Nutrition

The nurse is caring for a patient who is receiving intermittent gastric tube feedings. Which pH finding will allow the nurse to initiate the feeding?

3 The nurse can initiate feeding if the pH is 3. Correct placement of the tube in the stomach (gastric) is verified if the pH is lower than 4. If the tube has been inadvertently placed in a lung, the aspirate pH is 6 or higher. If the tube has been inadvertently placed in the intestines, the aspirate pH is 7 or higher. Due to the high risk of adverse events, a pH above 6 is reason to stop the procedure and again verify placement through radiological methods. STUDY TIP: Food goes through acid-base hydrolysis in its journey from the stomach to the intestines. The acidic pH in the stomach comes first, and the basic pH comes second, just like "a" comes before "b". Knowing this will help you remember that the stomach pH should be verrrry low (in this case, below 4) because it is acidic.

Which patient requires hospitalization?

A patient whose BMI is 12.5 kg/m2 The patient's BMI is 12.5 kg/m2. Patients whose body mass index (BMI) is less than 13 kg/m2 are considered severely malnourished and require highly skilled nursing care with hospitalization. A BMI of 18.5 kg/m2 to 24.9 kg/m2 indicates that the patient has normal weight and does not require nursing care and hospitalization.

The student nurse is assisting the registered nurse (RN) in caring for a patient who is on nasogastric tube feeding. The student nurse is unable to obtain an aspirate of the patient. How will the RN instruct the student nurse in this situation?

"Place the patient in the side-lying position and try again after 30 minutes." The nurse checks the aspirate of the patient to ensure proper placement of the tube. If the nurse is unable to obtain the aspirate, then the nurse should place the patient in side-lying position and try again after 30 minutes. The nurse should not completely remove the tube to obtain the aspirate. This intervention is appropriate if the patient shows signs of respiratory distress. The nurse should notify the primary health care provider or obtain an order for an X-ray only after two attempts have failed. This is because the failure to obtain the aspirate after two attempts indicates incorrect tube placement. I'm

A 3-year-old child has rickets. Which vitamin should be supplemented to the child's diet?

A deficiency of vitamin D causes rickets. Therefore, the child should receive vitamin D supplements. Deficiency of vitamin A causes night blindness. Lack of vitamin B causes neural tube defects. Vitamin C deficiency leads to scurvy.

A nurse works in a medical-surgical unit. Which patients in the unit require additional nutrients in their diet to maintain a positive nitrogen balance? Select all that apply.

A patient with major burns patient with an infection A patient with fever A positive nitrogen balance in the body is needed for growth and development, for maintaining muscle mass and vital organs, and for repair of tissues and wound healing. The body uses nitrogen for all these activities. The body is said to have a negative nitrogen balance when the body loses more nitrogen than it gains through food and internal body mechanisms. Patients with major burns, infections, and fever have a negative nitrogen balance due to tissue destruction and the need for tissue repair and replacement. Therefore, these patients require additional nutrients in their diet to maintain the nitrogen balance in the body and promote healing. Patients with epilepsy and backache do not have a negative nitrogen balance and do not need additional nitrogen.

The home care nurse is seeing the following patients. Which patient is at greatest risk for experiencing inadequate nutrition?

A recently widowed 76-year-old woman recovering from a mild stroke Older adults who are homebound and have a chronic illness have additional nutritional risks. Frequently this group lives alone with few or no social or financial resources to assist in obtaining or preparing nutritionally sound meals. This contributes to a risk for food insecurity caused by low income and poverty. In addition, the mild stroke might cause dysphagia.

The nurse is evaluating a student nurse who is administering solid medications to a patient through an enteral tube. Which behavior by the student nurse needs correction?

Adds the medication directly to the feeding tube before initiating the feeding The nurse should never add solid medications directly to the feeding tube as it decreases its absorption and effectiveness. Therefore, the nurse should instruct the student to administer the medication either by grinding it into powder or by dissolving in 15 to 30 mL of sterile water. This helps to prevent clogging of the tube with the drug particles. Enteric-coated medications should be taken on an empty stomach to prevent their disintegration in the stomach. If the food material can interact with the drug, the nurse should delay the feeding for a designated time. It helps to prevent adverse effects caused by food and drug interaction. The nurse should also allow the diluted medication to flow into the tube directly under gravity or by pushing gently through the plunger to help prevent aspiration.

