Yoost Chapter 30: Nutrition QUESTIONS

Body Mass Index (BMI)

A helpful tool for determining the extent of obesity and its potential health complications.

Kwashiorkor

A lack of protein accompanied by fluid retention.

A patient has suspected iron-deficiency anemia. The nurse monitors the patient and reports which of the following findings supporting this diagnosis? a. Elevated transferrin level b. Elevated oxygenation saturation c. Urine tests positive for protein d. Increased hemoglobin level

ANS: A Transferrin is a blood protein that binds with iron and is important to its transport. A decreased oxygenation and hemoglobin would be most likely due to the lack of oxygen-carrying capacity of the red blood cells. Positive protein in the urine (proteinuria) is an indication of chronic kidney disease.

Peristalis

A wax-like muscular movement.

Based on research on aging, the nurse knows that improper nutrition may result in the onset of which specific diseases? (Select all that apply.) a. Type 2 diabetes b. Atherosclerosis c. Osteoporosis d. Rheumatoid arthritis

A, B, C Research conducted by the National Institute on Aging (Boyd et al., 2008) reveals how improper nutrition may result in the onset of specific diseases of the endocrine, cardiovascular, gastrointestinal, and musculoskeletal systems, such as diabetes type 2, atherosclerosis, diverticulosis, osteoporosis, and some cancers. Rheumatoid arthritis is an inflammatory autoimmune disorder.

The nurse is helping a patient understand the difference between macronutrients and vitamins and minerals. She is correct when she lists the following items as macronutrients: (Select all that apply.) a. Water b. Potassium c. Starches d. Fiber e. Riboflavin

A, C, DThe major nutrients, often referred to as macronutrients (nutrients that are needed in large amounts), include carbohydrates (sugar, starches, and dietary fiber). Water is also a macronutrient. Potassium is a mineral, and riboflavin is vitamin B2these are micronutrients.

Food(s) rich in Vitamin A include: a. Carrots b. Bread c. Pumpkin d. Canola Oil e. Green, leafy vegetables f. Nuts

A, C, E

Fat-soluble Vitamins

A, D, E, and K.

A nurse is caring for a patient with a diagnosis of pellegra resulting from a niacin deficiency who complains of fatigue, loss of appetite, headache, weight loss, scaly sores, and neurological deterioration. The nurse performs a dietary assessment for which of the following vitamins? a. Vitamin B3 b. Vitamin B2 c. Vitamin C d. Vitamin B12

ANS: A Pellegra is the result of a niacin (vitamin B3) deficiency with the manifestations of fatigue, anorexia, headache, weight loss, dry, patchy skin, and changes in mental status. Vitamin C (ascorbic acid) is important as an antioxidant, and promotes healing and iron absorption. Deficiency of vitamin C results in impaired wound healing, decreased collagen formation, and a strong immune system and is found in citrus fruits, orange and yellow fruits, and sweet and white potatoes. Vitamin B12 (cyancobalamin) deficiency contributes to pernicious or megoblastic anemia. Vitamin B2 (riboflavin) deficiencies are involved in changes in the skin and vision such as cheilosis, dermatitis, and vision problems.

The nurse is educating a patient about including more omega-3 fatty acids in her diet. Which of the following food sources should be included? (Select all that apply.) a. Salmon b. Flaxseed c. Mackerel d. Steak

ANS: A, B, C Dietary sources of omega-3 include fatty fish, such as salmon, tuna, mackerel, and lake trout, as well as nuts, seeds, and oils; flaxseed oil contains the highest amount of total omega-3 fatty acids. Steak does not contain omega-3.

The nurse is planning dietary education for her patient. What food labeling consideration should she be aware of when planning her education? (Select all that apply.) a. Ask patients if they read food labels. b. Assess their level of understanding of food labels. c. Encourage them to read the food labels. d. Explain to them all food labels are different.

ANS: A, B, C Evidence indicates a consistent link between eating healthier foods and reading nutrition labels. Patients should be asked if they read food labels when shopping for groceries or food products. Evaluate their understanding of the main elements of a nutrient label (i.e., calories, fats, carbohydrates, sugar, and serving size). Assess patient understanding of the percentages of recommended daily allowances of fats, proteins, and carbohydrates listed on food labels. Uniform nutrition labeling for packaged food was introduced in the United States in 1994, as part of the Nutrition Labeling and Education Act (NLEA), to increase consumer awareness about the nutritional content of food and improve dietary practices; therefore, all labels are the same.

