Nutritional Concepts
The patient has just ordered lunch at a restaurant. According to the USDA MyPlate recommendations, which food item should the patient plan to divided and take a portion home in a carry-out box?
10 ounces grilled skinless chicken breast
Which patient should not be offered low-fat milk?
18 months old female who is transitioning to cow's milk
The mother asks the nurse about giving strained fruits to her infant. When should this food be introduced?
5 months, approximately 4-6 months of age
A patient reports routinely taking high doses of vitamin supplements. Which vitamin has the greatest potential for toxic effects related to high dosage?
A
Vitamin K symptoms of deficiency?
Increased prothrombin time in severe cases, hemorrhaging.
Low-density lipoproteins (LDL) Cholesterol 130-159
Borderline high
Total Cholesterol 200-239
Borderline high
Vitamin D symptoms of toxicity?
Calcification of soft tissues.
Calcium symptoms of toxicity?
Constipation, increased risk in males for urinary stone formation, reduced absorption of iron and zinc.
Vitamin D Function?
Maintain blood calcium and phosphorus balance.
Calcium food source?
Milk, cheese, milk products, green leafy vegetables, broccoli, legumes, fish with bones, fortified cereals.
Low-density lipoproteins (LDL) Cholesterol 100-129
Near or above optimal
Vitamin A symptoms of deficiency?
Night blindness, xerophthalmia, increased infections, follicular hyperkeratosis.
Vitamin K symptoms of toxicity?
None exhibited
According to the National Institute of Health's Office of Dietary Supplements, which patient should be advised to have an additional 35 mg/day of vitamin C beyond the usual recommended adult dose?
a patient who smokes cigarettes everyday
Potassium symptoms of deficiency?
Cramps, mental confusion, apathy, appetite loss (usually secondary to diarrhea or disease).
Total Cholesterol <200
Desirable
Vitamin A food sources ?
Egg yolks, liver, milk, carrots, winter squash, sweet potatoes, spinach, collards, kale, broccoli, apricots, cantaloupe.
Vitamin A symptoms of toxicity?
Fatigue, headache, nausea, vomiting, blurred vision, liver abnormalities, bone and skin changes.
Potassium function?
Fluid and acid-base balance, nerve conduction, muscle contraction.
Calcium function?
Formation and maintenance of bones and teeth, blood clotting, nerve conduction, muscle contraction
Vitamin K function?
Formation of blood clotting factors.
Vitamin D food source?
Fortified milk, fortified margarine, egg yolks, liver, fish.
Vitamin K food source?
Green leafy vegetables, milk, dairy products, liver, meat, egg yolks, green tea (synthesis by intestinal bacteria).
Potassium symptoms of toxicity?
Hypertension in susceptible individuals, increased calcium excretion.
Calcium symptoms of deficiency
Osteoporosis (adults)—weak, more porous bones. Stunted growth in children.
Vitamin D symptoms of deficiency?
Rickets (children)—abnormal shape and structure of bones.
Potassium food source?
Salt, processed foods, small amounts in whole unprocessed foods
Which patient is at the greatest risk for a negative nitrogen balance that will lead to atrophy of muscles?
The patient sustained severe burns to 50% of the body surface
What are the general function of six classes of nutrients?
They function in the body to provide energy, build and repair tissue, and regulate body processes.
Myplate, whom and what year was develop?
United States by the US Department of Agriculture (USDA) introduced in 2011
Vitamin A function?
Vision, epithelial tissue integrity, growth, reproduction, embryonic development, immune function.
The patient is trying to lose weight because he is obese and has been told that he has high risk for diabetes, coronary heart disease, and stroke. What is the most important point that the nurse would emphasize?
a weight loos of 5% to 15% can reduce health-related risks
The patient tells the nurse that he has problems with his cholesterol so a friend told him to eat avocados. What is the best response?
avocados are sources of monounsaturated fats, which are thought to lower bad cholesterol
Following bariatric surgery, a patient experiences nausea, cramping, diarrhea, sweating, lightheadedness, and palpitations after eating. What is the most important self-care measure for the nurse to reinforce?
avoid concentrated sweets and drinks fluids 30-60 minutes before and after meals
Low-density lipoproteins (LDL) Cholesterol 160-189
high
Which patient is at risk for pernicious anemia and is most likely to be prescribed a vitamin B12 supplement?
adheres to a strict diet
Which laboratory value would the nurse check to evaluate the protein status of a patient who has been receiving medical nutrition therapy?
albumin
The nurse sees an order for "clear liquid diet, advance as tolerated to regular diet." What does the nurse do to get the best food selection for the patient?
