Chapter 27: Nutrition and Fluids

The dietary guidelines help people

- Attain and maintain a healthy weight - Reduce the risk of chronic disease - Promote over-all health

When using Myplate, calories are balanced by

- Eating less - Avoiding over-sized portions

What are the 5 food groups in Myplate?

- Grains - Vegetables - Fruits - Milk - Protein foods

A safe temperature for hot food is

140F or higher

Whole grains in the group include

Bulgur, Oatmeal, and brown rice

Which vitamins must be ingested daily?

C and B complex

The amount of energy produced from the burning of food by the body is a

Calorie

GI

Gastro-intestinal

A general diet

Has no dietary limits or restrictions

The dietary guidelines for Americans are for persons

- 2 years of age and older - At risk for chronic disease

How many calories are in each of these? 1 gram of fat? 1 gram of protein? 1 gram of carbohydrate?

- 9 calories - 4 calories - 4 calories

Alcohol and coffee are avoided or not allowed by these religious groups.

- Adventist (Seventh-Day Adventist) - Church of Jesus Christ of Latter-Day Saints (Mormon) - Islam

What can be done to promote comfort when preparing residents for meals?

- Assist with elimination needs. - Make sure eyeglasses and hearing aids are in place. - Assist with oral hygiene. Make sure dentures are in place. - Make sure an incontinent person is clean and dry. - Position the person in a comfortable position. - Assist the person with hand-washing.

Certain diseases are linked to poor diet and lack of physical activity. They are:

- Cardiovascular disease - Hypertension - Diabetes - Obesity - Osteoporosis - Some cancers

When you are serving meal trays, you make sure the right person gets the right tray by

- Checking the ID bracelet against the dietary card (use 2 identifiers) - Calling the person by name

The dietary guidelines focus on

- Consuming fewer calories - Making informed food choices - Being physically active

What information do you need when you are delegated to measure intake and output?

- If the person has a special fluid order - When to report measurements—hourly or end-of-shift - What the person uses for voiding—urinal, bedpan, commode, or specimen pan - If the person has a catheter - What specific resident concerns to report at once

When making food choices, which foods are increased in the diet?

- Making half of your plate fruits and vegetables - Making at least half of your grains whole grains - Drinking fat-free or low-fat (1%) milk

What is the function of each of these nutrients? - Protein - Carbohydrates - Fats - Vitamins - Minerals - Water

- Needed for tissue growth and repair - Provide energy and fiber for bowel elimination - Provide energy - Needed for certain body processes - Used for many body processes (bone and tooth formation, nerve and muscle function, fluid balance, and other body processes) - Needed for all body processes

What information is found on food labels?

- Serving size and the number of servings in each package - Calories and calories from fat - Nutrients—total fat, cholesterol, sodium, carbohydrate, protein, vitamins A and C, calcium, and iron

Why is it important to sit facing the person when you feed him or her?

- Shows the person that you have time for him or her (more relaxing) - Can see how well the person is eating - Can see if the person has trouble swallowing

What should be reported after you have fed a person?

- The amount and kind of food eaten - Complaints of nausea or dysphagia - Signs and symptoms of dysphagia - Signs and symptoms of aspiration

When family memebers bring food to a resident, it is important that you tell ______________. The food must not interfere with with the ________________.

- The nurse - the person's diet

When you are delegated to serve meal trays, what information do you need from the nurse or care plan?

- The person's food allergies (if any) - What adaptive equipment the person uses - How much help the person needs opening cartons, cutting food, and buttering bread - It the person's intake is measured - If calorie counts are done - When to report observations - What patient or resident concerns to report at once

What 2 types of dining programs may be used with persons who are quietly confused?

Social dining and low-stimulation dining

When I&O is ordered, which of the following is not included in the measurement?

Solid Stool

When a person has dysphagia, the thickness of food served is chosen by the

Speech-language pathologist, occupational therapist, dietitian, and doctor or nurse

An example of moderate physical activity in Myplate is

Bicycling at less than 10 miles per hour

If dietary fat is not needed by the body, it is stored as

Body fat (adipose tissue)

People with limited incomes often buy

Carbohydrate foods

When a person is receiving a diabetic diet, the same amount of _______________ are eaten each day.

Carbohydrates, protein, and fats

How can you make sure the food tray is complete

Check items on the tray with the dietary card.

Which of the following needs to be done before the person is served a meal?