The nurse knows that a deficiency in vitamin C can result in the following conditions: (Select all that apply.) a. Stiff joints b. Osteopenia c. Petechiae d. Loose teeth e. Bleeding gums

ANS: A, B, C, D, E Deficiencies of vitamin C interfere with normal tissue synthesis and may result in gingivitis, which produces swollen and bleeding gums with loosened teeth, and painful, stiff joints. Other problems associated with malabsorption include anemia (a deficiency of red blood cells), excessive bleeding, petechiae (bleeding under the skin), poor wound healing, and neural tube defects. Osteopenia results from poor absorption of calcium.

The nurse is completing her documentation after feeding a patient with aspiration precautions. Which of the following items should she document? (Select all that apply.) a. Episodes of coughing or gagging b. Hesitation or fear of eating c. Amount eaten d. Aspiration protocol used e. Respiratory status

ANS: A, B, C, D, E It is important to document thoroughly the patient's experience during the feeding so the other nursing staff will be aware of patient's needs including any episodes of coughing, gagging, or choking; respiratory status; hesitancy or fear of eating; and occurrences of nausea, vomiting, regurgitation, and/or reflux symptoms. The nurse should also document the protocol used, the amount food eaten, and fluid intake.

The nurse is educating her patient about the risk of heart disease from metabolic syndrome. She knows metabolic syndrome is a cluster of the following symptoms: (Select all that apply.) a. Elevated blood glucose b. High waist circumference c. History of smoking d. Hypertension e. Elevation serum cholesterol

ANS: A, B, D, E Metabolic syndrome is a cluster of medical conditions characterized by insulin resistance and the presence of obesity, abdominal fat, elevated blood glucose, triglycerides, serum cholesterol, and hypertension. Smoking is not part of the syndrome.

The nurse is preparing some educational materials for her patient about the impact of obesity and a high body mass index (BMI). She knows that as BMI increases, so does the risk of these conditions: (Select all that apply.) a. Increase in blood pressure b. Increase in HDL c. Increase in total cholesterol d. Development of atherosclerosis

ANS: A, C, D As BMI levels rise, blood pressure and cholesterol levels also rise and the average high-density lipoprotein (HDL), or good, cholesterol levels decrease. Hyperlipidemia (elevation of plasma cholesterol, triglycerides, or both) or low HDL levels contribute to the development of atherosclerosis (the buildup of fat deposits on arterial vessel walls).

The nurse is providing dietary education to her patient to help him include more complex carbohydrates in his diet. Which of the following would be beneficial to include? (Select all that apply.) a. Green beans b. Bananas c. Beans d. Potatoes

ANS: A, C, D Complex carbohydrates provide the body with vitamins and minerals. Food sources include bread; rice; pasta; legumes such as dried beans, peas, and lentils; and starchy vegetables such as corn, pumpkin, green peas, and potatoes. Bananas are a fruit, which is a simple carbohydrate.

The nurse is completing a nutrition assessment on a patient. What are some important considerations? (Select all that apply.) a. The nurse should include the patient's cultural influences in her assessment. b. The food diary accuracy is the same for a 24-hour recall or 3- to 5-day food journal. c. The nurse should be nonjudgmental in her review. d. A consult with a registered dietician may be indicated

ANS: A, C, D When collecting data, the nurse should take into consideration the patient's culture and ethnicity. Recognizing these influences on the patient's nutritional intake allows the nurse to make informed decisions. The data analysis may reveal the need to refer the patient to a registered dietitian for further evaluation of nutritional status. The 24-hour recall is dependent on the ability of the patient to remember consumption of foods and their quantities from the previous day. It is vital to remember that the patient's recall may not be factual and the intake may not be that of a typical day. The other means of assessing a patient's usual dietary pattern is to have the patient keep a written journal of food intake for a certain amount of time. The food diary should encompass entries for 3 to 5 days and include dietary intake for a typical weekend.

The nurse instructs a patient with a vitamin A deficiency on food sources that could prevent symptoms. Which of the following food combinations would be appropriate? a. Corn and potatoes b. Carrots and spinach c. Iron-fortified bread or cereals d. Raisins and papaya

ANS: B Carrots and spinach are good sources of vitamin A. Corn and potatoes are good sources of starch and fiber. Raisins and papaya are excellent sources of calcium. Fortified bread and cereals are good sources of iron and fiber.