What test should be performed to confirm the correct placement of a nasogastric (NG) feeding tube before the start of feedings?

An X-ray study is the most accurate confirmation method for ascertaining the exact placement of a nasogastric feeding tube and should always be done on initial tube insertion. Auscultation is unreliable. The pH of the fluid returned is more reliable than auscultation or residual assessment but not as certain as X-ray confirmation. Residual assessment is difficult to obtain with small-bore feeding tubes.

A nurse is conducting a health awareness program on eating disorders. What are the examples of eating disorders? Select all that apply.

Anorexia nervosa is an eating disorder where people refuse to maintain body weight over a minimal normal weight for age and height. Persons may think of themselves as too fat though they are underweight. To maintain the desired body weight, they may fast, do more exercises, and eat minimally. Bulimia nervosa is characterized by a lack of control over eating behavior. There may be binge eating followed by self-induced vomiting to prevent weight gain. Loss of appetite is called anorexia. Diabetes mellitus is not an eating disorder; it is a metabolic disorder. Obesity is not an eating disorder, but it may be caused due to eating disorder.

The nurse is caring for a patient with dysphagia. Which nursing interventions are beneficial for the patient while feeding? Select all that apply.

Asking the patient to tuck the chin Checking the oral cavity for pocketing of food Elevating the patient's head of bed to 45 degrees Patients with dysphagia have difficulty swallowing. Tucking the patient's chin while swallowing helps reduce the gap between the pharynx and epiglottis and reduces the risk for aspiration. Checking the patient's mouth frequently for retention (pocketing) of food in the cheeks and elevating the patient's bed to a 45-degree angle also helps prevent aspiration. Feeding the patient in the supine position may cause gagging or choking. The nurse should wait for 10 seconds between bites to help the patient chew and swallow properly.

A nurse is caring for a patient with dysphagia. What complications of dysphagia should the nurse be aware of? Select all that apply.

Aspiration pneumonia Dehydration Decreased nutritional status Weight loss Dysphagia is difficulty swallowing. A patient who has difficulty swallowing may aspirate food while eating. Food in the respiratory tract can cause pneumonia. A patient with dysphagia may not be able to swallow liquids, thereby decreasing the fluid intake. It can result in dehydration. The patient may not be able to eat properly which affects nutritional intake, and weight loss may occur. Dysphagia does not cause gastrointestinal infection.

A patient is diagnosed with myasthenia gravis. The patient has difficulty swallowing due to this condition. What complications of dysphagia should the nurse be observant for? Select all that apply.

Aspiration pneumonia Dehydration Weight loss Dysphagia refers to the difficulty in swallowing. The chewed food may get aspirated during swallowing and may cause aspiration pneumonia. The inability to swallow may lead to a decreased intake of fluids, resulting in dehydration. Weight loss may occur due to inadequate intake of food. Dental caries are not a complication of dysphagia. They occur due to inadequate oral hygiene. Gastric ulcers may occur due to infection, drugs, or stress.

The nurse is teaching a program on healthy nutrition at the senior community center. Which points should be included in the program for older adults? Select all that apply.

Avoid grapefruit and grapefruit juice, which impair drug absorption. Take a multivitamin that includes vitamin D for bone health. Cheese and eggs are good sources of protein. Caution older adults to avoid grapefruit and grapefruit juice because these impair absorption of many drugs. Thirst sensation diminishes, leading to inadequate fluid intake or dehydration; thus older adults should be encouraged to ingest adequate fluids. Some older adults avoid meats because of cost or because they are difficult to chew. Cream soups and meat-based vegetable soups are nutrient-dense sources of protein. Cheese, eggs, and peanut butter are also useful high-protein alternatives. Milk continues to be an important food for older women and men who need adequate calcium to protect against osteoporosis (a decrease of bone mass density). Screening and treatment are necessary for both older men and women. Vitamin D supplements are important for improving strength and balance, strengthening bone health, and preventing bone fractures.

A nurse is assisting an older adult with dysphagia to eat. What should the nurse avoid?

