Nutrition/Hydration Inservice Quiz

Nutrition/Hydration Inservice Quiz

1. Dry skin, dark urine, thirst, and fatigue can be signs of dehydration?

True or False

2. The most essential nutrient for life is Protein?

True or False

3. What are the three types of thickened liquid?

4. When a tube feeding is infusing, the head of the bed must be elevated at least to a 30 degree angle?

True or False

5. What would you do if a client’s G-Tube was accidentally pulled out during a transfer?

a. Push it back in and pretend it did not happen

b. Notify the family member

c. Notify the office or supervising nurse immediately

d. Both b and c

7. As the caregiver I should enforce the clients diet?

True or False

8. Proper nutrition promotes:

a. Physical health

b. Increased energy

c. Aides with healing and resistance to illness

d. All of the above

9. I should always be aware and follow proper infection control practices?

True or False

10. I should report all problems/concerns to the Nurse/office voiced by the client and/or observed by me?

True or False

Key Terms:

Aspiration – inhalation of food or drink into lungs which has the potential to cause pneumonia or death.

Calories – the fuel or energy value of food.

Dehydration – excessive loss of fluid from the body.

Fluid Overload – condition in which the body is unable to handle the amount of fluids consumed.

Fluid Restriction – a restriction of the amount of fluids a person may have per day.

Hydration – fluids consumed.

NPO – nothing by mouth.

Nutrients – substances found in food which provide nourishment.

Nutrition – nourishment; the process by which the body takes in food to maintain health.

Water – H2O (one molecule of oxygen and two molecules of hydrogen) most essential nutrient for life.

Proper nutrition- Promotes physical health, helps to maintain muscle/skin/tissue, increases energy, aids with healing and resistance to illness.

A. Six basic nutrients

1. Carbohydrates

i. Provide energy for the body

ii. Provide fiber for bowel elimination

2. Fats

i. Aid in absorption of vitamins

ii. Provide insulation and protect organs

3. Minerals

i. Build body tissue and cell formation

ii. Regulate body fluids

iii. Promote bone and tooth formation

iv. Affect nerve and muscle function

4. Proteins

i. Promote growth and tissue repair

ii. Found in body cells

iii. Provide an alternate supply of energy

5. Vitamins

i. Two types: water soluble and fat soluble

ii. Body cannot produce

iii. Help the body function

6. Water

i. Most essential nutrient for life

B. Diet specifics

1. Basic or “general” diet

2. Therapeutic/special/modified diets include soft, bland, low sodium, Diabetic, and liquid to name a few.

3. Mechanically altered diets consist of Mechanical soft and Pureed.

4. Thickened liquids

i. Nectar thick

ii. Honey thick

iii. Pudding thick

C. Monitoring meal consumption/recording food/fluids consumed may be required.

D. Proper hydration promotes good physical health, aiding in digestion, elimination, and helps to prevent dehydration.

E. Role of the HHA

1. Encourage client to eat as much of their meal as possible

2. Honor likes and dislikes when assisting with meals.

3. Review diet before assisting with meal preparation.

4. Record food/fluid intakes if ordered by MD.

5. Encourage fluids, when not on restriction

6. Observe for and report to the nurse signs of dehydration:

i. Mild symptoms (include but are not limited to); thirst, loss of appetite, dry skin, flushed skin, dark colored urine, dry mouth, fatigue or weakness, chills.

ii. Advanced dehydration symptoms (include but are not limited to): increased heart rate, increased respirations, decreased sweating, decreased urination, increased body temperature, extreme fatigue, muscle cramps, headaches, nausea.

iii. Severe dehydration symptoms (include but are not limited to): muscle spasms, vomiting, racing pulse, shriveled skin, dim vision, painful urination, confusion, difficulty breathing, seizures.

7. Observe for and report to the nurse signs of fluid overload which may include:

i. Stretched and shiny-looking skin over a swollen area, increased abdomen size (ascites), shortness of breath or difficulty breathing (pulmonary edema), tightness of jewelry, clothing or accessories, low output of urine, even when the resident is drinking as much fluid as normal, a dimple in the skin covering the swollen area that remains for a few seconds after the pressing finger has bene released.

ii. Symptoms of more serious fluid overload include difficulty breathing, shortness of breath when lying down, coughing, cold hands or feet.

HHA’s will assist clients, as needed, with proper eating techniques as directed by the Nurse. HHA’s will observe for any difficulties/concerns with eating and drinking, (choking, coughing, pocketing of food, difficulty with chewing, etc.) reporting to the Nurse and/or office immediately. Note there are many possible factors that could affect adequate nutrition and hydration in the elderly, including but not limited to visual impairment, depression, medical diagnosis.

Caring for a client with a Tube Feeding and the client at Risk for Aspiration

The two most common types of feeding tubes are a NG tube (nasogastric tube), this tube is placed trough the nose into the stomach and a G-Tube (gastrostomy tube), tube placed directly into the stomach. Often these feeding tubes have a pump equipped with an alarm, should something go wrong. While the feeding is infusing the client should not lie flat and the head of the bed should be elevated at least 30 degrees. Caregivers should take care when assisting with personal care, to avoid the dislodgement of the tube. Should dislodgement occur at any time, contact the Nurse. The client with a feeding tube is often NPO, this may cause dry mouth, dry lips, or a sore throat. Frequent oral hygiene and lubricant for the lips should help. Caregiver should notify the Nurse immediately with any concerns/problems such as but not limited to vomiting, distended abdomen, redness, swelling, drainage, odor, pain, with the feeding tube.

Any client with ordered thickened liquids, pureed or mechanical soft diets, or having a diagnosis of esophageal reflux, GERD, or respiratory difficulty is at risk for aspiration. These clients should be encouraged to sit up or remain with the head of the bed elevated for at least 30 minutes (or as long as tolerated) following consumption of food or fluids.

Answer Key:





5. D



8. D


10. TRUE