Nutrition and Metabolism Focus Questions

Nutrition and Metabolism Focus Questions

 

PART I: Define the following terms in a way that you can best understand.

 

 

1. -opathy

 

 

2. -itis

 

 

3. -megaly

 

 

4. hepat-

 

 

5. hemat-

 

 

6. hypo-

 

 

7. hyper-

 

 

8. chole-

 

 

9. gastric

 

 

10. enteral

 

 

11. ascites

 

 

12. melena

 

 

13. dyspepsia

 

 

14. occult blood

 

15. bruit

 

 

16. Bile

 

 

17. Cholesterol

 

 

18. Cirrhosis

 

 

19. Enzymes

 

 

20. Fibrosis

 

 

21. Jaundice

 

 

22. Cyst

 

 

23. HemaglobinA1C

 

 

24. Body mass index

 

 

25. Fasting blood glucose

 

 

26. Glycemic index

 

 

27. Ketone

 

 

28. Kussmaul breathing

 

 

29. Proteinuria

 

 

30. Micronutrients

 

 

31. Macronutrients

 

 

32. Peristalsis

 

PART II: Answer the following questions thoroughly but not excessively. Only write what you can remember and in a way that you can understand. If you write too much or answer in a complicated way, you most likely will be unable to remember what you wrote. Accordingly, this would be a waste of your time.

 

 

Anatomy and Physiology Review

 

1. The gastrointestinal system is responsible for breaking down food. There are 4 primary processes from start to finish including ingestion, digestion, absorption, and elimination. Complete the chart below by listing which body parts are responsible for which functions; what the body part is actually doing during the process; and if it is part of the upper GI or lower GI. One organ is listed for you already as an example:

 

Process	Body parts involved	What is it doing?	Upper GI or Lower GI?
Ingestion	·         Teeth	·         Mechanical breakdown of food into smaller pieces	·         Upper
Digestion
Absorption
Elimination

2. A patient has a past health history of diabetes and hypertension. These comorbidities have the effect of reducing perfusion (circulation) throughout the body. How may a decrease in blood flow affect peristalsis?

 

 

3. Many medications are designed to breakdown in the digestive system and consequently may cause GI related symptoms. The chart below lists 4 common GI symptoms. Complete the chart and list if the symptom is related to the upper or lower GI:

 

Symptom	Upper GI symptoms or Lower GI symptoms?
Nausea
Vomiting
Diarrhea
Constipation

 

4. The stomach wall, also known as the gastric mucosa, is made up of specialized cells that produce and withstand acid. Certain medications, however, may break down the gastric mucosa. What are two common types drugs are known to do this? (hint: both have the effect of reducing inflammation).

 

 

5. Besides producing acid, the gastric mucosa also contains a chemical called intrinsic factor. What vitamin does this chemical have to do with? What role does this vitamin play in our body?

 

 

6. A patient has been stressed and not sleeping well. What hormone is released during times of stress? What effect will this hormone have on blood glucose levels? What effect may this hormone also have on the gastric mucosa (think back to question #4)?

 

 

 

 

 

 

 

 

 

 

7. You are assessing your patients GI system. Complete the chart related to GI assessment (from mouth to rectum):

 

Assessment technique	What may the nurse assess using the technique?
Inspection
Auscultation
Palpation

 

GI Procedures

 

8. A patient has just returned from an endoscopy in which they were given anesthetic agents. What would you expect from their cough and gag reflex? What complication may occur and what position should you put the patient in?

 

 

9. A few hours after your patient’s endoscopy you find that your patient is frequently swallowing. What do you think may be occurring?

 

 

10. A patient will be having a colonoscopy. What should be done to prepare the patient for this procedure? What should you teach the patient in regards to bleeding after they have completed the colonoscopy?

 

GI Disorders

 

11. Complete the chart:

 

Disorder	Pathophysiology (what is happening)?	Etiology (what made it happen)?	Signs and Symptoms (what can I expect to see)?	Complications (what’s the worst that can happen but not expected)?	Interventions (what can I, the nurse, do about it)
GERD
Gastritis
Peptic Ulcer Disease
Upper GI bleed
Lower GI bleed
Inflammatory Bowel Disease

 

 

12. A patient is diagnosed with cholecystitis (inflammation of gallbladder) and you are trying to differentiate if the gallstones are cholesterol or pigment. What is the difference?