Bites should be small to help avoid aspiration. Thickened liquids are easy to swallow. Making the client sit upright while eating helps the nurse prevent aspiration. Keeping the client upright for 45 to 60 minutes after eating helps in gastric emptying and prevents aspiration.

While assessing a child with a vitamin deficiency, the nurse finds that the child has severe bruises and bleeding. Which food substances will the nurse include in the child's diet plan to alleviate these symptoms?

Broccoli, spinach, and cabbage Dark green leafy vegetables such as broccoli, spinach, and cabbage are good sources of vitamin K. Vitamin K is essential for the formation of clotting factors. Deficiency of vitamin K impairs the clotting process and causes bleeding. Therefore, the presence of severe bruises and bleeding indicates that the child has vitamin K deficiency. Meat, eggs, and dairy products are rich in vitamin B12. Fresh yellow and orange fruits are rich in vitamin C. Legumes, nuts and whole grains are rich in vitamin B1.

A nurse is providing nasogastric (NG) feeding to an unresponsive patient. Which intervention indicates a correct technique of feeding?

Check residual volume every 4-6 hours Checking the residual volume every 4-6 hours is an effective measure to ensure that the feeding is being absorbed without risk of delayed gastric emptying. Stimulating the gag reflex increases the risk of aspiration. Patients should receive the prescribed dosage of the enteral feeding as directed by the healthcare provider. Enteral feedings should never be administered to a patient in a supine position because of the risk of aspiration.

The nurse, after reviewing the diet of a patient, finds that the patient eats large amounts of fatty food and beverages with artificial sweeteners. Which disorder does the nurse anticipate finding in the patient as a result of this diet?

Diarrhea Excessive consumption of fatty foods and beverages with artificial sweeteners increases the peristaltic movements of the gastrointestinal tract and the risk of diarrhea. Cachexia is a wasting away from lack of calories. Diverticulitis is a bacterial infection of the bowels that manifests as pain in the wall of the colon. It is not caused by the consumption of fatty foods. Anorexia nervosa is an eating disorder and is associated with a decrease in intake.

group of adolescents approach a nurse for advice regarding diet. They play football every day to participate in an interstate sporting event scheduled for next month. What dietary advice should the nurse give them? Select all that apply.

Drink water after exercise in hot climates." "Take vitamin and mineral supplements." "Eat iron-rich foods to prevent anemia." "Increase carbohydrate intake." Adolescents engaged in sports and moderate to high exercise need dietary modification to meet increased needs of energy, vitamins, minerals, trace elements, and other nutrients. Adequate hydration is very important. Adolescents must drink water before and after exercise to prevent dehydration. Extra vitamin and mineral supplements may be required to meet the additional demand. To maintain an optimal hemoglobin level, the adolescents should consume iron-rich foods like leafy vegetables and well cooked meat. Carbohydrate intake should be increased to meet the energy demands. Water intake should not be restricted as it may cause dehydration.

A 70-year-old hypertensive patient came to the clinic for a regular check-up. On assessment, the nurse finds that the patient has experienced a weight loss of 5 pounds and has a poor nutritional status. Which physical signs are indicative of poor nutritional status? Select all that apply.

Dry lips with cracks and fissures Flaccid, "wasted" muscles Hair that is dull, dry and stiff-textured When a person has poor nutritional status, the entire body is affected. The lips are dry and scaly; there may be cracks and fissures at the angle of the lips. The muscles appear flaccid. The muscles lose their tone and bulk due to tissue breakdown. Poor nutrition is reflected by the presence of thinning hair that has a dry, stiff texture and lack of shine. Pain in the chest is not a symptom of poor nutritional status. Chest pain can be due to medical conditions like angina and myocardial infarction. The patient is a known hypertensive; therefore tiredness after climbing stairs is common.

A community nurse is assessing the health of all the members in a family. Which signs and symptoms indicate a deficiency of calcium?

Fragile bones Calcium is required for healthy bone growth and bone density. Even after attaining full growth of bones, calcium is required to maintain the density of bone. Calcium deficiency may make the bones fragile. Iron deficiency leads to anemia, which may give a pale look to the skin and the conjunctiva. Enlargement of the thyroid gland is seen in goiter caused by iodine deficiency. Deficiency of vitamin C may result in bleeding gums.