Check the person's position

A cultural group that eats a diet high in sodium is in

China

A soft, waxy substance found in the bloodstream and all body cells is ____________________.

Cholesterol

When the person receives a full-liquid diet, it will include all of the foods on the clear-liquid diet as well as these foods:

Custard; eggnog; strained soups; strained fruit and vegetable juices; milk and milk-shakes; strained, cooked cereals; plain ice cream and sherbet; pudding; yogurt

Build and maintains bone mass throughout life

Dairy

A decrease in the amount of water in body tissues is

Dehydration

Body fuel for energy is found in

Fats, proteins, and carbohydrates

Older persons need _________________________ calories than younger people do.

Fewer

Nutritional needs increase during illness when the body must

Fight infection, heal tissue, and replace lost blood

FDA

Food and Drug Administration

What foods are included in a clear-liquid diet?

Foods that are liquid at body temperature, leave a small amount of residue, and are non-irritating and non-gas forming (water, tea, and coffee without milk or cream; carbonated drinks; gelatin; clear fruit juices; fat-free clear broth; hard candy, sugar, and popsicles)

Calcium is needed for

Forming bones and teeth, blood clotting, muscle contraction, and heart and nerve function

When you are caring for a person with diabetes, you should do all of these except

Give the person extra food and snacks whenever it is requested.

You can provide comfort during meals by doing all of these except

Giving complete personal hygiene and a linen change.

A __________________ is a calibrated container use to measure fluid.

Graduate

May prevent constipation

Grains

May prevent birth defects

Grains, vegetables, and fruits

If fluid intake exceeds fluid output, the person will

Have edema (swelling) in the tissues

Mg

Milligram

Ml

Milliliter

All pork and pork products are forbidden by

Muslims or Islam

A substance that is ingested, digested, absorbed, and used by the body is a

Nutrient

The many processes involved in the ingestion, digestion, absorption, and use of food and fluids by the body is

Nutrition

During illness

Nutritional needs increase to fight infection and heal tissue.

Requirements for food served in nursing centers are

OBRA

All of these are food groups in Myplate except

Oils

Why is it important to offer water often to older persons?

Older persons have a decreased sense of thirst. Their bodies need water but they may not feel thirsty.

OBRA

Omnibus Budget Reconciliation Act of 1987

When you are feeding a person, the spoon should be filled

One-third (1/3) full

Oz

Ounce

The amount of fluid lost is

Output

All of these may be a sign of a swallowing problem except

Person is able to eat a regular diet without problems

When a nursing center uses 24-hour catering or mobile food carts, it allows the residents to have freedom and

Personal choice

When you respect the person's likes and dislikes of food or complaints about the food, it meets the right to

Personal choice

When you are using the graduate to measure output, you read the amount by

Placing the graduate at eye level to read it

When the diet does not have enough ____________, it may affect nerve function, muscle contraction, and heat function.

Potassium

Provides nutrients needed for health and body maintenance

Protein

What is the most important nutrient?

Protein

Which nutrient is needed for tissue growth and repair?

Protein

When people buy cheaper foods, the diet may lack

Protein and certain vitamins and minerals

Provide B vitamins and Vitamin E

Protein foods

If you are serving a meal to a person on fiber and residue-restricted diet, the meal would not include

Raw fruits and vegetables

If a person you are caring for has an order for restricted fluids, which of these should you do?

Remove the water mug or keep it out of sight.

What religious group may have members that fast from meals on certain Fridays of the year?

Roman Catholic

All of these are requirements for food served in long-term care centers except

All food is served at room temperature

Food labels have all of this information except

All vitamins and minerals in the food.

The loss of appetite is

Anorexia

Appetite can be stimulated by

Aromas and thoughts of food

When you are keeping I&O records, you should measure all of these as intake except

Mashed potatoes and creamed vegetables

NPO

Non per os; nothing by mouth

When assisting a person who is on aspiration precautions, you can help to prevent aspiration while

As upright a position as the nurse and care plan direct

The breathing of fluid, food, vomitus, or an object into the lungs is

Aspiration

What should you do if a food tray has not been served within 15 mins?

Recheck the food temperature

When re-heating cooked foods, it should be heated

According to agency policy

USDA

United States Department of Agriculture

How much fluid is needed every day for normal fluid balance?