 

 

13. A patient is diagnosed with pancreatitis (inflammation of pancreas). If left untreated, which disease related to pancreatic function may develop?

 

 

14. A patient is diagnosed with hepatitis (inflammation of the liver) but you are unsure what type. What are the 3 types of hepatitis and how is each type transmitted? How does the time-frame of each type differ?

 

Diabetes

 

15. What is a typical fasting blood glucose range?

 

16. What do you expect of a patient’s blood glucose range during times of illness/stress and why?

 

 

17. At what blood glucose level or above do we typically medicate in the healthcare setting?

 

18. What is glycemic index refer to and how does it relate to blood sugar levels?

 

 

19. What is glycogen and where is it stored?

 

20. What hormone is produced from the alpha cells of the pancreas?

 

 

21. What hormone is produced from the beta cells of the pancreas?

 

22. What is the purpose of insulin and what does it do in the body?

 

 

23. What is insulin resistance and how is it developed?

 

24. What are ways the patients can reduce insulin resistance and improve blood sugar control?

 

Hypoglycemia

25. At what range of blood sugar is a patient considered hypoglycemic?

 

26. How may the body compensate when blood glucose levels are low?

 

 

27. What are 3 symptoms you would anticipate of your patient who is hypoglycemic and symptomatic?

 

28. What effect does hypoglycemia have on the brain/organs?

 

 

29. If a patient is experiencing hypoglycemia and is conscious, what and how much can you give them to raise their glucose levels?

 

30. If a patient is experiencing hypoglycemia and is unconscious, what and how much can you give them to raise their glucose levels?

 

 

31. What safety concerns is the patient at risk for while hypoglycemic?

 

Hyperglycemia

32. At what range of blood sugar is a patient considered hyperglycemic?

 

33. What are 3 symptoms you would anticipate of your patient who is hyperglycemic and symptomatic?

 

 

34. Why do patients who are hyperglycemic experience polyurea?

 

35. Why do patients who are hyperglycemic experience polydipsia?

 

 

36. Why do patients who are hyperglycemic experience polyphagia?

 

37. Why is hypoglycemia considered more of a medical emergency than hyperglycemia?

 

 

38. What is diabetic ketoacidosis (DKA)?
39. What electrolyte shifts happen between the blood/cell during DKA?

 

40. Why does muscle begin to breakdown during DKA and what is the byproduct produced?

 

 

41. What is ketosis and what is the byproduct produced?

 

42. What effect does DKA have on pH levels of the blood and cerebrospinal fluid (CSF)?

 

 

43. How does the change in pH of CSF affect the medulla oblongata and the respiratory system?

 

44. What is kussmaul respirations?

 

 

45. Why is fluid/electrolyte imbalance the primary concern for patients who are experiencing DKA? What is the patient at risk of developing?

 

46. What type of insulin is given intravenously to treat DKA?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Concept Mapping

 

Below you will find an incomplete concept map with a starting problem and an ending problem. You will see that the first concept has been provided with an explanation of the physiology that is occurring. Complete the remaining boxes to highlight step-by-step the process the body goes through when it experiences damage.

 

 

Start: Post-operative hemorrhage after an abdominal surgery	→	1stConcept: Tissue Integrity   There is damage to the abdomen resulting in compromised blood vessels and internal bleeding.	→	2ndConcept: Fluid Regulation                   *hint: What will bleeding do to fluid levels in circulation?
				↓
5thConcept: Metabolism             *hint: Will the other cells of the body be able to do their functions?	←	4thConcept: Oxygenation             *hint: What’s the relationship of oxygen and blood? What will happen to oxygen getting to the body cells?	←	3rdConcept: Perfusion                 *hint: What will happen to blood flow?
↓
6th Concept (End): Tissue Integrity of body organs   Necrosis of organs related to hypovolemic shock