorexia nervosa
Due to increase in insulin
Hypophosphatemia (#1 problem)
Hypokalemia
Hypomagnesemia
Arrhythmia
CHF
Respiratory distress
Prevent by repleting electrolytes
Peptic Ulcer Disease Assessment
Mechanism/Cause
Helicobacter Pylori
NSAIDs
Increased Stomach Acid
Assessment
Abdominal Pain
Heartburn (Pyrosis)
Melena
Weight Changes
GI Distress
Considerations
Most Commonly in Duodenum
Duodenal: Pain Relieved by Eating
Gastric: Pain Caused by Eating
2 mins
Colorectal Cancer Assessment
3rd Most Common Cancer
Assessment
Change in Bowel Habits
Bowel Obstruction
Rectal Bleeding
Anemia
Weight Loss
Ascites
Considerations
Colonoscopy
FOBT and FIT
2 mins
Colorectal Cancer Interventions
Interventions
Surgical Colon Resection
Radiation
Chemotherapy
Considerations
Bowel Cleansing
Screening
Colostomy
Dietary Consult
Body Image
3 mins
Crohn's Disease Assessment
Diarrhea
5-6 per day
Cramping Abdominal Pain
Fever
Weight Loss
Malabsorption
Anemia
Complications
Obstruction
Fistulas
2 mins
Cholecystitis Causes
Gallbladder Inflammation
6 Fs
Female
Fair (Caucasian)
Fat (Obese)
Fertile (Pregnant)
Forty (Advanced Age Over 40)
Flatulence
2 mins
Cholecystitis Interventions
Supportive Therapy
Antibiotics
Low Fat Diet
NG Tube
Analgesics
Lithotripsy
Cholecystectomy
T Tube
2 mins
Cholecystitis Assessment
RUQ Pain
Referred Shoulder Pain
Clay Colored Stools
Jaundice
Nausea and Vomiting
Dyspepsia (Indigestion)
Fever
Considerations
Increased WBCs
Fatty or Spicy Foods
Ultrasound
2 mins
Gallstones, Cholecystitis, and Cholangitis
Gallstones (cholelithiasis)
Increased cholesterol and/or Increased bilirubin
Decreased bile salts could cause stones
Risk factors: Fat, Female, Fertile, Forty
Estrogen: Induces cholesterol secretion
Progesterone: Gallbladder hypomotility
Cholesterol stones: Radiolucent
Pigment stones: Radiopaque = Calcium bilirubinate or Hemolysis
Pigment stone: Radiolucent (Brown) = Infection
Biliary colic: Neurohormonal activation by CCK
Painless in diabetes
Cholesterol stones seen in: Obesity, Crohn's Advanced Age, Estrogen Therapy, Multiparity, Rapid Weight Loss, Native American
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