A patient is admitted to the hospital with pernicious anemia and a surgical history of having had a gastrectomy six months ago. On assessment, the nurse questions the patient about compliance with taking which of the following medications that supports the development of red blood cells? a. Vitamin K b. Vitamin B12 c. Calcium supplement d. Magnesium supplement

ANS: B Patients who have had a gastrectomy lack the intrinsic factor and this results in deficiency of vitamin B12 and requires replacement (IM) for life due to the inability of the body to absorb this very important vitamin. Vitamin K, calcium, and magnesium are not relevant to this condition.

The nurse is preparing to insert a nasogastric (NG) tube in her patient. Which of the following steps in the process indicates a need for further education? a. The nurse lubricates 4 inches of the tube prior to insertion. b. The nurse marks the length of the tube with a marker for insertion. c. The nurse measures the length of tube needed using the nose-earlobe-xiphoid process. d. The nurse applies clean gloves for the procedure.

ANS: B Document the length of the tube to be used if the tube has a preprinted measurement scale. For any tube (with or without a preprinted scale), mark the measurement on the tube using a small piece of tape to ensure proper placement of the tube; fold the ends of the tape for easy removal. Do not use a permanent marker to mark the tube; it can cause confusion if the mark is not exact once the radiology confirms placement. Lubricate 4 inches of the tube tip with a water-soluble lubricant. For an NG tube, measure the length of tube needed for the patient by placing the tip of the tube at the tip of the patient's nose and extending it to the patient's earlobe and then to the patient's xiphoid process. Clean gloves are used.

The nurse is concerned about aspiration precautions when feeding her patient who has recently suffered a stroke. Which of the following procedures that the nurse performs would demonstrate a need for further education? a. The nurse uses thickened liquids. b. The nurse puts the bed at 30 degrees. c. The nurse encourages slow eating. d. The nurse has the patient alternate between food and sips of fluid.

ANS: B During feeding, the head of the bed needs to be elevated at 45 degrees or higher. Liquids are thickened, and patients are encouraged to use slow-eating habits and to alternate between bites of food and sips of fluids to facilitate swallowing.

The nurse is measuring his patient's height. Which of the following steps of the procedure indicates a need for further education on this skill? a. He instructs the patient to remove his shoes. b. He measures from the top of the patient's head to the bottom of the patient's foot arch. c. He positions the head against the headboard or measuring device. d. He makes sure the patient is standing erect.

ANS: B Nurses measure from the top of the head to the bottom of the heel. The patient is instructed to remove shoes, stand erect, and position the top of the patient's head against the headboard or measuring device for accuracy.

The nurse knows that patients should consume the following amounts of fiber every day: a. 25-35 g b. 20-35 g c. 25-40 g d. 20-40 g

ANS: B Older children, adolescents, and adults should consume 20 to 35 g of fiber a day. Food sources include whole grains, wheat bran, cereals, fresh fruits, vegetables, and legumes.

The nurse is providing education to patient about the difference between simple and complex carbohydrates. Which statement by the patient indicates a need for further education? a. "Simple carbohydrates give me quick energy." b. "Complex carbohydrates come from fruit." c. "Complex carbohydrates take longer to break down." d. "Simple carbohydrates come from milk products."

ANS: B Simple carbohydrates are broken down and absorbed quickly, providing a quick source of energy. Examples are sugars such as those derived from fruit (fructose), table sugar (sucrose), milk products (lactose), and blood sugar (glucose). Complex carbohydrates are composed of starches, glycogen, and fiber. They take longer to break down prior to absorption and utilization by the body's cells.

The nurse is caring for a patient receiving enteral feedings. She appropriately delegates the following to the UAP: (Select all that apply.) a. Verify tube placement b. Perform oral care c. Administer tube feeding d. Obtain vital signs and report results

ANS: B, C, D Administering an enteral feeding may be delegated, at the nurse's discretion, to UAP in accordance with state regulations and facility policies and procedures. The nurse should verify tube placement and assess the patient prior to delegating this procedure. The UAP can perform oral care and obtain vital signs and report results.

The nurse knows an appropriate outcome statement for the nursing diagnosis Impaired swallowing is: a. the patient will consume 50% of his meal. b. the patient will gain 2 lb a week. c. the patient will show no signs of aspiration during meals. d. the patient will demonstrate using an assistive device to feed himself.

