209 Exam 3 (Nutritional)

After a visit with the health care provider, the nurse calculates the client's body mass index (BMI). Which statement by the nurse best informs the client of the purpose of BMI? "BMI is used to screen for weight categories that can lead to health problems." "BMI is a screening tool that is used by insurance companies to screen for obesity." "BMI reflects a weight that is predetermined for all people." "BMI is the weight at which one feels most comfortable."

"BMI is used to screen for weight categories that can lead to health problems."

A nurse is discussing neonatal care with a new mother. Which statement by the nurse best describes the value of breastfeeding? "Breastfeeding helps you bond with the neonate, but formula must be added for complete nutrition." "Breastfeeding helps your body recover from pregnancy." "Breastfeeding provides extra iron for the growing neonate." "Breastfeeding provides the neonate with immunity against some bacteria and viruses."

"Breastfeeding provides the neonate with immunity against some bacteria and viruses." Explanation: Breast milk provides neonates with immunity against some bacteria and viruses, results in different intestinal flora than with artificial formula, decreases the incidence of allergies, and provides a well-balanced and ideal source of nutrition. Breastfeeding does help the mother bond with the neonate and is a complete source of nutrition.

A client tells the nurse, "As long as I only eat 2,400 calories per day, it does not matter which foods I eat." Which response by the nurse is best? "Be sure to eat a large amount of carbohydrates so you can have energy." "Can you share an example of what you ate yesterday?" "As long as you focus on protein intake, you will get the nutrition you need." "It does not matter which foods you eat, as long as you always make sure you get 2,400 calories."

"Can you share an example of what you ate yesterday?" Explanation: Healthy adult client on average require 1,800 to 2,400 cal/day. Unless the caloric intake includes an appropriate mix of proteins, carbohydrates, and fats, the person may be marginally nourished or malnourished. In other words, consuming 2,400 calories of chocolate, exclusive of any other food, is not adequate to sustain a healthy state. By asking the client for an example of the foods eaten, the nurse can help the client plan effectively. It is important to teach clients about healthy nutrition, so this response is most appropriate. The other responses from the nurse are not correct.

A client with diabetes mellitus must monitor carbohydrate intake. Which client statement requires nursing intervention? "I like to eat eggs for breakfast." "I'll monitor my intake of fruit juice." "My favorite drink is coffee with sugar." "At every meal, I eat a small portion of lean meat."

"My favorite drink is coffee with sugar." Explanation: Foods containing added sugar as a major ingredient tend to supply calories but few, if any, other nutrients. A client monitoring carbohydrate intake should be mindful of the intake of extra sugar. The other answer choices are appropriate for a client diagnosed with diabetes mellitus who is monitoring carbohydrate intake.

The nurse is conducting a client health history interview and notes the client is taking atorvastatin. This observation should prompt the nurse to ask the client which question first? "When did you last have your cholesterol levels checked?" "Is your diet made up primarily of carbohydrate-based foods?" "Do you take a daily multivitamin supplement?" "Do you only consume vegetarian foods?"

"When did you last have your cholesterol levels checked?" Explanation: Atorvastatin is a commonly prescribed HMO-COA reductase inhibitor. This classification of medication is taken to reduced blood cholesterol levels. It would be relevant to this observation for the nurse to follow with a question about the last time the client had serum triglyceride levels assessed to determine efficacy of the medication. Carbohydrates are not known to have a direct effect on increasing serum cholesterol levels. While it is important for the nurse to understand the client's nutritional intake and habits, this question would not be prioritized after noting that the client has this medication listed in the drug profile. Multivitamins provide supplementation for vitamin deficiencies but do not have a direct impact on a client's serum cholesterol levels. Overall, vegetarians have a lower incidence of colorectal cancer and fewer problems with obesity and diseases associated with a high-fat diet. Although the nurse can certainly inquire about what type of diet the client habitually consumes, this question does not directly relate to the observation that an antitriglyceride medication is being taken by the client.

Which nutritional guideline should a nurse provide to a client who is entering the second trimester of her pregnancy? "You'll need to eat more calories and to make sure you eat a balanced diet high in nutrients." "Try to eat your normal number of calories, but aim to eat a diet that's higher in fruits and vegetables." "The more food energy you consume, the greater the chances that you will have a healthy pregnancy." "Maintain your regular calorie intake, but take some supplements and emphasize organic foods."

