321 Exam 4 - Chpt 36 - Nutrition.

A nurse administers a continuous tube feeding via an NG tube. How often must the nurse check for residual?

4 to 6 hours Checking for residual before each feeding or every 4 to 6 hours during a continuous feeding according to institutional policy is implemented to identify delayed gastric emptying.

client wants to loose 15 pounds, and she informs the nurse she is counting her calorie intake each day. The client has a goal of losing one pound a week until she reaches her goal. The client asks the nurse how many calories she should decrease daily to lose a pound a week.

500 calories/day To lose 1 pound -0.45 kg- in a week, daily calorie intake should be decreased by 500 calories a day. One pound of body fat equals about 3,500 calories; 3,500 calories divided by 7 days = 500 calories/day.

A nurse is caring for a pregnant client who is a strict vegetarian. What type of diet should the client follow?

A diet rich in protein A vegetarian diet can be inadequate in protein, the need for which increases during pregnancy. Therefore, a diet rich in plant proteins will help.

A nurse teaches a student nurse about the role fats play in the human body. Which of the following is the major storage form of fat?

A nurse teaches a student nurse about the role fats play in the human body. Which of the following is the major storage form of fat? Triglycerides Triglycerides are the predominant form of fat in food and the major storage form of fat in the body; they are composed of one glyceride molecule and three fatty acids.

A nurse teaching a student nurse how to remove a nasogastric tube discusses interventions to be performed in unexpected situations. Which of the following statements accurately describes one of these interventions?

A nurse teaching a student nurse how to remove a nasogastric tube discusses interventions to be performed in unexpected situations. Which of the following statements accurately describes one of these interventions? If within 2 hours after NG tube removal, the patient's abdomen is showing signs of distention, notify the physician.

A nurse is assessing a 70-year-old client with a reduced appetite. Which of the following contributes to reduced appetite and reduced nutritional intake in older adults?

Adverse medication effects Medical conditions and adverse medication affect the appetite of older adults.

A nurse documents a client's hemoglobin as 8 g/dL. What nutritional condition does this biochemical data signify?

Anemia If hemoglobin is normal at 12 to 18 g/dL and it is decreased, anemia is present. A decreased hematocrit signifies dehydration. Malnutrition is related to serum albumin, blood urea nitrogen, and creatinine. Decreased serum albumin also signifies malabsorption.

A client visits a health care facility with complaints of loss of appetite following a prolonged illness. How should the nurse document the client's condition?

Anorexia The nurse should document the loss of appetite following prolonged illness as anorexia. Emaciation is excessive leanness. Cachexia is the general wasting away of body tissue. Nausea usually precedes vomiting and is associated with gastrointestinal sensations

After reviewing the client's chart, the nurse notes that the client has been ordered a clear liquid diet. Which meal tray would the client be allowed to eat?

Bouillon, apple juice, and gelatin Clear liquid diets contain foods that are clear liquids at room temperature or body temperature, such as gelatin, fat-free broth, bouillon, ice pops, clear juices, carbonated beverages, regular and decaffeinated coffee, and tea

A nurse is caring for a client with excessive abdominal fat. Which of the following is a risk associated with excessive abdominal fat about which the nurse should inform the client?

Cardiovascular disease Excess abdominal fat may lead to cardiovascular disease, hypertension, and diabetes.

A nurse is preparing a teaching plan for a client who is obese and has diabetes mellitus. Which of the following would the nurse include when discussing the the effect of diabetes on nutrition?

Cells cannot use glucose to produce energy. diabetes is the body producing insufficient amounts of insulin, and as a result the cells cannot use glucose to produce energy. When adequate insulin is unavailable, the transfer of glucose into the cell is impaired, glucose level of the blood rises.

The nurse is testing the blood glucose levels of a client with a history of diabetes. The nurse has performed hand hygiene, checked the order, informed the client and turned on the monitor. After removing a test strip from the vial, the nurse should do what?

Confirm that the strip and the meter share the same code. It is important to confirm that the code on the strip and the meter match.

A nurse is assessing a postmenopausal client with osteoporosis. Which of the following factors contribute to the development of osteoporosis in postmenopausal women and in elderly men?

