N3 Quiz 6 Nutrition
Which client statement indicates a good understanding of the nutritional modifications needed to manage hypertension? "A glass of red wine each day will lower my blood pressure." "I should eliminate caffeine from my diet to lower my blood pressure." "If I include less fat in my diet, I'll lower my blood pressure." "Limiting my salt intake to 2 grams per day will improve my blood pressure."
"Limiting my salt intake to 2 grams per day will improve my blood pressure." Explanation: To lower blood pressure, a client should limit daily salt intake to 2 g or less. Alcohol intake is associated with a higher incidence of hypertension, poor compliance with treatment, and refractory hypertension. Moderate caffeine and fat intake don't significantly affect blood pressure
A nurse is providing dietary instructions to a client with a history of pancreatitis. Which instruction is correct? "Maintain a high-fat diet and drink at least 3 L of fluid a day." "Maintain a high-sodium, high-calorie diet." "Maintain a high-carbohydrate, low-fat diet." "Maintain a high-fat, high-carbohydrate diet."
"Maintain a high-carbohydrate, low-fat diet." Explanation: A client with a history of pancreatitis should avoid foods and beverages that stimulate the pancreas, such as fatty foods, caffeine, and gas-forming foods; should avoid eating large meals; and should eat plenty of carbohydrates, which are easily metabolized. Therefore, the only correct instruction is to maintain a high-carbohydrate, low-fat diet. An increased sodium or fluid intake isn't necessary because chronic pancreatitis isn't associated with hyponatremia or fluid loss.
How much potassium is recommended for someone with hypertension and why is potassium important for a person with hypertension?
3.5 to 5 g or 3500 to 5000 mg of potassium per day Increasing potassium decreases sodium by increasing him sodium lost in the urine
How often should a bolus feedings be given and how much is in one feeding, and how long is the feeding administered for?
4- 6 Feedings per day. 200 - 400 mL 50 to 60 minutes
How many grams of carbohydrates per meal is a diabetic recommended to have How many units of insulin should a client receive for how many grams of carbohydrates
45 to 60 g One unit of insulin per 15 g of carb
What is the caloric distribution for a diabetic
50 to 60% carbs 20 to 30% fat 10 to 20% protein 10 to 20% fiber Carbs should come from whole grains
A group of students are reviewing material in preparation for a test on the male and female breasts. The students demonstrate understanding of the material when they identify which of the following? The breasts contain a limited supply of blood vessels. Progesterone is primarily responsible for the growth of breast tissue. Striated muscle in the nipples contract causing them to become erect. A primary function of the female breast is to produce milk.
A primary function of the female breast is to produce milk. Explanation: A primary function of the female breast is to produce milk, a process called lactation. The breasts contain an abundant supply of blood vessels and lymphatics. Estrogen is the hormone primarily responsible for the growth and development of breast tissue. Smooth muscle in the nipples contracts, causing them to become erect when cold, touched, or sexually stimulated.
What is transferrin? What is unique about it?
A protein that transports iron through the blood to the liver, spleen and bone marrow. It has a very short half-life, so it decreases faster than albumin
What are the fat soluble vitamins, how are they stored in the body and what foods are they usually found in?
ADEK, usually found in fatty foods and oils, stored in lipid tissue can be harmful if too many are taken
Which three labs do we look at for nutritional assessment? Which types of information do we also gather to assess nutrition?
Albumin, pre-albumin, and transferrin Dietary intake interview/food journal 24 hour recall Dietary interview of their food preferences
This results from a rapid release of immunoglobulin E. It is an immediate reaction between a specific antigen and antibody
Anaphylaxis
A client is experiencing anorexia and the physician is to order a medication to stimulate the client's appetite. Which of the following would the nurse least likely expect the physician to prescribe? Megestrol Dexamethasone Dronabinol Atropine
Atropine Explanation: Atropine is used to manage excessive oral and respiratory secretions when death is imminent. Dexamethasone, megestrol, and dronabinol may be used to stimulate appetite in clients who are at the end of life.
What are water soluble vitamins, how are they stored in the body, and which foods can you find them in?
B complex (6,9,12) vitamins and vitamin C. Not really stored in the body, excreted in the urine. Can find these in fruits and vegetables, except for B12 is found in: meat, fish, milk, cheese, and eggs.
When teaching a client with iron deficiency anemia about appropriate food choices, the nurse encourages the client to increase the dietary intake of which foods? Beans, dried fruits, and leafy, green vegetables Fruits high in vitamin C, such as oranges and grapefruits Berries and orange vegetables Dairy products
Beans, dried fruits, and leafy, green vegetables Explanation: Food sources high in iron include organ meats (e.g., beef or calf liver, chicken liver), other meats, beans (e.g., black, pinto, and garbanzo), leafy and green vegetables, raisins, and molasses. Taking iron-rich foods with a source of vitamin C (e.g., orange juice) enhances the absorption of iron.
