PN 120 Before Final Nutrition
explain a postprandial state
-Blood glucose concentration begins to drop Pancreas releases glucagon Stimulates liver to release glucose
What does cholesterol do?
-Creates bile acids -synthesizes steroid hormones -used to make vitamin D
What is a renal diet?
-Restricts protein, potassium, sodium, and phosphorus -Carbohydrates are encouraged to provide needed energy for healing -vitamin supplements -fluid intake limitations
What are saturated fats?
-Solid at room temperature -Animals fats, meat, whole milk, butter, ice cream -raises LDL
list ways to increase protein density
-add skim milk powder to milk -sub milk for water in recipes -melt cheese on food -spread pb on apples or crackers -sprinkle nuts on food coat breaded meats with eggs first, add hard boiled eggs to food -top fruit with yogurt -use plain yogurt in place of sour cream -add whey protein powder to drinks
what does vitamin K do
-aid in blood clotting* -bone metabolism -regulation blood calcium level -produce prothrombin - absorbed in the small intestine and stored in the fatty tissue and the liver
ketosis
-an undesirably high concentration of ketone bodies in the blood and urine -due to inadequate glucose -can cause dehydration and sodium depletion
what roles does a nurse have in nutrition?
-assessment/monitoring -nutrition therapy -enteral and parenteral nutrition -intake and weight -tolerance for food -liaison between dietitians and physicians -education -screening for malnutrition
name 4 things too much sugar can cause
-behavioral problems in children -obesity -diabetes mellitus -heart disease
symptoms of metabolic stress
-changes in metabolic rate -heart rate -blood pressure -nutrient matabolism
what is the metabolic pool with protein
-consists of recycled amino acids from body proteins that have broke down and also amino acids from food. -constant state of flux -contains supply of each amino acid
what is the difference between essential and nonessential proteins
-essential must be consumed through food, the body cannot make them. there are 9 -nonessential can be made by the body, there are 11
What are the guidelines for DGA
-follow a healthy eating plan -focus on variety, nutrient density, and amount -limit calories from added sugars and saturated fats and reduce sodium intake -shift to healthier food and beverage choices -support healthy eating patterns for all
what can a 30% loss of body protein cause
-impaired breathing -altered immune function -altered organ function -ultimately death
list the characteristics of dehydration
-impaired mental function -impaired motor control -increased body temp during exercise -increased resting heart rate -increased risk of life threatening heat stroke
how to promote an adequate intake
-let the patient select his or her menu -offer patients alternatives -try to advance diet as quickly as possible -set the stage for a pleasant meal -be positive about the food -provide assistance when necessary -encourage the patient to eat -identify the eating problem and find a solution
how would you limit saturated fat intake
-limit meat intake -switching to reduced or no fat dairy products -hydrogenated fats should be avoided
what is the AI for men 19-70 and women 19-70
-men 3.7 L/day -women 2.7 L/day
Why is insulin released?
-response to a rise in blood glucose levels -released from the pancreas
list ways to increase calorie density
-spread cream cheese on hot bread -add butter to hot foods -use gravy over potatoes, meat, or veggies -use mayo instead of salad dressing -use whipped cream on deserts/drinks -add honey to cooked cereals, fruit, coffee, or tea -add marshmallows to hot chocolate
functions of protein
-structural and functional component of every living cell -body structure/framework -enzymes -some body secretions and fluids -acid-base balance -transport molecules -fueling the body
what are phospholipids
-structural components of cell membranes -facilitate the transport of fat-soluble substances across the cell membrane
Note: schedule medical and surgical procedures at times when they are least likely to interfere with meals
.
note: synthetic folic acid in fortified food and supplements is better absorbed than folate that occurs naturally in foods
.
