Nutrition FINAL test A

pancreatitis- which is an expected finding

the pancreases during digestion, your pancreas makes pancreatic juices called enzymes. These enzymes break down sugars, fats, and starches. -Increased glucose: The nurse should expect an increased glucose level in a client who has acute pancreatitis due to decreased insulin production by the pancreas. -increased bilirubin and alkaline phosphatase as an expected finding in a client who has acute pancreatitis. - decreased calcium as an expected finding in a client who has acute pancreatitis.

counting carbs

-"I know the serving size can affect the number of carbohydrates I eat.: portion size affects the number of carbohydrates. -NO The nurse should instruct the client that generally three to five carbohydrate choices, or 45 g, are allowed per meal, plus one to two carbohydrate choices for each snack. -NO I know the carbohydrate count is dependent on the calories in the food item: The nurse should instruct the client that the carbohydrate count is not dependent on the calorie count of a food item. Fats and proteins can provide calories as well.

hypertension

-"I should choose whole grain pastas when selecting my foods: Whole grains are a healthy choice of carbohydrate because they contain ingredients that lower the risk of cardiovascular disease and improve blood pressure. -Increased potassium levels decrease blood pressure levels. The client should increase their consumption of foods containing potassium. -The nurse should instruct the client that low-sodium salt substitutes are not sodium-free and can contain nearly half as much sodium as table salt. so no salt substitutes at all -"I can drink up to three glasses of wine each day: The client can consume alcohol in moderation, if at all. Moderate daily alcohol intake is one drink for women and two drinks for men.

diabetes client HbA1c of 8.7

-"This shows that I have not been following my diet.": An HbA1c level of 8.7% is not within the expected reference range. The HbA1c goal level for a client who has diabetes is between 6.5% and 7%. -"I should have gone to my exercise class yesterday.: Short-term factors, such as exercise, do not affect the client's HbA1c level. -The client can give a blood sample at any time of the day because the HbA1c level indicates the average blood glucose levels for the previous 100- to 120-day period. Fasting is not required.

TPN- the client asks why TPN is being continued when he is eating foods now.

-"You should consume at least 60 percent of your calories orally before the parenteral nutrition can be discontinued: TPN can be discontinued when oral intake exceeds at least 60% of the client's estimated daily caloric requirements. OTHER -"Your blood glucose levels need to be within a normal range before the parenteral nutrition can be stopped: Blood glucose levels are monitored when a client is receiving TPN; however, this is not a criterion for discontinuation of the therapy. -"You should have a weight gain of at least 1 kilogram per day before the therapy is stopped: A weight gain of 1 kg/day is indicative of fluid overload, an adverse effect of TPN. -"Your bowel movements need to be regular before the therapy can be discontinued: Bowel function is monitored when a client is receiving TPN; however, it is not a criterion for discontinuation of the therapy.

dehydration

-A client who has a sodium level of 150 mEq/L: The nurse should identify that a sodium level of 150 mEq/L is above the expected reference range of 136 to 145 mEq/L and indicates hypernatremia. Hypernatremia, often called water deficit, is a decrease of sodium concentration in the blood caused by an excess of water. Manifestations of hypernatremia include confusion, headache, nausea, and fatigue.

Braden scale

-A client who scores a 1 (Very Poor) in the nutrition category of the Braden scale never finishes a complete meal, drinks little fluid, and does not drink any dietary supplements. -A client who scores a 2 (Probably Inadequate) in the nutrition category of the Braden scale only eats about half of meals or snacks and only occasionally takes dietary supplements. -A client who eats more than half of most meals, occasionally refuses a meal, and has four servings of protein each day scores a 3 (Adequate) in the nutrition category of the Braden scale. -A client who scores a 4 (Excellent) in the nutrition category of the Braden scale eats most of every meal, eats plenty of protein, and occasionally eats between meals.

