Nutrition HESI

Which of the following is NOT a part of the large intestine? -cecum -rectum -ileum -anal canal

Correct answer: ileum The ileum is the last part of the small intestine. The large intestine is divided into four parts: cecum, colon, rectum, and anal canal.

Which of the following minerals is a trace mineral? -chloride -sulfur -iron -sodium

Correct answer: iron Trace minerals are those minerals needed at less than 100 mg a day. Iron is a trace mineral, along with others such as copper, manganese, chromium, and molybdenum.

Your client has lesions at the corners of her mouth. This might indicate a deficiency of which of the following? -niacin -vitamin A -iron -riboflavin

Correct answer: riboflavin Riboflavin deficiency occurs when the chronic failure to eat sufficient amounts of foods that contain riboflavin. This can produces lesion of the skin, lesions of smooth surfaces in the digestive tract, or nervous disorders.

The hormone that causes the pancreas to release sodium bicarbonate is which of the following? -secretin -gastrin -motilin -all of the above

Correct answer: secretin Secretin is the hormone that causes the pancreas to release sodium bicarbonate. This neutralizes the acidity of the chyme in the process of digestion.

Which of the following is NOT a water soluble vitamin? -niacin -vitamin D -vitamin C -folate

Correct answer: vitamin D Vitamin D is a fat-soluble vitamin, along with vitamins A, E, and K. The other choices are all water-soluble vitamins.

Folic Acid Sources:

Asparagus, turnip greens, orange juice, tomato juice, broccoli, legumes, fortified grains, spinach

food sources of magnesium

Avocados Canned white tuna Cauliflower Cooked rolled oats Green, leafy vegetables Milk Peanut butter Peas Pork, beef, chicken Potatoes Raisins Yogurt

Water Soluble Vitamins

B vitamins and vitamin C

Nursing considerations with cardiac/DASH diet:

a. Restrict total amounts of fat, including saturated, trans, polyunsaturated, and monounsaturated; cholesterol; and sodium b. Teach the client about the DASH diet or other prescribed diet

Niacin Sources:

Grains, Dairy, Nuts, Polutry

The nurse is caring for a client with a diagnosis of celiac disease. The nurse recognizes that client teaching has been effective when the client makes which statement?

I will eat rice cereal for breakfast. Celiac disease should avoid gluten-containing products such as wheat, barley, oats, and rye.

Soft diet

a. Used for clients with difficulty chewing or swallowing b. Used for clients with ulcerations of the mouth or gums, broken jaws, or dysphagia and for those who have experienced oral surgery, plastic surgery of the head or neck, or stroke

The primary nutritional function of the large intestine is

absorption of water.

Medical nutrition therapy for acute glomerulonephritis consists of

adequate calories to maintain metabolic needs

A potent hormone produced by the adrenal glands that acts on the distal nephron tubule to reabsorb sodium is

aldosterone

calcium iron zinc D

all vegetarians need adequate:

Elevated blood urea nitrogen, serum creatinine, and serum uric acid levels are reflected in the laboratory finding of

azotemia.

An example of a high-fiber meal is

bean chili.

A good example of complementary proteins IS

beans and rice.

vitamin A deficiency

bitot's spots is a sign of

phosphorus

bone development, muscle contraction kidney function, nerve conduction, heart beat regularity

The that cannot function without organ glucose as an energy source is the

brain.

The in the intestine responsible enzymes for digestion of carbohydrates are found specifically in the

brush border.

If 2 g of nitrogen are excreted in the urine for 6.25 g of protein consumed, the every body is said to be in

catabolism

foods to eat to increase B 12

cereal soy meat

An example of a food that contains invisible fat is

cheese.

hypoglycemia

cold, clammy, dizzy, tachycardia, tingling

A protein that contains all indispensable amino acids in the correct proportion and ratio is

complete.

Polysaccharides

complex carbs

Cholesterol

complex fat related compound; a normal component of blood and all body cells, especially brain and nerve tissue

air embolism hyperglycemia hypervolemia hypoglycemia infection pneumothorax

complications of PN:

The PN is caring for a client with HF. What outcome of diet therapy should the PN evaluate as a therapeutic response for this client?

control fluid balance

Trans fat be found in may

crackers.

Nursing considerations with clear liquid diets

deficient in energy (calories) and many nutrients easily digested and absorbed minimal residue left in GI tract unappetizing and boring intended for short-term use relatively transparent to light and are liquid at body temperature are considered "clear liquids," such as water, bouillon, clear broth, carbonated beverages, gelatin, hard candy, lemonade, ice pops, and regular or decaffeinated coffee or tea limit caffeine intake may consume salt and sugar NO dairy or pulp

Saturated fatty acids are

solid at room temperature

The pancreatic hormone known as the referee for pancreatic hormonal control of blood glucose is

somatostatin.

A plant-based protein that is a complete protein is

soy

A rich source of vitamin E in the diet is

soybean oil.

Lipopriteins

special carriers that carry cholesterol to and from body cells

Vitamins regulate body metabolism by working as

specific catalysts.

Precursor

substance that precedes and can be changed into an active vitamin

Hypervitaminosis

the excess of one or more vitamins

assess allergies (eggs) assess cardiac and renal status assess swallow, gag, and bowel sounds patency and intactness of the line check for redness, swelling, erythema, drainage, or broken skin check WBC and RBC counts check vital signs

things to do with TPN:

An important function of sodium is

water balance.

A breast-feeding mother of an infant with lactose intolerance asks the nurse about dietary measures. What foods should the nurse tell the mother are acceptable to consume while breast-feeding?

-Egg yolk -Dried beans -Green leafy vegetables -cauliflower -molasses. These are Alternative calcium sources

A 17-year-old client is found to have anorexia nervosa. The psychiatrist, in conjunction with the client and the parents, decides to institute a behavior modification program. What does the nurse recall is a major component of behavior modification? 1 Rewarding positive behavior 2 Reducing necessary restrictions 3 Deconditioning fear of weight gain 4 Reducing anxiety-producing situations

1

A client describes abdominal discomfort following ingestion of milk. Which enzyme, as a result of a genetic deficiency, should the nurse consider to be the cause of the client's discomfort? 1 Lactase 2 Sucrase 3 Maltase 4 Amylase

1

Average person consumes how much sodium:

3400

A client who has had recurrent infections before and during pregnancy should be instructed to eat a nutrient-rich diet as a means of supporting the body's natural defense mechanisms. What should the nurse encourage the client to include in her diet? 1 Fat-soluble vitamins 2 Dietary fiber and oat bran 3 Low-fat foods with essential fatty acids 4 Vitamins C and E

4

Dispensable amino acids

5 amino acids that the body can manufacture from other amino acids, so they are not necessary in the diet

PN stresses to a female client the importance of osteoporosis prevention. Which foods should the PN recommend the client add to her diet?

Canned Tuna

All are potentially modifiable risk factors for osteoporosis:

Anorexia nervosa, low in take of calcium and vitamin D, Excessive alcohol consumption.

Fruits, Vegetables and cereals are sources of:

Antioxidants

The nurse is creating a plan of care for a client receiving enteral feedings. Which client problem is the highest priority?

Aspiration

A client who is recovering from surgery has been advanced from a clear liquid diet to a full liquid diet. The client is looking forward to the diet change because he has been "bored" with the clear liquid diet. The nurse should offer which full liquid item to the client?

Custard. Full liquid food items include: plain ice cream, sherbet, breakfast drinks, milk, pudding and custard, soups that are strained, refined cooked cereals, and strained vegetable juices.

Vitamin A Deficiency is:

Decrease in Night Vision

which food items are lowest in potassium, providing less than 200 mg per serving?

Grapes Asparagus Applesauce

The RN suspects that a female client is altering her own diabetic journals to please her healthcare provider. Which laboratory test should the RN review to assess the client's compliance with self management for type 1 diabetes mellitus (DM)?

Hemoglobin A1c b/c it measures the average blood glucose level over the past 3 months, including the past 24-hour period, and should be used to compare w/ the client's diabetic journal.

Used for clients with anemia

High iron diet

A client has been on total parenteral nutrition (TPN) for 8 weeks at home. The health care provider prescribes that the TPN be weaned by 50 mL per hour per day until discontinued. The client asks the nurse why the TPN cannot just be stopped. The nurse explains that unless the TPN infusions are tapered gradually, the client is at risk for developing which complication?

Hypoglycemia

The nurse is providing instructions to a client regarding food items that are high in vitamin D. The client demonstrates understanding of the instructions by stating the need to include which food item in the diet?

Milk

The nurse is teaching a client who has iron deficiency anemia about foods she should include in the diet. The nurse determines that the client understands the dietary modifications if which items are selected from the menu?

Oranges and dark green leafy vegetables

The nurse provides instructions to a client with a low magnesium level about the foods that are high in magnesium. The nurse should tell the client to consume which foods?

Peas Cauliflower Peanut butter Canned white tuna sources of magnesium include: avocado, canned white tuna, cauliflower, green leafy vegetables such as spinach and broccoli, milk, oatmeal, peanut butter, peas, pork, beef, chicken, potatoes, raisins, and yogurt.

the PN is caring for a patient who was recently dx with DM II. What information is most important with the client about life-style changes?

Portion controlled healthy diet selections

An interprofessional team meeting is scheduled in the afternoon to discuss interventions addressing Mr. Ivy's dysphagia. With which member of the interprofessional team should the PN coordinate concerning Mr. Ivy's dysphagia?

Speech Therapist Speech therapist have expertise in the evaluation and management of clients with dysphagia.

Chyme is the word used for the intestinal contents when they are in the

Stomach

Vitamin C Lowers risk of:

Stomach Cancer, Breast Cancer, Mouth and Esophageal Cancer

The PN is preparing a client for surgery. Which criteria should the PN use to determine a client's nutritional status before the procedure?

Subjective global assessment

The practical nurse is caring for a client who was recently diagnosed with cirrhosis of the liver. Which foods should be limited in the client's diet?

Peanut butter

Nursing considerations with a high calorie high protein diet:

a. Encourage nutrient-dense, high-calorie, high-protein foods such as whole milk and milk products, peanut butter, nuts and seeds, beef, chicken, fish, pork, and eggs. b. Encourage snacks between meals, such as milkshakes, instant breakfasts, and nutritional supplements.

Patients with chronic kidney failure treated with peritoneal dialysis must consider needs based on energy

absorbed from the dialysate. energy

sources of potassium

beans, spinach, potatoes, dried apricots, acorn squash, yogurt, salmon, avocados, mushrooms and bananas

B12 pernicious anemia

beefy red tongue is a sign of

Carbohydrate digestion

begins in the mouth and occurs primarily in the small intestine; carbs are reduced to simple sugars such as glucose for absorption.

vitamin D

development of bone and tissue

Symptoms of chronic renal failure include

diarrhea.

Two amino acids joined together are called

dipeptide

deep breath and bear down

during a tubing change have the patient

GI tract IV

enteral = parenteral =

The mode of feeding that provides nutrition through a tube directly into the gut is called

enteral feeding.

vitamin B

every production, makes RBC's and coenzyme

Converting noncarbohydrate substances into glucose is called

gluconeogenesis.

Sucrose is composed of

glucose and fructose.

The basic single unit of carbohydrate found in the body is

glucose.

The basic building blocks of fat are

glycerol and fatty acids.

Triglycerides are composed of

glycerol and fatty acids.

The carbohydrate form in which glucose is stored in the human body is

glycogen.

A nursing student is caring for a client who has been admitted to the hospital with malnutrition. The nursing instructor determines that the student has made a correct assessment of malnutrition consequences if the student documents which noted findings?

-Cachexic -Lethargic -Dry, flaking skin -Poor wound healing

The nurse is caring for a postoperative general surgery foreign-speaking client with a history of poor nutrition. What are some reasonable issues that can impact this client?

-Longer hospital stays and increased medical costs -Reduced quality of life and increased mortality rate -Impaired wound healing and increased risk of postoperative infection -Impaired functioning of the gastrointestinal (GI) tract, cardiovascular system, respiratory system, and immune system

The nurse provides education about signs and symptoms of hypoglycemia to a client with newly diagnosed type 1 diabetes. The nurse concludes that the teaching was effective when the client acknowledges the need to drink orange juice when experiencing which symptoms? 1 Nervous and weak 2 Thirsty with a headache 3 Flushed and short of breath 4 Nausea and abdominal cramps

1

The parents of a 6-month-old ask a nurse how to introduce their infant to pureed foods. How should the nurse respond? 1 "Introduce one food at a time every 4 to 7 days." 2 "Mix the pureed food with the formula two or three times a day." 3 "Try to maintain the formula intake regardless of solid food intake." 4 "Offer pureed foods by spoon after the bottle of formula is finished."

1

A nurse is caring for a client with cholelithiasis. Which clinical manifestation does the nurse expect if the client develops obstructive jaundice? 1 Yellow sclera 2 Pain on urination 3 Dark brown stools 4 Coffee-ground emesis

1 Cholelithiasis is the presence of one or more calculi (gallstones) in the gallbladder

The next day the PN initiates the feeding prescribed by the healthcare provider. The prescription is for half-strength formula to infuse at 40 mL/hours. The formula is available in 8ounce cans. The PN is preparing enough formula for 12 hours. How many cans of formula will the PN need?

1 The PN needs a total volume of 480mL (12hrs x 40mL/hour). Because the prescription is for half-strength formula, the PN must dilute the formula with an equal amount of water. Therefor the vol. of formula needed is 240mL (480/2). An 8oz can of formula contains 240mL (8oz x 30 mL/ounce.) Consequently only 1 can of formula is needed.

The nurse is providing dietary instructions to a client regarding a high-protein diet. The nurse should instruct the client to consume which food item that is highest in protein content?

1 cup of cottage cheese

What would the nurse explain is the recommended age when a child can start having whole cow's milk? Record your answer using a whole number. _____ year(s) old

1 year old (The use of whole cow's milk, 2% cow's milk, or alternate milk products before the age of 12 months is not recommended)

A postoperative client has been placed on a clear liquid diet. The nurse should provide the client with which items that are allowed to be consumed on this diet? Select all that apply 1. Broth 2. Coffee 3. Gelatin 4. Pudding 5. Vegetable juice 6. Pureed vegetables

1, 2, 3

A nurse is providing dietary teaching for a client with celiac disease. Which foods should the nurse teach the client to avoid when following a gluten-free diet? Select all that apply 1 Rye 2 Oats 3 Rice 4 Corn 5 Wheat

1,2,5

The nurse instructs a client with chronic kidney disease who is receiving hemodialysis about dietary modifications. the nurse determines that the client understands these dietary modifications if the client selects which items from the dietary menu? 1. Cream of wheat, blueberries, coffee 2. Sausage and eggs, banana, orange juice 3. Bacon, cantaloupe melon, tomato juice 4. Cured pork, grits, strawberries, OJ

1. The diet for a client with chronic kidney disease who is receiving hemodialysis should include controlled amounts of sodium, phosphorus, calcium, potassium and fluids.

Fat-soluble vitamins

1. A, D, E, and K 2. sufficient fats needed in diet to carry fat-soluble vitamins 3. stored in body so deficiencies are slow to appear 4. absorbed in the same manner as fats; thus, anything that interferes with the absorption of fats interferes with the absorption of fat-soluble vitamins 5. fairly stable in cooking and storage

proteins essential amino acids complete proteins incomplete proteins

1. Amino acids, which make up _____, are critical to all aspects of growth and development of body tissues, and provide 4 cal/g. 2. Build and repair body tissues, regulate fluid balance, maintain acid-base balance, produce antibodies, provide energy, and produce enzymes and hormones. 3. _____ are required in the diet because the body cannot manufacture them. 4. _____ contain all essential amino acids; _____ lack some of the essential fatty acids. 5. Inadequate amounts can cause malnutrition and severe wasting of fat and muscle tissue.

Water-soluble vitamins

1. B and C 2. not stored in the body; possible deficiency if vitamins not included in daily diet 3. easily destroyed by air and in cooking

full liquid diet

1. Indication: May be used as a transition diet after clear liquids after surgery or for clients who have difficulty chewing, swallowing, or tolerating solid foods

Renal diet

1. Indications: Acute kidney injury and chronic kidney disease, and those clients requiring hemodialysis or peritoneal dialysis 2. Nursing considerations a. Controlled amounts of protein, sodium, phosphorus, calcium, potassium, and fluids may be prescribed; may also require modifications of the amounts of fiber, cholesterol, and fat based on individual requirements; clients receiving peritoneal dialysis usually have diets prescribed that are less restrictive with fluid and protein intake than those receiving hemodialysis.

high calcium diet

1. Indications: Calcium is needed during bone growth and in adulthood to prevent osteoporosis and facilitate vascular contraction and vasodilation, muscle contraction, and nerve transmission. 2. Nursing considerations a. Primary dietary sources of calcium are dairy products (see Box 11-2 for food items high in calcium). b. Clients with lactose intolerance need to incorporate nondairy sources of calcium into their diet regularly.