What are good foods for someone with hypo parathyroidism to eat?
Broccoli, kale, spinach, almonds, oranges, OJ, green leafy's, sardines And no milk, cheese, dry beans,, cola, egg yolk
Which types of foods are deodorizing for a patient with a colostomy
Buttermilk, yogurt, and parsley
Components of an enteral formula
Caloric density, fiber, content, vitamins, electrolytes, fat content
Foods to avoid for someone with hyperparathyroidism
Cheese, milk, kale, spinach, sardines, OJ
What are some common foods, medication's, insects, and medical equipment that may cause anaphylactic response
Common foods: nuts, shellfish, fish, milk, eggs, soy, wheat Common medication's: anabiotic's, especially penicillin and sulfa, allopurinol, radiocontrast agents, anesthetic agents, like lidocaine or procaine, vaccines, hormones, aspirin, an NSAID Common insects: bees, wasps, hornets, yellow jackets, ants Latex, (Medical, and nonmedical products )
A client scheduled for surgery follows a vegan eating plan. For which potential postoperative complication will the nurse plan care for this client? Blood clots Stasis pneumonia Delayed wound healing Hypoactive bowel sounds
Delayed wound healing Explanation: The client following a vegan eating plan is at risk for a low protein intake. The reduced protein can lead to impaired or delayed wound healing and cause decreased skin and wound strength. A low protein intake does not cause blood clots, stasis pneumonia, or hypoactive bowel sounds.
Which foods are thought to be associated with the risk of cancer?
Dietary substances that appear to increase the risk of cancer include fats, alcohol, salt-cured or smoked meats, nitrate and nitrite-containing foods, and red and processed meats. Nitrates are added to cured meats, such as ham and bacon.
What are cyclic and enteral feedings
Done overnight, usually stopped early in the morning so that the client will be hungry for breakfast
Which types of foods cause excessive odor and gas for a patient with a colostomy
Eggs, cabbage, fish, beans, asparagus, broccoli
What is an interesting fact about fat in relation to diabetes? What is a good BMI for someone with diabetes to aim for?
Fat increases resistance to insulin They should aim to be under 30 BMI, or at most 20% above the ideal body weight
How is constipation defined
Fewer than three bowel movements weekly, RPMs, that are dry, hard, small or difficult to pass
Symptoms of a moderate anaphylactic response
Flushing, warmth, anxiety, and itching. In addition to any of the mild symptoms, bronchospasms, an edema of airways, cough, wheeze
Diet for a person with colostomy
For the first 6 to 8 weeks low residue Then, they should avoid foods that are difficult to digest such as: seeds, poppy, seeds, corn, popcorn, celery 2 L of fluid per day Pruner, apple juice for constipation Deodorizing foods/avoid odor foods Chew foods completely
Which waist circumference for men and women are considered excessive abdominal fat
For women it is 35 inches and more and for men it is 40 inches and more
Diet for someone with hypoparathyroidism
High calcium diet, low in phosphorus, aluminum carbonate with meals
Intestinal disorder with constipation diet
High fiber, 25 to 30 g per day, increase water, increase exercise Examples of high fiber, include fruits, raspberries, apples, bananas, pears, vegetables, new nuts, seeds, pasta, oatmeal, popcorn, brown rice
Diet for someone with hyperparathyroidism
Increased fluid intake of at least 2 L a day Diet, low in calcium and vitamin D Prune juice, stool softeners
An elderly client exhibits blood pressure of 110/76 while prone, 100/72 sitting, and 92/64 standing. The nurse instructs the client to Ingest five or six small meals each day. Minimize the use of stool softeners. Use whirlpool baths for relaxation. Take daily hot showers.
Ingest five or six small meals each day. Explanation: A client who experiences orthostatic hypotension should eat five or six small meals to minimize hypotension that can occur after large meals. The client should avoid straining when having a bowel movement. A stool softener would be useful. Hot showers and whirlpools should be avoided.
The nurse assesses a patient who has an obvious goiter. What type of deficiency does the nurse recognize is most likely the cause of this? Thyrotropin Iodine Thyroxine Calcitonin
Iodine Explanation: Oversecretion of thyroid hormones is usually associated with an enlarged thyroid gland known as a goiter. Goiter also commonly occurs with iodine deficiency.
Why is aluminum carbonate given with meals for someone with hyperparathyroidism?