"You'll need to eat more calories and to make sure you eat a balanced diet high in nutrients." Explanation: Nutrient needs during pregnancy increase in order to support growth and maintain maternal homeostasis, particularly during the second and third trimesters. During the last two trimesters, women of normal weight need approximately 300 extra calories per day. Key nutrient needs include protein, calories, iron, folic acid, calcium, and iodine. It would be inaccurate to encourage the client to maximize calorie intake, take supplements, and emphasize organic foods.

Factors that increase the need for calories

- Illness/surgery because the body needs calories to recover -Stress -Periods of rapid growth -Working out

Factors that affect your ability to acquire and prepare food

-Knowledge about foods -Swallowing impairment [dysphasia] -Discomfort during or after eating [candida can form in the mouth from antibiotics] -Anorexia, nausea, vomiting -Excessive intake of calories and fat -Inflammation of the intestines and esophagus -Diabetic patients because these patients can't use certain nutrients because of lack of insulin

Examples of altered nutritional function

-Withholding food - NPO such as before surgery or fasting for bloodwork -Using special diets

Non-physiological factors that affect nutrition

-lifestyle -Culture/beliefs -Economic resources [some people may not have the ability to afford healthy food] -Use of alcohol because alcohol uses vitamin B to be metabolized so you'll see that vitamin B levels are low in those who use alcohol

A nurse administers a continuous tube feeding via an NG tube. The nurse must check for residual every: 2 hours. 4 to 6 hours. 8 to 12 hours. 12 to 24 hours.

4 to 6 hours.

Levels of Hemoglobin A1C

4-5= normal 5-6= prediabetic >6= diabetic

Which of the following are appropriate choices for a patient prescribed a full liquid diet (select all that apply) Plain yogurt Custard Ice cream Mashed potatoes Pureed meat Gelatin

A full liquid diet includes smooth-textured dairy products (such as plain yogurt), custards, refined cooked cereals, vegetable and fruit juices, ice cream, and all the elements of a clear liquid diet, such as coffee, carbonated beverages, and gelatin. Mashed potatoes and pureed meat are not permitted until the patient progresses to a pureed diet or beyond.

A nurse should recognize that which of the following is correct regarding albumin level as a diagnostic marker for nutritional status? Albumin level is a poor short-term indicator of protein status. Hydration status does not affect a patient's albumin level. An albumin level of 3.2 g/dL is within the normal reference range. Albumin level is calculated by keeping a 24-hr record of protein intake.

Albumin level is a poor short-term indicator of protein status. Albumin is not sensitive to acute changes in nutritional status. Its long half-life (21 days) makes it a better indicator of chronic illness states than of current protein status at a given point in time.

The nurse is caring for a client who refuses most foods on the dietary tray. Which nursing intervention is appropriate? Allow the client privacy during mealtime. Delegate feeding assistance to the unlicensed assistive personnel. Assess when client generally eats meals. Contact the healthcare provider to prescribe an appetite stimulant.

Assess when client generally eats meals. Explanation: There are many reasons a client may refuse food that is served. The nurse should assess for food preferences, when the client generally eats, whether the client has digestive concerns, and cultural beliefs about foods. Leaving the client alone to eat, or simply delegating feeding, does not encourage intake. The client does not need an appetite stimulant until a full assessment has been conducted and other interventions have been implemented.

To assess a stroke patient for complications secondary to inadequate swallowing, the nurse should do which of the following? Auscultate the patient's lungs. Place the tip of a tongue depressor on the patient's posterior tongue. With a penlight, inspect the patient's uvula and the soft palate. Place fingers on the patient's throat at the level of the larynx and ask him to swallow.

Auscultate the patient's lungs. "Silent" aspirations are a common complication of swallowing impairment.

_________ are an essential source of energy & fiber

Carbohydrates

Sources of less saturated fats

Chicken, fish, veggies

A nurse is preparing to administer medication to a client who is unable to swallow due to esophagitis. Upon review of the client's history, which condition would the nurse identify as contributing to the client's esophagitis? Chronic vomiting Gallstones Intestinal inflammation Low blood pressure

Chronic vomiting Explanation: Esophagitis, an inflammation of the esophagus, can result from burns, poisons, infections, or chronic vomiting. It causes discomfort and impairs swallowing. Cholecystitis is an inflammation of the gallbladder that is usually caused by the presence of gallstones. Inflammatory bowel disease, such as Crohn's disease or ulcerative colitis, greatly affects absorption of nutrients and water from the intestine. The intestinal inflammation results in severe diarrhea. Low blood pressure or abnormal change in blood pressure can lead to hypotension, not esophagitis.

A client who is receiving tube feedings has developed diarrhea. Which nursing intervention is appropriate? Use a small-diameter feeding tube. Consult with the health care provider about using a milk-free formula. Maintain the sitting position for at least 30 minutes after feeding. Increase the amount of supplemental water that is given.