Anorexia related to cancer treatment

-Add extra calories and protein to every meal -The nurse should serve cold foods rather than hot foods. Hot foods emit odors that can further decrease the client's appetite. -The nurse should advise the client to eat small, frequent meals approximately every 2 hr. Not 3 meals a day. -Recommend cooking aromatic foods to stimulate appetite: Cancer treatments can cause an increased sensitivity to odors, precipitating nausea and increasing anorexia.

postop following a gastric bypass procedure

-Begin each meal with a protein:The nurse should instruct the client to begin each meal by eating a protein. The client should consume 60 to 120 g of protein each day. -The nurse should instruct the client to eat slowly and to stop eating after beginning to feel full. -NO Eat six small meals per day: three meals and two snacks of a limited portion size each day. -The nurse should instruct the client to eat slowly, take time to chew food well, and plan for meals to last between 30 and 60 min.

nutrient dense food choices

-Canned pinto beans are a better choice than refried beans: Canned pinto beans contain less fat than refried beans. -NO Sausage is a healthy choice of protein: Canadian bacon or another low-fat meat is a better option for protein than sausage. -NO Sweetened fruit yogurt is a healthy breakfast choice: -NO Sweetened fruit yogurt is higher in fat and added sugars; therefore, plain, fat-free yogurt with fresh fruit is a better choice. -Pasta with red sauce is a better choice, because it contains less fat than pasta with white sauce.

head and neck resection to treat cancer and is receiving radiation therapy

-Changes in the production of saliva:Changes in salivation are a potential complication of a head and neck resection and radiation therapy. -Malabsorption of nutrients is a potential complication of radiation enteritis, an effect of radiation to the abdomen and pelvis. -Radiation enteritis occurs following radiation of the pelvis or abdomen, rather than the head and neck. -Bone marrow suppression is an adverse effect from chemotherapy not radiation

reduce the risk of osteomalacia (marked softening of your bones, most often caused by severe vitamin D deficiency)

-Consume 20 mcg of vitamin D daily. -eat foods rich in antioxidants. Antioxidants include vitamins C, E, and beta-carotene. -decrease intake of foods high in purine such as organ meats and certain types of seafood. -recommended dose of vitamin E is 15 mg per day.

dumping syndrome and is experiencing weight loss

-Consume liquids between meals: to slow movement of food from the stomach. -The nurse should teach the client that complex carbohydrates are better tolerated than simple carbohydrates. -The nurse should teach the client that high-fat foods are not a cause of dumping syndrome. -The nurse should teach the client that a high-protein diet is not a cause of dumping syndrome and can improve anemia.

cancer prevention

-Eat at least 2.5 cups of fruits and vegetables each day. -should engage in at least 150 min of moderate-intensity exercise each week -limit alcohol consumption to one to two drinks per day -avoid consuming high-calorie foods and beverages to decrease the risk for cancer.

suspected of having lactose intolerance

-FLATULENCE: Flatulence, bloating, and cramping, and diarrhea are expected findings associated with lactose intolerance.

BMI of 34, 8 weeks pregnant what should she do

-Gain approximately 6.8 kg (15 lb):The nurse should advise the client that based on her BMI, she should gain 4.9 to 9.1 kg (11 to 20 lb) during her pregnancy. -The nurse should advise the client to gain some weight during pregnancy, but less weight than clients whose BMI is within the expected reference range or lower. -she should not attempt to lose weight during pregnancy. -The nurse should advise the client that a weight gain of 12.7 to 15.8 kg (28 to 35 lb) during pregnancy is too high for a client who has a BMI of 34.