2000 to 2500 ml

The body needs no more than

2300mg

When you are measuring I&O, you need to know that 1 ounce equals

30 ml

The safe temperature to keep foods at are A. cold foods _____________________ B. Hot foods _______________________ C. The danger zone for food is _________________ for more than _________________ hours or _______________________ hour if temperature is warmer than 90F. D. Keep the refrigerator at _____________ or below. Keep the freezer at ____________ below.

A 40oF or below B 140oF or above C 40oF to 140oF; 2; 1 D 40oF or below; 0oF or below

Which vitamins can be stored by the body?

A, D, E, and K

List the amount of milliliters in the following: A. 1 ounce equals _________ ml B. 1 pint equals about _______ ml C. 1 quart equals about ________ ml

A. 30 B. 500 C. 1000

If you are feeding a person a dysphagia diet, what observations should be reported to the nurse immediately? A. _________________________, ____________________________, or _____________________ during or after meal. B. ___________________________ or __________________________________.

A. Choking; coughing; difficulty breathing B. Abnormal breathing; respiratory sounds

Explain each of the concepts below that are recommended by the USDA to keep food safe. A. clean ____________________ B. Separate ____________________ C. Cook _________________ D. Chill ___________________

A. Wash hands, utensils, and counter tops often. B. Avoid cross-contamination. Do not let raw meat, poultry, or their juices touch other foods that will not be cooked. C. Cook food to a safe internal temperature. Use a food thermometer to check internal temperature. when re-heating cooked food, re-heat to 165F. D. Refrigerate or freeze food within 2 hours. If the air is 90oF or above, chill food within 1 hour.

When feeding a person, liquids are given

During the meal, alternating with solid foods.

__________ is difficulty or discomfort in swallowing.

Dysphagia

All of these food choices are included in Myplate except

Eating high-fat foods

________________________ is the swelling of body tissues with water.

Edema

F

Fahrenheit

When the body tissues swell with water, what organ has to work harder?

Heart

A person who is constipated and has other GI disorders may receive a ___________________ diet. The foods in this diet increase the ______________________ to stimulate _________________.

High-fiber; amount of residue and fiber in the colon; peristalsis I

A person who has serious burns would receive a

High-protein diet

Why do the diets of some older people lack protein?

High-protein foods are often costly

What OBRA requirement relates to the temperature of foods served in long-term care centers?

Hot food must be served hot. Cold food is served cold. Food servers keep food at the correct temperature.

Having an adequate amount of water in body tissues is

Hydration

ID

Identification

When delegated to provide drinking water, what information do you need from the nurse and the care plan?

If a person can have ice

Which of these occur when the person has a poor diet and poor eating habits?

Increased risk for accidents and injuries

All of these may occur with aging except

Increases in taste and smell

________________ is the amount of fluid taken in.

Intake

I&O

Intake and output

What mineral allows red blood cells to carry oxygen?

Iron

Those who practice ____________________ as their religion eat only fish with scales and fins.

Judaism (Jewish faith)

When you give oral hygiene to a person who is receiving nothing by mouth, the person must not

Swallow any fluid

If you become impatient while feeding a resident with dementia, you should

Talk to the nurse

When choosing from the protein food group, foods that may have a higher risk for heart disease are those

That are high in fat and cholesterol

The amount needed from each food group in Myplate depends on

The age, sex, and physical activity of the person

A person may be given a mechanical soft diet because

The person has chewing problems

If a food tray is not served within 15 mins, what should be checked?

The temperature of the food

When residents are served meals in a family dining program

They serve themselves as at home.

What vegetable juices are high in sodium?

Tomato, V-8, bloody Mary mixes

When you are feeding a person, you should

Use a teaspoon because it is less likely to cause injury.

May reduce risk of kidney stones ___________ or _____________.

Vegetable and Fruit

May help lower calorie intake ___________ or _________________.

Vegetables; fruits

Milk and milk products, liver, green leafy vegetables, eggs, breads, and cereals are good sources of which vitamin?

Vitamin B2

What vitamin is important for these functions? Formation of substances that hold tissues together, healthy blood vessels, skin, gums, bones, and teeth; wound healing; prevention of bleeding; resistance to infection

Vitamin C

Which vitamins is needed for the formation of substances that hold tissue together?

Vitamin C

If a person is receiving a high-calorie diet, the calorie intake is ____________________ daily.

increased to about 3000 to 4000 calories

If a person has poorly fitted dentures and has chewing problems, the doctor may order a ____________________ diet.

mechanical soft