Low-purine diet

1. Indications: Gout, kidney stones, and elevated uric acid levels 2. Nursing considerations a. Purine is a precursor of uric acid, which forms stones and crystals. . Foods to restrict include anchovies, herring, mackerel, sardines, scallops, glandular meats, gravies, meat extracts, wild game, goose, and sweetbreads.

sodium restricted diet

1. Indications: Hypertension, heart failure, kidney disease, cardiac disease, and liver disease 2. Nursing considerations a. Individualized; can include 4 g of sodium daily (no-added-salt diet), 2 g to 3 g of sodium daily (moderate restriction), 1 g of sodium daily (strict restriction), or 500 mg of sodium daily (severe restriction and seldom prescribed) b. Encourage the intake of fresh rather than processed foods, which contain higher amounts of sodium. c. Canned, frozen, instant, smoked, pickled, and boxed items usually contain higher amounts of sodium. Lunch meats, soy sauce, salad dressings, fast foods, soups, breakfast cereals, and snacks such as potato chips and pretzels also contain large amounts of sodium. d. Certain medications contain significant amounts of sodium. e. Salt substitutes may be used to improve palatability. Most salt substitutes contain large amounts of potassium and should not be used by clients with kidney disease.

Protein restricted diet

1. Indications: Used for renal disease and end-stage liver disease 2. The nutritional status of critically ill clients with protein-losing conditions should have their protein needs assessed by estimating the protein equivalent of nitrogen appearance (PNA); a nutritionist should be consulted. 3. Nursing considerations a. Provides enough protein to maintain nutritional status but not an amount that will allow for the buildup of waste products from protein metabolism (40-60 g of protein daily) icon01-9780323484886b. The less protein allowed, the more important it becomes that all protein in the diet be of high biological value (contain all essential amino acids in recommended proportions). c. An adequate total energy intake from foods is critical for clients on protein-restricted diets. (Protein will be used for energy rather than for protein synthesis.) d. Special low-protein products, such as pastas, bread, cookies, wafers, and gelatin made with wheat starch, can improve energy intake and add variety to the diet. e. Carbohydrates in powdered or liquid form can also provide additional energy. f. Vegetables and fruits contain some protein. For very low-protein diets, these foods must be calculated into the diet. icon01-9780323484886g. Foods from the milk, meat, bread, and starch groups are limited.

Fat emulsion

1. Lipids provide up to 30% of calorie (energy) needs, nonprotein calories, and prevent or correct fatty-acid deficiency. 2. Lipid solutions are isotonic and therefore can be administered through a peripheral or central vein. .prepared from soybean or safflower oil with egg yolk to provide emulsification. The primary components are linoleic, oleic, palmitic, linolenic, and stearic acids (assess the client for allergies). Glucose-intolerant clients or those with diabetes mellitus may benefit from receiving a larger percentage of their PN from lipids, which helps control blood glucose levels and lower insulin requirements caused by infused dextrose. The bottle is examined for the separation of the emulsion into layers, fat globules, and the accumulation of froth. If observed, it is not used and is returned to the pharmacy. Additives should not be put into the fat emulsion solution. Monitor vital signs every 10 minutes, and observe for adverse reactions for the first 30 minutes of administration. If signs of an adverse reaction occur, stop the infusion and notify the registered nurse 8. Serum lipids are checked 4 hours after discontinuing the infusion.

Parental nutriton

1. Parenteral nutrition (PN) (also termed hyperalimentation or total parenteral nutrition [TPN]) supplies nutrients via the veins. 2. PN consists of both partial parenteral nutrition (PPN) and total parenteral nutrition (TPN). The indication of the type used depends on the client's nutritional needs. 3. Supplies carbohydrates in the form of dextrose; fats in a special emulsified form; proteins in the form of amino acids; vitamins; minerals; electrolytes; and water. icon01-97803234848864. Prevents subcutaneous fat and muscle protein from being catabolized by the body for energy. 5. PN solutions are hypertonic because of their higher concentration of glucose and the addition of amino acids.

A client with parenteral nutrition (PN) infusing has disconnected the tubing from the central line catheter. The nurse assesses the client and suspects an air embolism. The nurse should immediately place the client in which position? 1. On the left side, with the head lower than the feet 2. On the left side, with the head higher than the feet 3. On the right side, with the head lower than the feet 4. On the right side, with the head higher than the feet

1. Rationale- Air embolism occurs when air enters the catheter system, such as when the system is opened for intravenous (IV) tubing changes or when the IV tubing disconnects. Air embolism is a critical situation; if it is suspected, the client should be placed in a left side-lying position. The head should be lower than the feet. This position is used to minimize the effect of the air traveling as a bolus to the lungs by trapping it in the right side of the heart. The positions in the remaining options are inappropriate if an air embolism is suspected.

The nurse is changing the central line dressing of a client receiving parenteral nutrition (PN) and notes that the catheter insertion site appears reddened. The nurse should next assess which item? 1. Client's temperature 2. Expiration of the bag 3. Time of last dressing change 4. Tightness of tubing connections

1. Rationale- Redness at the catheter insertion site is a possible indication of infection. The nurse would next assess for other signs of infection. Of the options given, the temperature is the next item to assess. The tightness of tubing connection should be assessed each time the PN is checked; loose connections would result in leakage, not skin redness. The expiration date on the bag is a viable option, but this also should be checked at the time the solution is hung and with each shift change. The time of the last dressing change should be checked with each shift change.

The nurse is caring for a client with cirrhosis of the liver. To minimize the effects of the disorder, the nurse teaches the client about foods that are high in thiamine. The nurse determines that the client has the best understanding of the dietary measures to follow if the client states an intention to increase the intake of which food? 1. Pork 2. Milk 3. Chicken 4. Broccoli

1. The client with cirrhosis needs to consume foods high in thiamine. Thiamine is present in a variety of foods of plant and animal origin. Pork products are especially rich in this vitamin.

Nursing considerations with vegan and vegetarian diets:

1. Vegan and vegetarian diets are not usually prescribed but are a diet choice made by a client. 2. Ensure that the client eats a sufficient amount of varied foods to meet nutrient and energy needs. 3. Clients should be educated about consuming complementary proteins over the course of each day to ensure that all essential amino acids are provided. 4. Potential deficiencies in vegetarian diets include energy, protein, vitamin B12, zinc, iron, calcium, omega-3 fatty acids, and vitamin D (if limited exposure to sunlight). 5. To enhance absorption of iron, vegetarians should consume a good source of iron and vitamin C with each meal. 6. Foods eaten may include tofu, tempeh, soy milk and soy products, meat analogs, legumes, nuts and seeds, sprouts, and a variety of fruits and vegetables. 7. Soy protein is considered equivalent in quality to animal protein.

minerals

1. _____ are components of hormones, cells, tissues, and bones. 2. Act as catalysts for chemical reactions and enhancers of cell function. 3. Almost all foods contain some form of them. 4. A deficiency can develop in chronically ill or hospitalized clients. 5. Electrolytes play a major role in osmolality and body water regulation, acid-base balance, enzyme reactions, and neuromuscular activity

carbohydrates

1. _____ are the preferred source of energy. 2. Sugars, starches, and cellulose provide 4 cal/g. 3. Promote normal fat metabolism, spare protein, and enhance lower gastrointestinal function. 4. Major food sources include milk, grains, fruits, and vegetables. 5. Inadequate intake affects metabolism.

Fat

1. _____ provide a concentrated source and a stored form of energy. 2. Protect internal organs and maintain body temperature. 3. Enhance absorption of the fat-soluble vitamins. 4. Provide 9 cal/g. 5. Inadequate intake of leads to clinical manifestations of sensitivity to cold, skin lesions, increased risk of infection, and amenorrhea in women. 6. Diets high in this can lead to obesity and increase the risk of cardiovascular disease and some cancers.

Functions of proteins (5)

1. build and repair body tissue (primary function) 2. furnish energy if levels of carbs or fat are insufficient 3. maintain normal circulation of tissue and blood vessel fluids through plasma proteins 4. aid metabolic functions by combining with iron to form hemoglobin - used to manufacture enzymes and hormones 5. aid body defenses by manufacturing lymphocytes and antibodies

Classification of nutrients

1. carbs 2. fats 3. proteins 4. vitamins 5. minerals 6. water

Functions of minerals (6)

1. constitute bones and teeth 2. transmit nerve impulses and aid in muscle contraction 3. control water balance (sodium, potassium) 4. maintain acid-base balance 5. synthesize essential body compounds 6. act as catalysts for tissue reactions

Characteristics of vitamins (5)

1. contain no calories 2. essential to life because they generally cannot be synthesized by the body and are necessary for cell metabolism 3. functions include tissue building and regulation of body functions 4. needed in minute amounts 5. well-balanced diet should provide adequate vitamins to fulfill body requirements

Inability of the body to use specific nutrients properly as a result of:

1. diseases of the digestive tract 2. faulty absorption in digestive tract 3. metabolic disorders such as diabetes 4. drug interactions or toxicity

The 9 U.S. dietary goals/guidelines

1. eat a variety of foods 2. balance the food you eat with physical activity 3. engage in regular physical activity 4. choose a diet with plenty of whole-grain products, vegetables, fruits, and fat-free or low-fat milk 5. choose a diet low in fat, saturated fat, and trans fatty acids 6. choose a diet with little added sugar 7. choose a diet with little salt and consume potassium-rich foods 8. if you drink alcoholic beverages, do so in moderation 9. avoid microbial foodborne illnesses

Functions of water (6)

1. essential component of all tissues and fluids 2. transportation of nutrients from the digestive tract to the bloodstream and from cell to cell 3. removal of waste products from cells to outside the body 4. lubrication of joints 5. solvent for all chemical processes of the body

Characteristics of minerals (4)

1. found in all body tissues and fluids 2. occur naturally in foods (especially unrefined foods) 3. do not furnish energy but regulate body processes that furnish energy 4. remain stable in food preparation

Effects of excess fat intake (3)

1. obesity 2. predisposition to serious conditions such as heart disease, diabetes, and stroke 3. increased surgical risk

Excess carbohydrates in diet can lead to

1. obesity 2. tooth decay and gum disease 3. malnutrition (if empty calorie foods are consumed extensively)

Functions of carbs (3)

1. provide energy 2. protein-spraing effect: allows protein to be used for tissue building rather than energy production 3. essential for complete metabolism of fats: incomplete fat metabolism leads to buildup of ketones and acidosis

Functions of food (3)

1. provides energy 2. builds and repairs body tissues 3. regulates and controls the chemical processes in the body, which are essential for providing energy and building tissues

Functions of fats (lipids) (6)

1. supply energy for body activities when carbs are not available 2. act as insulation to maintain body temperature and protect organs from mechanical injury 3. carry fat-soluble vitamins and aid in their absorption 4. provide a feeling of fullness and satisfaction after eating because of their slow rate of digestion 5. furnish the essential fatty acid linoleic acid, which is found primarily in vegetable oils 6. omega-3 fatty acids may contribute to lower risks of heart disease

Function of cellulose (3)

1. to absorb water 2. provide bulk 3. stimulate peristalsis

Steps to decrease dietary fat (5)

1. use leaner cuts of meat and more poultry 2. use egg substitute or fewer eggs 3. use low-fat milk products 4. limit use of fat in cooking 5. decrease consumption of red meat

If the bag of intravenous solution is empty and the nurse is waiting for the delivery of a new bag of solution from the pharmacy, a ______ in _____ solution should be infused at prescribed rate to prevent hypoglycemia; the prescribed solution should be obtained as soon as possible.

10% dextrose in water

To meet the published Dietary Reference of carbohydrate for a Intakes, the grams 1600 kcal/day diet would be

180 to 260.

A 17-year-old adolescent was recently found to have type 2 diabetes mellitus. What information will the nurse include when providing education to the family? 1 "Your teen will need insulin injections for the rest of her life." 2 "The most important interventions are good nutrition and portion control." 3 "This is a condition where the body produces antibodies against its own cells." 4 "This condition causes weight loss and increased appetite, thirst, and urination."

2

A client was admitted with full-thickness burns 2 weeks ago. Since admission, the client has lost an average of 1 lb (0.5 kg) of weight each day. Which action will the nurse most likely take based upon the adjusted dietary plan? 1 Provide low-sodium milk. 2 Provide high-protein drinks. 3 Provide foods that are low in potassium. 4 Provide 10% more calories in the form of fats.

2

A client with hepatic cirrhosis begins to develop slurred speech, confusion, drowsiness, and a flapping tremor. Which diet can the nurse expect will be prescribed for this client based upon the assessment? 1 No protein 2 Moderate protein 3 High protein 4 Strict protein restriction

2

A nurse is planning care for a client with substance-induced persisting dementia resulting from long-term alcohol use. Which nutritional problem, in addition to the effect of alcohol on brain tissue, has contributed to substance-induced persisting dementia? 1 Increase in serotonin 2 Deficiency of thiamine 3 Reduction in iron intake 4 Malabsorption of riboflavin

2

The nurse is caring for a client who is receiving a thiazide diuretic for hypertension. Which food selection by the client indicates to the nurse that dietary teaching about thiazide diuretics is successful? 1 Apples 2 Broccoli 3 Cherries 4 Cauliflower

2

The nurse is taking care of a client with cirrhosis of the liver and ascites. Which lunch is the best choice for a client with this disorder? 1 Ham sandwich with cheese, whole milk, and potato chips 2 Penne pasta, spinach, banana, and decaffeinated iced tea 3 Baked lasagna with sausage, salad, and milkshake 4 Hamburger, french fries, and cola

2

A client receiving abdominal surgery has a large abdominal wound. The nurse should encourage the client to eat which food item that is naturally high in vitamin C to promote wound healing? 1. Milk 2. Oranges 3. Bananas 4. Chicken

2 Citrus fruits and juices are especially high in vitamin C

The nurse is preparing to hang fat emulsion (lipids) and notes that fat globules are visible at the top of the solution. The nurse should take which action? 1. Rolls the bottle of solution gently 2. Obtains a different bottle of solution 3. Shakes the bottle of solution vigorously 4. Runs the bottle of solution under warm water.

2. Rationale- Fat emulsion (lipids) is a white, opaque solution administered intravenously during parenteral nutrition therapy to prevent fatty acid deficiency. The nurse should examine the bottle of fat emulsion for separation of emulsion into layers of fat globules or for the accumulation of froth. The nurse should not hang a fat emulsion if any of these are observed and should return the solution to the pharmacy. Therefore the remaining options are inappropriate actions.

The nurse is caring for a group of adult clients on an acute care medical-surgical nursing unit. The nurse understands that which client would be the least likely candidate for parenteral nutrition (PN)? 1. A 66 year-old client with extensive burns 2. A 42 year-old client who has had an open cholecystectomy 3. A 27 year-old client with severe exacerbation of Crohn's disease 4. A 35 year-old client with persistant nausea and vomiting from chemotherapy

2. Rationale- Parenteral nutrition is indicated in clients whose gastrointestinal tracts are not functional or must be rested, cannot take in a diet enterally for extended periods, or have increased metabolic need. Examples of these conditions include those clients with burns, exacerbation of Chron's disease, and persistent nausea and vomiting due to chemotherapy. Other clients would be those who have had extensive surgery, have multiple fractures, are septic, or have advanced cancer or acquired immunodeficiency syndrome. The client with the open cholecystectomy is not a candidate because this client would resume a regular diet within a few days following surgery.

The nurse is making initial rounds at the beginning of the shift and notes that the parenteral nutrition (PN) bag of an assigned client is empty. Which solution readily available on the nursing unit should the nurse hang until another PN solution is mixed and delivered to the nursing unit? 1. 5% dextrose in water 2. 10% dextrose in water 3. 5% dextrose in Ringer's lactate 4. 5% dextrose in 0.9% sodium chloride

2. Rationale- The client is at risk for hypoglycemia; therefore the solution containing the highest amount of glucose should be hung until the new PN solution becomes available. Because PN solutions contain high glucose concentrations, the 10% dextrose in water solution is the best of the choices presented. The solution selected should be one that minimizes the risk of hypoglcemia. The remaining options will not be as effective in minimizing the risk of hypoglycemia.