asses the patient's overall response to the clear liquid diet
A patient with ascites has fluid restriction of 1000 ml/per 24 hours. The nurse observes that the patient frequently asks visitors and staff to give him extra fluids. What would the nurse do first to improved the patient's compliance?
asses the patient's understanding of the fluid restrictions
What are nursing responsibilities in promoting nutrition for patients? select all that apply
assisting patients to eat or drink, recording the patient's fluid and food intake, observing the patients for signs of poor nutrition, communicating dietary concerns to other members of the health care team, monitoring laboratory values that are related to nutritional intake
The patient expresses a strong preference for beef that is marble with fat at every meal, because of the flavor and the feeling of fullness and satisfaction. Nurse would advise that this eating habit is likely to increase risk for which health condition?
atherosclerosis
Total Cholesterol greater than >240
high
Which patient is most likely to be a candidate for bariatric surgery?
body mass index of 40 or higher
The patient reports noticing that his gums bleed very easily. If the bleeding is caused by a nutritional deficiency, which types of food will correct the problem?
broccoli, peppers, and tomatoes
What are three provide energy?
carbohydrates, fats, and proteins
What are the six classes of nutrients?
carbohydrates, fats, proteins, vitamins, minerals, and water.
A woman is in the first trimester of pregnancy. She reports several episodes of nausea and vomiting, a headache, and irritably. The nurse observes shallow breathing and perspiration, and the woman appears shaky and nervous. What would the nurse do first?
check blood glucose level
What is a nutrient?
chemical compound or element necessary for good health that is found in food
The patient reports a habit of smoking at least one pack of cigarettes everyday. Which foods would the nurse encourage the patient to eat, because of the heavy smoking habit?
citrus fruits
A parent tells the nurse "the school nutritionist advised parents to send packed lunches that include complete proteins, but I'm not exactly sure what that means." What is the best response?
complete proteins are generally of animal origin, like eggs or meat
The nurse routinely participates in long distance endurance sports, such as running, swimming, and cycling. Which foods should the nurse eat to have energy over a longer period of time?
corn and potatoes
The nurse is talking to an adolescent girl about nutrition, but the girl seems bored, uninterested, and unlikely tot ry any of the nurse's suggestions. What should the nurse do?
describe how nutrition improves skin and facial appearance
A patient is interested in adding antioxidants to the diet. What is the best advice?
eat a wide variety of fruits and vegetables
The patient is newly diagnosed with type 2 diabetes. In taking to the patient about diet management, what would the nurse suggest?
emphasize consistent mealtimes approximately every 4-5 hours
Which parental action encourages good dietary habits in the child?
encourage the child to help with food preparation and create a positive environment
A patient is on fluid restrictions because of renal failure. Which interventions would the nurse use? select all that apply
explain the various sources of fluid such as IV fluids, gelatin, and fluids taken with medications, suggest chewing gum and sucking on breath mints, explain the rationale for fluid restrictions, show the volume of fluid that is allowed for the shift, post a sign in the room so that visitors are aware of fluid restrictions
Adipose tissue?
fat helps insulate the body from temperature extremes act as a cushion to protect organs and other tissues from being bumped or jarred. fats are also a component of all cell membranes.
A patient has symptoms of steatorrhea and flatulence. Which diet is the provider most likely to recommend?
fat-controlled diet
Which item is allowed on a clear liquid diet?
gelatin
A patient who is a known diabetic presents with weakness, diaphoresis, and disorientation. What should the nurse do?
give the patient a glass of milk
The patient has risk for osteoporosis. Which foods is the nurse most likely to suggest?
green leafy vegetables and citrus fruits
Which patient is most likely to benefit from an increase in dietary fiber?
has a high risk for metabolic syndrome
Which patient is most likely to be prescribed a carbohydrate-modified diet?
has diabetes mellitus
Which laboratory results is the nurse most likely to examine to determine if the treatment for iron deficiency anemia is effective?
hemoglobin level
The patient was advised by the provider to "watch intake of cholesterol." Which question is the most useful in assessing the likelihood of the patient's adherence to the provider's advice?
how do you plan to manage your intake of cholesterol
The patient going to be discharged with a prescription for an anti coagulant medication. Which question should the nurse ask?
how many servings of leafy green vegetables would you normally eat in a week
The nurse is talking to a 17 years old female whose parents have reluctantly allowed her to start a vegan diet if she agrees to talk to a health care provider before beginning the diet. The provider is most likely to monitor her for which nutrition-related condition?
iron deficiency anemia
The mother reports that her child took a few extra chewable vitamins, because he thought they were gummy candies. Which questions is the most important to asses for potential toxicity?