It helps excrete phosphorus from the G.I. tract
What BMI is underweight, normal, overweight, and obese
Less than 18.5 is underweight. 18.5 to 24.9 is healthy 25 to 29 is overweight 30 and up is obese
Which type of BMI is associated with higher mortality rates in the hospital
Low BMI
What is the diet that helps with hypertension? How many servings are in each group for this type of diet? What other things can be done to help with hypertension
Low Sodium, high potassium and Dash diet. Dash: Daily: 7 to 8 grains, 4 to 5 vegetables, 4 to 5 fruits, 2 to 3 dairy, 2-3 fats/oil, 2 meats 4-5 nuts/beans/seeds weekly 5 sweets weekly Exercise, lose weight, stop smoking, avoid caffeine and alcohol
Diet for someone with end, stage renal disease?
Low protein and fluids Fluid should only be the exact same as the previous day +500 to 600 mL
Intestinal disorder with diarrhea diet
Low residue diet, avoid caffeine, carbonated, beverages, cold, or hot food, fruit, vegetables, fatty foods, milk products for a few days and monitor for electrolyte imbalance Low FOD map diet for sugar triggers
Inflammatory bowel disorder, (ulcerative, colitis, and Crohn's disease) diet
Low residue, high-protein, high calorie, possible lactose restriction, vitamin therapy and iron supplementation No alcohol, smoking, or cold food
What is an important thing to know about diet for someone with congestive heart failure?
Low, sodium and fluids No more than 2 g of sodium per day, and clients must weigh themselves daily
A patient who has been treated for uric acid stones is being discharged from the hospital. What type of diet does the nurse discuss with the patient? Low-calcium diet High-protein diet Low-phosphorus diet Low-purine diet
Low-purine diet Explanation: For uric acid stones, the patient is placed on a low-purine diet to reduce the excretion of uric acid in the urine. Foods high in purine (shellfish, anchovies, asparagus, mushrooms, and organ meats) are avoided, and other proteins may be limited.
While the nurse is preparing a client for a cardiac catheterization, the client states that they have allergies to seafood. Which of the following medications may the nurse give prior to the procedure? Methylprednisolone Furosemide Lorazepam Phenytoin
Methylprednisolone Explanation: Prior to cardiac catheterization, the patient is assessed for previous reactions to contrast agents or allergies to iodine-containing substances, as some contrast agents contain iodine. If allergic reactions are of concern, antihistamines or methylprednisolone (Solu-Medrol) may be administered to the patient before angiography is performed. Furosemide, Lorazepam, and Phenytoin do not counteract allergic reactions.
Severe anaphylactic response symptoms
Mild and moderate symptoms plus rapid progression of bronchospasm, laryngeal, edema, severe dyspnea, cyanosis, hypotension, dysphasia, or difficulty swallowing, abdominal cramping, vomit, diarrhea, seizure, cardiac arrest, and seizure
What is the onset of mild anaphylaxis versus severe? What are the differentiators that make a response moderate versus mild
Mild onset is usually within the first two hours of exposure, severe has an abrupt onset Moderate will have all of the symptoms of mild plus Flushing, warmth, anxiety, bronchospasm, airway, edema, dyspnea, wheezing, and coughing
Specific foods to avoid for someone with hypo parathyroidism and why
Milk, cheese, dry beans, cola, egg yolk Because they are high in phosphorus
What is considered diarrhea, or how many beams per day What is considered acute versus persistent, versus chronic
More than three BM's per day with altered consistency, altered motility A cute would be where it lasts only one or two days, persistent, is where it last 2 to 4 weeks, acute and persistent, can be caused by viruses Chronic is where it last more than four weeks
What should the nurse do when caring for a client with alcoholism who is diagnosed with Imbalanced Nutrition: Less than Body Requirements? Obtain a baseline weight Encourage daily exercise Avoid providing liquid sleep medications Avoid providing foods that contain alcohol
Obtain a baseline weight Explanation: The nurse should obtain a baseline weight. Documenting the client's current weight helps evaluate whether the client's nutritional intake is maintained or has increased. Encouraging daily exercise may not really help balance the client's nutrition. Avoiding liquid sleep medication or foods with alcohol content will not help the client balance nutrition requirements.
Diet modifications for patient diagnosed with chronic inflammatory bowel disease include which of the following? Low residue Low protein Calorie restriction Iron restriction
Oral fluids and a low-residue, high-protein, high-calorie diet with supplemental vitamin therapy and iron replacement are prescribed to meet the nutritional needs, reduce inflammation, and control pain and diarrhea.
Symptoms of a mild anaphylactic response
Peripheral tingling and a sensation of warmth, possible sensation of fullness in the mouth and throat, nasal congestion, Peri, orbital, swelling, pruritus, sneezing, tearing of the eyes
How long is pre-albumin stored versus albumin? What does albumin measure? Which type of lab is a better indicator of recent, poor nutrition?