ANS: C An appropriate goal statement for Impaired swallowing is that the patient will not exhibit any signs or symptoms of aspiration during this hospitalization (e.g., lungs clear, respiratory rate within normal range for patient). Consuming 50% of meals and gaining weight are appropriate goals for Imbalanced nutrition: less than body requirements. Using assistive devices is an appropriate goal for Feeding: self-care deficit.

The nurse is providing education to an older adult around diet to support the challenges related to aging. Which statement indicates a need for further education? a. "I should choose foods that are nutrient dense." b. "High-fiber foods minimize the risk of constipation." c. "I should eat more calories to avoid malnutrition." d. "I can add spices to enhance the taste of food."

ANS: C Calorie needs change because of more body fat and less lean muscle. Less activity further decreases calorie requirements. Eating whole-grain foods and a variety of fruits and vegetables and drinking water may minimize the risk of constipation. The challenge for older adults is to choose foods that are nutrient dense; these foods are high in nutrients in relation to their calories. Older adults may experience a decreased sense of smell or taste, so the addition of spices and herbs may enhance the taste of foods.

The nurse is explaining to the UAP that the patient is on a full-liquid diet. Which statement by the UAP indicates a need for reorientation? a. "I can give the patient orange juice." b. "I can give the patient yogurt." c. "I can give the patient oatmeal." d. "I can give the patient milk."

ANS: C Full-liquid diets consist of foods that are or may become liquid at room or body temperature. Full-liquid diets include juices with and without pulp, milk and milk products, yogurt, strained cream soups, and liquid dietary supplements. Oatmeal is not considered part of a full-liquid diet.

The nurse is educating her patient about who has just been placed on a renal diet. Which statement by the patient indicates a need for further education? a. "I need to eat a low-sodium diet." b. "I can have limited amounts of meat." c. "I can drink unlimited cola if it is diet." d. "I should avoid or limit bananas."

ANS: C Renal diets restrict potassium, sodium, protein, and phosphorous intake. Fresh fruits (except bananas) and vegetables are excellent dietary choices for individuals on a renal diet. Meats, processed foods, peanut butter, cheese, nuts, caramels, ice cream, and colas are typically allowed in limited quantities or contraindicated.

The nurse knows that initial verification of a nasogastric placement is important. Which method is considered the only reliable method to determine enteral tube placement? a. Auscultation of air bolus b. Measurement of pH of the aspirate c. Radiographic image d. Aspirate contents to visually inspect appearance

ANS: C Studies support the use of radiographic confirmation as the only reliable method to date of confirming enteral tube placement. Using only pH and the appearance of aspirate from the newly inserted tube is not a safe method of verifying proper gastric tube placement, especially in patients receiving antacid medications. Auscultation of an air bolus to assess tube placement is no longer recognized as a reliable source in determining gastric tube placement.

The nurse has received an order from the health care provider to discontinue the nasogastric tube. Which of the following actions by the nurse indicates a need for further education? a. The nurse clears the tube with air prior to discontinuing. b. The nurse stops the tube feeding. c. The nurse instructs the patient to cough while pulling out the tube. d. The nurse clamps the tube while pulling it out.

ANS: C To remove the tube, instruct the patient to take a deep breath and hold it; pinch the tube, and pull it out smoothly and quickly. The nurse should stop any feedings, and suction and flush the tube with water and/or air as appropriate. The nurse should not ask the patient to cough while pulling out the tube. Coughing during tube insertion may indicate the tube is entering the patients lungs.

The nurse is caring for an adolescent patient with anorexia nervosa. She knows the best treatment option is: a. hospitalization with skill nursing care. b. compulsory tube feedings. c. individually determined by a collaborative team. d. outpatient treatment.

ANS: C Ultimately, the decision on how best to ethically treat an adolescent suffering from an eating disorder needs to be one of collaboration among the child's physician, nurse, counselor, spiritual adviser, parents, and other concerned adults. Highly skilled nursing care with hospitalization is preferred prior to a drop in BMI levels below 13 kg/m2. Compulsory tube feedings are not always the best option. Although most adolescents with eating disorders can be treated on an outpatient basis, those who exhibit severe depression, extreme physical complications resulting from electrolyte imbalances, or suicidal tendencies may require extensive inpatient treatment.