After assessing a child with malnourishment, the nurse anticipates that the child has a vitamin C deficiency. Which symptom supports the nurse's anticipation?

Gingivitis The deficiency of vitamin C impairs skin integrity and tissue formation. It causes swollen and bleeding gums with loosened teeth resulting in gingivitis. Edema, nausea, and glossitis are not associated with vitamin C deficiency. Protein deficiency may result in kwashiorkor and fluid accumulation resulting in edema. Nausea can be a sign of many gastrointestinal disturbances, but it does not occur with vitamin C deficiency. Glossitis is the inflammation of the dorsal surface of the tongue. It occurs due to folic acid deficiency, but not vitamin C deficiency.

A 70-year-old patient came to the clinic for a regular check-up. The patient lives alone. On assessment, the nurse finds that the patient has experienced a weight loss of 5 pounds and has a poor nutritional status. The nurse decides to assess the food preferences and dietary intake of this patient. Which questions should the nurse ask the patient? Select all that apply.

How do you prepare your food?" "How many meals do you have in a day?" Do you follow any special diet due to your medical condition?" When assessing the dietary and food intake of a patient, it is important to know how the patient prepares the food. Various cooking practices affect the nutritional value of food. Asking how many meals the patient has in a day is important to assess the nutritional status. Asking if the patient is following any special diet is important because it helps the nurse determine if the patient is lacking any nutrients. Asking the patient about buying foods from the nearby store does not provide any information regarding the dietary intake. Asking the patient how many hours it has been between eating dinner and sleeping is not important in assessing dietary intake.

Which statement made by an adult patient demonstrates understanding of healthy nutrition teaching?

I will make sure that I eat a balanced diet and exercise regularly. Obesity is an epidemic in the United States. Proposed contributing factors are sedentary lifestyle and poor meal choices. Healthy eating and participation in exercise or other activities of healthy living promote good health.

What is the advantage of enteral feeding over parenteral feeding?

It maintains intestinal function and integrity. Enteral feedings maintain GI function and integrity. Unfortunately, tube feeding does not offer taste or much satisfaction to the patient. Each method of tube feeding can allow some mobility, but usually patients have accompanying problems that would interfere. Formulas can contain bacteria or be contaminated if not prepared in clean conditions. Formulas should not be used for longer than 4 to 8 hours, and tubing and bags should be changed daily.

A nurse is caring for a patient who is on enteral feedings. Which signs in the patient would indicate adverse effects of the formula? Select all that apply.

Nausea Vomiting Diarrhea Intolerance to feedings occurs when the gastrointestinal system is not completely functional to accept feedings. It can manifest as nausea and vomiting due to large amount of gastric residue. Diarrhea may occur due to indigestion. Low residual volume indicates that the feedings are tolerated. Fever is unrelated to feedings.

On reviewing the diet of a patient, the nurse finds that the patient consumes large amounts of coffee and low protein foods. Which deficiency does this diet help to prevent in the patient?

Niacin deficiency Coffee contains significant amounts of niacin. If a patient drinks excess coffee and avoids the intake of protein rich foods, then that patient would not develop a niacin deficiency. Coffee is not high in calcium, potassium, or vitamin C. Calcium is high in milk, milk products, salmon with bones, spinach, kale, tofu, and orange juice. Potassium is high in dietary sources of milk, bananas, legumes, green leafy vegetable and orange juice, tomatoes, avocados and cantaloupe. Dietary sources of vitamin C include fresh yellow and orange fruits, papaya, kiwi, broccoli, and sweet and white potatoes.

A nurse has formulated the following nursing diagnosis following an initial assessment. Which nursing diagnosis would be a priority for meeting the patient's needs?

Pain related to oral ulcers The patient's needs should be met in order of priority. The pain due to oral ulcers should be a priority, as this pain could affect the patient's nutritional intake and affect all other related interventions. Once the pain is relieved, the nutritional intake can be increased. Correcting imbalanced nutrition that is less than the body requirement should be the second priority, as it may affect other body systems. However, this diagnosis can be only addressed once the oral pain is relieved. Deficient knowledge regarding the diet therapy is the third priority of this nursing diagnosis. This diagnosis can only be addressed once the patient is relieved of pain. The risk of constipation is the last priority. It can be addressed once the pain is relieved. The risk can be prevented by increasing the dietary intake and advising the patient on diet changes.