Consult with the health care provider about using a milk-free formula. Explanation: The nurse will consult with the health care provider about using a milk-free formula since milk can induce diarrhea. Other interventions do not address the problem of diarrhea.

A nurse is caring for a patient who has impaired swallowing due to a cerebrovascular accident. Which of the following interventions should the nurse use to assist the patient with feeding? Provide the patient with a straw. Offer the patient thin fluids. Elevate the head of the bed 45 to 90°. Place food in the weaker side of the mouth.

Elevate the head of the bed 45 to 90°. The patient's head should be sufficiently elevated to prevent aspiration.

Which intervention should the nurse take for a client who is receiving continuous tube feedings? Position the client in the supine position for 1 to 2 hours after feedings to promote digestion. Elevate the head of the bed at least 30 to 45 degrees to prevent aspiration. Encourage the client to cough and breathe deeply after feedings to prevent dislodging of tubing. Aspirate any additional formula left in the stomach 30 minutes after eating to prevent vomiting.

Elevate the head of the bed at least 30 to 45 degrees to prevent aspiration. Explanation: An elevation of at least 30 to 45 degrees or higher in a client receiving tube feedings will prevent reflux and prevent aspiration. Positioning the client in the supine position for extended periods may lead to aspiration. There is no need to aspirate the contents of the client's stomach after feeding. Coughing and deep breathing do not prevent the tube from being dislodged.

An older adult patient in a long-term care facility is receiving intermittent enteral feedings in his room. His affect is flat, and the nurse suspects that he is feeling isolated. Which of the following interventions is appropriate for this patient? Encourage him to go to the dining room at meal times to talk with other patients. Suggest that he watch television while his feedings are being administered. Remind him that he can have visitors after his feeding administration times. Ask the facility chaplain to speak with the patient.

Encourage him to go to the dining room at meal times to talk with other patients. By encouraging the resident to maintain a normal schedule and social interactions, the nurse is helping to rebuild his social network and reverse patterns of isolation.

What independent nursing intervention can be implemented to stimulate appetite? Administer prescribed medications. Recommend dietary supplements. Encourage or provide oral care. Assess manifestations of malnutrition.

Encourage or provide oral care. Explanation: There are many methods of stimulating appetite in a client to prevent malnutrition. One independent nursing intervention that is useful is to encourage or provide oral care. Administering medications and recommending dietary supplements are useful but are not independent nursing actions. The health care provider would need to prescribe the medications. Assessing manifestations of malnutrition occurs after malnutrition is recognized.

What do older people need more of in order to help move their bowels?

Fiber

Ideal body weight examples

Ideal body weight for a woman who is 5'0 is 100 lbs and every inch up it's 5 pounds up so a normal weight for a person who is 5'5 is 125 pounds Ideal body weight for a man who is 5'0 is 105 pounds and it's 6 pounds up for every inch so a 5'8 man should normally be 148 pounds

Which of the following intervention should the nurse use at meal times for a patient who has visual deficits? Identify the food location as though the plate were a clock. Direct the order in which food items are consumed. Have the patient tilt her head forward while eating. Avoid talking to the patient during mealtime.

Identify the food location as though the plate were a clock. Explanation: Telling the patient, for example, that the chicken is at 9 o'clock and the broccoli is at 12 o'clock helps orient her to the items on the plate and thus facilitates independence in eating.

Which nursing action is performed according to guidelines for aspirating fluid from a small-bore feeding tube? Use a small syringe and insert 10 mL of air. If fluid is obtained when aspirating, measure its volume and pH and flush the tube with water. Continue to instill air until fluid is aspirated. Place the client in the Trendelenburg position to facilitate the fluid aspiration process.

If fluid is obtained when aspirating, measure its volume and pH and flush the tube with water. Explanation: The nurse would measure the volume and pH of the aspirated fluid, then flush the tube with water. The nurse would not place the client in Trendelenburg position as this could lead to reflux of the feeding from the stomach and possibly cause aspiration of the solution into the lungs. The nurse would not use a small syringe or continue to instill air until fluid is aspirated.

A nurse is working with a 54-year-old client with a history of constipation. The client asks if there is anything that should be added to the diet to ease defecation. Which teaching should the nurse provide? Decrease the amount of carbohydrates you eat. Include plenty of high-fiber foods in your diet, including beans, vegetables and fruits. Increase the amount of protein you eat, including salmon and chicken. Drink a glass of red wine each night before dinner.