An elderly patient is admitted with a diagnosis of osteoporosis and bone scan results that reveal a reduction in bone mass. The nurse encourages the patient to eat foods that are a. high in iron. b. low in vitamin E. c. low in sodium. d. high in calcium.

ANS: D Osteoporosis and diminished bone mass are the result of poor absorption of calcium. Dietary sources include milk and milk products, salmon with bones, spinach, kale, fortified whole wheat bread, tofu, and orange juice. Iron, vitamin A, and sodium are important nutrients but not linked to the identified problem. Calcium is the most abundant mineral in the body and responsible for bone strength. Sodium and vitamin E are not specific to bone.

The nurse is performing an oral examination on a patient and notices a beefy-red tongue. She knows this is a characteristic finding in: a. anorexia nervosa. b. malnutrition. c. bulimia. d. pernicious anemia.

ANS: D In conditions such as pernicious anemia, a characteristic finding is a sore, smooth-surfaced, beefy-red tongue, which may interfere with the person's ability to chew certain foods. Anorexia nervosa and bulimia are eating disorders. In malnutrition the oral mucosa may be a darker red than normal with oral lesions and/or the tongue may reveal white irregular areas.

Lipid

Any fat found within the body, including true fats and oils such as fatty acids, cholesterol, and phospholipids.

Malnutrition

An imbalance in the amount of nutrient intake and the body's needs.

Bulimia Nervosa

Another common eating disorder.

A 15-year-old female gymnast is hospitalized with the diagnosis of bulimia nervosa. Which data would the nurse anticipate finding in the patient's admission history and physical assessment? a. Excessive intake of food, self-induced vomiting, and use of laxatives b. Refusal to eat, body image disturbance, constipation, and amenorrhea c. Excessive exercise, refusal to eat, poor muscle tone, and social isolation d. Hair loss, BMI of 27, occasional use of diuretics, calorie intake 2200/day

Answer: a Bulimia involves the obsession with binging (the intake of excessive amounts of food), with consumption of as much as 2000 to 3000 calories at one time, followed by purging (vomiting). In an effort not to gain weight from the excessive amount of food eaten, the affected person may use self-induced vomiting or excessive exercise. It also may involve the abuse of laxatives or diuretics. A refusal to eat, excessive exercise, body image disturbance, poor muscle tone, hair

Nutrients

Are the necessary substances obtained from ingested food that supply the body with: 1.) energy 2.)build and maintain bones, muscles, and skin 3.) aid in the normal growth and function of each body system.

A patient recovering from major abdominal surgery is to be progressed from a clear liquid diet to the next diet level. Which statement by the nurse would be most appropriate in this circumstance? a. "You will progress from a clear liquid diet to a mechanical soft diet." b. "If you can tolerate the clear liquid diet, your next meal will be a full liquid." c. "You will receive a regular diet tray with anything you want at the next meal." d. "It is important that you eat a pureed diet after you are able to tolerate the clear liquids."

Answer: b A full liquid diet is used as a transition diet to avoid overdistending the abdomen after abdominal surgery. A mechanical soft diet incorporates modified food consistency such as ground meat or soft cooked foods. It also is used for people who have difficulty chewing effectively. The regular diet has no restrictions, which could cause damage to the abdomen if the wrong food were selected. A pureed diet is given to persons who cannot tolerate the texture of some foods, which have to be blended so the patient can chew them. There is no indication that this patient has difficulty chewing food.

A Jewish patient who adheres to a kosher diet is diagnosed with type 1 diabetes. What would be the best response of the nurse when the patient refuses to take insulin, stating, "Insulin contains pork and I do not eat pork"? a. "There is only a tiny amount of pork by-product in insulin." b. "All of the insulin used today is made synthetically." c. "I will notify your physician to change the insulin order." d. "You really do not have the option of not taking insulin."

Answer: b All insulin manufactured today is biosynthetic. It is no longer derived from pork or cattle pancreas. There is no need to contact the physician to change the order. Patients always have the right to refuse medication. In this case, educating the patient about the source of the insulin should allay any fears of the insulin coming from pigs

A young adult female is considering becoming pregnant and is not taking any multivitamins. Which instruction would best help reduce the potential for development of neural tube defects in the fetus? a. Discuss taking selenium supplements with meals. b. Stress the importance of prenatal exercise. c. Recommend folic acid dietary supplements. d. Inquire about the patient's diet and birth control method.