The nurse, while assessing a patient who is on jejunostomy feedings, finds that the patient has dumping syndrome. Which findings support the nurse's conclusion? Select all that apply.

Pallor Nausea Abdominal cramps A patient on jejunostomy feedings may show the signs of dumping syndrome due to distention of the jejunum. The signs and symptoms of dumping syndrome include pallor, nausea, and abdominal cramps. Hyperthermia, increased temperature, is not a symptom of the dumping syndrome. Rather, the patient may have increased heart rate and diarrhea due to dumping of the contents into the intestine.

A patient with anemia has a sore, beefy-red tongue. Which type of anemia does this assessment finding support?

Pernicious anemia The presence of a sore and beefy-red tongue indicates that the patient has pernicious anemia. The patient with pernicious anemia lacks intrinsic factor resulting in vitamin B12 deficiency. Sickle cell anemia is an inherited disease, which is characterized by the presence of sickle shaped red blood cells. The characteristic symptom of sickle cell anemia is sudden body pain mainly affecting the bones, lungs, abdomen, and joints. Folic acid deficiencies in the adult patient may be evident in symptoms such as the presence of an inflamed tongue or glossitis. A patient with iron deficiency anemia has a sore or swollen tongue, but not a beefy-red tongue. STUDY TIP: Because vitamin B12 deficiency can result from a strict vegan diet---one that contains no animal products at all--- it's ironic that the tongue's description is "beefy-red"!

The nurse sees the unlicensed assistive personnel (UAP) perform the following for a patient receiving continuous enteral feedings. What intervention does the nurse need to address immediately with the UAP? The UAP:

Places the patient supine while giving a bath. Patients receiving enteral feedings should have the head of the bed elevated a minimum of 30 degrees, preferably 45 degrees, unless medically contraindicated. Laying the patient supine increases the risk of aspiration of the feeding and should be avoided. This needs to be addressed to maintain patient safety.

Following an assessment of a patient, the nurse formulates the diagnosis of "Imbalanced Nutrition: Less Than Body Requirements." What were the assessment findings in the patient? Select all that apply.

Poor muscle tone Hair loss Pale conjunctiva The nursing diagnosis Imbalanced Nutrition: Less Than Body Requirements" refers to the condition when nutritional intake is inadequate to meet the metabolic demands of the body. Inadequate nutrition can affect all systems of the body. The musculoskeletal system may be affected, leading to poor muscle tone. The integumentary system may be affected, leading to hair loss. The production of red blood cells may decline, leading to anemia. Low hemoglobin is evident as pale conjunctiva and mucous membrane. Body mass index measures weight corrected for height. A BMI between 25 and 30 indicates overweight. A smooth and supple skin indicates adequate nutrition and healthy fluid balance. Nutritional deficiency may lead to dry, scaly skin.

An adult patient has a body mass index (BMI) of 20 kg/m2. What should the nurse interpret from it?

The patient has a healthy weight BMI is a measurement that describes relative weight for height and is significantly correlated with total body fat content. One can determine BMI by dividing weight in kilograms by height in meters squared (BMI = weight kg/height m2). The desired range for healthy adults is 18.5 to 24.9 kg/m2, which reflects a healthy weight for height. A patient with a BMI of 25 to 29.9 kg/m2 is considered overweight. A patient with a BMI less than the normal range may have an imbalanced nutrition. Those with a BMI greater than 40 kg/m2 are classified as morbidly obese.

A nurse weighs a patient with renal failure and finds the body weight to be 112 pounds. The patient's weight on the previous day was 110 pounds. What should the nurse interpret from the finding?

The patient has retained a liter of fluids. In renal failure, kidneys may not be able to excrete the required amount of fluids from the body, resulting in fluid retention. An increase in body weight over a period of 24 hours indicates water retention in a patient with renal failure. Retention of 500 ml of fluids would cause an increase of one pound in body weight. Therefore, if there is an increase of 2 pounds in body weight, the patient has fluid retention of one liter. This weight gain is not considered healthy, as it indicates that the kidneys are unable to excrete the additional fluids in the body. The weight gain indicates a deteriorating kidney function. If the patient has not passed urine for a long time, it does not cause an increase in body weight. In addition, body weight is measured only after the patient has passed urine.