Include plenty of high-fiber foods in your diet, including beans, vegetables and fruits. Explanation: Fiber promotes peristalsis to maintain normal bowel elimination. Decreasing carbohydrates in the diet or increasing protein in the diet do not prevent constipation. Alcohol has no known effect on constipation. A diet high in fiber, including beans, vegetables, fruits, and whole grains, will help prevent constipation and ease defecation.

What is the main issue with using BMI?

It's not a concrete way to assess a patient off of because of big variations for example high BMI could be because of increase in muscle mass

Types of special diets

Liquid diet: PTS might drink only liquids after surgery as a transitional diet. Patients might drink liquid only diet's for after episodes of vomiting or diarrhea [liquids can be clear such as tea or full such as orange juice] Soft diet: This is when patients transition from liquid diet to regular diet. Use when patients have G.I. problems for example low fiber to rest a G.I. system. This is when they eat puréed foods Dysphagia diet: This is a mix between solid textures and thick liquids for when swallowing is impaired. The solids are: pureed, mechanical soft, advanced, regular. The liquids are: spoon thick [a frosty], honey-like, nectar-like, thin

A nurse is caring for a client who has a vitamin B12 deficiency. Which food would the nurse recommend to help with this deficiency? Liver Pork Cantaloupe Broccoli

Liver Explanation: The best foods from which to obtain B12 include organ meats and seafood. Pork provides thiamin. Cantaloupe provides vitamin B6; broccoli provides vitamin C.

Which of the following strategies for enhancing the intake of healthful foods is appropriate for an adolescent? Encouraging the adolescent to consume snack foods from the grains food group Permitting the adolescent to skip breakfast to enhance appetite at later meals Making healthful food choices more convenient and available for the adolescent Allowing the adolescent complete autonomy in making food choices

Making healthful food choices more convenient and available for the adolescent This helps prompt the adolescent to make healthier food choices.

A nurse has received a physician's order to insert a nasogastric tube in an adult client. What is the correct order for insertion of a nasogastric tube? 1. Measure the insertion distance. 2. Insert the nasogastric tube to the pharynx. 3. Have the client tuck his chin to the chest. 4. Have the client take small sips of water. 5. Insert the tube to the indicated mark. 6. Aspirate a small amount of stomach contents and check pH.

Measure the insertion distance. Insert the nasogastric tube to the pharynx. Have the client tuck his chin to the chest. Have the client take small sips of water. Insert the tube to the indicated mark. Aspirate a small amount of stomach contents and check pH.

Sources of complete proteins

Meat, poultry, fish

A patient with a gastric ileus post-operatively requires nutritional support for approximately 2 weeks. Which of the following types of feeding tubes is appropriate for this patient? Nasogastric tube Nasointestinal tube Percutaneous endoscopic gastrostomy tube Percutaneous endoscopic jejunostomy tube

Nasointestinal tube A nasointestinal tube allows postpyloric feeding by depositing enteral formula directly into the intestines. This is an appropriate choice for a patient who lacks stomach motility (gastric ileus) and requires short-term (less than 4 weeks) enteral feeding.

A nurse has assessed the residual amount before beginning a nasogastric tube feeding and has found 100 ml What will the nurse do next? Nothing; this amount is within normal limits. Report the finding to the physician. Omit the feeding and document the reason. Rinse the tube and repeat the assessment.

Nothing; this amount is within normal limits. Explanation: A residual of more than 200 mL for a nasogastric tube and 100 mL for a gastrostomy tube may indicate that the feeding should be interrupted or delayed for 30 to 60 minutes. A finding of 100 mL is within normal limits; the nurse should administer the tube feeding.

A nutritionist helps to plan a diet for a client with diabetes. Which food is a carbohydrate that should be included to help improve glucose tolerance? Milk Eggs Oatmeal Nuts

Oatmeal Explanation: Oatmeal is a water-soluble carbohydrate that helps improve glucose tolerance in diabetics. Milk, eggs, and nuts are proteins.

A nurse is feeding a client. Which action will the nurse take? Explain that a bib will be used in case the meal gets messy. Inform the client that the experience will be quick, approximately 10 minutes. Feed the client the meal starting with the protein, explaining it is the most important. Offer options of foods and for the order to be eaten.

Offer options of foods and for the order to be eaten. Explanation: The loss of independence that comes with the inability to self-feed can be a severe blow to a person's self-esteem. Asking the client's preference regarding the order of items eaten can help maintain dignity while being fed. The nurse should be prepared to spend as much time with the client to assist with the entire meal to support self-worth for the client. Telling a client what the nurse will do does not promote self-esteem but identifies the nurse wanting to control the feeding.