Answer: c Folic acid is necessary to prevent the formation of neural tube defects such as spina bifida. Selenium is unrelated to the prevention of neural tube defects. Exercise, diet, and birth control methods do not specifically relate to neural tube defect prevention.

What nursing intervention would be most beneficial to implement in an effort to prevent aspiration by a patient receiving tube feedings? a. Check the pH of stomach contents before starting each feeding. b. Hold prescribed medications until after each feeding. c. Elevate the head of the patient's bed at least 45 degrees. d. Slow the delivery of the tube feeding to 15 mL/hour.

Answer: c If the head of the bed head is elevated 45 degrees during feedings, the risk of vomiting, or regurgitating the tube feeding formula and aspirating it into the lungs, is reduced. Checking the pH of stomach contents does not reduce the incidence of aspiration. Slowing the delivery of tube feedings may decrease the incidence of diarrhea, but not aspiration. Holding prescribed medication pertains to the compatibility of medications with the tube feeding, rather than the risk of aspiration.

A female Muslim patient is admitted to the hospital and informs the nurse that it is the month of Ramadan. Which action by the nurse is most appropriate in caring for this patient? a. Provide a vegetarian diet for the patient on Friday throughout her hospitalization. b. Ask the dietitian to visit the patient to ensure that fruit and cheese are not combined. c. Check on the potential effect fasting until sundown will have on the patient's condition. d. Document that milk and milk products cannot be prepared with meat or meat products.

Answer: c Persons of the Islamic faith fast until sundown during the month of Ramadan. Fruit is not restricted in the patient's culture or religion. No meat on Fridays is commonly followed in the Catholic faith. Kosher diets restrict the preparation of meat and milk products together.

A patient tells the nurse that he needs to increase his intake of potassium because he has been taking large doses of diuretics. To minimize complications from hypokalemia, the nurse should instruct the patient to include which of the following foods as a part of his diet? a. Cheese and crackers b. Peanut butter and jelly sandwich c. Tomatoes and spinach d. Apples and grapes

Answer: c Tomatoes and spinach are good sources of potassium. Cheese and crackers are sources of calcium and fiber. Peanut butter is a good source of protein; jelly is mostly sugar and does not provide necessary nutrients. Apples and grapes are fruit and are sources of fiber.

What snack choice would be the best suggestion by the nurse for a patient on a renal diet? a. Peanut butter b. Bananas c. Diet cola d. Carrot sticks

Answer: d Carrot sticks are the best snack food to suggest for a patient on a renal diet. Renal diets restrict potassium, sodium, protein, and phosphorus intake, making peanut butter, bananas, and diet cola poor choices.

Which action should the nurse take when caring for a patient receiving a continuous enteral feeding through a percutaneous endoscopic gastrostomy (PEG) tube if the feeding tube becomes occluded? a. Use 15 mL of cranberry juice in a 30-mL syringe to clear the tubing. b. Ask to have the PEG tube replaced to prevent rupture of the gastrostomy. c. Flush the PEG tube with 60 mL of cold tap water, using gravity. d. Try using cola if a 20- to 30-mL warm-water flush is ineffective.

Answer: d Using cola, which is a carbonated beverage, to try to flush the tube if flushing with warm water does not work would be the best option. Using cranberry juice in a small, 30-mL syringe is not recommended and may cause excessive force on the tube, resulting in rupture. Replacing the tube would increase the patient's discomfort and should be a last-resort action. Cold tap water and gravity should not be used, because this measure is unlikely to be effective owing to the lack of even, gentle force needed to clear the occlusion, and because cold water may cause abdominal cramping if it reaches the stomach.

The nurse is caring for an elderly patient who has residual weakness on the right side as the result of a cerebrovascular accident (stroke). The nurse is correct in reporting dysphagia when the patient exhibits which symptoms? (Select all that apply.) a. Incomplete lip closure b. Presence of a normal gag reflex c. A change in voice quality after eating d. Difficulty speaking, with a slow, weak voice e. Abnormal movements of the mouth, tongue, and lips

Answers: a, c, e Persons with residual weakness of the throat and mouth after a stroke have poor muscle tone in the mouth and throat, lack of tongue action, and loss of the ability to chew and swallow effectively. Normal gag reflex is not an adverse symptom. Difficulty speaking is dysphasia.

Free Radicals

By-products that result when the body transforms food into energy.