Pre-albumin is only stored for 2 to 4 days where is albumin is stored for 20 to 22 days. Pre-albumin would be a better indicator of a recent nutrition deficit Albumin measures protein density in adults
Which types of food have a lower glycemic response
Raw or whole foods tend to have a lower glycemic response versus cooked chopped or puréed foods. For example, eat a piece of fruit rather than drink the fruit juice.
Why are continuous feedings good for some clients?
Reduces the risk of aspirations, abdominal distention, nausea, vomiting, and diarrhea, and also great for clients with poor gastric emptying
The nurse advises the patient who has just been diagnosed with acute gastritis to: Take an emetic to rid the stomach of the irritating products. Refrain from food until the GI symptoms subside. Restrict food and fluids for 12 hours. Restrict all food for 72 hours to rest the stomach.
Refrain from food until the GI symptoms subside. Explanation: It usually takes 24 to 48 hours for the stomach to recover from an attack. Refraining from food until symptoms subside is recommended, but liquids should be taken in moderation. Emetics and vomiting can cause damage to the esophagus.
What makes an anaphylactic response severe versus moderate?
Severe has a an abrupt onset with all of the moderate symptoms. Plus, the progression is very rapid with laryngeal edema, abdominal cramping, diarrhea, severe dyspnea, cyanosis, hypotension, swelling, vomiting, seizures, leading to cardiac death. It seems like with severe, it is more of a whole body response rather than to localized facial or upper airway symptoms
The physician has written the following orders for a new client admitted with pancreatitis: bed rest, nothing by mouth (NPO), and administration of total parenteral nutrition (TPN) . Which does the nurse attribute as the reason for NPO status? To drain the pancreatic bed To aid opening up of pancreatic duct To prevent the occurrence of fibrosis To avoid inflammation of the pancreas
To avoid inflammation of the pancreas Explanation: Pancreatic secretion is increased by food and fluid intake and may cause inflammation of the pancreas.
A client with severe and chronic liver disease is showing manifestations related to inadequate vitamin intake and metabolism. He reports difficulty driving at night because he cannot see well. Which of the following vitamins is most likely deficient for this client? Vitamin A Thiamine Riboflavin Vitamin K
Vitamin A Explanation: Problems common to clients with severe chronic liver dysfunction result from inadequate intake of sufficient vitamins. Vitamin A deficiency results in night blindness and eye and skin changes. Thiamine deficiency can lead to beriberi, polyneuritis, and Wernicke-Korsakoff psychosis. Riboflavin deficiency results in characteristic skin and mucous membrane lesions. Vitamin K deficiency can cause hypoprothrombinemia, characterized by spontaneous bleeding and ecchymoses.
Potential causes of calcium renal stones include
excessive intake of vitamin D, hypercalcemia, hyperparathyroidism, excessive intake of milk and alkali, and renal tubular acidosis.
Dumping syndrome symptoms
feelings of fullness, nausea, cramping, dizziness, diaphoresis, and osmotic diarrhea, indicates dumping syndrome.
Diet therapy for clients diagnosed with irritable bowel syndrome (IBS) includes: caffeinated products. spicy foods. high-fiber diet. fluids with meals.
high-fiber diet. Explanation: A high-fiber diet is prescribed to help control constipation. Individuals experiencing diarrhea may be advised to eat a low-fiber diet. Foods that are possible irritants, such as caffeine, spicy foods, lactose, beans, fried foods, corn, wheat, and alcohol, should be avoided. Fluids should not be taken with meals because they cause abdominal distention.
A client has been recently diagnosed with type 2 diabetes, and reports continued weight loss despite increased hunger and food consumption. This condition is called: polyphagia. polydipsia. polyuria. anorexia.
polyphagia. Explanation: While the needed glucose is being wasted, the body's requirement for fuel continues. The person with diabetes feels hungry and eats more (polyphagia). Despite eating more, he or she loses weight as the body uses fat and protein to substitute for glucose.
The nurse assesses a client who has a nasogastric tube for long-term nutritional needs for complications associated with the medical device. Complete the following sentence by choosing from the lists of options. The nurse monitors the client for ------------------------ , a finding indicative of ------------------------ , a noted complication of nasogastric tubes.
purulent nasal drainage rhinosinusitis Purulent nasal drainage is a symptom the nurse monitors for when assessing for complications associated with a nasogastric tube. Clients who require nasogastric tube feedings are at risk for rhinosinusitis; thus, the nurse monitors the client for purulent nasal drainage.
How is BMI calculated?
weight in kg/height in meters squared