A nurse is providing teaching to a patient who is receiving intermittent nasogastric feedings. Which of the following should the nurse instruct the patient to report immediately? A feeling of fullness Persistent coughing Discomfort in the naris Postfeeding belching

Persistent coughing This could indicate that the distal end of the nasogastric tube has moved into the respiratory tract. Immediate assessment is needed, because the patient might be at risk for aspiration.

A client with partial-thickness (second-degree) burns is encouraged to increase the proteins in the diet. Which food selection from the hospital menu indicates that the client understands how to choose foods high in protein? Pasta with Alfredo sauce Scrambled eggs with cheese Cereal and milk Toasted bran muffin and jelly

Scrambled eggs with cheese Explanation: Scrambled eggs with cheese is a food choice high in protein content. Egg and cheese are both proteins. Pasta is a carbohydrate, but the Alfredo sauce is made with milk or a milk base, which is protein. Cereal is a complex carbohydrate with a variety of fortified nutrients, and the milk is a protein/carbohydrate source. Bran muffin and jelly are both carbohydrate sources.

Which laboratory test is the best indicator of a client in need of TPN? Hemoglobin Hematocrit Serum albumin Creatinine

Serum albumin Explanation: Assessment of serum albumin level is the best indicator of a client in need of total parenteral nutrition (TPN). Clients whose levels are 2.5 g/dL (25 g/L) or less are at severe risk for malnutrition. Creatinine is used to assess kidney function. Hemoglobin and hematocrit assess the red blood cells of a client.

A nurse has just received a client's laboratory results and is reviewing them. Which finding should the nurse recognize as an indication of malnutrition or malabsorption? Serum albumin 2.8 g/dL (28 g/L) Hemoglobin (Hgb) 11.3 g/dL (113 g/L) Creatinine 1.9 mg/dL (168 µmol/L) Hematocrit (Hct) 56% (0.56)

Serum albumin 2.8 g/dL (28 g/L) Explanation: Normal serum albumin is 3.3 to 5 g/dL (33 to 50 g/L). Decreased albumin indicates malnutrition or malabsorption. Decreased Hgb indicates anemia. Increased creatinine indicates dehydration. Increased Hct indicates dehydration.

A nurse is caring for a client who has a malabsorption disease. The nurse should understand that which structure in the gastrointestinal system absorbs the majority of digested food and minerals? Stomach Large intestine Small intestine Liver

Small intestine Explanation: Most absorption of digested food and minerals occurs in the small intestines. The stomach is responsible for storing food, secreting digestive enzymes, and digestion. The large intestine forms feces and absorbs water to regulate the consistency of stool. The digestive function of the liver is the production of bile.

A nurse is caring for a patient who has sustained a head injury and whose level of consciousness fluctuates. The provider prescribes a full liquid diet progressing to pureed diet as tolerated. Before initiating feedings, it is essential that this patient undergo which of the following? -Chest x-ray -Nasogastric tube insertion -Swallowing examination -Olfactory nerve evaluation

Swallowing examination Patients at high risk for aspiration include those with a decreased level of consciousness. This patient has some periods of decreased alertness, thus a swallowing examination is essential to determine his ability to ingest food safely by mouth.

A nurse is performing a nutritional assessment. When obtaining and interpreting intropometric values, the nurse should recognize which of the following? -A weight increase of 4 lbs in a patient with renal failure indicates rentention of 1,000 mL of fluid -Isolated measurements of height and weight are of greater significance than changes over time -The ratio of height-to-wrist circumference is the most accurate way to identify obesity -The patient should be weighed at the same time each day on the same scale

The patient should be weighed on the same scale at the same time each day. Weighing a patient on the same scale at the same time of day provides the most consistent data for gauging trends in the patient's weight, as shifts in fluid intake and output can alter weight significantly. The patient should also be weighed with the same amount of clothing and/or linen each time.

(Nutritional lab values and what they mean) Hematocrit & Hemoglobin

These determine your red blood cell count and oxygen carrying ability

(Nutritional lab values and what they mean) Immunocompetence testing

This is allergy testing. It's tested in the urine and the blood

What is a bland diet?

This is when certain spices are taken out for a patient with gastritis or Crohn's disease

What is a restrictive diet?

This is when you pull out a certain ingredient from a patient's food. For example, 2 g sodium diet's are restrictive diets because they are low in sodium

What does "Diet as tolerated" mean?

This means progress at the patient's pace. So you start with a liquid diet and see how they tolerate it then bring it up slowly.