A patient tells the nurse, "I eat all fruits and vegetables except bananas, and I eat very little meat and cheese." What does the nurse infer from this information?

The patient is on a renal diet. The renal diet includes all fresh fruits and vegetables except bananas. Bananas should be avoided and meats and cheese should be limited because they have a high protein content. In a cardiac diet, the patient should avoid high-cholesterol and high-sodium dietary items. Pureed diet and thickened diet are prescribed to patients who have difficulty swallowing and have high risk of aspiration. A pureed diet does not restrict the intake of banana, meat, nor cheese. Any foods are allowed on a regular diet.

A 19-year-old patient with megaloblastic anemia is on folic acid (Folvite) therapy. On reviewing the laboratory reports, the nurse finds that the patient still has a reduced red blood cell count and low folate levels. What does the nurse anticipate from these findings?

The patient is taking oral contraceptives. Oral contraceptives inhibit the absorption of folic acid supplement (Folvite) and decrease its effectiveness. Folic acid deficiency can result in megalobastic anemia. Folic acid supplement (Folvite) alleviates the symptoms of megaloblastic anemia by increasing folic acid levels and red blood cell count. Laxatives, diuretics, and analgesics do not interact with folic acid supplement (Folvite).

The nurse is inserting a nasogastric tube. Place the steps in the proper sequence.

The procedure follows a set series of steps, starting with performing hand hygiene and putting on gloves to decrease the transmission of microorganisms. Raise the bed to working height, and lower the side rails as appropriate and safe. Raise the head of the bed to the high-Fowler's position (or as far as the patient can tolerate up to that position). Raising the head of the bed allows gravity to assist with proper insertion and decreases patient discomfort during the procedure. Choose a naris on the basis of which one is most intact and has the greatest airflow; try to avoid placement in a naris that has undergone previous surgery or injury. Prepare the bedside setup. Place the setup on whichever side of the bed allows the dominant hand to be closest to the patient. Prepare the tape or tube fixation device, and prepare the NG tube. Insert the tube. Do not force it. The patient's neck should be hyperextended. Advance the tube while the patient is swallowing; provide water to the patient (if the patient is able to swallow and allowed to drink fluids). Secure the tube. Keep the tube clamped until placement of the tube is verified. Check the initial tube placement with an x-ray; checking pH may be permitted to confirm correct placement after verification by x-ray. Radiology is the only reliable method of determining accurate placement; however, the placement may be reverified with an alternative method.

While caring for a geriatric patient with dysphagia, the nurse provides a thickened liquid diet for the patient. What is the rationale for the nurse's action?

To prevent the risk of aspiration A patient who has difficulty chewing or swallowing (dysphagia) has risk of aspiration due to suction of the liquid into the airways. Therefore, to prevent aspiration, the nurse should provide thickened liquid diet to the patient. Fiber helps prevent the risk of constipation. A low sodium, low cholesterol diet helps prevent the risk of hypertension. A diabetic diet helps prevent hypoglycemia.

The nurse is assessing a patient with suspected bulimia nervosa. Which findings are consistent with bulimia? Select all that apply.

Tooth decay Self induced vomiting Bulimia nervosa is an eating disorder characterized by frequent episodes of binge eating followed by the frantic efforts to avoid gaining weight (purging). Patients with this disorder eat as many as 2000 to 3000 calories at a time and use self-induced vomiting to avoid gaining weight. Patients with anorexia nervosa disorder may refuse to socialize with friends or family when food is involved. Anorexia nervosa patients have strict dietary intake regimens as a means of gaining control. Patients with anorexia nervosa disorder also refuse the intake of healthy foods.

renal failure, protein intake should be approximately 1 to 1.4 g per kilogram body weight. What is the best source of this protein?

Use of high-biologic value or high-quality proteins is recommended in renal failure. A high-quality protein contains all essential amino acids in sufficient quantity. These proteins help in growth and development, and help in maintaining nitrogen balance. Fish is a source of high quality protein and contains all essential amino acids. Cereals and legumes like peas and beans are incomplete proteins and lack one or more of the nine essential amino acids.