A client is being weaned from parenteral nutrition (PN) and is expected to begin taking solid food today. The ongoing solution rate has been 100 ml/hour. The nurse anticipated that which prescription regarding PN will accompany the diet prescription? 1. Discontinue the PN 2. Decrease PN rate to 50 mL/hour 3. Start 0.9% normal saline at 25 mL/hour 4. Continue current infusion rate prescription for PN

2. Rationale- When a client begins eating a regular diet after a period of receiving PN, the PN is decreased gradually. PN that is discontinued abruptly can cause hypoglycemia. Clients often have anorexia after beng without food for some time, and the digestive tract also is not used to producing the digestive enzymes that will be needed. Gradually decreasing the infusion rate allows the client to remain adequately nourished during the transition to a normal diet and prevents the occurrence of hypoglycemia. Even before clients are started on a solid diet, they are given clear liquids followed by full liquids to further ease the transition. A solution of normal saline does not provide the glucose needed during the transition of discontinuing the PN and could cause the client to experience hypoglycemia.

Which nursing action is essential prior to initiating a new prescription for 500 mL of fat emulsion (lipids) to infuse at 50 mL/hour? 1. Ensure that the client does not have diabetes 2. Determine whether the client has an allergy to eggs 3. Add regular insulin to the fat emulsion, using aseptic technique 4. Contact the health care provider (HCP) to have a central line inserted for fat emulsion infusion

2. Rationale-The client beginning infusions of fat emulsions must be first assessed for known allergies to eggs to prevent anaphylaxis. Egg yolk is a component of the solution and provides emulsification. The remaining options are unnecessary and are not related to the administration of fat emulsion.

A client has been discharged to home on parenteral nutrition (PN). With each visit, the home care nurse should assess which parameter most closely in monitoring this therapy? 1. Pulse and weight 2. Temperature and weight 3. Pulse and blood pressure 4. Temperature and blood pressure

2. Rationale-The client receiving PN at home should have her or his temperature monitored as a means of detecting infection, which is a potential complication of this therapy. An infection also could result in sepsis because the catheter is in a blood vessel. The client's weight is monitored as a measure of the effectiveness of this nutritional therapy and to detect hypervolemia. The pulse and blood pressure are important parameters to assess, but they do not relate specifically to the effects of PN.

A 9-year-old child who has iron-deficiency anemia tells the school nurse, "I get dizzy in gym class." What is the most likely explanation for this symptom? 1 Inflammation of the inner ear 2 Sudden drop in blood pressure 3 Insufficient cerebral oxygenation 4 Decreased level of serum glucose

3

A client is receiving total parenteral nutrition. The nurse assesses for which client response that indicates hyperglycemia? 1 Paralytic ileus 2 Respiratory rate below 16 3 A fruity odor to the breath 4 Serum glucose of 105 mg/100 mL

3

A client who is recovering from a surgery has been advanced from a clear liquid diet to a full liquid diet. The client is looking forward to the diet change because he has been bored with the clear liquid diet. The nurse should offer which full liquid item to the client? 1. Tea 2. Gelatin 3. Custard 4. Ice pop

3

A client with osteoporosis has been receiving dietary information from the nurse. Which food selection by the client indicates that the nurse's dietary instruction was effective? 1 Red meat 2 Soft drinks 3 Turnip greens 4 Enriched grains

3

A nurse instructs a client with viral hepatitis about the type of diet that should be ingested. Which lunch selected by the client indicates understanding about dietary principles associated with this diagnosis? 1 Turkey salad, french fries, sherbet 2 Cottage cheese, mixed fruit salad, milkshake 3 Salad, sliced chicken sandwich, gelatin dessert 4 Cheeseburger, tortilla chips, chocolate pudding

3

Which nutrient deficiency in the pregnant adolescent may result in decreased birth weight as a consequence of low bone mineral density in the fetus? 1 Zinc 2 Iron 3 Calcium 4 Folic acid

3

A mental health nurse is admitting a client with anorexia nervosa. When obtaining the history and physical assessment, the nurse expects the client's condition to reveal what? 1 Edema 2 Diarrhea 3 Amenorrhea 4 Hypertension

3 Amenorrha- the absence of menstruation, often defined as missing one or more menstrual periods

The nurse is planning to teach a client with malabsorption syndrome about the necessity of following a low-fat diet. The nurse develops a list of high-fat foods to avoid and should include which food item on the list? 1. Oranges 2. Broccoli 3. Cream Cheese 4. Broiled haddock

3 Cream cheese is a high fat food

A client receiving parenteral nutrition (PN) complains of a headache. The nurse notes that the client has an increased blood pressure, bounding pulse, jugular vein distention, and crackles bilaterally. The nurse determines that the client is experiencing which complications of PN therapy? 1. Sepsis 2. Air embolism 3. Hypervolemia 4. Hyperglycemia

3. Rationale Hypervolemia is a critical situation and occurs from excessive fluid administration or administration of fluid too rapidly. Clients with cardiac, renal, or hepatic dysfunction are also at increased risk. The client's signs and symptoms presented in the question are consistent with hypervolemia. The increased intravascular volume increases the blood pressure, whereas the pulse rate increases as the heart tries to pump the extra fluid volume. The increased volume also causes neck vein distention and shifting of fluid into the alveoli, resulting in lung crackles. The signs and symptoms presented in the question do not indicate sepsis, air embolism, or hyperglycemia.

The nurse is caring for a restless client who is beginning nutritional therapy with parenteral nutrition (PN). The nurse should plan to ensure that which action is taken to prevent the client from sustaining injury? 1. Calculate daily intake and output 2. Monitor the temperature once daily 3. Secure all connections in the PN system 4. Monitor blood glucose levels every 12 hours

3. Rationale The nurse should plan to secure all connection tubing (tape is used per agency protocol). This helps prevent the restless client from pulling the connections accidentally. The nurse should also monitor intake and output, but this does not relate specifically to a risk for injury presented in the question. In addition, the client's temperature and blood glucose levels are monitored more frequently that the time frames identified in the options to detect signs of infection and hyperglycemia, respectively.

The nurse is preparing to hang the first bag of parenteral nutrition (PN) solution via the central line of an assigned client. The nurse should obtain which most essential piece of equipment before hanging the solution? 1. Urine test strips 2. Blood glucose meter 3. Electronic infusion pump 4. Noninvasive blood pressure monitor

3. Rationale- The nurse obtains an electronic infusion pump before hanging a PN solution. Because of the high glucose content, use of an infusion pump is necessary to ensure that the solution does not infuse too rapidly or fall behind. Because the client's blood glucose level is monitored every 4 to 6 hours during administration of PN, a blood glucose meter also will be needed, but this is not the most essential item needed before hanging the solution. Urine test strips (to measure glucose) rarely are used because of the advent of blood glucose monitoring. Although the blood pressure will be monitored, a noninvasive blood pressure monitor is not the most essential piece of equipment needed for this procedure.

The nurse monitoring the status of a client's fat emulsion (lipid) infusion and notes that the infusion is 1 hour behind. Which action should the nurse take? 1. Adjust the infusion rate to catch up over the next hour 2. Increase the infusion rate to catch up over the next two hours 3. Ensure that the fat emulsion infusion rate is infusing at the prescribed rate 4. Adjust the infusion rate to run wide open until the solution is back on time

3. Rationale- The nurse should not increase the rate of a fat emulsion to make up the difference if the infusion timing falls behind. Doing so could place the client at risk for fat overload. In addition, increasing the rate suddenly can cause fluid overload. The same principle (not increasing the rate) applies to PN or any intravenous (IV) infusion. Therefore the remaining options are incorrect.

A client receiving parenteral nutrition (PN) suddenly develops a fever. The nurse notifies the health care provider (HCP) and the HCP initially prescribes that the solution and tubing be changed. What should the nurse do with the discontinued materials? 1. Discard them in the unit trash 2. Return them to the hospital pharmacy 3. Send them to the laboratory for culture 4. Save them for return to the manufacturer

3. Rationale- When the client who is receiving PN develops a fever, a catheter-related infection should be suspected. The solution and tubing should be changed, and the discontinued materials should be cultured for infectious organisms. The other options are incorrect. Because culture for infectious organisms is necessary, the discontinued materials are not discarded or returned to the pharmacy or manufacturer.

A client with arthritis reports receiving several dietary suggestions over the years. Which recommendation for a daily diet should the nurse reinforce? 1 Wheat germ and yeast 2 Yogurt and blackstrap molasses 3 Multiple vitamin supplements in large doses 4 Adequate foods in a variety of different food groups

4

A client with dementia and a percutaneous endoscopic gastrostomy (PEG) tube is being cared for at home. Which action provides evidence that a family member is effectively managing the client's care? 1 Empty feeding bag stays attached to the tubing. 2 Tube is flushed with air after medication is given. 3 Replacement of the tube is done on a weekly basis. 4 Head of the bed remains elevated after the feeding

4

A nurse is teaching the parents of a school-aged child with celiac disease about the nutrients that must be avoided in a gluten-free diet. What nutrients should the nurse teach the parents to avoid? 1 Saturated oils and fats 2 Milk and hard cheeses 3 Corn and rice products 4 Wheat and oat products

4

A nurse may find that for optimum nutrition a client with a cerebrovascular accident (also known as "brain attack") needs assistance with eating. What should the nurse do? 1 Request that the client's food be pureed. 2 Feed the client to conserve the client's energy. 3 Have a family member assist the client with each meal. 4 Encourage the client to participate in the feeding process

4

A pregnant client tells the nurse, "I'm sticking to my diet, and I don't eat anything containing salt." How should the nurse respond? 1 "You're doing fine. Just keep up the good work." 2 "A low-salt diet will protect you from getting swollen feet." 3 "We now encourage pregnant women to increase their salt intake because of changes in the circulation." 4 "Salt is necessary in your diet. Use a little when you're cooking, but avoid processed meats and canned foods with salt."

4

An obese adult develops an abscess after abdominal surgery. The wound is healing by secondary intention and requires repacking and redressing every 4 hours. Which diet should the nurse expect the healthcare provider to prescribe to best meet this client's immediate nutritional needs? 1 Low in fat and vitamin D 2 High in calories and fiber 3 Low in residue and bland 4 High in protein and vitamin C

4

During change of shift report the night nurse indicates that a client cannot tolerate the prescribed intermittent tube feedings. Which action should the receiving nurse take first? 1 Suggest that an antiemetic be prescribed 2 Change the feeding schedule to omit nights 3 Request that the type of solution be changed 4 Gather more data from the night nurse about the technique used

4

What is the required average daily intake of calories in preschoolers? 1 400 2 700 3 1,000 4 1,800

4

When assessing the characteristics of an adolescent with anorexia nervosa, how does the nurse expect to describe the adolescent? 1 Manic 2 Rebellious 3 Hypoactive 4 Perfectionistic

4

A client with hypertension has been told to maintain a diet low in sodium. The nurse who is teaching thi client about foods that are allowed should include which food item in a list provided to the client? 1. Tomato soup 2. Boiled shrimp 3. Instant oatmeal 4. Summer squash

4 Summer squash: Foods that are low in sodium include fruits and vegetables

calcium iron vitamin A vitamin C

4 marker nutrients (eat them and you will consume all other nutrients as well)

The nurse is teaching a client who has iron deficiency anemia about foods she should include in her diet. The nurse determines that the client understands the dietary modifications if she selects which items from her menu? 1. Nuts and ilk 2. Coffee and tea 3. Cooked rolled oats and fish 4. Oranges and dark green leafy vegetables

4. Dark green leafy vegetables are a good source of iron nad oranges are a good source of vitamin C, which enhances iron absorption

A client receiving parenteral nutrition (PN) in the home setting has a weight gain of 5 lb in 1 week. The nurse should next assess the client for the presence of which condition? 1. Thirst 2. Polyuria 3. Decreased blood pressure 4. Crackles on auscultation of the lungs

4. Rationale- Optimal weight gain when the client is receiving PN is 1 to 2lb/week. The client who has a weight gain of 5lb/week while receiving PN is likely to have fluid retention. This can result in hypervolemia. Signs of hypervolemia include increased blood pressure, crackles on lung auscultation, a bounding pulse, jugular vein distention, headache, and weight gain more than desired. Thirst and polyuria are associated with hyperglycemia. A decreased blood pressure is likely to be noted in deficient fluid volume.

The nurse is preparing to change the parenteral nutrition (PN) solution bag and tubing. The client's central venous line is located in the right subclavian vein. The nurse asks the client to take which essential action during the tubing change? 1. Breath normally 2. Turn the head to the right 3. Exhale slowly and evenly 4. Take a deep breath, hold it, and bear down.

4. Rationale- The client should be asked to perform the Valsalva maneuver during tubing changes. This helps avoid air embolism during tubing changes. The nurse asks the client to take a deep breath, hold it, and bear down. If the intravenous line is on the right, the client turns is or her head to the left. This position increases intrathoracic pressure. Breathing normally and exhaling slowly and evenly are inappropriate and could enhance the potential for an air embolism during the tubing change.

A client is receiving parenteral nutrition (PN). The nurse monitors the client for complications of the therapy and should assess the client for which manifestations of hyperglycemia? 1. Fever, weak pulse, and thirst 2. Nausea, vomiting, and oliguria 3. Sweating, chills, and abdominal pain 4. Weakness, thirst, and increased urine output

4. Rationale-The high glucose concentration in PN places the client at risk for hyperglycemia. Signs of hyperglycemia include excessive thirst, fatigue, restlessness, confusion, weakness, Kussmaul's respirations, diuresis, and coma when hyperglycemia is severe. If the client has these symptoms, the blood glucose level should be checked immediately. The remaining options do not identify signs specific to hyperglycemia.

Conditionally indispensable amino acids

6 amino acids that must be consumed in the diet under certain physiological conditions

A postoperative client has been placed on a clear-liquid diet. The nurse provides the client with which items that are allowed to be consumed on this diet? A. Vegetable juices. B. Custard. C. Sherbet. D. Bouillon.

A clear liquid diet consists of foods that are relatively transparent to light and liquid at room and body temperature. Foods allowed on the clear liquid diet (bouillon, popsicles, plain gelatin, ice chips, sweetened tea or coffee (no creamer), carbonated beverages, and water)Options A, B, and C are full liquid diet.

The home care nurse is conducting a diet history with an older client who lives alone. The nurse finds that the client's typical 24-hour food intake consists of eggs and sausage for breakfast, a fast-food lunch of hamburger and french fries, takeout fried chicken for dinner, and ice cream in the evening. To decrease the risk of cancer, what statement would the nurse make to the client?

A high-fat diet increases your risk for colon cancer

The RN is preparing a dietary plan for a client who is on a low residue diet? What foods should the RN instruct the client to avoid?

A low residue diet is low in fiber, soft in texture, and easily digested. Processed foods, like salami, are high in sodium, fat, and encased with a tough membrane and should be avoided.

The nurse instructs a client with renal failure who is receiving hemodialysis about dietary modifications. The nurse determines that the client understands these dietary modifications if the client selects which items from the dietary menu? A. Mushroom and blueberry. B. Beans and banana. C. Fish and tomato juice. D. Potato and spinach.

A renal diet is one that is low in sodium, phosphorous, potassium and protein. Options B, C, and D are high in sodium, phosphorus, and potassium.

Which foods should the RN instruct a client who is receiving chemotherapy to eat? A. Cooked broccoli, caulliflower, and boiled eggs. B. Orange Juice. C. Baked potatoes. D. Pastries. E. Pastas. F. Fried chicken.

A, C, and E are correct. Clients who are receiving chemotherapy often are immunosuppressed and should eat foods that are cooked (A and C) to minimize exposure of contaminates or other bacteria from soil. A bland diet that is high in carbohydrate calories (E) is easier for a client to consume while undergoing chemotherapy. Chemotherapy can cause mucosa breakdown so any acidic foods or drinks (B) should be avoided. Client receiving chemotherapy benefit from increase in calories, but choosing foods that are high in fats, such as (D and F), may cause nausea and vomiting.

The RN in an assisted living community is assisting an Orthodox Jewish client make weekly dinner choices. Which main course selections should the RN suggest that are suitable for a kosher diet? A. Lamb chops with mint jelly. B. Crab cakes with cocktail sauce. C. Pork chops with cranberry relish. D. Steak with cream sauce.

A. Lamb chops with mint jelly. Kashrut is the body of Jewish religious law dealing with foods that can and cannot be eaten and how those foods must be prepared and eaten, which Orthodox Jews follow to "keep the diet kosher." Lamb (A) is a food selection within the guidelines of Jewish religious law. Shellfish (B) is restricted and not w/in religious law. Pork chops (C) is the byproduct of an animal that is considered unclean and not allowed to be consumed. Meat and dairy cannot be mixed together on a plate or during a meal, so (D) should not be a recommended choice.