(Nutritional lab values and what they mean) Hemoglobin A1C

This shows the body's insulin use over a couple of months

(Nutritional lab values and what they mean) Creatinine excretion

This shows the waste product level from your kidneys. It's tested in the urine and the blood and this is actually bad because it shows that urine waste is going in the wrong direction

Which of the following is the primary purpose to ask a patient to keep a 3 to 7 day food diary? To allow the patient to rely on health professionals to identify problem areas To determine any changes in the patient's appetite To evaluate any significant changes in body weight To assess the pattern of intake and compare with daily reference intakes

To assess the pattern of intake and compare with daily reference intakes. A time period of 3 to 7 days is an adequate amount of time for assessing dietary habits and patterns and thus the adequacy of the patient's nutritional intake.

The nurse has observed that a client's food intake has diminished in recent days. What intervention should the nurse perform in order to stimulate the client's appetite? Try to ensure that the client's food is attractive and sufficiently warm. Reduce the frequency of meals in order to allow the client to develop an appetite. Offer nutritional supplements and explain the potential benefits of each. Offer larger meals and encourage the client to eat as much as is comfortable.

Try to ensure that the client's food is attractive and sufficiently warm. Explanation: Food in the health care setting can often be unattractive and cool. Ensuring that it is appealing to the eyes and presented at the correct temperature can stimulate the client's appetite. Meals should be small and more frequent, not less frequent and larger. Supplements may be nutritionally necessary, but these do not act to increase the client's appetite.

Signs of altered nutritional status

Underweight [BMI under 20] Recent significant weight gain or loss that constitutes as 5% of baseline in a month or 10% in a six-month period Decreased energy Altered bowel patterns

The nurse is preparing to insert an ordered nasogastric tube in a 28-year-old client. Which action should the nurse prioritize after the client mentions a history of a fractured nose as a teenager? assess for deviated septum verify with the health care provider to continue with the insertion document history and insert tube place tube in nostril with best passage

assess for deviated septum Explanation: The presence of a deviated septum, which can occur after a fracture, would exclude that nostril for tube insertion; depending on the fracture, this could include both nostrils. If the nurse notes both nostrils are involved, then the health care provider would need to be informed for further instructions. It might be possible that only one nostril is affected and the nurse could insert the tube in the unaffected side but that can only be determined after the assessment. If would be inappropriate to just document and insert due to the narrowed passageway and increased risk of damaging the nasal mucosa by forcing the nasogastric tube through the nostril.

A nurse is providing liquid nourishment 4 to 6 times a day in feedings of less than 30-minutes duration to a client who is being tube fed. To which of the following tube-feeding schedules is the nurse adhering? cyclic variable continuous bolus

bolus Explanation: A bolus or intermittent feeding is the instillation of liquid nourishment 4 to 6 times a day in less than 30 minutes, usually 250 to 400 mL of formula per administration. Cyclic feeding (over a period of 8 to 12 hours) is followed by a 16- to 12-hour pause. Continuous feeding is administered at a steady rate of approximately 1.5 mL/minute. Feeding schedules are not characterized as being variable.

sources of complex carbs

bread, cereal, pasta

Women need more _______ after menopause because of osteoporosis

calcium

The nurse is helping a client who eats a normal diet of 2000 calories daily to read a nutritional label on a box of cereal. Which nutrient does the nurse identify as appropriate for this client? total fat greater than 65 g cholesterol less than 300 mg sodium greater than 2400 mg saturated fat greater than 30 mg

cholesterol less than 300 mg Explanation: Daily values are calculated in percentages based on standards set for total fat, saturated fat, cholesterol, sodium, carbohydrate, and fiber in a 2000-cal diet. Total fat should be less than 65 g; saturated fat should be less than 20 g; cholesterol should be less than 300 mg; and sodium should be less than 2400 mg.

A nurse inserting a nasogastric tube asks the patient to flex her head toward her chest after the tube passes through the nasopharynx. This action facilitates proper insertion of the tube by closing off the glottis. preventing curling of the tube in the mouth. allowing the patient to breathe through her mouth. opening the lower esophageal sphincter.

closing off the glottis. This action prohibits the tube from entering the trachea.

A nurse is caring for a client who is reporting nausea. Which is a sign of nausea? dizziness and perspiration impaired swallowing slow pulse rate emotional distress

dizziness and perspiration

Fats are responsible for ______ and ________

energy & insulation

A nurse is assessing the volume of liquid nutrition that has been tube-fed to a client. What will happen if the volume of feeding exceeds the client's physiologic capacity? diarrhea pallor obesity gastric reflux

gastric reflux Explanation: Overfilling the client's stomach can cause gastric reflux, regurgitation, vomiting, aspiration, and pneumonia. Exceeding the volume of feeding beyond a client's physiologic capacity does not lead to diarrhea, pallor, or obesity. As a rule of thumb, the gastric residual should be no more than 100 mL or no more than 20% of the previous hour's tube-feeding volume.