Decreased physical activity Smoking Heredity factors and race Other factors include a chronically insufficient calcium intake and decreased estrogen level. Malabsorption syndromes can lead to problems in calcium absorption, causing osteoporosis.

The nurse caring for a client for several days has assessed that he has been eating poorly during his hospitalization. Which nursing measure should the nurse implement to assist the client in improving his nutritional intake?

Encourage his daughter to prepare food at home and bring it to the client. - (The nurse should solicit food preferences and encourage favorite foods from home, when possible. Be sure the foods look attractive and the eating area is free of odors, clutter, and distractions during mealtime.

A woman consumes pasta, grains, and other carbohydrates for which purpose?

Energy The main function of carbohydrates is to provide energy

The physician has prescribed routine exercises for an elderly client to perform on a daily basis. Which of the following is a benefit of exercising for an elderly client?

Exercise helps in increasing appetite. Exercise may lead to increased appetite in elderly clients. Elderly clients may become more sedentary and should be taught the benefits of exercise within their abilities.

It is false that Carbonated sodas (such as Coca Cola) are effective to clear a clogged feeding tube.

False

A nurse is caring for a client with complaints of frequent nausea. Which food should the nurse recommend to the client when the nausea is relieved?

Fruit juices Once nausea is relieved, assisting the client to resume fluid intake and nourishment becomes a priority. The nurse starts this process gradually, offering sips of clear fluids, such as fruit juices first. Bland foods, such as boiled vegetables, can be given, but later.

Which of the following types of feeding tubes would be most appropriate for a patient requiring enteral feeding for a long period of time?

Gastrostomy tube

A nurse is caring for a patient with a gastrostomy tube in place. Which of the following is an accurate guideline for care of the insertion site?

If the gastric tube insertion site has healed and the sutures are removed, use soap and water to clean the site. If the gastrostomy tube is new and still has sutures holding it in place, dip a cotton-tipped applicator into sterile saline solution and gently clean removing any crust or drainage.

Which of the following is an appropriate intervention when unexpected situations occur during the administration of a tube feeding?

If the tube becomes clogged when aspirating contents, use warm water and gentle pressure to remove the clog.

A woman age 20 years has announced her intention to implement a zero-fat diet in order to lose weight and maximize her health. What is a potential consequence of completely eliminating fat sources from the woman's diet?

Impaired vitamin absorption In addition to providing caloric needs, fats are necessary for the absorption of fat-soluble vitamins.

In planning to meet the nutritional needs of a critically ill client in the intensive care unit, which factor will increase the client's basal metabolic rate?

Infection Factors that increase a person's BMR include growth, infections, fever, emotional tension, extreme environmental temperatures, and elevated levels of certain hormones-epinephrine and thyroid hormones.

A nurse is caring for a visually impaired client. How should the nurse manage the feeding for this client?

Inform the client about what kind of food is being offered with each mouthful. It is important to inform visually impaired clients about the food in each mouthful, to help them eat properly.

Which of the following statements accurately describe a step in the administration of a tube feeding?

Intermittent feedings use gravity for instillation or a feeding pump to administer the formula over a set period of time. Intermittent feedings are the preferred method of introducing the formula over a set period of time via gravity or pump.

A nurse is caring for a client with a wound infection. The dietician has prescribed a diet rich in vitamin A. The client asks the nurse, "Why do I need Vitamin A?" The nurse integrates an understanding of which of the following as a major reason when responding to the client?

It helps maintain healthy epithelium Vitamin A is important for maintenance of healthy epithelium, maintenance of normal vision especially in dim light, promotion of normal skeletal and tooth development, and promotion of normal cellular proliferation.

A female client has developed an abscess following abdominal surgery, and her food intake has been decreasing over the past two weeks. Which of the following laboratory findings may suggest the need for nutritional support?

Low serum albumin levels Serum albumin levels are a good indicator of a client's nutritional status; decreased levels are suggestive of malnutrition

A client with influenza is prescribed a diet that is rich in fiber and carbohydrates. Which of the following would the nurse incorporate into the education plan as a major reason for the high fiber diet?