What is the RDA for protein for an adult
0.8 g/kg or 10%-35% or total calories for AMDR
what is the general amount of food per year of age for infants
1 tbsp of food per year of age
when do you give an infant cows milk
1 year- whole milk 24months- lowfat/skim milk
how much do you advance a feeding
10-20 mL/hour every 8-12 hours
what is the initial rate of tube feeding
10-40 mL/ hour
how soon should you stop tube feeding before giving a medication
15 minutes
What is the AI for sodium for young adults
1500 mg/day
how much sodium is recommended for a sodium restricted diet
1500 mg/day or 2000 mg/day
What is the healthy BMI range?
18.5-24.9
What ages does the Dietary Guidelines for Americans encompass?
2 years and older
how long do you wait in between trying new foods for an infant
2-3 days
what percentage of water loss is life-threatening
20%
how often should someone exercise
200-420 minutes/week
how soon does a nutritional assessment need to be done?
24 hours within being admitted
What is overweight BMI?
25-29.9
how much fiber is in a high fiber diet
25-35 g per day
How many grams of fiber is recommended daily for adults?
25-38g or 45%-65% of total calories for carbohydrates
what is the current IU.day for vitamin D
4000 IU/day or 100 ug/day
when do you introduced fortified cereal to an infant
6 months
What percentage of total body weight is water?
60%
how much folic acid per day
600 mcq during pregnancy, 400mcq from a supplement
A client says that she doesn't eat much meat. After teaching the client about serving sizes, the nurse determines that the teaching has been effective when the client states that an ounce of meat provides approximately the same amount of protein as which of the following? -8oz of milk -8oz of nuts -2oz of cheese -2 eggs
8oz of milk
How many amino acids are essential
9
what percentage of fat is absorbed
95%
A client who has eaten too many dietetic candies sweetened with sorbitol may experience which of the following? A: Diarrhea B: Heartburn C: Vomiting D: Low blood glucose
A
Which of the following recommendations would be most effective for someone wanting to eat more fiber? A: eat legumes more often B: eat raw vegetables in place of cooked vegetables C: Use potatoes in place of white rice D: Eat fruit for dessert in place of ice cream
A
Vitamins do not provide calories. What do they do. A. help metabolize energy B. function like drugs at normal doses c. provide essential nutritional needs at gram or higher doses D. prevent biochemical reactions in the body.
A. do not provide energy but are needed for metabolism of energy
A client with hyperlipidemia is prescribed niacin. The client asks if he can just include more niacin-rich foods in his diet and forgo the need for niacin in pill form. Which of the following would be the nurse's best response? A: The dose of niacin needed to treat hyperlipidemia is far more than can be consumed through eating a niacin-rich diet. B: You can't get the therapeutic form of niacin through food. C: Niacin from food is not as well absorbed as niacin from pills. D: If you are able to consistently choose niacin-fortified foods in your diet, your doctor may allow you to forgo the pills and rely on dietary sources of niacin.
A: The dose of niacin needed to treat hyperlipidemia is far more than can be consumed through eating a niacin-rich diet.
A client asks why sugar should be limited in the diet. Which of the following is the nurse's best response? A: A high sugar intake increases the risk of heart disease and diabetes B: Foods high in sugar generally provide few nutrients other than calories and may make it hard to consume a diet that has enough of all the essential nutrients. C: There is a direct correlation between sugar intake and the risk of obesity. D: Sugar provides more calories per gram than starch, protein, or fat.
B
Which B vitamin can cause permanent neurologic damage and may not demonstrate signs of symptoms for 10 years? A. B6 B. B12 C. Folate D. B2
B. B12
The client asks if taking supplements of beta-carotene will help reduce the risk of cancer. Which of the following would be the nurse's best response? A: Supplements of beta-carotene may help reduce the risk of heart disease but not of cancer. B: supplements of beta-carotene have not been shown to lower the risk of cancer and may even promote cancer in certain people. C: Although evidence is preliminary, taking beta-carotene supplements is safe and may prove to be effective against cancer in the future. D" Natural supplements of beta-carotene are generally harmless; synthetic supplements of bate-carotene may increase cancer risk and should be avoided.
B. Supplements of beta-carotene have not been shown to lower the risk of cancer and may even promote cancer in certain people.