Fat Soluble Vitamins

ADEK

A postoperative client has been tolerating a full liquid diet, and the nurse plans to advance the diet to solid food as prescribed. Which assessment is most important for the nurse to make before advancing the diet to solids?

Ability to chew

When the PN demonstrated the use of the feeding equipment, Mrs. Ivy looks away. The PN observes that she is crying. What action should the PN employ?

Acknowledge the stressful nature of the situation and ask Mrs. Ivy if she is ready to continue. This is a therapeutic response, offering support and allowing the client to feel in control of the situation

Gradually, Mr. Ivy becomes weaker and he is admitted to the nearby medical center. His healthcare provider recommends the insertion of a feeding tube, by means of precutaneous esophageal gastrostomy (PEG). Mr. Ivy signs the consent form, and the procedure is scheduled for the next day. That evening, the PN notes that Mr. Ivy medical record contains an advanced directive requesting that he not be resuscitated in the event of an arrest, which is confirmed in the prescriptions written by the healthcare provider. While the PN is conversing with Mr and Mrs Ivy, Mrs Ivy confirms that Mr Ivy has asked that "heroic measures be taken to save his life." What action should the PN take?

Advise Mr. Ivy that an identifying bracelet needs to be secured on his wrist in case an emergency occurs. An identifying wrist bracelet indicating that resuscitation should not be performed helps ensure that the clients wishes are known.

The health care provider has prescribed a clear liquid diet for a postoperative client. The nurse prepares to deliver the lunch tray to the client and checks the tray to be sure that which has occurred?

All food items are liquid at body temperature.

Vitamin E Benefits:

Antioxidant, protects vitamin A and certain lipids from damage, helps prevent alzheimers disease. Catarats, atherosclerosis.

The nurse is providing dietary teaching to a client who is receiving a potassium-retaining diuretic about foods that are low in potassium. Which foods should the nurse include on a list of foods with low potassium content?

Apple. Fruits low in potassium include: Apples, cherries, grapefruit, peaches, pineapple, and cranberries.

gas forming foods include:

Apples Artichokes Barley Beans Bran Broccoli Brussels sprouts Cabbage Celery Figs Melons Milk Molasses Nuts Onions Radishes Soybeans Wheat Yeast

The nurse has conducted dietary teaching with a client diagnosed with iron deficiency anemia. The nurse instructs the client that which food item is a good dietary source of iron?

Apricots. foods high in iron: red meat, liver and other organ meats, blackstrap molasses, and oysters. Other good sources of iron: kidney beans, whole-wheat bread, egg yolk, spinach, kale, turnip tops, beet greens, carrots, raisins, and apricots.

The PN findings include right-sided weakness, slurred speech and dysphagia. The PN recognizes that Mr.Ivy is at high risk for several problems. In reviewing the previously established nursing plan of care, the PN determines that which problem has the highest priority?

Aspiration Aspiration or the entry of foreign substances such as food or fluids into the lungs, may cause hypoxia or respiratory distress; this the highest

food sources of potassium

Avocado Bananas Cantaloupe Carrots Fish Mushrooms Oranges Pork, beef, veal Potatoes Raisins Spinach Strawberries Tomatoes

The RN is teaching a female client guidelines to manage stress incontinence. Which dietary change should the RN emphasize that will benefit the client?

Avoid alcohol and caffeine b/c they are both considered diuretics and irritants, which aggravate the bladder and worsen the client's incontinence.

Food sources of sodium

Bacon Butter Canned food Cheese Cottage cheese Cured pork Hot dogs Ketchup Lunch meat Milk Mustard Processed food Snack food Soy sauce Table salt White and whole-wheat bread

The nurse is evaluating the effect of dietary counseling on the client with cholecystitis. The nurse determines that the client understands the instructions given if the client states that which food item(s) are acceptable in the diet?

Baked fish

The speech therapist schedules a home visit to reevaluate Mr.Ivy. The therapist determines that dysphagia precautions are still needed. The PN and unlicensed assistive personnel (UAP) arrive at the home shortly after the therapist's evaluation is completed. The UAP prepares to assist Mr.Ivy with his noon meal and to attend to his personal hygiene by giving him a bed bath. What instruction should the PN provide the UAP?

Bather the client first and then place him in high Fowler's position during and after the meal. The head of the bed should be elevated to a high Fowler's position while the client with dysphagia is eating and should be kept elevated for at least 1 hour following the meal to reduce the risk of aspiration.

A client with liver cancer receiving chemotherapy tells the nurse that some foods on the meal tray taste bitter. The nurse should try to limit which food that is most likely to cause this taste for the client?

Beef and Pork

A client has been given a prescription for gemfibrozil. The nurse should instruct the client to limit which food while taking this medication?

Beef. Gemfibrozil is a lipid-lowering agent. Beef is fat. should not eat.

dividing the client's weight in kilograms by height in meters squared

Body mass index (BMI) can be calculated by:

Vitamin D Helps in:

Bones, Calcium, teeth, normal blood levels of calcium.

Vitamin C Helps in the body by:

Bones, Teeth, Skin, Wound Healing

Food sources of iron

Breads and cereals Dark green vegetables Dried fruits Egg yolk Legumes Liver Meats

Vitamin A Sources

Broccoli, Oranges, Carrots, Milk, Sweet Potatoes, Spinach, pumpkin

A postoperative client has been placed on a clear liquid diet. The nurse should provide the client with which items that are allowed to be consumed on this diet?

Broth, Coffee, Gelatin. A clear liquid diet consists of foods that are relatively transparent to light and are clear and liquid at room and body temperature. These foods include items such as water, bouillon, clear broth, carbonated beverages, gelatin, hard candy, lemonade, ice pops, and regular or decaffeinated coffee or tea.

The nurse is providing dietary instructions to a client about food items that are high in vitamin C. Which food item does the nurse recommend as being highest in vitamin C?

Cabbage

High calcium diet

Calcium is needed during bone growth and in adulthood to prevent osteoporosis and to facilitate vascular contraction, vasodilation, muscle contraction, and nerve transmission

The nurse is instructing a client with hyperkalemia on the importance of choosing foods low in potassium. The nurse should teach the client to limit which of the following foods? A. Grapes. B. Carrot. C. Green beans. D. Lettuce.

Carrots has 320 mg of potassium per 100 mg serving; green beans give 209 mg of potassium, 194 mg for lettuce, and 191 mg for grapes all in 100 mg serving. Other foods that are low in potassium include: applesauce, blueberries, pineapple, and cabbage.

The nurse should include which item in a list of the most helpful foods for a vegan client wishing to increase foods high in vitamin A?

Carrots. green leafy vegetables, and yellow vegetables

Two processes of metabolism

Catabolism: breakdown of food molecules which releases energy Anabolism: food molecules are built up into more complex chemical compounds

The nurse is creating a plan of care for a client receiving enteral feedings via a gastrostomy tube (G-tube). The nurse should plan to include which intervention in the plan of care?

Check around the stoma site for skin irritation.

Which actions should the nurse include when caring for a client with continuous tube feedings through a nasogastric (NG) tube?

Check the residual every 4 hours. Check for placement every 4 hours. Hang a new feeding bag every 24 hour NOT 72 hours. Check skin integrity at the site of NG tube insertion. Check for placement before administering medications.

The nurse is providing instructions to a client with hypophosphatemia. Which food item should the nurse instruct the client to avoid?

Cheese because it's high calcium. High calcium = Low phosphorous

Measures to Relieve Thirst

Chew gum or suck hard candy. Freeze fluids so that they take longer to consume. Add lemon juice to water to make it more refreshing. Gargle with refrigerated mouthwash.

The nurse is providing instructions to a client with kidney disease about a low-protein diet. The client demonstrates understanding of the dietary instructions by stating the need to limit which food in the diet?

Chicken has high protein

The PN is reinforcing dietary instructions to the parents of a 6 month old baby boy diagnosed with PKU phenylketonuria. What should the PN direct the patients to eliminate from his diet?

Chicken and fish

The RN is providing dietary instructions to the parents of a 6-month old baby diagnosed w/ phenylketonuria (PKU). Which foods should the RN teach the parents to eliminate in the infant's diet?

Chicken and fish. Phenylketonuria (PKU) is a genetic defect that does not metabolize the amino acid, phenylalanine which becomes toxic to brain development in the baby. Foods that contain phenylalanine, such as chicken and fish, and cow's milk protein or products with artificial sweeteners, should not be offered when the baby's diet progresses. Grapes and berries, green vegetables, cereals and breads are safer food that limits phenylalanine when progressing the infant's diet through growth and development.

In planning a low-sodium diet for a client who has recently been diagnosed with heart failure, the nurse should offer the client which food item?

Chicken breast

A nurse is teaching a client with pancreatitis about following a low-fat diet. The nurse develops a list of high-fat foods to avoid and includes which food on the item list? 1. Broccoli 2. Apple 3. Salmon 4. Chocolate milk

Chocolate milk is a high-fat food. Options 1 and 2: Fruits and vegetables are low in fat because they do not come from animal sources. Option 3: Salmon is naturally lower in fat.

The PN observes that the dressing around Mr. Ivy PEG tube insertion site is intact with a small amount of serosanguineous drainage. What actions should the PN execute? (select all)

Circle the Amount of drainage on the initial dressing. ---Circuling the amount of drainage allows the PN to compare any changes in the amount of drainage now with the amount of drainage. Chart a description of the color, location, and amount of drainage-- Accurate recording in Mr. Ivys chart of the characteristics of the drainage on the dressing will provide written documentation for future reference

A client is recovering from debridement of the right leg. A nurse encourages the client to eat which food item that is naturally high in vitamin C to promote wound healing? A. Milk. B. Chicken. C. Banana. D. Strawberries.

Citrus fruits and juices are especially high in vitamin C. Options A and B: Meats such as chicken and dairy products such as milk are high in vitamin B. Option C: Banana is rich in potassium.

Nursing considerations with soft diets:

Clients with mouth sores should be served foods at cooler temperatures Clients who have difficulty chewing and swallowing because of dry mouth can increase salivary flow by sucking on sour candy Encourage the client to eat a variety of foods Provide plenty of fluids with meals to ease chewing and swallowing of foods Drinking fluids through a straw may be easier than drinking from a cup or glass; a straw may not be allowed for clients with dysphagia (because of the risk of aspiration) All foods and seasonings are permitted; however, liquid, chopped, or pureed foods or regular foods with a soft consistency are tolerated best Foods that contain nuts or seeds, which easily can become trapped in the mouth and cause discomfort, should be avoided Raw fruits and vegetables, fried foods, and whole grains should be avoided

The only fat soluble antioxidant synthesized in the body is:

CoQ10

Leading source of antioxidants in the U.S is:

Coffee

carbohydrates amino acids fat emulsions (lipids) vitamins minerals and trace elements electrolytes water insulin heparin

Components of PN: 1. _____ (60-70%) 2. _____(3.5-20%) 3. _____ (30%) 4. _____ 5. _____ and _____ 6. _____ 7. _____ 8. _____ 9. _____

The couple discusses the decision together, and Mr. Ivy decides to have the procedure as scheduled. He is taken to the procedure room where a PEG tube is inserted. Mr. Ivy returns to his room following the insertion of the PEG tube. He has an IV of Lactated Ringer's solution infusing at 50mL/hour, but does not have any feeding solution attached to the PEG tube. What initial action should the PN implement?

Continue to monitor the client without infusing any solution through the PEG tube. Feeding supplements are typically initiated when bowel sounds are present, usually within 24 hours following PEG tube insertion.

A child with leukemia is complaining of nausea. The nurse suspects that the nausea is related to the chemotherapy regimen. The nurse, concerned about the child's nutritional status, should offer which item during this episode of nausea?

Cool, clear liquids

Active 2 - 3 year old children should have a daily calorie intake of which of the following? -1000 -1400 -1600 -2000

Correct Answer: 1,400 An active child who is 2 - 3 years old should have a daily intake of 1,400 calories. If the child is sedentary, the calorie count recommended per day is 1,000.

A condition that is classified as shock and can result in respiratory distress that is life threatening is called: -Anesthetic vasoconstriction -Anaphylaxis -Idiosyncratic reaction -Subcutaneus acidosis

Correct Answer: anaphylaxis Anaphylaxis is a form of an allergic reaction that is so severe it can be life threatening. The reaction can be triggered by drug sensitivity or hypersensitivity to other substances such as the venom from a bee sting. Individuals suffering from anaphylaxis can have respiratory distress, such as problems breathing or swallowing. Additional symptoms of anaphylaxis are pain in the abdomen, coughing, wheezing, diarrhea, vomiting, nausea, hives, redness of the skin, swelling of the face, tongue and eyes, tightness in the chest, arrhythmia (change in the normal heart beat, such as the heart beats fast, skips a beat, beats slowly or beats irregularly), and even unconsciousness.

Stage 2 hypertension would be indicated by which of the following blood pressure measurements? -120/80 mm Hg -135/88 mm Hg -142/95 mm Hg -162/101 mmHg

Correct answer: 162/101 mmHg Blood pressure categories range from normal to stage 2 hypertension. A reading of 162/101 mmHg indicates stage 2 hypertension.

Which of the following foods would provide the highest amount of protein? -1 large boiled egg -3 oz of roasted skinless turkey breast -1 cup of 2% milk -1 cup of split pea with ham soup

Correct answer: 3 oz of roasted skinless turkey breast 3 oz of roasted skinless turkey breast provides 25 grams of protein. The other choices provide 10 or less grams of protein.

Which of the following zones of temperature allows for rapid bacteria and production of toxins by some bacteria? -4.4 - 60° C -0 - 4.4° C -0 - 32° F -165 - 212° F

Correct answer: 4.4 - 60° C This zone of temperature (4.4 - 60° C) is known as the danger zone Temperatures in this zone allow rapid growth of bacteria and production of toxins by some bacteria. In Fahrenheit the danger zone is 40 to 140° F.

Carbohydrate requirement for infants aged 7 - 12 months is which of the following? -30 g/day -95 g/day -4.6 g/day -60 g/day

Correct answer: 95 g/day Infants have the highest calorie and protein needs per body weight of any time in the life cycle because of rapid growth and development and high activity rates. The carbohydrate requirement for infants of 7 - 12 months is 95 g/day (AI). For infants 0 - 6 months the requirement is 60 g/d (AI).

Which of the following is NOT a conditionally essential amino acid? -Alanine -Arginine -Cysteine -Glycine

Correct answer: Alanine Currently, there are six amino acids that are considered conditionally indispensable. These are Arginine, Cysteine, Glutamine, Glycine, Proline, and Tyrosine. Alanine is a dispensable amino acid.

Fat free means which of the following? -a food contains less than 0.5 g of fat per serving -a food has no more than 3 g of fat per serving of per 100 g of the food -a food has 1 g or less of saturated fat per serving -a food has less than 5 calories per serving

Correct answer: a food contains less than 0.5 g of fat per serving If a package is labeled "fat free," it must contain less than 0.5 g of fat per serving. Low fat means a food has no more than 3 g of fat per serving or per 100 g of the food.

The dietary standards that are described as "values for carbohydrate, fat, and protein expressed as percentages of total daily caloric intake" are which of the following? -acceptable macronutrient distribution ranges -tolerable upper intake levels -estimated average requirements -daily value

Correct answer: acceptable macronutrient distribution ranges The acceptable macronutrient distribution ranges were established to assure the provision of an adequate amount of total energy and nutrients and an attempt to reduce the risk of chronic illnesses.

In terms of the pathophysiology of ingestion, a dysfunction of the esophagus is which of the following? -achalasia -gastritis -steatorrhea -pinocytosis

Correct answer: achalasia Achalasia is a dysfunction of the esophagus. There are two clinical conditions: cardio spasm and hiatal hernia. Achalasia is dangerous because the person may aspirate food in the esophagus into the lung, leading to serious infection.

The most abundant serum protein is which of the following? -albumin -transferrin -IGF-1 -fibronecten

Correct answer: albumin Albumin is the most familiar and abundant of the serum proteins, as well as the most readily available clinically. Serum albumin level has been shown to be an indicator of depleted protein status and decreased dietary protein intake.

Folate deficiency has been linked to which of the following diseases? -spina bifida -anencephaly -megaloblastic anemia -all of the above

Correct answer: all of the above All of the first three choices are linked to folate deficiency. Other signs of deficiency are inflammation of the mouth and tongue, poor growth, depression and mental confusion, and problems with nerve functions.