Which type of feeding tube would be most appropriate for a client requiring enteral feeding for a long period of time? gastrostomy tube nasogastric tube nasointestinal tube Salem Sump tube

gastrostomy tube Explanation: When enteral feeding is required for a long-term period, an enterostomal tube may be placed through an opening created into the stomach (gastrostomy) or into the jejunum (jejunostomy)

Carbohydrate are responsible for what types of glycemia?

hypo/hyperglycemia

Nasogastric tube feedings are an appropriate choice for a patient who has a paralytic ileus. has recently experienced facial trauma. is postoperative following laryngectomy. has pancreatitis.

is postoperative following laryngectomy. Immediately following removal of the larynx, patients typically receive IV fluids or parenteral nutrition until the gastrointestinal tract recovers from anesthesia. Then, a nasogastric tube is inserted and left in place for about 7 to 10 days to provide enteral feedings until swallowing is safe and adequate.

To prevent a common complication of continuous enteral tube feedings, a nurse should limit the time the formula hangs to 4 hr. chill the formula prior to administration. deliver the formula at a brisk rate. allow the feeding bag to empty before refilling it.

limit the time the formula hangs to 4 hr. Formula that hangs longer than 4 to 8 hr is at risk for bacterial contamination, typically manifested by the patient as diarrhea.

A 45-year-old client on the inpatient unit has just resumed eating a normal diet. The nurse checks a blood sugar with the morning labs and the result is 99.10 mg/dL (5.5 mmol/L). How would the nurse interpret this blood glucose? normal mildly elevated severely elevated low

normal Explanation: Normal blood glucose is 80 to 110 mg/dL (4 to 7 mmol/L).

The most reliable method for verifying initial placement of a small-bore feeding tube is by measuring the pH of gastric aspirate. auscultating the epigastric area while injecting air. obtaining an abdominal x-ray. placing the open end of the tube in a cup of water.

obtaining an abdominal x-ray. This is the most reliable method for verifying initial placement of a small-bore feeding tube.

The community nurse is educating client groups about nutrition. Which group does the nurse identify that will benefit most from nutritional counseling and intervention? married, pregnant women over 30 years of age double income, married individuals older adults living on a fixed income people who live in farming communities

older adults living on a fixed income Explanation: Older adults who are socially isolated or living on fixed incomes will benefit most from nutritional counseling and intervention. Other individuals are not at the same level of risk.

A nurse calculates the BMI of a client during a general survey as 26. Under which category would this client fall? underweight normal overweight obesity class I

overweight Explanation: This client has a BMI of 26, which falls in the category of overweight: 25.0 to 29.9. The other BMI values are: underweight, <18.5; normal, 18.5 to 24.9; obesity class I, 30.0 to 34.9; obesity class II, 35.0 to 39.9; and extreme obesity, 40.0+.

To prevent aspiration during the administration of an enteral tube feeding, a nurse should flush the feeding tube with 30 mL of water. add blue food coloring to the enteral formula. ensure the formula is at room temperature. place the patient in Fowler's position.

place the patient in Fowler's position. The Fowler's position is recommended during tube feeding to reduce the risk of regurgitation, which can lead to aspiration. If Fowler's is uncomfortable for the patient, an acceptable alternative is elevating the head of the bed at least 30°.

Protein helps do what to body tissues?

repair them

Sources of simple carbs

sugars,syrups, honey, fruit

A nurse is preparing a presentation for a local community group on healthy nutrition using information from the USDA's website, ChooseMyPlate.gov. Which recommendation would the nurse be least likely to include? using appropriate portion sizes switching to whole milk replacing sugary drinks with water making fruits and vegetables account for half of your plate

switching to whole milk Explanation: According to the ChooseMyPlate.gov food guide, individuals should switch to fat-free or low-fat (1%) milk, monitor portion sizes, drink water instead of sugary drinks, and make one-half the plate for fruits and vegetables.

What organ aids in absorbing nutrients from food

the liver

(Nutritional lab values and what they mean) Serum albumin and pre-albumin

these indicate your protein levels

Which nutrient does the nurse identify as appropriate for a client with a normal dietary order who is consuming 2000 calories daily? total fat less than 65 g cholesterol greater than 300 mg sodium less than 2000 mg saturated fat greater than 20 mg

total fat less than 65 g Explanation: Daily values (DVs) are calculated in percentages based on standards set for total fat, saturated fat, cholesterol, sodium, carbohydrate, and fiber in a 2,000-cal diet. Total fat should be less than 65 g; saturated fat should be less than 20 g; cholesterol should be less than 300 mg, and sodium should be less than 2400 mg.

