Altered Nutrition

What is the required average daily intake of calories in preschoolers?

1,800 Rationale: The average daily intake of calories required in preschoolers is 1800 calories. Four hundred, 700, and 1,000 would be too low.

A nurse is caring for a newly admitted client with anorexia nervosa. What is the priority treatment for the client at this time?

Correction of electrolyte imbalance Rationale: Starvation or inadequate/inappropriate nutrition can lead to electrolyte imbalances, which are life threatening. Medication and therapy will be prescribed later and are not the priority at this time. Client independence, not separation from family members, is supported.

A client with cancer of the colon had surgery for a resection of the tumor and the creation of a colostomy. During the six-week postoperative checkup, the nurse teaches the client about nutrition. Which response by the client indicates learning has taken place?

I should follow a diet that is as close to usual as possible Rationale: Although foods that produce gas are generally avoided, the diet should be as close to normal as possible for optimal physiologic and psychologic adaptation. A high-protein diet is important until healing occurs, but this is at the six-week checkup; a balanced diet generally meets nutritional needs for protein. There is no need to limit sodium. Absorption of nutrients is unaffected; there is no need to increase the caloric intake.

The nurse assesses a client who is receiving total parenteral nutrition for the specific complication of what condition?

Infection Rationale: The concentration of glucose in the solution (20% to 25%) is a rich culture medium for bacterial and fungal growth. Hepatitis is not associated with total parenteral nutrition. Anorexia often is present before the medical decision to begin total parenteral nutrition; it is not a complication. Dysrhythmias are not related directly to total parenteral nutrition, but rather to concomitant hypokalemia, which can occur if potassium is not added to the solution.

After surgery for cancer of the pancreas, the client's nutrition and fluid regimen are influenced by the remaining amount of functioning pancreatic tissue. The nurse considers both the exocrine and the endocrine functions of the pancreas and expects that, postoperatively, the client's dietary regimen will be focused on the management of what substances?

Fats and carbhydrates Rationale: Formation of lipase necessary for digestion of fats is an exocrine function; the endocrine function is to secrete insulin, which is a hormone essential in carbohydrate metabolism. Although it is necessary to avoid alcohol, this is not related to pancreatic exocrine functions; caffeine is unrelated to pancreatic function. Fluid and electrolyte problems are not related specifically to exocrine or endocrine pancreatic functioning. Deficiencies of vitamins and minerals may occur because of inadequate intake, but these deficiencies are not specifically related to exocrine or endocrine pancreatic functioning.

A nurse is teaching a client about gastroesophageal reflux disease (GERD). Which statement made by the client indicates correct understanding of GERD management?

I will place a 6 inch block under the head of my bed to help with digestion Rationale: Elevation of the head of the bed can enhance esophageal emptying and reduce symptoms of GERD. A low-fat, high-protein diet is recommended. Eating should be avoided three hours before bedtime to reduce acid production, and the client should be instructed to consume small, frequent meals throughout the day to avoid gastric distention.

A client is admitted to the hospital with a diagnosis of Crohn disease. What is most important for the nurse to include in the teaching plan for this client?

Meeting nutritional needs Rationale: To avoid gastrointestinal pain and diarrhea, these clients often refuse to eat and become malnourished. The consumption of a high-calorie, high-protein diet is advised. Diarrhea, not constipation, is a problem with Crohn disease. Preventing an increase in weakness is a secondary concern that results from malnutrition; correcting the malnutrition will increase strength. Anticipating a sexual alteration generally is not a problem with Crohn disease.

What is the role of shark cartilage in the management of human immunodeficiency (HIV) and acquired immunodeficiency syndrome (AIDS)?

Shark cartilage is a complementary therapy Rationale: Shark cartilage is considered as an alternative or complementary therapy to prescribed medications for clients with HIV and AIDS. Lymphocyte transfusions and bone marrow transplants are used to improve immunity in clients with HIV and AIDS. Lemon juice and lemongrass may provide relief from oral thrush in some clients with HIV and AIDS. A high-calorie, high-protein diet is advised to clients with HIV and AIDS to improve their nutritional status.

The primary reason the nurse encourages a client with a spinal cord injury to increase oral fluid intake is to prevent which problem?

Urinary tract infection Rationale: Clients in the early stages of spinal cord damage experience an atonic bladder, which is characterized by the absence of muscle tone, an enlarged capacity, no feeling of discomfort with distention, and overflow with a large residual. This leads to urinary stasis and infection. High fluid intake limits urinary stasis and infection by diluting the urine and increasing urinary output. Dehydration is not a major problem after spinal cord injury. Pressure-relieving devices and position changes are most essential in preventing skin breakdown. An electrolyte imbalance is not a major problem after spinal cord injury.

A nurse is conducting cholesterol screening for a manufacturing corporation during a health fair. A 50-year-old man who is 6 feet (183 cm) tall and weighs 293 pounds (133 kg) puts out his cigarette and asks the nurse how to modify his risk factors for coronary artery disease. On which risk factors should the nurse help the client focus?

Weight Smoking Rationale: Obesity is a modifiable risk factor that is associated with coronary artery disease (CAD); an increased fat intake contributes to an increased serum cholesterol and atherosclerosis. Smoking, which constricts the blood vessels, is a modifiable risk factor for CAD. The incidence of CAD does increase with age. However, age is not a modifiable risk factor. Height is unrelated to the incidence of CAD. Family history is not a modifiable risk factor for CAD because one cannot control heredity.