A diabetic diet is now based more on keeping the total carbohydrate intake consistent with less emphasis on the source of the carbohydrate. What has this change in focus meant for diabetic diets? A. Sugar alternatives are substituted for simple sugars. B. Sweets can be included in the diabetic diet. C. Calorie control is most important for diabetics. D. Diabetics need to learn the glycemic load of foods
B. because regular sugar does not raise blood sugar level more than complex carbs do.
When developing a teaching plan for a client who is on warfarin, which of the following foods would the nurse suggest the client consume a consistent intake of because of their vitamin K content? A: liver, milk and eggs B: brussels sprouts, cauliflower, and spinach C: fortified cereals, whole grains, and nuts D: dried peas and beans, wheat germ, and seeds
B. brussels sprouts, cauliflower, and spinach
What do nutritional assessments data consist of?
BMI laboratory data clinical diagnosis dietary data client's medical-psycho-social history, functional assessment, and physical exam
The client wants to eat fewer calories and lose weight by substituting regularly sweetened foods with those that are sweetened with sugar alternatives. Which of the following would be the most effective substitution? A: sugar free cookies for regular cookies B: sugar free chocolate candy for regular chocolate candy C: sugar free soft drinks for regular soft drinks D: sugar free ice cream for regular ice cream
C
The nurse know her explanation of glycemic index was effective when the client says which of the following? A: choosing foods that have a low glycemic index is an effective way to eat healthier. B: low glycemic index foods promote weight loss because they do not stimulate the release of insulin. C: glycemic index may help choose the best foods to eat before, during, and after training D: glycemic index is a term to describe the amount of refined sugar in a food.
C
The nurse knows her instructions about choosing dairy products that are lactose free have been effective when the client verbalizes she may tolerate A: Whole milk B: fat-free milk C: cheddar cheese D: pudding
C
A client asks if it is better to consume folic acid from fortified foods or from a vitamin pill. Which of the following is the nurse's best response? A: It is better to consume folic acid through fortified foods because it will be better absorbed than through pill form. B: it is better to consume folic acid through vitamin pills because it will be better absorbed than through fortified foods. C: Fortified foods and vitamin pills have the same form of folic acid, so it does not matter which source you use because they are both well absorbed. D: It is best to consume naturally rich sources of folate because that form is better absorbed than the folic acid in either fortified foods or vitamin pills.
C. Fortified foods and vitamin pills have the same form of folic acid, so it does not matter which source you use because they are both well absorbed.
A client is diagnosed with pernicious anemia. what vitamin is he not absorbing? A: folic acid B: vitamin B6 C: Vitamin B12 D Niacin
C. Vitamin B12
Which vitamin is given in large doses to facilitate wound and bone healing? A: vitamin A B: vitamin D C: vitamin C D: niacin
C. Vitamin C.
Which population is at risk for combined deficiencies of thiamin, riboflavin, and niacin? A: pregnant women B: vegetarians C: alcoholics D: Athletes
C. alcoholics
The nurse knows that instructions have been effective when the client verbalizes that the sources of synthetic trans fat are -red meat and full-fat dairy products -commercial baked goods and stick margarine -pretzels and nuts -butter and lard
Commercial baked goods and stick margarine
A client is on a low calorie diet that recommends she test her urine for ketones to tell how well she is adhering to the guidelines of the diet. What does the presence of ketones signify about her intake A: It is too high in protein B: it is too high in fat C: it is too high in carbohydrates D: it is too low in carbohydrates
D
Compared to refined grains, whole grains have more A: Folic acid B: Vitamin A C: Vitamin C D: Phytonutrients
D
Which statement indicates that the client understands the instruction about using a vitamin supplement? A: USP on the label guarantees safety and effectiveness B: natural vitamins are always better for you than synthetic vitamins C: Vitamins are best absorbed on an empty stomach D: taking a multivitamin cannot fully make up for poor food choices
D. Taking a multivitamin cannot make up for poor food choices
What is one of the functions of vitamin D? A. synthesis of prothrombin B. protects PUFAs and other lip molecules C. aides in reproduction D. helps immune function
D. helps immune function
how much should a pregnant woman increase her iron by?