Which of the following is NOT a mediator cell that releases substances that mediate immune reactions? -mast cell -basophil -platelet -barrier epithelial cell

Correct answer: barrier epithelial cell Barrier epithelial cells are the first line of defense - skin and mucous membrane. All of the others are mediator cells that produce increased vascular permeability, smooth muscle contraction and increased inflammatory response.

The degree to which an ingested nutrient gets absorbed and is available to the body is which of the following? -diffusion -transport -bioavailability -absorption

Correct answer: bioavailability Bioavailability is influenced by substances in food, drugs, and body stores. Medications can also influence bioavailability by either blocking or enhancing absorption.

Calorimetry is the measurement of heat released when foodstuffs are burned for energy. Which of the following is a calorimeter used to measure heat released when food is burned in the chamber of the calorimeter? -Atwater calorimeter -Benniger's apparatus -oxidator -bomb calorimeter

Correct answer: bomb calorimeter The bomb calorimeter is used to measure heat released when food is burned in the chamber of the calorimeter. The subsequent heat release is measured. The Atwater calorimeter and Benniger's apparatus are used for direct calorimetry in humans.

The muscle at the base of the esophagus that prevents gastric reflux from moving into the esophagus is which of the following? -fundus -pylorus -cardiac sphincter -esophageal sphincter

Correct answer: cardiac sphincter At the lower end of the esophagus the cardiac sphincter opens to allow passage of the bolus (chewed food) into the stomach. The cardiac sphincter prevents the acidic content of the stomach from flowing back into the esophagus.

Which of the following oils has the most saturated fat per tablespoon? -canola oil -safflower oil -sunflower oil -cottonseed oil

Correct answer: cottonseed oil Cottonseed oil has 27% saturated fat per tablespoon. The other choices have 7 - 12% saturated fat per tablespoon.

Which of the following is a monosaccharide, a single sugar unit? -sucrose -lactose -dextrose -maltose

Correct answer: dextrose Dextrose is the only monosaccharides of the choices given. The other choices are disaccharides - two monosaccharides linked together between the aldehyde or ketone and a hydroxyl on another sugar.

Nausea and diarrhea caused by food moving too quickly from the stomach to the small intestine is known as which of the following? -hypermetabolic syndrome -hypometabolic syndrome -dumping syndrome -steatorrhea

Correct answer: dumping syndrome Dumping syndrome sometimes follows gastric surgery. It occurs within 15 to 30 minutes after eating. It is caused by food moving too quickly from the stomach to the small intestine.

Insulin produced outside the body is called which of the following? -pseudo-pancreatic insulin -endogenous insulin -exogenous insulin -all of the above

Correct answer: exogenous insulin Exogenous insulin is produced outside the body. It is a protein. It must be injected because, if swallowed, it would be digested and would not reach the bloodstream as the complete hormone.

Atoms or groups of atoms with an odd (unpaired) number of electrons are known as which of the following? -antioxidants -free radicals -prohormones -retinol equivalents

Correct answer: free radicals Free radicals are atoms or groups of atoms with an odd (unpaired) number of electrons. They can be formed when oxygen interacts with certain molecules. Once formed, these highly reactive radicals can cause a chain reaction.

Which of the following is least likely to be a change associated with aging? -slowed peristalsis -decreased tolerance to fats -lactose intolerance -increased digestive enzymes

Correct answer: increased digestive enzymes Aging may cause slowed peristalsis, decreased HCl production in the stomach, loss of digestive enzymes, and atrophy gastritis. These may interfere with absorption of iron, calcium, and vitamin B12 and cause gastrointestinal upsets.

A toxicity of vitamin D can cause which of the following? -rickets -muscle spasms -enlargement of the liver -kidney stones

Correct answer: kidney stones Toxicity of vitamin D can cause kidney stones or calcification of soft tissues. Deficiency of vitamin D can cause rickets, osteomalacia, osteoporosis, poorly developed teeth and bones, and muscle spasms.

The amount of heat required to raise the temperature of one kg of water from 14.5 to 15.5 Celsius is which of the following? -calorie -kilocalorie -joule -energy value

Correct answer: kilocalorie The energy value of food is expressed in terms of units of heat. A kilocalorie is different from the calorie which equals 0.001 kcal. In other words, the kilocalorie equals 1,000 calories.

The lymphatic vessels in the small intestine that absorb fatty acids and glycerol are which of the following? -villi -microvilli -capillaries -lacteals

Correct answer: lacteals Each villus in the small intestine contains numerous capillaries (tiny blood vessels) and lacteals. The lacteals are lymphatic vessels that absorb fatty acids and glycerol (end products of digestion) in addition to the fat-soluble vitamins.

Manganese is least likely to be found in which of the following foods? -whole grains -nuts -fruits -liver

Correct answer: liver Manganese is found in whole grains, nuts, fruits, and tea. It is functional in bone formation and metabolic processes and is a component of enzymes.

A tumor that not only interferes with normal cell function but also invades normal tissues and robs the normal tissues of the nutrients needed to survive is which of the following? -malignant tumor -benign tumor -neoplasia -natural tumor

Correct answer: malignant tumor A malignant tumor not only interferes with normal cell function but also invades normal tissues and robs the normal tissues of the nutrients needed to survive. A benign tumor causes clinical disease only by interfering with normal cell function.

Which of the following deficiency diseases is characterized by a lack of all nutrients? -xerophtalmia -pellagra -marasmus -rickets

Correct answer: marasmus Marasmus is a form of severe malnutrition characterized by energy deficiency. A child with marasmus looks emaciated. Body weight is reduced to less than 60% of the normal (expected) body weight for the age. Marasmus occurrence increases prior to age one.

Enterotoxins affect which of the following? -skin -mucous membranes -nervous system -skeletal system

Correct answer: mucous membranes Enterotoxins affect mucous membranes in the digestive tract. Toxins, in general, can be produced by bacteria during food preparation or storage, or by bacteria in one's digestive tract.

An abnormal growth of cells is known as which of the following? metastasis -carcinogen -hypoplasia -neoplasia

Correct answer: neoplasia Neoplasia is the abnormal development of cells. The abnormal growth is called a neoplasm.

The functional unit of the kidney is which of the following? -renal pyramid -renal papilla -cortex -nephron

Correct answer: nephron The cortex and the renal pyramids make up the parenchyma, the functional portion of the kidney. The functional unit of the kidney is the nephron.

Which of the following enzymes converts starches to simple sugars? -pancreatic lipase -pancreatic amylase -trypsin -peptidase

Correct answer: pancreatic amylase Chyme triggers the pancreas to secrete its juice into the small intestine. Pancreatic juice contains (among other enzymes) pancreatic amylase which converts starches (polysaccharides) to simple sugars.

A deficiency disease caused by a lack of niacin is which of the following? -pellagra -scurvy -spina bifida -megaloblastic anemia

Correct answer: pellagra Niacin serves as a coenzyme in energy metabolism and consequently is essential to every body cell. Niacin is essential for the prevention of pellagra which is a disease characterized by sores on the skin and by diarrhea, anxiety, confusion, irritability, poor memory, dizziness, and untimely death if left untreated.

Which of the following foods has the highest amount of dietary fiber per standard portion? -Brussels sprouts -carrots -fresh apple -potato with skin

Correct answer: potato with skin A potato with skin on has over 2 g dietary fiber per standard portion. This is more than any of the other three choices, even though they are also good sources of fiber.

The type of kidney stone that develops after a urinary tract infection is which of the following? -uric acid stone -struvite stone -cystine stone -calcium oxalate stone

Correct answer: struvite stone Struvite stones are composed of magnesium ammonium phosphate. They are sometimes called infection stones because they develop following urinary tract infections caused by certain microorganisms. A low-phosphorus diet is often prescribed.

Of the following major minerals which one is most likely to be found in eggs? -potassium -magnesium -sulfur -sodium

Correct answer: sulfur Sulfur is found in eggs, poultry, and fish. its function is the maintenance of the protein structure. It is necessary for building hair, nails, and all body tissues.

The term for the functional junctions between a neuron and an effector, such as muscle or a gland is which of the following? -neuroglia -neurons -synapses -ganglia

Correct answer: synapses Synapses are the functional junctions between a neuron and an effector, such as muscle or a gland. They may be either electrical or chemical in nature. An electrical synapse allows an electrical current to spread between cells through gap junctions.

Kaposi's sarcoma most often develops at which stage of HIV infection? -incubation stage -first stage -ARC period -third and end stage

Correct answer: third and end stage The third and end stage of HIV infection is known as AIDS. It is manifested by a very low T-cell count, which makes it impossible for the body to fight off infections. Kaposi's sarcoma commonly develops at this point.

Which of the following foods contains the least niacin? -meat -legumes -fish -vegetables

Correct answer: vegetables The best sources of niacin are meats, poultry, and fish. Peanuts and other legumes are also good sources. Vegetables and fruits contain little niacin.

The nurse is evaluating a client's ability to select food items for a low-potassium diet. Which food item, if selected by the client, would indicate an understanding of this diet?

Cranberry juice

The nurse instructs a client with chronic kidney disease who is receiving hemodialysis about dietary modifications. The nurse determines that the client understands these dietary modifications if the client selects which items from the dietary menu?

Cream of wheat, blueberries, coffee. kidney disease who is receiving hemodialysis should include controlled amounts of sodium, phosphorus, calcium, potassium, and fluids,

The nurse is teaching a client who has iron deficiency anemia about foods she should include in her diet. The nurse determines that the client understands the dietary instructions if she selects which of the following from her menu? A. Nuts and fish. B. Oranges and dark green leafy vegetables. C. Butter and margarine. D. Sugar and candy.

Dark green leafy vegetables are rich in iron while oranges are a good source of vitamin C, which enhances iron absorption.

What should the RN recommend to a client who has mild hypertension change in their daily diet?

Decrease the intake of canned food can decrease salt intake. Increasing leafy green vegetables and fiber in a client's diet help maintain blood pressure and weight. Foods containing simple sugars should be exchanged for complex carbohydrates to aid in weight control.

The nurse is giving dietary instructions on a client who is on a vegan diet. The nurse provides dietary teaching focus on foods high in which vitamin that may be lacking in a vegan diet? A. Vitamin A B. Vitamin D C. Vitamin E D. Vitamin C

Deficiencies in vegetarian diets include vitamin B12 which are found in animal products and vitamin D (if limited exposure to sunlight).Options A, C, and D are found in fruits and vegetables, which are eaten by a vegetarian.

Nursing considerations with mechanical soft diets

Degree of texture modification depends on individual need, including pureed, mashed, ground, or chopped Foods to be avoided in mechanically altered diets include nuts; dried fruits; raw fruits and vegetables; fried foods; tough, smoked, or salted meats; and foods with coarse textures

Cholesterol rates

Desirable: less than 200 mg/dL High risk: 240 mg/dL and over

Dietary lack of specific essential nutrients caused by:

Dietary lack of specific essential nutrients caused by: 1. anorexia or bulimia 2. alcoholism 3. poor food habits or eating nutritionally deficient foods

The nurse has instructed a client in the foods that are best to consume on a low-fat diet. The nurse determines that the client understands this diet if the client indicates which food item is lowest in fat?

Dry toast and strawberry jelly

Food sources of zinc

Eggs Green, leafy vegetables Meats Protein-rich foods

Vitamin K Sources:

Eggs, Dark green veggies, Milk,

Vitamin D Sources:

Eggs, Milk, Sun, Fish,

The feedings are changed to bolus feeding three times a day. After receiving instruction, Mrs. Ivy correctly demonstrate the ability to perform the skill and says that she is ready to handle this responsibility. Mr. Ivy is discharged home, and home healthcare services resume. During a home visit, the PN observes Mrs.Ivy as she administers a bolus feeding to Mr.Ivy, who is sitting upright in the bed. After checking the residual volume, Mrs.Ivy pours the feeding into a syringe attached to the feeding tube. She then holds the syringe upright while the feeding enters the stomach. Upon observing this procedure, what action should the PN take?

Ensure that Mrs. Ivy flushes the tubing with water after the feeding syringe is empty. flushing the syringe and tubing with water reduces the risk for obstruction of the tubing.

A client is admitted to a long-term care facility with the diagnosis of weight loss secondary to anorexia. The health care provider prescribes an enteral tube feeding of a standard formula to run at 40 mL/hour. A nursing student is assigned to care for the client, and the nursing instructor asks the student to describe the nursing considerations related to a tube feeding. Which statement, if made by the student, indicates an understanding of this dietary treatment?

Enteral feedings require the normal digestive capabilities of the gastrointestinal tract

food sources of phosphorus

Fish Nuts Organ meats Pork, beef, chicken Whole-grain breads and cereals

sources of iron

Fish, Red meat, liver, eggs, driet fruit, cereal, some, yellow vegetables (e.g. spinach).

The nurse is providing dietary instructions to a client with a diagnosis of hyperphosphatemia. The nurse determines that the client understands the instructions if the client states the importance of eliminating which item from the diet?

Fish. foods that are high in phosphates include: fish, eggs, milk products, vegetables, whole grains, and carbonated beverages.

Green leafy vegetables; liver, beef, and fish; legumes; grapefruit and oranges Meats, poultry, fish, beans, peanuts, grains Pork and nuts, whole-grain cereals, and legumes Milk, lean meats, fish, grains Yeast, corn, meat, poultry, fish Meat, liver Citrus fruits, tomatoes, broccoli, cabbage

Folic acid: Niacin: Vitamin B1 (thiamine): Vitamin B2 (riboflavin): Vitamin B6 (pyridoxine): Vitamin B12 (cobalamin): Vitamin C (ascorbic acid):

A nurse is caring for a client with Wernicke-Korsakoff syndrome. The physician asks the nurse to teach the client to consume thiamine-rich food. The nurse instruct the client to increase the intake of which food items? A. Chicken. B. Milk. C. Beef. D. Broccoli.

Food sources of thiamine include beef, liver, nuts, oats, oranges, pork, eggs, seeds, legumes, peas and yeast.Option A: Poultry contains niacin. Option B: Milk contains vitamins A, D, and B2. Option D: Broccoli contains folic acid, vitamins C, E, and K.

Listeria monocytogenes

Foodborne illness that is most common with unpasteurized dairy or undercooked meats

What type of food item should the RN recommend to a client who recently had a total colectomy and colostomy?

Foods like Chicken Noodle Soup where there is no residual gas production after eating and digesting. Foods like carbonated beverages, boiled cabbage, and bean burritos create a large amount of gas after digestion, which can be embarrassing and uncomfortable for the client.

Nursing consideration with a potassium modified diet:

Foods that are low in potassium include applesauce, green beans, cabbage, lettuce, peppers, grapes, blueberries, cooked summer squash, cooked turnip greens, pineapple, and raspberries

A client with heart failure has been told to maintain a low sodium diet. A nurse who is teaching this client about foods that are allowed includes which food item in a list provided to the client? A. Pretzels. B. Whole wheat bread. C. Tomato juice canned. D. Dried apricot.

Foods that are lower in sodium includes fruits and vegetables like dried apricot.

A client who is recovering from a surgery has been ordered a change from a clear liquid diet to a full liquid diet. The nurse would offer which full liquid item to the client? A. Popsicle. B. Carbonated beverages. C. Gelatin. D. Pudding.

Full liquid food items include items such as plain ice cream, sherbet, breakfast drinks, milk, pudding, and custard, soups that are strained, refined cooked cereals, and strained vegetable juices.Options A, B, and C are clear liquid diet.

The nurse has provided dietary instructions to a client regarding food items that are high in vitamin B complex. The client demonstrates understanding of the dietary instructions by stating the importance of including which food item in the diet?

Grains

The nurse is providing a dietary session to a group of clients about the vitamin content of various foods. The nurse should tell the clients that which food item is highest in vitamin A?

Green leafy vegetables

Folic Acid Lowers risk of:

Heart Disease, Colon Cancer

The nurse is talking to the mother of a 2-month-old infant who is being seen in the health care provider's office for a well-child visit. Which statement by the mother would indicate that further teaching is needed about nutrition for this infant?

I started my daughter on cereal a week ago, and she loves the rice cereal.

The nurse is providing discharge dietary teaching to a client with a history of irritable bowel syndrome (IBS). What comment made by the client tells the nurse that further instruction is needed?

I'll eat more beans and peas.

Citrus fruit

IRON

Vitamin A Helps in these body areas:

Immune System, Eyes, Skin

After Mr.Ivy has been on half-strength formula at 40mL/hour for 2 weeks and adjusts to the feedings, the healthcare provider readjusts the prescription. The new prescription states that the formula should be increased by 10mL/hour as long as the clients residual volume is less than half the previously infused total volume. After infusing the half-strength formula at 40mL/hour for 6hours the PN checks the clients residual volume and obtains 75mL. What action should the PN implement?