Atorvastatin

-Grapefruit juice: The nurse should teach the client to avoid taking atorvastatin with grapefruit juice because it can increase serum levels of the medication, which can increase the risk for rhabdomyolysis and toxicity. -The nurse should teach the client that it is safe to take atorvastatin with coffee, milk, and orange juice.

inflammatory bowel disease

-Hydrolyzed formula:Hydrolyzed or elemental formula provides protein and other nutrients in their simplest form, requiring little or no digestion and decreasing stimulation of the bowel.

celiac disease

-I need to eliminate rye from my diet: Eating sources of gluten, such as barley or rye, increases the manifestations of celiac disease. -Acidic foods do not affect the manifestations of celiac disease. -Oil content of food might need to be decreased in a client who is on a low-fat diet, but oil does not affect the manifestations of celiac disease.

healthy diet to control hypertension

-I will eat four servings of unsalted nuts per week: Female clients should consume four to five servings of unsalted nuts, seeds, or legumes per week for a heart-healthy diet. -Female clients should eat a diet rich in potassium to control hypertension. -Female clients should eat a diet rich in nonfat or low-fat dairy products to control hypertension and therefore should avoid whole milk. -one to two drinks per day, to control hypertension.

4 months old infant

-I will introduce a new solid food every 5 days: The client understands that new food items should be introduced every 4 to 7 days to monitor for indications of food allergies. OTHER -Fruit juices should be introduced at 6 months of age, limited to 120 mL (4 oz), and offered in a cup. -The infant should receive the majority of calories from infant formula or breast milk not solid foods. -Infants should consume 1 to 2 teaspoons of solid food initially at each feeding NOT TABLESPOONS

3 year old child

-I will put low-fat milk in her cup for her to drink: Whole milk provides necessary fat for neurological development for children up to 2 years of age, after which the child should consume low-fat or skim milk. Therefore, the nurse should identify this statement as indicating an understanding of the teaching.

vegetarian diet

-Include two servings per day of nuts when on a vegetarian diet: The nurse should instruct the client to eat two servings of nuts or flaxseed per day to receive the daily requirement of omega-3 fatty acids. -NO Fewer calories are required when on a vegetarian diet: Clients who are consuming a vegetarian diet require a deceased intake of dietary fat rather than fewer calories. The nurse should instruct the client to increase intake of nutrient-dense foods to avoid the breakdown of the body's protein for energy requirements. -NO Foods that contain vitamin B12 are animal-related. The best sources of dietary vitamin B12 are meats and other animal products. As vitamin B12 is generally not present in plant-based foods, the nurse should instruct the client to take vitamin B12 supplements or consume foods fortified with B12 to compensate for a potential deficiency. -NO Consume high-fat cheese to replace meats when on a vegetarian diet.The nurse should instruct the client to consume low-fat cheese as a protein substitute. High-fat cheese has more saturated fat and calories than meat.

mucositis (mouth to the stomach)

-Increase fluid intake to 2 L per day: A client who has mucositis should increase fluid intake to promote hydration and peristalsis. -A client who has mucositis should avoid glycerin-based swabs because they cause dryness and irritation. -avoid acidic foods to prevent further irritation. -provided with room temperature or cooled liquids to reduce irritation.F

warfarin eat in moderation

-Leafy green vegetables: The nurse should recommend the client eat in moderation and maintain consistent intake of leafy green vegetables, which contain a natural form of vitamin K that can negate the anticoagulation effects of warfarin.

increase fiber

-Leave the skin on when eating fruit: consuming the skin on fruits and vegetables adds fiber to the diet. -increase fluid intake as fiber intake increases -NO 1/2 cup of bran: The nurse should instruct the client to add a small amount of bran to the daily diet, working up to 3 tablespoons daily, which is less than ¼ cup. Adding fiber gradually should prevent abdominal distention and excessive flatus. -NO Replace legumes with broiled meats: The nurse should instruct the client to replace meat-based meals with meals that feature dried peas or beans to add fiber to the diet.

highest amount of calcium

-Low-fat yogurt contains 314 mg of calcium per cup -Cheddar cheese contains 214 mg of calcium per ounce. -One egg contains 25 mg of calcium. -Spinach contains 122 mg of calcium per half cup.