A nurse is caring for a client with a history of cardiac and vascular disease. Which fats should the nurse allow in the client's diet for his condition? unsaturated fats trans fats saturated fats hydrogenated fats

unsaturated fats Explanation: Unsaturated fat is a healthier form of fat than saturated fat, because it contains less hydrogen, and therefore can be included in the client's diet. Saturated fats are lipids that contain as much hydrogen as their molecular structure can hold and are generally solid. Most saturated fats are found in animal sources, such as the marbled fat in meat. Saturated fats are responsible for cardiac and vascular diseases. Trans fats are unsaturated fats that have been hydrogenated, a process in which hydrogen is added to the fat. Consumption of trans fats, saturated fats, and hydrogenated fats increases the risk of coronary heart disease.

A nurse is caring for a client with a history of cardiac and vascular disease. Which fats should the nurse allow in the client's diet for his condition? unsaturated fats trans fats saturated fats hydrogenated fats

unsaturated fats Explanation: Unsaturated fat is a healthier form of fat than saturated fat, because it contains less hydrogen, and therefore can be included in the client's diet. Saturated fats are lipids that contain as much hydrogen as their molecular structure can hold and are generally solid. Most saturated fats are found in animal sources, such as the marbled fat in meat. Saturated fats are responsible for cardiac and vascular diseases. Trans fats are unsaturated fats that have been hydrogenated, a process in which hydrogen is added to the fat. Consumption of trans fats, saturated fats, and hydrogenated fats increases the risk of coronary heart disease.

A nurse in a rural health center meets a new client, age 4. The nurse notices as the client enters the clinic that his legs appear to be bowed. When he smiles, the nurse also notes that his dentition is quite malformed for a child his age. What vitamin deficiency would the nurse most suspect? vitamin A vitamin B vitamin C vitamin D

vitamin D Explanation: Severe vitamin D deficiency manifests as rickets, osteomalacia, poor dentition, and tetany.

Fat soluble vitamins

A, D, E, K

Water soluble vitamins

B-complex & C

Why does the GI tract play an important role in immunology?

Because the G.I. tract contains 70% to 80% of all immune-secreting cells

Sources of highly saturated fats

Beef, lamb, coconut oil

Examples of minerals

Calcium, iron, sodium, potassium, iodine, fluoride

When teaching the parents of a toddler about feeding and eating, the nurse should include which of the following safety measures? -Give the child 8 to 12 oz of fruit juice daily -Do not offer the child raw vegetables -Do not give the child peanut butter -Have the child drink 28 to 32 oz of milk daily

Do not offer the child raw vegetables. Raw vegetables, as well as hot dogs, grapes, nuts, popcorn, and candy, have been implicated in choking deaths and should be avoided at least until the child is 3 years old.

Sources of incomplete proteins

Dried peas, beans, peanut butter, veggies

Which of the following dietary modifications should an adolescent in sports implement? -Drink water before and after sports activities -Decrease carbohydrates to 30%-40% of daily calories -Keep protein intake at the same level -Increase fats to 30%-40% of caloric intake

Drink water before and after sports activities. An adolescent should drink water before and after sports activities to prevent dehydration.

After teaching the client about a low-fat diet, which items selected by the client would indicate to the nurse that the client comprehends the nutritional teaching? Coffee with non-dairy creamer Peanut-butter sandwich Egg white omelet with vegetables Frozen hash browns with vegetables

Egg white omelet with vegetables

Which of the following formulas is appropriate to administer to a patient who has a dysfunctional gastrointestinal tract? Modular Elemental Polymeric Specialty

Elemental Elemental formulas contain predigested nutrients that are easy for a partially functional gastrointestinal tract to absorb.

What is a normal triglyceride level?

less than 150 mg/dL

To determine how much of the length of a nasoenteric tube to insert, a nurse should measure the distance from the tip of the patient's nose to the earlobe and from the earlobe to umbilicus. xiphoid process. manubrium plus 10 to 20 cm more. xiphoid process plus 20 to 30 cm more.

xiphoid process plus 20 to 30 cm more. Measuring from the tip of the nose to the earlobe to the xiphoid process approximates the distance from the nose to the stomach for 98% of patients. For duodenal or jejunal placement, an additional 20 to 30 cm is required.