A patient is diagnosed with complete obstruction of the bile duct due to a gall stone. The patient passes fats in stool due to indigestion of fats. Which vitamin deficiency is the patient at risk of? Select all that apply.

Vitamin A Vitamin D Vitamin E Vitamin K Vitamins A, D, E, and K are fat-soluble vitamins and may not get absorbed if the fats are excreted undigested. Vitamin B and C are water-soluble vitamins and their absorption is not dependent on fats. STUDY TIP: Memorize which vitamins are fat-soluble and which are water soluble. Create a mnemonic if needed, such as, "BeCause Water is important!" All vitamins are either water- or fat-soluble, so once you know one group's vitamins (water- or fat-soluble), you know the rest of the vitamins belong to the other group.

Which vitamins are fat-soluble and are stored in the adipose tissue of the body? Select all that apply.

Vitamins are of two types, fat soluble and water soluble. Vitamins A, D, E, & K are fat soluble and are stored in the body. These vitamins may become deficient in persons who do not include fats in their diet. Vitamins B and C are water-soluble vitamins and are found in most fruits and vegetables. These vitamins are not stored in the body.

A nurse is inserting a nasogastric tube in a patient. In which order should the nurse perform the interventions starting with the first step to the last?

While inserting a nasogastric tube, the nurse should initially lubricate the tip of the tube. This helps to reduce friction and prevents trauma to the nasal mucosa. Then, the nurse should hyperextend the patient's neck and insert the tube and ensure that it is not forced into the nasopharynx. The nurse then tilts the patient's chin forward and rests it on the chest when the tube reaches the nasopharynx. If the patient has difficulty swallowing, then the nurse should provide water and encourage the patient to breathe. Thereafter, the tube should be secured using a fixation device to ensure that the tube is not disturbed.

A 70-year-old patient is admitted to the hospital post stroke. The patient suffers from right-sided hemiplegia and dysphagia. Identify the complication of dysphagia that the nurse might observe in the patient.

aspiration pneumonia Dysphagia may increase the risk of the food getting into the airway while eating. It may get aspirated and lead to aspiration pneumonia. Difficulty in swallowing fluid leads to decreased fluid intake, resulting in dehydration. Inability to swallow may reduce food intake and result in weight loss.

The nurse is assessing a geriatric patient who has lost all teeth. Which complication does the nurse most closely monitor for in the patient due to this condition?

cardiovascular disorders Tooth loss is associated with increased body mass index (BMI), which creates a higher risk for cardiovascular disease. The increase in BMI appears to occur from increased consumption of high-calorie foods with low-level nutrients, such as soft, sweet foods that promote obesity. Tooth loss is not associated with renal, cerebral, or hepatic disorders.

The nurse teaches a patient who has had surgery to increase which nutrient to help with tissue repair?

protein Proteins provide a source of energy (4 kcal/g), and they are essential for synthesis (building) of body tissue in growth, maintenance, and repair. Collagen, hormones, enzymes, immune cells, deoxyribonucleic acid (DNA), and ribonucleic acid (RNA) are all made of protein.

The nurse is caring for a burn patient with elevated transferrin levels. Which supplement does the nurse expect to be prescribed?

iron supplements Burns may elevate the transferrin levels in the body due to low serum iron levels. Therefore, iron supplements should be prescribed to the patient in order to increase the serum iron levels and to reduce the transferrin levels. Vitamin K, vitamin A, and potassium deficiencies do not cause a decrease in transferrin levels. Therefore, the nurse does not expect potassium, vitamin K, and vitamin A supplements to be prescribed for the patient.

While assessing a patient, the nurse finds that the patient is a strict vegan. Which condition does the nurse monitor for in this patient?

pernicious anemia Vegan food has fewer amounts of vitamin B12, which are essential for the formation of red blood cells. Therefore, the patient who follows a strict vegan diet has the risk of pernicious anemia due to vitamin B12 deficiency. Marasmus and kwashiorkor are caused due to the deficiency of protein. As legumes are a rich source of protein, a patient following a vegetarian diet would not be at a particularly high risk of marasmus and kwashiorkor. Crohn's disease refers to the inflammation of the bowel that affects the gastrointestinal system and is not caused by a vegetarian diet.