Child with type 1 diabetes Somogyi Phenomenon

-Monitor blood glucose levels during the night: Somogyi phenomenon is fasting hyperglycemia that occurs in the morning in response to hypoglycemia during the nighttime. The nurse should assess for this phenomenon by monitoring blood glucose levels during the night. -

continuous enteral feedings, what should you do to prevent aspiration

-Monitor gastric residuals every 4 hr: The nurse can identify delayed gastric emptying by monitoring gastric residuals regularly. Delayed gastric emptying places the client at risk for aspiration and can necessitate a decrease in the feeding rate. -The head of the client's bed should be elevated to between 30º and 45° during the feeding and for at least 1 hr afterward. -Confirmation of proper tube placement by radiograph should take place before initiating enteral tube feedings. It is not necessary to confirm placement again unless there is an indication that the tube has become displaced. -Flushing the tube with 30 to 50 mL of water before and after medication administration helps maintain tube patency but does not help prevent aspiration.

client wants to lose weight- take first

-Obtain a 24-hr dietary recall. -The nurse should recommend the client weigh themselves regularly to monitor weight loss or gain; however, there is another action the nurse should take first. -The nurse should assist the client with the creation of a personalized exercise plan to increase strength and promote weight loss; however, there is another action the nurse should take first. -The nurse should initiate a personalized diet modification plan with the client based on the client's assessment data to promote weight loss; however, there is another action the nurse should take first.

ZINC

-PINTO BEANS: The nurse should determine that pinto beans are the best food source to recommend because they contain the highest amount of zinc per serving.

breast feeding

-Plan 5-min feedings on each breast on the first day after birth: to promote milk production. -NO Plan to breastfeed the newborn every 4 hr: The nurse should instruct the clients to breastfeed on demand when the newborn shows indications of hunger, usually 8 to 12 times per day. -NO Offer the newborn 30 mL (1 oz) of glucose water after the first breastfeeding session: The nurse should instruct the clients to avoid offering the newborn fluids other than breast milk to promote milk production. -Offer supplemental formula until the milk supply is established: avoid using supplemental formula or water with artificial nipples to decrease the risk of nipple confusion.

weight management for cardiovascular health

-Plan to lose weight gradually at ½ to 1 pound per week!!!! -The nurse should inform the participants that if a nutritionally-balanced diet is carefully planned and followed, vitamin supplements are not necessary. Evidence-based practice indicates that multivitamin supplements do not decrease or prevent cardiovascular disease. -The nurse should inform the participants that plant-based protein assists in lowering cholesterol levels, which ultimately reduces the workload of the heart. Adequate protein is also important for maintaining muscle mass, which aids in weight management. -limit their sodium intake to 1,500 mg/day.

HIV- which of the following findings as an indication to increase the clients nutritional intake.

-Presence of herpes simplex virus infection:Secondary infection triggers inflammatory responses that increase the client's metabolic rate. Therefore, the nurse should identify the presence of herpes simplex virus infection as an indication to increase the client's nutritional intake. OTHER -T-helper (CD4+) cells 700/mm3: This finding is within the expected reference range. The nurse should recognize that a decreased CD4+ cell count is associated with a need for increased nutritional intake, and a count below 200/mm3 indicates progression to AIDS. -an increased HIV viral load indicates progression of the disease, which increases nutritional needs. -a decrease in lean body mass or fat as indicating possible HIV-associated wasting syndrome and a need for increased nutritional intake.

Islamic dietary laws during ramadan

-Provide a snack for the client after sunset: During Ramadan, clients who follow Islamic dietary laws consume meals before dawn and after sunset. The nurse should offer the client a snack or light meal after sunset. -fast during daytime hours. When not fasting, Islamic dietary law specifies that caffeine is prohibited and beverages are consumed after, rather than with, meals. -can eat during nighttime hours.

dehydrated and receiving an intermittent enteral feeding

-Provide the formula as a continuous infusion: to prevent receiving a high carbohydrate load with each feeding. -A client who is experiencing distention and bloating should receive a low-fat formula. A client experiencing dehydration should receive a low-protein formula. -DO NOT DILUTE BEFORE ADMIN because A client who is experiencing dehydration should receive additional water, but diluting the formula will also reduce the amount of nutrients the client receives.