Maintenance of normal bowel elimination Dietary fiber is a minimal source of energy but plays an essential role in stimulating peristalsis and maintaining normal bowel elimination.

An older adult client has a decubitus ulcer with drainage, dysphagia, and immobility. She consumes less than 300 calories per day and has a large amount of interstitial fluid. The client is in a state of ...

Negative nitrogen balance A negative nitrogen balance exists when excretion of nitrogen exceeds the intake

nurse is caring for a young adult female client who has a folic acid defiency. When teaching the client about this condition, the nurse would include a discussion about the client's increased risk for which of the following?

Neural tube deficits in the fetus Folic acid deficiency in pregnant women can lead to neural tube deficits like spina bifida in the fetus. Because fetal neural development begins so early in pregnancy, women in their childbearing years must have adequate folic acid intake.

A nutritionist helps to plan a diet for a client with diabetes. Which of the following foods is a carbohydrate that should be included to help improve glucose tolerance?

Oatmeal Oatmeal is a water-soluble carbohydrate that helps improve glucose tolerance in diabetics.

A nurse is caring for a client who is not able to take food orally and who will be on IV therapy for at least 10 days. The nurse knows that the client will likely receive which of the following types of nutrition?

Peripheral parenteral nutrition Peripheral parenteral nutrition provides temporary nutritional support of 2000 to 2500 calories daily. It can meet a client's metabolic needs when oral intake is interrupted for 7 to 10 days, or it can be used as a supplement during a transitional period

The average dietary nutrient intake level that meets the nutritional requirement of almost all healthy people in a selected age and gender group is the

RDA level The RDA level is the average dietary intake level that meets the nutritional requirement of almost all healthy people in a selected age and gender group.)

A nurse is caring for a client diagnosed with high risk for cardiovascular disease. Which of the following items should the nurse make sure is not on the client's dietary tray?

Red meat A client with a high risk of cardiovascular disease should not be given red meat, which is high in cholesterol. LDL is called "bad cholesterol" because the cholesterol is deposited within the walls of arteries, which can eventually result in cardiovascular disease.

A nurse is caring for a client with chronic anemia. Which of the following should be included in the diet of this client?

Red meat..... Red meat is a source of iron. It therefore should be included in the diet of a client with chronic anemia. Dairy products, citrus fruits, and yellow vegetables are nutrient-dense foods and not sources of iron. Dairy products are sources of fat, whereas citrus fruits and yellow vegetables are sources of vitamins.

Prior to starting a tube feeding, the nurse assesses the pH and color of the patient's gastric contents and receives a pH of 6.2. the aspirate is off-white . where is the tip of the tube most likely located?

Respiratory tract pH respiratory tract is 6.0 or higher the aspirate is off-white and tinged with mucus. Aspirate from stomach has pH of less than 5.5 is grassy green, tan, off-white, bloody, brown. pH of intestines is 7.0 or higher ,the color of the aspirate is medium , deep golden yellow

A nurse is caring for a client with vitamin D deficiency at the healthcare facility. Which of the following are signs of vitamin D deficiency? Select all that apply.

Rickets in children Poor dental health Osteomalacia Signs of vitamin D deficiency are rickets in children, poor dental health, tetany, and osteomalacia, which results in soft bones and a tendency toward spontaneous fractures secondary to vitamin D and calcium deficiency.

Which of the following laboratory results indicates the presence of malnutrition

Serum albumin 2.8 g/dL because A normal albumin range is 3.4 to 5.4 g/dL. If you have a lower albumin level, you may have malnutrition. It can also mean that you have liver disease or an inflammatory disease.

The nurse is caring for a patient on a telemetry unit following a myocardial infarction. The patient has undergone numerous medication changes since the event. Which of the following foods should be avoided when a client is taking Coumadin following a myocardial infarction?

Spinach Spinach is an essential source of vitamin K. Since vitamin K is essential for clotting, it should be consumed sparingly with anticoagulant therapy

You are slowly advancing a nasogastric tube (NGT) when the patient begins to gasp and is unable to vocalize. Which of the following has likely occurred?

The NGT is in the patient's airway.