DRI 50%
Common symptoms of foodborne illness
Diarrhea, fever, nausea, abdominal cramps,
What does DGA stand for
Dietary Guidelines for Americans
What serves as the federal policy on nutrition?
Dietary Guidelines for Americans
True/False: There is a universal definition of diet quality.
False
t/f Enriched wheat bread is nutritionally equivalent to whole wheat bread.
False
t/f The sugar in fruit is better for you than the sugar in candy.
False
t/f A half of the body's glycogen reserve is in the liver.
False, 1/3
t/f Most commonly consumed American foods provide adequate fiber to enable people to meet the recommended intake.
False, only about half
True/False. Terms such as "low", "free", and "high" are not reliable.
False, they are legally defined and therefor reliable and valid.
what are the 3 different eating styles offered by the Dietary Guidelines of Americans?
Healthy U.S. Style Eating Pattern healthy Mediterranean style eating pattern healthy vegetarian eating pattern
The client asks what foods are rich in protein and are less expensive than meat. Which of the following foods would the nurse recommend she eat more of? Breads and cereals Legumes Fruit and vegetables Fish and Shellfish
Legumes
What is a heart healthy diet
Low-fat, low cholesterol, high-fiber, low-salt
What is the most used tool for Americans making wise food choices?
MyPlate
What do structure/function claims do?
Offer the possibility that a food may improve body function
What does the my plate mainly focus on?
Portion sizing
A client who is in a positive nitrogen balance is most likely to be: -a healthy adult -starving -pregnant -losing weight
Pregnant
What do antioxidants do?
Protect the body from free radicals
When developing a teaching plan for a client who needs to limit saturated fat, which of the following foods would the nurse suggest the client limit? -seafood and poultry -nuts and seeds -olive oil and canola oil -red meat and full-fat dairy products
Red meat and full-fat dairy products
What key notes should you use when planning client outcomes?
SMART specific measurable attainable resident/client centered
An adult in the hospital have been diagnosed with marasmus. Which of the following would you expect? -The client has experienced severe weight loss. -The client denies hunger. -The client has edema and a swollen abdomen. -The onset of the deficiency was rapid.
The client has experienced severe weight loss.
What is enternal nutrition?
The delivery of nutrition through a tube inserted into the gastrointestinal (GI)tract
what controls our daily fluid balance
The sensation of thirst and the action of the hormone vasopressin
Where does the majority of carbohydrate digestion occur?
The small intestine
What is the primary function of fat? -to facilitate protein metabolism -to provide energy -to promote the absorption of fat-soluble viatmins -to facilitate carbohydrate metabolism
To provide energy
t/f Beverages, such as soft drinks, fruit drinks, sport drinks, and sweetened coffee and tea, contribute more added sugars to the typical American diet than any other food or beverage.
True
t/f Bread is just as likely as candy to cause cavities
True
t/f Carbohydrates are found in every MyPlate group except oils.
True
t/f Starch is made from glucose molecules
True
t/f The Dietary Guidelines recommend Americans limit their intake of added sugars to less than 10% of total calories consumed.
True
True/False The RDAs are intended for healthy people only.
True. the RDAs are intended for healthy people and also people at risk for chronic disease
Which statement indicates the client understands vegetarian diets? -Vegetarians need to eat more calories than non-vegetarians in order to spare protein. -Vegetarian diets are always healthier than non-vegetarian diets. -Vegetarians usually do not consume enough protein. -Vegetarians may need to take supplements of iron, vitamin B12, and calcium.
Vegetarians may need to take supplements of iron, vitamin B12, and calcium.
Which vitamins are antioxidants?