Increase the rate of the formula to 50mL/Hour The client has received 240mL, during the previous 6 hours. Half of that volume is 120mL. Because the residual volume obtained was 75mL, the rate of the formula should be increased by 10mL/hour to 50ml/hour

Potassium diet

Indications a. A low-potassium diet is indicated for hyperkalemia, which may be the result of impaired renal function, hypoaldosteronism, Addison's disease, angiotensin-converting enzyme inhibitor medications, immunosuppressive medications, potassium-retaining diuretics, and chronic hyperkalemia. b. A high-potassium diet is indicated for hypokalemia, which may be the result of renal tubular acidosis, GI losses (diarrhea, vomiting), intracellular shifts, potassium-wasting diuretics, antibiotics, mineralocorticoid or glucocorticoid excess caused by primary or secondary aldosteronism, Cushing's syndrome, or exogenous corticosteroid use.

high-fiber (high-residue)

Indications: Used for clients with constipation; irritable bowel syndrome, when the primary symptom is alternating constipation and diarrhea; and asymptomatic diverticular disease

Considering the need for dysphagia precautions , how should the PN intervene?

Instruct the UAP to add a thickening agent to all liquids. because clients with dysphagia typically have swallowing liquids, a thickening agent is added that changes the consistency and makes swallowing easier

When adding to the plan of care, which intervention should be included to provide the PN with the most accurate information regarding Mr. Ivy's ongoing, overall nutritional status?

Instruct the home health aide to weigh the client once a week. Regular accounting of the client's weight provides a useful measurement of the client's general nutritional status. Assessment of the client's pattern of weight gain or loss should be combined with other measures, such as general and dietary evaluation, for a thorough picture of the client's nutritional status

The nurse is assessing the skin of a client with a history of malabsorption deficiency and discovers brittle nails. What type of nutritional deficiency should the nurse suspect based on this observation?

Iron deficiency

The nurse provides dietary instructions to a client at risk for hypokalemia about which foods are high in potassium and should be included in the daily diet. The nurse should tell the client that which fruit is highest in potassium?

Kiwi. bananas, cantaloupe, oranges.

Over time, the continuous feeding is increased to 80mL/hour and it is changed to full-strength formula. Mrs. Ivy was instructed by the RN about the management of continuous feeding with the PEG tube 2days ago. The PN plans to review with Mrs. Ivy how to manage the continuous feeding when Mr.Ivy is discharged. What information should be gathered by the PN, prior to the PN reviewing Mrs.Ivy ability to manager her husbands continuous feeding, and before asking Mrs.Ivy to perform a return demonstration? (select all)

Lean Mr. Ivy anticipated discharge date--this action is important to establish an appropriate time for a return demonstration and possible second return demonstration if needed. Determine if Mrs. Ivy feels ready to verbally review and demonstrate the skill.--Readiness to learn and demonstrate a new skill is essential in order to verify competency prior to discharge. If a client is reluctant to learn a new skill the PN can obtain further data, such as information about financial resources and educational level, which could have an impact on the clients readiness to learn. Obtain information about the couples education level.---it is important to ascertain Mrs.Ivys ability to read and understand written directions. Ascertain whether Mrs.Ivy understands that she cannot make formula substitutions--It is important to ensure that the client and his family understand the importance of maintaining prescribed tube feedings.

The nurse is caring for a client with cirrhosis of the liver. To minimize the effects of the disorder, the nurse teaches the client about foods that are high in thiamine. The nurse determines that the client has the best understanding of the dietary measures to follow if the client states an intention to increase the intake of which food?

Legumes

The RN is teaching an obese adolescent. What is an effective strategy for the RN to recommend to the adolescent about weight management?

Limit juices and soda drinks. Based on national reports by the CDC, an adolescent drinks an average of 22 ounces of full-calorie sodas per day. Changing this habit can render immediate results if the adolescent eliminates or limits drinking juices and commercial soda drinks.

Essential Fatty acids that must be derived from diet are:

Linoleic and alpha linoleic acid

Fat Soluble Vitamins transported by:

Lipoproteins

Fat Soluble Vitamins Stored where:

Liver & Adipose Tissue

S& S of Scurvy are:

Loss of appetite and irritability, diarrhea, fever, tenderness and swelling in legs

A client is diagnosed with a moderate case of acute ulcerative colitis. The nurse doing dietary teaching should give the client examples of foods to eat that represent which therapeutic diet?

Low fiber without milk to help reduce the frequency of diarrhea

The nurse is planning to teach a client with malabsorption syndrome about the necessity of following a low-fat diet. The nurse develops a list of high-fat foods to avoid and should include which food items on the list?

Margarine Cream cheese Luncheon meats

Vitamin E Sources:

Margarine, Whole Grains, Nuts, Leafy Greens

Full liquid diet

May be used as a transition diet after clear liquids following surgery or for clients who have difficulty chewing, swallowing, or tolerating solid foods

Vitamin B-12 Sources:

Meat, fish, milk, eggs, poultry, cheese, fortified soy milk

The nurse is teaching a client with tuberculosis about nutrition and foods that should be increased in the diet. The nurse should suggest that the client increase which food items?

Meats and citrus fruits. tuberculosis need to increase intake of protein, iron, and vitamin C.

The RN is caring for a client with a stage III pressure ulcer. The RN recognizes which food group that contains zinc should be added to the client's dietto aid in wound healing?

Meats and shellfish, b/c they are enriched with zinc and promote wound healing.

The breast-feeding mother of an infant with lactose intolerance asks the nurse about dietary measures. The nurse should tell the mother to avoid which food?

Milk

The nurse has given dietary instructions to an older female client to minimize the risk of osteoporosis. The client demonstrates understanding of the dietary teaching by stating that she will increase intake of which food?

Milk

intake and output, assessing weight, monitoring for edema, and monitoring for signs of dehydration each kilogram (2.2 lb) of weight gained or lost is equal to 1 liter of fluid retained or lost

Monitor the client's hydration status by assessing (4)

How should the PN explain the results of the calorie count to Mr and Mrs Ivy?

Mr Ivy's calorie consumption is insufficient and will result in weight loss. An average adult requires 20 to 35 calories per kg. per day. Mr. Ivy, who weighs 125lbs or 57kg, need minimum of 1140 calories per day to maintain his current weight

a. Primary dietary sources of calcium are dairy products. b. Lactose-intolerant clients should incorporate nondairy sources of calcium into their diet regularly.

Nursing considerations with a high calcium diet:

a. Purine is a precursor for uric acid, which forms stones and crystals. b. Foods to restrict include anchovies, herring, mackerel, sardines, scallops, organ meats, gravies, meat extracts, wild game, goose, and sweetbreads.

Nursing considerations with a low purine diet:

The home care nurse is visiting a male client who is recovering at home after suffering a brain attack (stroke) 2 weeks ago. The client's wife states that the client has difficulty feeding himself and difficulty with swallowing food and fluids. Which would be the initial nursing action?

Observe the client feeding himself.

The nurse is monitoring the nutritional status of a client receiving enteral nutrition. Which intervention should the nurse implement to determine the effectiveness of the tube feedings?

Obtain a daily weight.

The PN recognizes that Mr. Ivy's right-sided weakness is also a factor that contributes to his risk for altered nutrition. With which member of the interprofessional team should coordinate regarding this problem?

Occupational Therapists OT have expertise in helping clients adapt fine motor movements for the provision of self care. They can help with placement and manipulation of objects such as eating utensils.

Mr.Ivy has a new prescription for an appetite stimulant. What is the most important information for the PN to obtain before advising Mr.Ivy when he should take the medication?

Onset of action. The PN should determine when the drug will start to take effect, so that medication can be taken when the greatest therapeutic effect can be achieved.

A client is recovering from abdominal surgery and has a large abdominal wound. The nurse should encourage the client to eat which food item that is naturally high in vitamin C to promote wound healing?

Oranges

The nurse is providing instructions to a client with osteoporosis regarding appropriate food items to include in the diet to increase her intake of calcium. The nurse determines the need for further instruction when the woman tells the nurse that she will be sure to increase her intake of which food that is lowest in calcium?

Pork contains least calcium

The nurse is providing dietary instructions to a client about food items that are high in niacin. Which food item should the nurse recommend as highest in niacin?

Poultry. eggs, meats, and dairy products

The nurse is giving a presentation on good nutrition to a group of teenage mothers. Which level of prevention is the nurse implementing?

Primary level

Niacin Helps in:

Promotes conversion of food to energy, Treat hyperlipidemia, nervous system and digestive system.

Vitamin A Lowers the risk of:

Prostate Cancer, Lung Cancer, Cataracts

A deficiency of Thiamine in the diet causes:

Protein Malnutrition

The PN reports the data about Mr.Ivy nutritional status to the healthcare provider, who asks the PN to obtain a blood sample for several lab tests. The PN obtains the blood sample. The next day, the PN reviews a copy of the lab results. Which serum lab value reflects Mr. Ivy's altered nutrition?

Protein of 5.0 g/dL the range for normal serum protein level in an adult is 6.4-8.3 g/dL. A level of 5.0 g/dL is low and it may be an indicator of malnutrition

Vitamin K Helps in:

Proteins, calcium essential to blood clotting, helps prevent hip fractures. Prevents tetany

The PN also encourages Mrs.Ivy to prepare high-calorie snacks for Mr.Ivy. Mrs. Ivy states that her husband loves applesauce and asks if this a good snack choice. How should the PN respond?

Provide applesauce since he likes it, along with supplemental high calorie snacks to improve the client's nutrition, the PN needs to consider the likes and dislikes of the client in addition to the needed nutrients. Combining applesauce, which the client likes, but which is not high calorie snack with supplemental snacks that contain more calories best meets the needs of the client

The next morning, the PN enters Mr Ivys room to prepare him to go to the procedure room. The PN states that the procedure is scheduled in 30min. Mr. Ivy, who is lethargic from his sleeping pill, tells the the PN he has changed his mind and does not want the procedure performed, stating he would rather just "go ahead and die." His wife is in the room and she becomes very upset by her husband's comment. What action the PN implement?

Provide the couple with privacy to discuss the decision. The PN must address the clients expressed desire to cancel the procedure. The PNs initial actions should include allowing the couple privacy to discuss the decision, addressing any concerns of the client and encouraging further communication.

Mechanical soft

Provides foods that have been mechanically altered in texture to require minimal chewing Used for clients who have difficulty chewing but can tolerate more variety in texture than a liquid diet offers Used for clients who have dental problems, surgery of the head or neck, or dysphagia (requires swallowing evaluation and may require thickened liquids if the client has swallowing difficulties)

The PN is preparing a client about to hace a stool guiac test. Which food should the PN tell the clinet to aoid 3 days propr to collecting the specimen for this test?

Raw broccoli

After reviewing priorities, what is the next action the PN should take when adding to Mr. Ivy's plan of care?

Reconsider Goals The PN should first complete the subjective and objective physical findingd, interpret the data to identify problems, and then reevaluate goals. After the goals and expected outcomes are verified, the PN implements interventions, which are then evaluated to determine if the expected outcomes and goals were accomplished

The PN obtains the assistance of an interpreter when caing for a primiparous client from mexico who speaks very little English and delivered a full term neonate yesterday. When informing the postpartum dietary plan of care for the client, what should the PN tell the interpreter to encourage her to include in her diet? select all that apply.

Red meats, leafy greens, fresh fruits

Vitamin D Deficiency

Rickets, Osteomalacia

The PN and clinical dietitian collaborate to update the plan of care to improve Mr.Ivy's nutritional status. After the Ivys meet with the clinical dietitian, the PN reinforces information about foods high in protein with Mr and Mrs Ivy and reviews with them the sample menus provided. Which breakfast selection provides the most protein?

Scrambled eggs and sausage both eggs and sausage are good sources of protein

A client is being seen in the clinic for symptoms of hyperinsulinism. The nurse provides information to the client regarding dietary measures for the condition. Which diet would be most appropriate to suggest to the client?

Small, frequent meals with protein, fat, and carbohydrates at each meal

The nurse is instructing a client with hypertension on the importance of choosing foods low in sodium. The nurse should teach the client to limit intake of which food? 1. Apples 2. Bananas 3. Smoked sausage 4. Steamed vegetables

Smoked foods are high in sodium

The nurse is instructing a client with hypertension on the importance of choosing foods low in sodium. The nurse should teach the client to limit intake of which food?

Smoked sausage

The RN prepares the dietary treatment plan for a client who has ascites secondary to cirrhosis of the liver. Which instruction should the RN include when teaching the dietary plan? A. Restricted sodium intake. B. Increased protein intake. C. Restrict fluid intake. D. Increase potassium intake.

Sodium restrict (A) should be reinforced due to the relationship of sodium intake and fluid retention which exacerbates ascites. Protein (B) should be limited b/c protein metabolism increases ammonia levels in the blood. Fluid intake should be given in limited volumes throughout the day (C), but restricting sodium has a higher priority. (D) does not have a direct affect on the accumulation of ascites.

The nurse is providing dietary instructions to a client about the food items that are high in vitamin K. Which food item does the nurse recommend as being highest in vitamin K?

Spinach. Liver and green leafy vegetables

The nurse is consulting with a dietitian to plan a menu for a client who is on a regular diet and is a vegan. Which food item would the nurse and the dietitian select for the client's meal?

Stir-fried vegetables. Vegans exclude animal products. No egg.

Low fiber low residue

Supplies foods that are least likely to form an obstruction when the intestinal tract is narrowed by inflammation or scarring or when gastrointestinal motility is slowed Used for inflammatory bowel disease, partial obstructions of the intestinal tract, gastroenteritis, diarrhea, or other gastrointestinal disorders

The school nurse is providing a nutritional counseling session to a group of adolescents. The school nurse should instruct the adolescents that which item is a good source of vitamin C?

Sweet potatoes

While Mrs. Ivy administers the feeding Mr.Ivy tells the PN that he has had 5 to 7 liquid diarrhea stools a day for the last 2 days. Whats actions should the PN take with the client? (in order)

Tell Mrs. Ivy to hold the remaining feeding. Auscultate for the presence of bowel sounds Assess the elasticity of Mr.Ivy's skin Notify the healthcare provider of the diarrhea.

A client who was receiving enteral feedings in the hospital has been started on a regular diet and is almost ready for discharge. The client will be self-administering supplemental tube feedings between meals for a short time after discharge. The client expresses concern about performing this procedure at home. What is the nurse's best response?

Tell me more about your concerns about going home.

The PN notes a change in Mr.Ivy's weight. The PN coordinates with the dietitian, who helps a 24hr calorie count. The dietitian reports to the PN that Mr.Ivy, who weighs 125lbs and is 67inches tall, consumes 800 calories per day. How should the PN monitor the client's functional ability related to nutrition?

The clients ability to feed himself with his left hand. this evaluation provides information about the client;s functional ability

Before notifying the healthcare provider of the data reported by the dietitian, what information is most important for the PN to obtain?

The clients calculated body mass index the body mass index is calculated based on the clients height and weight and provides a picture of the clients current nutritional status regarding over or under nutrition

sclerosis, phlebitis, or swelling

The delivery of hypertonic solutions into peripheral veins can cause ... (3)

What information is most important for a RN to teach a client with Type 2 Diabetes mellitus (DM) regarding life-style changes?

The priority action of self-management is reinforcing dietary life-style changes, such as portion-controlled, heart healthy diet selections to acheive tight blood glucose control and to prevent complications with DM.

The nurse has determined that an unconscious client is at risk for nutritional problems. Which outcome indicates to the nurse that the goals have not yet been fully met?

Total protein concentration of 4.5 g/dL (45 g/L). The normal total protein level is 6.4 to 8.3 g/dL. The normal BUN is 10 to 20

The nurse instructs a client about a low-fat diet. Which menu selection indicates that the client understands the nurse's instructions?

Turkey breast, boiled rice, and fruit

The PN is reenforcing diet teaching for a client with a simple goiter. Which foods should the PN recommend that the client eliminate from the diet?

Turnips

The RN is teaching a client who has a goal of losing 25 lbs about diet and weight loss. Which is the most common problem that the RN should recognize about the accuracy of client reporting about daily food intake?

Under reporting of food intake. A client is more likely to under report what has been eaten due to the embarrassment or inability to comply with the weight loss goal.