is iron listed as one of the ingredients
What converted to glycogen?
it is used when the body's blood glucose level is low
What does glycogen do?
it stored form of carbohydrates
The patient has sustained severe injuries in an accident. Which food sources supply the nutrient that plays the biggest role in helping the patient to build and repair injured tissue?
lean meats, poultry, and fish
High-density lipoprotein (HDL) <40 men; <50 women
low
A 69 years old patient reports frequently taking antacids. Why does this patient have an increase risk for developing pernicious anemia?
low stomach acidity blocks the absorption of vitamin B12 from foods
What is a kilocalorie (kcal)?
measurement of energy, much as a pound is a measurement of weight
The patient is interested in lowering his cholesterol levels and reducing the risk of cardiovascular disease. Which breakfast trays offers the most water-soluble fiber to help the patient meet his goals?
oatmeal topped with cinnamon and raw apples slices
The nurse is talking to patient who has high cholesterol and family history of cardiovascular disease. Which foods are most likely to counteract the high cholesterol?
oats and barley
The nurse is assessing an older resident at a long term care center. The resident appears flushed, skin turgor is poor, mucous membranes are dry, and resident seems unusually irritable. What would the nurse do first?
obtain an order for electrolyte values
Low-density lipoproteins (LDL) Cholesterol <100
optimal
What are lipids?
organic substances fatty nature that are insoluble in water and necessary for good health. Fats and cholesterol are lipids
The nurse is evaluating the performance of a unlicensed assistive personnel (UAP) who is feeding a patient. Which action indicates a need for correction?
placing the patient in a recumbent position
The patient is taking a diuretic medication every day. Which electrolyte value is the most important to monitor?
potassium
The UAP brings holiday cupcakes to the long-term care center and passes them out to all of the residents before checking with the nurse. What should the nurse do first?
praise the UAP for bringing seasonally appropriate good cheer to the residents.
Which admission assessments should be performing for long-term residents in a relation to potential nutritional problems? select all that apply
problems with fine motor movements, ability to chew and swallow different textures of foods, typical daily fluid intake dietary restrictions related to chronic health problems, food preferences or ritual related to cultural background
During a trip to a developing country, the nurse observes that many of the toddlers appear very fat with enlarged abdomens and swollen extremities. Which nutritional deficiency is associated with these symptoms?
protein
What nutrients plays the biggest role for building and repairing tissue?
protein
Lipids function in the body?
provide the most concentrated source of energy of all the nutrients and can be used directly from the fat in foods or adipose tissue, the body stored from fat
What are the three major functions of nutrients?
providing energy, building and repairing tissue, and regulating body processes
What is Dietary reference intake (DRI) refers to?
refers to a set of nutrients based values for evaluating and planning diets
The patient reports sensations of bloating, gas, and constipation after adding lots of fruits, vegetables, and whole grains to her diets. So she has decided to go back to her former dietary pattern and exclude these foods. What is the best advice that nurse can give the patient?
slowly increase intake of fiber foods and drink at least 8 glasses of water each day
The nurse is working with a patient who requires an increase in complete proteins in the diet. Which foods will the nurse recommend? select all that apply
soy, eggs, fish, yogurt
The home health nurse sees that the patient's potassium level is 3.6 mmol/L. There is nothing in the patients medication or health history that should affect the potassium levels. What will the nurse do?
suggest that the patient eat sweet potatoes, fruits, vegetables. fresh meat, legumes, and milk
The nurse is teaching a patient who has heart failure to read nutrition labels on food products. Which nutrition fact is the most important for this patient to pay attention to?
the number of milligrams of sodium per serving
Which patients have conditions that would prompt the nurse to monitor serum sodium levels? select all that apply
the patient is having a prolonged high fever, the patient has severe diarrhea and vomiting, the patient has chronic renal disease, the patient has cystic fibrosis
What is the purpose of DRI's?
to help individuals optimized their health, prevent disease, and avoid consuming too much of a nutrient
Patients with nasogastric (NG) tubes may develop otitis media. What will the nurse do to prevent this occurrence?
turn the patient side to side every 2 hours
The patient is trying to understand the difference between dietary references intake (DRIs) and recommended dietary allowances (RDAs). Which patient statement best indicates an understanding of DRIs?
using DRIs, I could decrease my risk for diabetes and monitor my sugar consumption
Low-density lipoproteins (LDL) Cholesterol greater than >190
very high
What do not provide energy?
vitamins, minerals and water
An asian American patient reports experiencing nausea, bloated feeling , and flatulence after eating. Which question is most relevant?
what did you eat just before the onset of the symptoms