lowering solid fat intake to an adolescent consuming 2,000 calories per day

-Restrict your daily meat intake to 5 ounces: limit meat intake to about 5 oz per day. A meat portion should be no larger than the size of a deck of cards. -The nurse should instruct the client to select ground beef that is at least 90% lean. -The nurse should instruct the client to select cheeses that contain no more than 3 g of fat per serving. -The nurse should instruct the client to choose margarine that contains no more than 2 g of saturated fat per tablespoon.

decreasing sodium

-Season foods with herbs and spices: The nurse should instruct the client to replace salt with herbs and spices when seasoning foods. -The nurse should instruct the client to avoid products that are high in sodium, such as soy sauce, mayonnaise, and ketchup. -The nurse should instruct the client that processed cheeses are high in sodium and should be avoided. -The nurse should instruct the client to avoid processed foods such as frozen dinners, which can be high in sodium.

dumping syndrome following a gastrectomy

-Select grains with less than 2 g fiber per serving: Clients at risk for dumping syndrome better tolerate low-fiber grains that contain less than 2 g fiber per serving to slow gastric emptying. -The nurse should instruct the client to eat small, frequent meals to slow gastric emptying. -lie down after eating to slow the movement of food through the gastrointestinal system. -avoid simple sugars and sugar alcohols, which make food mass more hypertonic, causing a greater fluid volume shift and triggering dumping syndrome.

bottle feed an infant with a cleft lip

-Squeeze the infant's cheeks together while feeding:The nurse should gently squeeze the infant's cheeks together to decrease the width of the cleft, allowing the infant to achieve a better seal, which reduces the risk of aspiration. -The nurse should place a high-flow rate nipple on the bottle because the infant can have difficulty achieving a good seal -a bottle with a one-way valve to assist the infant in effective feeding, because this allows the liquid to flow into the infant's mouth rather than back into the bottle. Providing an effective flow of formula reduces the risk of aspiration. -The nurse should burp the infant after each ounce of feeding or at least two to three times during the feeding. Infants who have a cleft lip can swallow air while feeding, which can cause vomiting and an increased risk of aspiration.

risk factor for impaired wound healing

-The client consumes 1,000 kcal daily:Adults who have had surgery require at least 1,500 kcal daily to meet energy needs and build protein for tissue healing. The nurse should recognize that a 1,000 kcal/day intake is below the client's needs. -A hemoglobin level below the expected reference range is a risk factor for impaired wound healing. -Pulses +3 strength are an expected finding.The nurse should identify decreased tissue perfusion as a risk factor for impaired wound healing. -takes ZINC: The body uses zinc to build proteins and aid the immune response. The nurse should identify this finding as a factor that will promote wound healing.

Parkinsons during meal time what is priority

-The client drools while eating: Drooling while eating can indicate that this client is at greatest risk for aspiration of food from dysphagia, which can lead to pulmonary complications OTHER -The client's hand trembles when they holds their spoon: The nurse should offer the client assistance with feeding to promote adequate food and fluid intake -The client chooses to sit alone during the meal: The nurse should identify that the client is at risk for social isolation due to the disease process, which can lead to depression -The client eats all of their cake and a few bites of bread:Eating small portions of non-nutritious foods instead of high-protein, high-calorie foods indicates that the client might be at risk for malnutrition; however, the nurse should identify another finding as the priority.

manifestation of dysphagia (difficulty swallowing)

-The client's voice changes after eating: The nurse should identify that hoarseness or a change in voice after eating is a manifestation of dysphagia because partially swallowed food can alter the client's voice. -clients who have dysphagia can become discouraged while eating and consume less food, possibly leading to malnutrition. -The nurse should identify that painful swallowing is a manifestation of dysphagia.

osteoprosis highest amount of calcium

-The nurse should determine that ½ cup roasted almonds is the best food source to recommend because ½ cup of almonds contains 185 mg of calcium. Calcium helps to prevent bone loss in clients who have osteoporosis. -One half cup of roasted sunflower seeds contains 45 mg of calcium. -Two tablespoons of peanut butter contain 17 mg of calcium. -One cup of avocado contains 18 mg of calcium.

fluid volume excess

-The nurse should identify that a client who has fluid volume excess can develop crackles in the lungs, shortness of breath, and dyspnea. - bounding pulses, decreased hematocrit, and weight gain.

