• Monosaccharides and disaccharides
• Found primarily in sugars

• Contains all essential amino acids in sufficient quantity to support growth and maintain nitrogen balance
• Ex: fish, chicken, soybeans, turkey, and cheese

• Required for growth, maintenance of lean muscle mass and vital organs, and woud healing
• Body uses nitrogen to build, repair, and replace body tissues

• Protein: 4kcal/g
• Lipids: 9kcal/g

• Important for DNA synthesis and growth of RBC
• Women of childbearing age: 400 mcg
• Pregnant women: 600 mcg

Ovolactovegetarian

• cough during eating
• change in voice tone/quality after swallowing
• abnormal movements of the mouth, tongue or lips
• slow, weak, imprecise, or uncoordinated speech

• Provides nutrients into the GI tract
• Preferred method for patients unable to swallow or take in nutrients orally yet has a functioning GI tract

• Re-Feeding Syndrome (2)

• Potassium, magnesium, and phosphate move intracellularly, resulting in low serum (extra cellular) levels and edema 
• Severly malnourished patients at risk during EN or PN therapy

• Coughing
• Gastroesophageal reflux disease (GERD)
• Nasotracheal suctioning
• Artificial airway
• Decreased LOC
• Lying flat

• Nutrients are provided intravenously to the superior vena cava
• For patients unable to digest or absorb enteral nutrition or are in highly stressed physiological states

• IV fat emulsion are opaque and white
• Do not administer if oil droplets are observed or an oily/creamy layer is noted on the surface b/c it can cause fat emboli

• Results from a puncture insult to the pulmonary system and involves the accumulation of air in pleural cavity with subsequent collapse of lung
• Most often occurs during CVC placement for PN therapy

• The use of specific nutritional therapies to treat an illness, injury, or condition 
• Extremely significant in gastrointestinal diseases

• Absorption
• Secretion
• Elimination

• Lg. intestine becomes less responsive to stiumlation by laxatives
• Impairs normal defecation reflex
• Altered absorption of nutrients, fluid, electrolyte imbalances, and generalized weakness

• A SYMPTOM, NOT A DISEASE
• Infrequent stool and/or hard, dry, small stools that are difficult to eliminate

• Results from unrelieved constipation
• A collection of hardened feces wedge in the rectum a person cannot expel

• Perform a digital examination of the rectum
• Palpate for the impacted mass

• Temporary in the transverse colon
• Stoma has 2 opening: one that puts out stool and the other that only puts out mucous

• Bowel is surgically cut, and both ends are brought through the abdomen
• One opening puts out stool and the other opening puts out mucous

• Measures microscopic amounts of blood in feces
• Useful as a diagnostic screening tool for colon cancer

• Use tip of a wooden applicator to obtain a small portion of a stool specimen
• Thinly smear stool on guaiac paper in box one of slide
• Apply a second fecal specimen from a different portion of the stool in box 2 of slide

• Adult: 7.5-10cm (3-4 inches)
• Adolescent: 7.5-10cm (3-4 inches)
• Child: 5-7.5cm (2-3 inches)
• Infant: 2.5-3.75cm (1-1.5 inches)

• Blue, brown, or black in color
• Indicates circulation problems to stoma

• Never use an enema set to irrigate
• Use a special cone-tipped irrigator to prevent bowel penetration and backflow of the irrigating solution

• Decreased hemoglobin level and lowered oxygen-carrying capacity of the blood
• Diminished concentration of inspired oxygen (occurs at high altitudes)
• Inability of the tissues to extract oxygen from the blood
• Decreased diffusion of oxygen from alveoli to blood
• Poor tissue perfusion with oxygenated blood
• Impaired ventilation (as with multiple rib fractures or chest trauma)

• Decreased LOC
• Dizziness
• Behavioral changes
• Fatigue/aggitation
• Dyspnea
• Increased pulse rate and depth of respiration
• Elevated BP

• Cyanosis
• Decreased respiration rate due to respiratory muscle fatigue

• Extracellular fluid loss and reduced circulating blood volume --> decreased circulating BV results in hypoxia to body tissues

• Decreased functioning of the left ventricle
• Decreased cardiac output
• Signs/symptoms: fatigue, shortness of breath, dizziness, and confusion

• Imparied functioning of right ventricle
• Results from pulmonary disease or long-term left-sided failure
• As failure continues, the amount of blood ejected by right ventricle decreased and blood begins to "back up" in the systemic ciculation

• Elevated pulmonary vascular resistance (PVR)
• as PVR continues to increase the right ventricle works harder and oxygen demand of the heart increases

• Sudden onset of sharp chest pains that may lead to a feeling of tightness 
• Shortness of breath
• Rapid HR
• Rapid breathing
• Cough
• Fatigue
• Cyanosis

• Apply negative pressure during withdrawal of catheter, never on insertion
• Do not suction longer than 15 seconds and then oxygenate patient

• Gives a predetermined level of pressure
• The continous air pressure is what keeps the upper airway open

• A catheter is placed through the thorax to remove air and fluids from the pleural space to prevent air from re-entering or to re-establish intrapleural and intraplumonic pressures
• Closed and kept below the chest 

• Useful for patients with pulmonary disease, post-op patients, and women in labor to promote relaxation 
• More difficult breathing exercise because it requires patient to relax intercostal and accessory respiratory muscles while taking deep inhalations

• Awakening to void one more times a night
• Often a sign of renal alteration

• Be aware of the volume and frequency of voiding to assess for urinary retention
• Assess the abdomen for evidence of bladder distention and tenderness

• Pain/burning during urination
• Fever, chills, nausea, and vomiting develop as infection worsens
• Irritated bladder causes a frequent and urgent sensation of the need to void
• Blood-tinged urine
• Concentrated and cloudy urine due to the presence of WBC and bacteria

• Renal failure that can no longer be controlled by conservative management
• Worsening of uremic syndrome associated with end-stange renal disease
• Severe electrolyte and/or fluid abnormalities that cannot be controlled by simpler measures

• Day: 1200-1500 ml
• Per Hour: at least 30ml

• Use strictly aseptic technique
• Maintain a closed urinary drainage system
• Prevent pooling of urine in the tubing and reflux of urine into the bladder
• Empty drainage bag at least every 8 hours 
• Perform routine perineal care

• Time period begins after the patient urinates and ends with a final voiding at the end of the timed period
• Measures adrenocorticol steriods or hormone levels, creatinine clearance, or protein quantity test

• Causes muscle contraction and change in muscle length
• Ex: walking, jogging, swimming, and bicycling

• Enhances circulatory and respiratory functioning
• Increases muscle mass, tone, and strength
• Promotes osteoblast activity thus combating osteoporosis

• Tightening or tensing muscles without moving body parts
• Ideal for patients who don't tolerate increased activity and immobilized patients

• Range of Motion
• Gait
• Exercise

• A person's cane length is equal to the distance between the greater trochanter and the floor 

• Need a physical examination before beginning an exercise program
• Monitor blood glucose level immediately before and after exercise
• Perform low-to-moderate intensity exercises
• Carry concentrated form of carbohydrates
• Wear medical bracelet