The nurse is explaining the process of bariatric surgery to a severely obese client who has attended a medically supervised weight loss program for approximately 6 months. The client is considering this procedure. What are some conditions that may interfere with a client's commitment to lifelong behavioral changes and that may lead to poor surgical outcomes? Select all that apply.

Untreated depression Binge eating disorders Drug and alcohol abuse Inability to comply with nutritional recommendations

Soft diet

Used for clients who have difficulty chewing or swallowing Used for clients who have ulcerations of the mouth or gums, oral surgery, broken jaw, plastic surgery of the head or neck, or dysphagia, or for the client who has had a stroke

High fiber high residue

Used for constipation, irritable bowel syndrome when the primary symptom is alternating constipation and diarrhea, and asymptomatic diverticular disease

Low purine diet

Used for gout, kidney stones, and elevated uric acid levels

Sodium restricted diet

Used for hypertension, heart failure, renal disease, cardiac disease, and liver disease

Protein restricted

Used for renal disease and end-stage liver disease The nutritional status of critically ill clients with protein-losing renal diseases, malabsorption syndromes, and continuous renal replacement therapy or dialysis should have their protein needs assessed by estimating the protein equivalent of nitrogen appearance (PNA); a nutritionist should be consulted.

High calorie- high protein

Used for severe stress, burns, wound healing, cancer, human immunodeficiency virus, acquired immunodeficiency syndrome, chronic obstructive pulmonary disease, respiratory failure, or any other type of debilitating disease

Renal diet

Used for the client with acute kidney injury or chronic kidney disease and those requiring hemodialysis or peritoneal dialysis

vegan vegetarian diet

Vegan and Vegetarian Diets A. Vegan 1. Vegans follow a strict vegetarian diet and consume no animal foods. 2. Eat only foods of plant origin (e.g., whole or enriched grains, legumes, nuts, seeds, fruits, vegetables). 3. The use of soybeans, soy milk, soybean curd (tofu), and processed soy protein products enhance the nutritional value of the diet.

Folic Acid Helps in:

Vital for new cell creation, lowers homocysteine levels, prevent birth defects in brain and spine

Women taking oral contraceptives should increase her intake of which dietary supplement?

Vitamin C NOT calcium.

Mrs. Ivy looks at the newly prescribed medication, which is a brand name drug, and states, "next time we fill this prescription, I hope we can get this in a generic form. Maybe it be so expensive. How should the PN respond?

Your pharmacist and healthcare provider can determine if there is a generic drug that is a safe alternative to the brand name drug Although brand name and generic medications are bioequivalent, the inhert ingredients may vary, sometimes resulting in differing effects. Therefore, the healthcare provider must approve the substitution of a generic medications for a prescribed brand name medication.

continuous administration intermittent or cyclic administration

________: infused continuously over 24 hours; Most commonly used in a hospital setting ________: commonly administered overnight; Allows clients requiring PN on a long-term basis to participate in activities of daily living during the day without the inconvenience of an IV bag and pump set; Monitor glucose levels closely because of the risk of hypoglycemia due to lack of glucose during non-infusion times.

parenteral nutrition (PPN or TPN)

___________ supplies nutrients via the veins. supplies carbohydrates in the form of dextrose, fats in an emulsified form, proteins in the form of amino acids, vitamins, minerals, electrolytes, and water. prevents subcutaneous fat and muscle protein from being catabolized by the body for energy. hypertonic due to the higher concentrations of glucose and addition of amino acids.

A risk factor for developing type 2 diabetes is

a history of gestational diabetes.

Cellulose

a polysaccharide that makes up the framework of plants; provides bulk fr the diet; cannot be broken down by the human digestive system and therefore is not absorbed

A problem that is most likely to affect the accuracy of patients' reported food intake is

a tendency to underreport food intake.

Oral glucose tolerance test (GTT)

a test used to screen for DM

Insulin is produced by the

a-cells of the pancreas.

Nursing considerations with a renal diet:

a. Controlled amounts of protein, sodium, phosphorus, calcium, potassium, and fluids may be prescribed; may also need modification in fiber, cholesterol, and fat based on individual requirements; clients on peritoneal dialysis usually have diets prescribed that are less restrictive with fluid and protein intake than those on hemodialysis b. Most clients receiving dialysis need to restrict fluids c. Monitor weight daily as a priority because weight is an important indicator of fluid status.

Nursing considerations with low residue diets:

a. Foods that are low in fiber include white bread, refined cooked cereals, cooked potatoes without skins, white rice, and refined pasta. b. Foods to limit or avoid are raw fruits (except bananas), vegetables, nuts and seeds, plant fiber, and whole grains. c. Dairy products should be limited to 2 servings a day.

Nursing considerations with a high fiber diet:

a. High-fiber diet provides 20 to 35 g of dietary fiber daily b. Volume and weight are added to the stool, speeding the movement of undigested materials through the intestine c. High-fiber foods are fruits and vegetables and whole-grain products d. Increase fiber gradually and provide adequate fluids to reduce possible undesirable side effects such as abdominal cramps, bloating, diarrhea, and dehydration e. Gas-forming foods should be limited

Caridac Diet

a. Indicated for atherosclerosis, diabetes mellitus, hyperlipidemia, hypertension, myocardial infarction, nephrotic syndrome, and kidney failure b. Reduces the risk of heart disease c. Dietary Approaches to Stop Hypertension (DASH) diet: recommended to prevent and control hypertension, hypercholesterolemia, and obesity d. The DASH diet includes fruits, vegetables, whole grains, and low-fat dairy foods; meat, fish, poultry, nuts, and beans; and is limited in sugar-sweetened foods and beverages, red meat, and added fats.

Cardiac diet

a. Indicated for atherosclerosis, diabetes mellitus, hyperlipidemia, hypertension, myocardial infarction, nephrotic syndrome, and renal failure b. Reduces the risk of heart disease c. Dietary Approaches to Stop Hypertension (DASH) diet: recommended to prevent and control hypertension, hypercholesterolemia, and obesity d. The DASH diet includes fruits, vegetables, whole grains, and low-fat dairy foods; meat, fish, poultry, nuts, and beans; and is limited in sugar-sweetened foods and beverages, red meat, and added fats.

Nursing considerations with a sodium restricted diet:

a. Individualized; can include 4 g of sodium daily (no-added-salt diet), 2 to 3 g of sodium daily (moderate restriction), 1 g of sodium daily (strict restriction), or 500 mg of sodium daily (severe restriction and seldom prescribed) b. Encourage intake of fresh foods, rather than processed foods, which contain higher amounts of sodium. c. Canned, frozen, instant, smoked, pickled, and boxed foods usually contain higher amounts of sodium. Lunch meats, soy sauce, salad dressings, fast foods, soups, and snacks such as potato chips and pretzels also contain large amounts of sodium; teach patients to read nutritional facts on product packaging regarding sodium content per serving. d. Certain medications contain significant amounts of sodium. e. Salt substitutes may be used to improve palatability; most salt substitutes contain large amounts of potassium and should not be used by clients with renal disease.

potassium modified diet

a. Low-potassium diet is indicated for hyperkalemia, which may be caused by impaired renal function, hypoaldosteronism, Addison's disease, angiotensin-converting enzyme inhibitor medications, immunosuppressive medications, potassium-retaining diuretics, and chronic hyperkalemia. b. High-potassium diet is indicated for hypokalemia, which may be caused by renal tubular acidosis, gastrointestinal losses (diarrhea, vomiting), intracellular shifts, potassium-losing diuretics, antibiotics, mineralocorticoid or glucocorticoid excess resulting from primary or secondary aldosteronism, Cushing's syndrome, or exogenous corticosteroid use.

Nursing considerations with a protein restricted diet:

a. Provide enough protein to maintain nutritional status but not an amount that will allow the buildup of waste products from protein metabolism (40 to 60 g of protein daily). b. The less protein allowed, the more important it becomes that all protein in the diet be of high biological value (contain all essential amino acids in recommended proportions). c. An adequate total energy intake from foods is critical for clients on protein-restricted diets (protein will be used for energy, rather than for protein synthesis). d. Special low-protein products, such as pastas, bread, cookies, wafers, and gelatin made with wheat starch, can improve energy intake and add variety to the diet. e. Carbohydrates in powdered or liquid forms can provide additional energy. f. Vegetables and fruits contain some protein and, for very low-protein diets, these foods must be calculated into the diet. g. Foods are limited from the milk, meat, bread, and starch groups.

Mechanical soft diet

a. Provides foods that have been mechanically altered in texture to require minimal chewing b. Used for clients who have difficulty chewing but who can tolerate more variety in texture than a liquid diet offers c. Used for clients who have dental problems, have undergone surgery of the head or neck, or have dysphagia (requires swallowing evaluation and may require thickened liquids if the client has swallowing difficulties)

Nursing considerations for a fat restricted diet:

a. Restrict total amount of fat, including saturated, trans, polyunsaturated, and monounsaturated b. Clients with malabsorption may also have difficulty tolerating fiber and lactose c. Vitamin and mineral deficiencies may occur in clients with diarrhea or steatorrhea d. A fecal fat test may be prescribed and indicates fat malabsorption with excretion of more than 6 to 8 g of fat (or more than 10% of fat consumed) per day during the 3 days of specimen collection

clear liquid diet

a. Serves the primary function of providing fluids and electrolytes to prevent dehydration b. Initial feeding after complete bowel rest c. Used initially to feed a malnourished person or a person who has not had any oral intake for some time d. Clear liquid diet is used for bowel preparation for surgery or tests, as well as postoperatively and in clients with fever, vomiting, or diarrhea. e. Clear liquid diet is used in gastroenteritis.

Low fiber/low residue diet

a. Supplies foods that are least likely to form an obstruction when the intestinal tract is narrowed by inflammation or scarring or when GI motility is slowed b. Used for inflammatory bowel disease, partial obstructions of the intestinal tract, gastroenteritis, diarrhea, or other GI disorders

Nursing considerations with a carbohydrate consistent diet:

a. The Exchange System for Meal Planning, developed by the Academy of Nutrition and Dietetics and the American Diabetes Association, is a food guide that may be recommended. b. The Exchange System groups foods according to the amounts of carbohydrates, fats, and proteins they contain; major food groups include the carbohydrate, meat and meat substitute, and fat groups. c. A carbohydrate consistent diet focuses on maintaining a consistent amount of carbohydrate intake each day and with each meal; also known as "carb counting."

Carbohydrate-consistent diet

a. The Exchange System for Meal Planning, developed by the Academy of Nutrition and Dietetics and the American Diabetes Association, is a food guide that may be recommended. b. The Exchange System groups foods according to the amounts of carbohydrates, fats, and proteins that they contain; major food groups include the carbohydrate, the meat and meat substitute, and the fat groups. c. A carbohydrate consistent diet focuses on maintaining a consistent amount of carbohydrate intake each day and with each meal; also known as "carb counting."

Nursing considerations with a high iron diet:

a. The high-iron diet replaces iron deficit from inadequate intake or loss. b. The diet includes organ meats, meat, egg yolks, whole-wheat products, dark green leafy vegetables, dried fruit, and legumes. c. Inform the client that concurrent intake of Vitamin C with iron foods enhances absorption of iron.

fat restricted diet

a. Used to reduce symptoms of abdominal pain, steatorrhea, flatulence, and diarrhea associated with high intakes of dietary fat, and to decrease nutrient losses caused by ingestion of dietary fat in individuals with malabsorption disorders b. Used for clients with malabsorption disorders, pancreatitis, gallbladder disease, and gastroesophageal reflux

Clear liquid diet

a. provides fluids and some electrolytes to prevent dehydration. b. is used as an initial feeding after complete bowel rest. c. is used initially to feed a malnourished person or a person who has not had any oral intake for some time. d. is used for bowel preparation for surgery or diagnostic tests, as well as postoperatively and in clients with fever, vomiting, or diarrhea. e. Clear liquid diet is used in gastroenteritis.

Protein is composed of building units called

amino acids.

The starch-splitting enzyme in the mouth

amylase

Physical measurements of the body, including height, weight, and skinfold thickness, are referred to as

anthropometric measurements.

vitamin C

antioxidant, collagen synthesis

vitamin E

antioxidant, healthy immune system

The absence of urine production, indicating kidney failure, is called

anuria.

During hemodialysis, protein intake is usually

at least 1.2 g/kg.

It is important to weigh hospitalized patients

at the same time each day.

A high dietary intake of cholesterol and saturated fat is associated with an increased risk for

atherosclerosis.

Protein digestion

begins in the stomach and is completed in the small intestine; proteins are broken down into amino acids for absorption

Fat digestion

begins in the stomach but occurs primarily in the small intestine; fats are reduced to fatty acids and glycerol for absorption

types of antioxidants include:

beta carotene selenium vitamin E vitamin C

Recommended daily intake of fat

between 20%-35% of total caloric intake; less than 10% should be from saturated fat

An emulsifying agent that aids fat digestion and absorption is

bile .

egg allergy

determine ___ before giving lipids

It is common for patients with acute kidney failure to need

enteral nutrition.

Triglycerides

fats eaten in foods or made in the body from other sources such as carbohydrates

Iron is stored as

ferritin

potassium sodium chloride

fluid balance, nerve conduction, and muscle contraction (3)

Intracellular

fluid within cells

Campylobacter jejuni

foodborne illness that is found in water sources or unpasteurzed dairy, and is transferred by chickens and birds through feces

Samonella typhi

foodborne illness that is most common with undercooked meats

Clostridium botulinum

foodborne illness that most commonly occurs with inappropriate preparation of canning foods

Complete proteins

foods that contain all 8 essential amino acids in amounts capable of meeting human requirements

Incomplete proteins

foods that lack one or more of the essential amino acids

Complementary proteins

foods that, when eaten together, supply the amino acid that is missing or in short supply in the other food

Major minerals

found in the largest amounts in the body and are needed in large amounts calcium, phosphorous, potassium, sodium, chlorine, magnesium, and sulfur

carbs

fruit, sugar, milk, bread, pasta, rice, legumes, starchy veggies

The hormone considered to act in an opposite manner to insulin is

glucagon.

Evidence of under nutrition (1)

greater risk of physical illness, limited in physical work and mental capacity, and have lower immune system function than do people receiving adequate nutrients

magnesium

halibut, seeds, nuts, tofu, swiss chard, spinach, wheat, yeast and molasses

saturated fats

hard margarine, shortening, and processed foods (they are hard at room temp)

Pasteurized

heated to a specific temperature to destroy pathogenic bacteria

A reason to include dietary fiber in the diet is because fiber

helps normalize bowel function.

An example of a body protein is

hemoglobin

Iron plays a role in

hemoglobin synthesis.

The PN is review with the parents of a 6 month baby about the dangers of botulism in food. Which food should the PN reinforce not feeding to their infant before the age of 12 months?

honey

3. Lipid solutions are isotonic and therefore can be administered through a peripheral or central vein; the solution may be administered through a separate IV line below the filter of the main IV administration set by a Y-connector or as an admixture to the PN solution (3-in-1 admixture consisting of dextrose, amino acids, and lipids). 4. Most fat emulsions are prepared from soybean or safflower oil, with egg yolk to provide emulsification; the primary components are linoleic, oleic, palmitic, linolenic, and stearic acids (assess the client for allergies). 5. Glucose-intolerant clients or clients with diabetes mellitus may benefit from receiving a larger percentage of their PN from lipids, which helps to control blood glucose levels and lower insulin requirements caused by infused dextrose. 6. Examine the bottle for separation of emulsion into layers or fat globules or for the accumulation of froth; if observed, do not use and return the solution to the pharmacy. 7. Additives should not be put into the fat emulsion solution. 8. Follow agency policy regarding the filter size that should be used; usually a 1.2-μm filter or larger should be used because the lipid particles are too large to pass through a 0.22-μm filter. 9. Infuse solution at the flow rate prescribed—usually slowly at 1 mL/minute initially—monitor vital signs every 10 minutes, and observe for adverse reactions for the first 30 minutes of the infusion. If signs of an adverse reaction occur, stop the infusion and notify the health care provider (HCP) 10. If no adverse reaction occurs, adjust the flow rate to the prescribed rate. 11. Monitor serum lipids 4 hours after discontinuing the infusion.

how to administer lipids:

xray aspirated pH CO2 (would be present if in lungs)

how to check ng tube placement

1. Evaluation of nutritional status by a nutritionist or pharmacist is done before PN is discontinued. 2. If discontinuation is prescribed, gradually decrease the flow rate for 1 to 2 hours while increasing oral intake (this assists in preventing hypoglycemia). 3. After removal of the IV catheter, change the dressing daily until the insertion site heals. Note that central lines should not be left in without a reason due to risk of infection, but in some situations are left in place and used for other necessary reason (venous access, medication administration). 4. Encourage oral nutrition. 5. Record oral intake, body weight, and laboratory results of serum electrolyte and glucose levels. *****Abrupt discontinuation of a PN solution can result in hypoglycemia. The flow rate should be decreased gradually when the PN is discontinued.*****

how to discontinue PN:

gradually decrease the flow to allow the pancreas to adjust

how to prevent hypoglycemia with TPN

Unsaturated fats

hydrogen can be added to one or more places in a chemical structure

Studies indicate that exercise

improves uptake of glucose by the cells.

central TPN

in a central large vein (subclavian or jugular) and are placed for longer than 7-10 days

hyperglycemia

increased thirst, increased urine, increased hunger, headache, dehydration, nausea and vomiting, and weakness

1. Clients with severely dysfunctional or nonfunctional gastrointestinal tracts who are unable to process nutrients may benefit from PN. 2. Clients who can take some oral nutrition, but not enough to meet their nutrient requirements, may benefit from PN. 3. Clients with multiple gastrointestinal surgeries, gastrointestinal trauma, severe intolerance to enteral feedings, or intestinal obstructions, or who need to rest the bowel for healing, may benefit from PN. 4. Clients with severe nutritionally deficient conditions such as acquired immunodeficiency syndrome, cancer, burn injuries, or malnutrition, or clients receiving chemotherapy, may benefit from PN.

indications for parenteral nutrition:

be associated Very high protein intakes may with increased risks for

inflammation in the glomerular cells of the kidney.