DASH diet

-Total cholesterol 190 mg/dL: A feature of the DASH diet is a reduction in total cholesterol. This laboratory finding is within the expected reference range of cholesterol less than 200 mg/dL, and indicates that the client has achieved one of the goals of the DASH diet. -A feature of the DASH diet is a reduction in sodium intake. -Fasting glucose 130 mg/dL: A feature of the DASH diet is a reduction in serum glucose, as hyperglycemia is an associated risk factor for hypertension and coronary heart disease. This laboratory finding is above the expected reference range of 70 to 130 mg/dL and indicates that the client has not reached a goal of the DASH diet.

Kosher diet

-Vegetable salad with cheese: Clients who adhere to a kosher diet can eat dairy products combined with non-meat products at the same meal. -do not eat pork. -do not combine dairy products with meat products at the same meal. -do not eat shellfish (shrimp)

increasing micronutrients for a client who has difficulty see at night

-Vitamin A: Vitamin A enables the eyes to adapt to dim lighting more rapidly at night, which improves night vision.

breast milk and storage

-You cannot place thawed breast milk back in the freezer: The nurse should instruct the client that completely thawed breast milk can be stored in the refrigerator but must be used within 24 hr. Breast milk that has been previously frozen should not be refrozen once it has thawed completely. Thawing creates a possibility for bacterial growth and causes a decrease in antibacterial activity, which destroys antibodies in the milk. OTHER -You can store expressed breast milk in the freezer for up to 18 months: The nurse should instruct the client that the recommended duration of time for safely storing expressed breast milk is 6 months. However, it is acceptable for expressed breast milk to be stored for a maximum of 12 months. -The nurse should instruct the client to place the container of breast milk in the refrigerator to slowly thaw. If the breast milk is needed sooner, the nurse should instruct the client to place the container of breast milk under warm, running water. -The nurse should instruct the client that any milk left in a bottle from a feeding should be immediately discarded.

fluid volume deficit

-weak and thready pulse. -increased hematocrit. -Weight loss

highest glycemic index

Glycemic index is a tool used to rank foods according to the degree in which the food raises serum glucose levels. -BAKED POTATO: The glycemic index of a baked potato is 85 to 90. -The glycemic index of peanuts is 14. -The glycemic index of macaroni is 45. -The glycemic index of sweet corn is 60.

MAOI- should question which food?

NO TYRAMINE Clients who take MAOIs should avoid the consumption of most types of cheese and other foods that contain high levels of tyramine, which can lead to hypertensive crisis. OTHER -Grapefruit juice, whole milk, whole grain bread contains little or no tyramine; therefore, consumption is not restricted for clients who are taking MAOIs.

Phosphorus

Phosphorus assists in the formation of bones and teeth and the regulation of hormone activity,

Promethazine

Promethazine is administered for the treatment and prevention of nausea and vomiting

diabetic ketoacidosis

Testing for urinary ketones occurs when a client is experiencing diabetic ketoacidosis.

"I will avoid eating 1 hour before bedtime."

The client should avoid eating 2 to 3 hr before bedtime to promote sleep and reduce stress.

Hyperglycemia manifestations

The nurse should identify that abdominal cramps as well as nausea, breath with a fruity odor, also known as acetone breath, as well as rapid shallow breathing, polydipsia(thirsty), vomiting, ketonuria are manifestations of hyperglycemia.

hypoglycemia manifestations

The nurse should identify that diaphoresis, irritability, tachycardia, hunger and tremors are manifestations of hypoglycemia.

The client has an increase in bowel sounds after eating.

The nurse should identify that peristalsis increases after eating to promote the passage of food through the intestines. This is an expected finding of gastrointestinal functioning