The nurse is attempting to open an occluded PEG tube. Which of the following interventions requires re-education? a. Flush the tube with a small amount of air b. Flush the tube using a 50- to 60-mL syringe and 20 to 30 mL of warm water. c. Reinsert the stylet to break up the clot. d. Flush the tube with a carbonated beverage.

COnce the stylet is removed, it is never reinserted because it can puncture the intestine. If the tube becomes occluded, flush it with a small amount of air. If this is unsuccessful in removing the occlusion, flush the tube using a 50- to 60-mL syringe and 20 to 30 mL of warm water. If flushing the tube with water is ineffective, try carbonated beverages or pineapple juice if not contraindicated.

The nurse is caring for a patient who is receiving total parenteral nutrition (TPN). The nurse knows she should change the tubing every: a. 72 hours. b. 48 hours. c. 24 hours. d. 12 hours.

CTubing should be changed every 24 hours, with aseptic technique used to minimize the risk of contamination, and the dressing over the site should be changed every 48 hours, with assessment for signs and symptoms of infection (redness, swelling, or drainage).

Carbohydrates

Chemical substances composed of carbon, hydrogen, and oxygen molecules. They supply the body with 4 kilo-calories (KCAL) per gram.

Minerals

Chemicals needed for energy, muscle building, nerve conduction, blood clotting, and immunity to disease.

Fiber

Complex Carbohydrates and is classified as soluble or insoluble.

Trans Fatty Acids

Composed of partially hydrogenated fatty acids, and saturated fats are known to raise the body's total cholesterol.

Saturated Fatty Acids

Contain as many hydrogen atoms as the carbon atoms can bond with and no double carbon bonds.

Dysphagia

Difficulty in swallowing.

Water-soluble Vitamins

Dissolve in the body and are excreted in the urine.

Hyperlipidemia

Elevation of plasma cholesterol, triglycerides, or both.

Ketones

From incomplete fat oxidation when carbohydrates are not available.

Monounsaturated Fatty Acids

Have only one double bond between carbon atoms.

Aspiration

Inhalation of fluid or foreign matter into the lungs and bronchi.

Osmolality

Ionic concentration.

Absorption

Movement of the smaller elements through the walls of the digestive tract and into the blood.

Polyunsaturated Fatty Acids

Multiple pairs of double carbon bonds.

Micronutrients

Nutrients needed by the body in limited amounts.

Macronutrients

Nutrients that are needed in large amounts: 1.) Carbohydrates 2.) Sugar 3.) Starches 4.) Dietary Fibers

Amino Acids

Often are referred to as the "building blocks" of protiens.

Vitamins

Organic compounds responsible for regulation of body processes, reproduction, and growth.

Cachexia

Physical Wasting

Mlabsorption

Problematic or inadequate absorption of nutrients in the intestinal tract.

Enzymes

Proteins responsible for catalyzing most chemical reactions in the body, such as digesting food and synthesizing new compounds.

Anorexia Nervosa

Serious disorder in which the person exhibits life-threatening practices as a result of an altered mental state.

Anorexia

Refers to a loss of appetite in patients experiencing illness or side effects from allergies, medications, treatments, such as chemotherapy that suppress the desire to eat.

Marasmus

Resulting from both protein and calorie deficiency.

Chyme

Semi-liquid product of digestion that travels from the stomach through the intestines.

Kilo-calories

The amount of heat energy it takes to raise the temperature of 1000 grams of water 1 degrees Celsius.

Nutrition

The body's intake and use of adequate amounts of necessary nutrients for tissue growth and energy production.

Digestion

The breaking down of food into smaller particles of nutrients.

Catabolism

The breaking down of substances from complex to simple, resulting in a release of energy.

Bingeing

The intake of excessive amounts of food.

Basal Metabolic Rate (BMR)

The minimum amount of energy required to maintain body functions in the resting, awake state.

Triglycerides

The most abundant lipids in food.

Metabolism

The process of chemically changing nutrients, such as fats and proteins, into end products that are used to meet the energy needs of the body or stored for future use, thereby helping to maintain homeostasis in the body.

Obesity

The result of the person's energy intake consistently exceeding energy use.

Anthropometry

The study of measurements of the human body.

Anabolism

The use of energy to change simple materials into complex body substances and tissue.

Purging

Vomiting

Cholesterol

Waxy, fatlike substance that is found in all cells of the body.

Enteral Feeding

Tube feeding, as the only method of nutritional support poses certain challenges.