Thyroid-stimulating hormone controls the uptake of

iodine.

The trace mineral that plays a role in hemoglobin formation and general metabolism is

iron.

A medical test used to determine skeletal system integrity

is urinary calcium excretion.

The three common, long-term complications of diabetes affect cells in the

kidney, eye, and nerve tissue.

BUN electrolytes hematocrit pre albumin glucose

labs to monitor with tube feedings:

The massive edema of nephrotic syndrome is caused by

large protein losses in the urine.

A food source of cholesterol would be

liver

The major site or organ in the body for metabolic processing of carbohydrates the

liver.

Hypoglycemia

low blood sugar

megaloblastic anemia

low folic acid causes

Compared with the pH in the small intestine, the pH in the stomach is

lower.

Fat molecules enter into the bloodstream through the

lymph vessels.

Persistent hyperglycemia during pregnancy is associated with an increased risk of

macrosomia.

The mineral that is a catalyst for many reactions in cells that produce energy is

magnesium

The primary focus of medical nutrition therapy for diabetes care is to

maintain glycemic control.

Synthetic

manufactured vitamins

The greatest source of dietary zinc is

meat.

the home health PN is caring for a client with a stage 3 pressure ulcer. Which food group that contains zinc should be added to he clients diet to aide in wound healing?

meats and fish`

Phenylketonuria is caused by the inability to produce the enzyme needed to

metabolize the amino acid phenylalanine.

Examples of invisible fats

milk, avocado, cheese, lean meat

potassium

milk, bananas, legumes, green leafy veggies, OJ, tomatoes, juices, avocado and cantaloupe

During times of illness, diabetes is managed by

modifying the texture of the meal plan while still providing adequate carbohydrates

The building blocks for all carbohydrates are

monosaccharides

When fats are hydrogenated, they become

more solid.

The mucosal lining of the intestine is protected from irritation and erosion by secretions of

mucus

Trace minerals

needed in small amounts iron, zinc, copper, iodine

calcium

nerve conduction, muscle contraction, blood vessel dilation, and secretion of hormones

A. Check the PN solution with the HCP's prescription to ensure that the prescribed components are contained in the solution; some health care agencies require validation of the prescription by 2 registered nurses. B. To prevent infection and solution incompatibility, IV medications and blood are not given through the PN line. C. Blood for testing may be drawn from the central venous access site; a port other than the port used to infuse the PN is used for blood draws after the PN has been stopped for several minutes (per agency procedure) because the PN solution can alter the results of the sample. The client with a central venous access site receiving PN should still have a venipuncture site. D. Monitor partial thromboplastin time and prothrombin time for clients receiving anticoagulants. E. Monitor electrolyte and albumin levels and liver and renal function studies, as well as any other prescribed laboratory studies. Blood studies for blood chemistries are normally done every other day or 3 times per week (per agency procedures) when the client is receiving PN; the results are the basis for the HCP continuing or changing the PN solution or rate. F. Monitor blood glucose levels as prescribed (usually every 4 hours) because of the risk for hyperglycemia from the PN solution components. G. In severely dehydrated clients, the albumin level may drop initially after initiating PN, because the treatment restores hydration. H. With severely malnourished clients, monitor for "refeeding syndrome" (a rapid drop in potassium, magnesium, and phosphate serum levels). I. The electrolyte shift that occurs in "refeeding syndrome" can cause cardiovascular, respiratory, and neurological problems; monitor for shallow respirations, confusion, weakness, bleeding tendencies, and seizures. If noted, the HCP is notified immediately. J. Abnormal liver function values may indicate intolerance to or an excess of fat emulsion or problems with metabolism with glucose and protein. K. Abnormal renal function tests may indicate an excess of amino acids. L. PN solutions should be stored under refrigeration and administered within 24 hours from the time they are prepared (remove from refrigerator 0.5 to 1 hour before use). M. PN solutions that are cloudy or darkened should not be used and should be returned to the pharmacy. N. Additions of substances such as nutrients to PN solutions should be made in the pharmacy and not on the nursing unit. O. Consultation with the nutritionist should be done on a regular basis (as prescribed or per agency protocol).

nursing considerations with PN:

Nutrition diagnostic statements may include

nutrient deficiencies

Nutrition counseling is a form of

nutrition intervention.

Nursing considerations with a full liquid diet:

nutritionally deficient in energy (calories) and many nutrients includes clear and opaque liquid foods, and those that are liquid at body temperature all clear liquids and items such as plain ice cream, sherbet, breakfast drinks, milk, pudding and custard, soups that are strained, refined cooked cereals, fruit juices, and strained vegetable juices often necessary to meet nutrient needs for clients on a full liquid diet for more than 3 days

polyunsaturated fats (eat less of these)

oils and fish

monounsaturated fats (eat more of these)

oils, almonds, sesame seeds, avocado, cashews

beta carotene

orange, red, yellow, and green veggies

Foods high in cholesterol

organ meats, animal fat, egg yolk, and shellfish

Vitamins

organic compounds needed in small amounts for growth and maintenance of life

Saturated fats

organic compounds that are completely filled with all the hydrogen they can hold

A decrease in the activation of vitamin D in kidney disease results in

osteodystrophy

If the gastrointestinal tract cannot be used to provide nutrition, then

parenteral nutrition may be used to isupply nutrients

_____ is sually administered through a large distal vein in the arm with a standard peripheral intravenous (IV) catheter or midline or through a peripherally inserted central catheter (PICC). A midline is placed in an upper arm vein such as the brachial or cephalic vein with the tip ending below the level of the axillary line; If a PICC cannot be established, the subclavian vein or internal or external jugular veins can be used for PPN.

partial parenteral nutrition

The focus of a successful and effective nutrition plan of care is the

patient.

vitamin B deficiency

pellagra

Pepsinogen is converted by hydrochloric acid in the stomach to

pepsin.

into peripheral vein

peripheral TPN (PPN) only temporarily placed

The mineral for the controlled necessary oxidation of carbohydrate, fat, and protein in producing and storing available energy for the body is

phosphorus

Foods high in saturated fat include

pork sausage

The part of the circulatory system that transports blood from the intestines liver is called the

portal circulation system

If nitrogen intake exceeds nitrogen excretion, the condition is called

positive nitrogen balance.

The major electrolyte found inside cells is

potassium.

Major stages of the lifespan with specific nutritional needs are _____, _____, _____, _____, and _____. Adults and older adults may experience physiological aging changes, which influence individual nutritional needs.

pregnancy, lactation, infancy, childhood, and adolescence

Mastication is an important part of digestion because it

prepares the food for digestion by enzymes

vitamin K

promotes clotting of blood deficiency causes bruising and bleeding

Peptidases are enzymes that act on

proteins

Which nutrient is primarily anabolized

proteins

Classic symptoms of glomerulonephritis include

proteinuria.

We need some fat in our diet to

provide essential fatty acids.

Carbohydrates play a major role in nutrition because they

provide the major source of energy

The vitamin most closely associated with protein metabolism is

pyridoxine.

vitamin A

resistance to infection, night vision, helps with growth and development deficiency causes blindness and decreased immunity

air embolism fever infection fluid volume overload blood sugar changes

risks with TPN:

sodium

salt, smoked meat, fish, olives, pickles

For patients with chronic kidney failure, potassium intake is based on

serum potassium level.

The form of insulin that has its peak action between 2 and 4 hours after administration is the

short-acting form.

▪ Chest and back pain ▪ Chills ▪ Cyanosis ▪ Diaphoresis ▪ Dyspnea ▪ Fever ▪ Flushing ▪ Headache ▪ Nausea and vomiting ▪ Pressure over the eyes ▪ Thrombophlebitis ▪ Vertigo

signs and symptoms of an adverse reaction to lipids:

Monosaccharides

single sugars which require no digestion and are easily absorbed into the bloodstream

include Early signs of diabetes may

skin infections.

Fat digestion occurs mainly in the

small intestine.

A significant source of vitamin A is found in

spinach.

Sources of cellulose

stalks and leaves of plants, skins of fruits and vegetables, outer coverings of seeds and cereals

Non-nutritive sweeteners provide

sweetness but no energy.

Indispensable amino acids

the 9 amino acids that the body cannot manufacture in sufficient quantity (or at all) and therefore must be supplied in the diet

The nutrient intake guideline that sets the maximal nutrient intake that is unlikely to pose a risk of toxicity in healthy individuals is called

the Tolerable Upper Intake Level (UL).

Kashrut

the body of Jewish religious law dealing with foods that can and cannot be eaten and how those foods must be prepared and eaten, which Orthodox Jews follow to "keep the diet kosher." No food products from pigs, no shellfish, and dairy cannot be mixed with meat either on the same plate or during the same meal.

Protein plays an important role in the body in

the body's defense.

A biochemical test used to detect anemia is

the complete blood count .

The type of diet recommended for a person with a kidney stone depends on

the composition of the stone.

A test used to evaluate breakdown of skeletal muscle is

the creatinine height index.

A common tool used to assist in dietary management of diabetes is

the food exchange system.

Patients with chronic kidney disease often develop anemia due to

the inadequate production of erythropoietin

The basic means of communication among health care team members is

the patient's medical record.

Hydrogenation

the process of adding hydrogen to a liquid or polyunsaturated fat and changing it to a solid or semisolid state

Invisible fats

those in which the fat is less obvious

Visible fats

those readily seen

Exogenous goitrogen

thyroid-inhibiting substances that should be avoided if the client has a goiter. Ex: Turnips

The primary function of protein in the body IS

tissue building.

chloride

tomatoes, celery, seaweed, and olives

Dietary fiber

total amount of naturally occurring material in foods, mostly plants, that is not digested by the human digestive system and therefore is not absorbed

A laboratory test that indicates immune capacity is the

total lymphocyte count.

_____ is administered through a central vein; the use of a PICC is acceptable. Other sites that can be used include the subclavian vein and the internal or external jugular veins.

total parenteral nutrition

omega 3 & 6

unsaturated essential fatty acids such as fish, nuts, seeds, oil, and flax seed

Metabolism

use of food by the body cells for producing energy and building complex chemical compounds

_____ follow a strict vegetarian diet and consume no animal foods; Eat only foods of plant origin (e.g., whole or enriched grains, legumes, nuts, seeds, fruits, vegetables); The use of soybeans, soy milk, soybean curd (tofu), and processed soy protein products enhance the nutritional value of the diet.

vegan

selenium

vegetables, oatmeal, brown rice, chicken, dairy, garlic, onions, seafood, and whole grains

The fingerlike projections in the small intestine that ensure maximal absorption of nutrients are called

villi

A vitamin that plays a major role in blood clotting is

vitamin K.

Patients who are being treated with the drug warfarin should limit foods high in

vitamin K.

1. _____ facilitate metabolism of proteins, fats, and carbohydrates and act as catalysts for metabolic functions.

vitamins

Noncaloric essential nutrients in necessary small amounts for specific metabolic very control and disease prevention are called

vitamins

fluid overload

weak pulse, HTN, tachycardia, concussion, decreased urine OP, pitting edema, JVD, crackles on the lungs

fiber

whole grain, wheat bran, cereals, fruits, veggies and legumes

Home-Care Instructions

▪ Reinforce to the client and caregiver how to administer and maintain parenteral nutrition fluids. ▪ Reinforce to the client and the caregiver how to change a sterile dressing. ▪ Obtain a daily weight at the same time of day in the same clothes. ▪ Stress that weight gain of more than 3 lb/week may indicate excessive fluid intake and should be reported. ▪ Monitor the blood glucose level, and report abnormalities immediately. ▪ Check for signs and symptoms of infection, thrombosis, air embolism, and catheter displacement. ▪ Teach the client and caregiver about the signs and symptoms of side or adverse effects such as infection, thrombosis, air embolism, and catheter displacement. ▪ Teach the client and caregiver the actions to take if a complication arises and about the importance of reporting complications to the primary health care provider. ▪ For symptoms of thrombosis, the client should report edema of the arm or at the catheter insertion site, neck pain, and jugular vein distention. ▪ The leakage of fluid from the insertion site or pain or discomfort as the fluids are infused may indicate the displacement of the catheter. This must be reported immediately. ▪ Reinforce to the client and caregiver the importance of follow-up care. ▪ Teach the client to keep electronic infusion devices fully charged in case of electrical power failure.

The hormone that stimulates the pancreas to release its secretions is

secretin.

A nutrient that helps prevent free radical damage to membranes is

selenium

Major minerals are

required by the body in amounts of more than 100 mg/day.

Ways to ingest water

1. ingested fluids 2. water in foods that are eaten 3. water formed from cell oxidation

Chloride

salt

folic acid deficiency fortified grain

what causes neural tube defects: food to increase:

position on the L side with head lower than feet

what to do if theres a suspected air embolism

slow the infusion, get vitals, call the doctor, and stay with the patient

what to do with fluid overload

A food that is a good source of calcium is

yogurt

Sodium-Free Spices and Flavorings

▪ Allspice ▪ Almond extract ▪ Bay leaves ▪ Caraway seeds ▪ Cinnamon ▪ Curry powder ▪ Garlic powder or garlic ▪ Ginger ▪ Lemon extract ▪ Maple extract ▪ Marjoram ▪ Mustard powder ▪ Nutmeg

Signs of an Adverse Reaction to Lipids

▪ Chest and back pain ▪ Chills ▪ Cyanosis ▪ Diaphoresis ▪ Dyspnea ▪ Fever ▪ Flushing; rash ▪ Headache ▪ Nausea and vomiting ▪ Pressure over the eyes ▪ Thrombophlebitis ▪ Vertigo

food sources of calcium

Cheese Collard greens Milk and soy milk Rhubarb Sardines Tofu Yogurt

Vitamin B-12 Helps in:

Lowers risk of heart disease, making new cells, breaks down fatty and amino acids,

Two categories of dietary fiber

Soluble and insoluble

Carbohydrate consistent

Used for clients with diabetes mellitus, hypoglycemia, hyperglycemia, and obesity

Energy needs of the body are based on three factors:

1. physical activity 2. basal metabolism: the energy required for the body to sustain life while in a resting state 3. thermal effects of food: energy required for the digestion, absorption, and metabolism of foods

Sources of carbs (3)

1. polysaccharides: bread, cereal, pasta, rice 2. disaccharides: table sugar, sugar cane 3. monosaccharides: fruit, honey, milk

LDL

"bad cholesterol"; tens to circulate in the blood stream and form plaque on the inner walls of arteries

HDL

"good cholesterol"; carries cholesterol away from the arteries and back to the liver for removal from the body

An example of an oil high in monounsaturated fatty acids is

)olive oil.

Food distribution for the patient with diabetes is characterized by

)providing equal amounts of food at regular intervals.

An essential fatty acid is one that

)the body cannot manufacture for itself

The nurse is caring for a pregnant client who is iron deficient. What groups are vulnerable to this condition?

-Alcoholics -Vegetarians -Women of childbearing years -Older people who consume poor diets

Vitamin C Sources:

Berries, Spinach, tomates, citrus fruits,

Sorbitol

naturally occurring sugar that is not absorbed, may cause diarrhea in children

The term amino refers to compounds containing

nitrogen.