A physician orders nutritional therapy administered via a central vein for a patient who cannot take foods orally. What is the term for this type of nutrition?

Total parenteral nutrition.... TPN TPN is nutritional therapy that bypasses the gastrointestinal tract and is administered through a central vein.

it is true that Insertion of a nasogastric tube into a patient who has facial fractures can result in misplacement of the tube into the patient's brain.

True

A nurse is caring for a client with a history of cardiac and vascular disease. Which of the following fats should the nurse allow in the client's diet for his condition?

Unsaturated fats Unsaturated fat is a healthier form of fat than saturated fat, because it contains less hydrogen, and therefore can be included in the client's diet

Which vitamin is found only in animal foods?

Vitamin B12 Vitamin B12 functions in the formation of mature red blood cells and in synthesis of DNA and RNA. This vitamin is only found in animal foods: meats, fish, poultry, milk, and eggs

Which of the following is a fat-soluble vitamin?

Vitamin E

When planning interventions in the immediate hours after birth the nurse recognizes the need to provide an injection of which of the following to manage a lack of due to lack of bacteria in the intestinal tract?

Vitamin K Approximately half of the body's requirement of vitamin K is synthesized by bacteria in the lower intestinal tract.

A client who has bleeding tendencies has a deficiency in which vitamin?

Vitamin K Vitamin K deficiencies are manifested in two ways: an increased tendency to hemorrhage which is an escape of blood from a ruptured blood vessel.

Which of the following is the most reliable method for verifying the correct placement of a nasogastric tube?

Which of the following is the most reliable method for verifying the correct placement of a nasogastric tube? a) Radiologic confirmation of position

The nurse is preparing to administer a patient's tube feeding. How should the nurse position the patient prior to beginning the infusion?

With the head of the bed at 30 to 45 degrees Tube feedings should be administered with the head of the patient's bed at 30 to 45 degrees, or as near to normal eating position as possible.

You are preparing to remove a patient's nasogastric tube. Arrange the following steps in the correct order.

You are preparing to remove a patient's nasogastric tube. Arrange the following steps in the correct order. Verify tube placement. Flush tube with 10 mL water. Clamp tubing with fingers. Instruct the patient to take a deep breath and hold it. Quickly remove the tube. Offer mouth care to the patient.

You are the nurse caring for a client with an enlarged thyroid. What nutritional deficiency is linked to an enlarged thyroid?

You are the nurse caring for a client with an enlarged thyroid. What nutritional deficiency is linked to an enlarged thyroid? Iodine A chronic deficiency of iodine can lead to endemic goiter. The major initial symptom is an enlarged thyroid gland.

You have presented an educational inservice about nasogastric tubes. You ask participants to identify reasons a nasogastric tube would be placed in a patient. Which of the following responses by participants are correct? Select all that apply.

a) "To drain unwanted fluid and air from the stomach" b) "To remove undesirable substances, such as poisons" c) "To deliver nutrients" d) "To monitor for bleeding in the gastrointestinal tract" e) "To allow the intestinal tract to rest after bowel surgery"

Which of the following nutritional guidelines should a nurse provide to a client who is entering the second trimester of her pregnancy?

b) "You'll need to eat more calories and to make sure you eat a balanced diet high in nutrients." Nutrient needs during pregnancy increase to support growth and maintain maternal homeostasis, particularly during the second and third trimesters. During the last two trimesters, women of normal weight need approximately 300 extra calories per day.

You are preparing to administer an intermittent feeding to a patient who has a feeding tube. You are unable to aspirate gastric contents. Which of the following actions is correct? Select all that apply.

b) Connect a syringe filled with warm water to the feeding tube and apply gentle pressure. e) Check to see that the feeding tube clamp is open.

Place the following steps in the correct order: You are preparing to insert a nasogastric tube (NGT) into an adult patient. Arrange the following steps in the correct order.

first Place patient in high Fowler's position. second Measure intended length to insert the NGT. third Lubricate the tube tip with water-soluble lubricant. fourth Direct the tube upward and backward along the floor of the nose. fifth Instruct the patient to place chin onto the chest. sixth Advance the tube while the patient swallows