Vitamins C and E and beta-carotene
a mother asks why toddlers shouldn't drink all the milk they want. Which of the following is the nurse's best response? a. consuming more than the recommended amount of milk can displace the intake of iron-rich foods from the diet and increase the toddler's risk of iron deficiency anemia. b. consuming more than the recommended amount of milk increases the risk of milk allergy. c. too much milk can lead to over hydration. d. consuming more than the recommended amount of milk will provide too much protein.
a
the client asks if meal replacements, such as Jenny Craig products, are a good idea to help with weight loss. Which of the following would be the nurse's best response? a. they are a great way to control portions and can help you adhere to your diet when used as suggested. b. they are gimmicks that fail to teach you how to control your own intake. they are not recommended. c. most people gain weight while using them. you should stay away from them. d. they are not nutritionally balanced so you actually have to overeat in order to meet your nutritional requirements if you use them.
a
which of the following increases the risk of dumping syndrome after bariatric surgery? a. consuming high sugar foods or fluids with meals b. not chewing food thoroughly c. inadequate protein intake. d. eating too frequently
a
What is sucrose?
a disaccharide made of glucose and fructose
define glycemic load
a food's impact on blood glucose levels
which groups are adolescents most likely to eat in inadequate amounts? select all that apply. a. whole grains. b. vegetables. c. fruits. d. meats
a, b, c
A woman at 5 weeks of gestation is complaining of nausea throughout the day. What should the nurse recommend? a. small frequent meals of easily digested carbohydrates. b. small, frequent meals that are high in protein. c. a liquid diet until the nausea subsides. d. a low fiber intake
a.
a woman who was at her healthy weight when she got pregnant is distraught by her 4-pound weight gain between 20 and 24 weeks of gestation. At this point in her pregnancy, her total weight gain is right on target. What is the nurse's best response? a. a 4 pound per month weight gain at this point in your pregnancy is normal. b. although it is considered less than the recommended amount, it is not a cause for concern. Just be sure to follow your meal plan next month so you get enough calories and nutrients. c. i recommend you write down everything you eat for a few days so we can identify where the problem lies. d. a 4 pound weight gain in 1 month at this point in your pregnancy may be a sign that you are at risk for pre-eclampsia. you should cut back on the extras in your eating pattern to limit your weight gain for next month.
a.
calorie requirements during adolescence a. are higher than during adulthood because of growth and developmental changes. b. peak early and then fall until adulthood is reached c. are lower than during childhood. d. cannot be generalized because individual variations exists.
a.
what nutrients is not likely to be consumed in adequate amounts during pregnancy so a supplement may be needed? a. iron b. calcium c. vitamin B12 d. Vitamin C
a.
when developing a teaching plan for a client who is lactose intolerant, which of the following foods would the nurse suggest as sources of calcium the client could tolerate? a. cheddar cheese, bok choy, broccoli b. spinach, beet greens, skim milk c. poultry, meat, eggs d. whole grains, nuts and cocoa
a.
which of the following recommendations would be most effective at helping a client maximize iron absorption? a. drink orange juice when you eat iron-fortified breakfast cereal. b. avoid drinking coffee when you eat red meat. c. drink milk with all meals. d. eat dried peas and beans in place of red meat.
a.
ARDS
acute respiratory distress syndrome -give small frequent meals
what are intermittent tube feedings
administered in equal portions at selected interval. 250-400 mL over 30-45 minutes 4-6 times a day
what is the basic building block of protein
amino acids (there are 20 common amino acids)
what can a deficiency of vitamin B12 cause
anemia
where is cholesterol found
animal products except egg whites
what is a common cause of foodborne illnesses
animal proteins and cross contamination
what are 2 complete proteins
animal proteins and soy proteins
which foods is sterol found in
animals
what does protein synthesis do
assembles amino acids into proteins the body needs
a healthy, young adult client asks how much water he should drink daily. Which of the following would be the nurse's best response? a. The old adage is true: drink eight 8-oz glasses of water daily. b. Drink to satisfy thirst and you will consume adequate fluid. c. you can't over-consume water, so drink as much as you can spread out over the course of the day. d. it is actually not necessary to drink water at all. it is equally healthy to meet your fluid requirement with sugar-free soft drinks.
b
a major reason why it becomes increasing difficult to keep losing weight on a weight loss diet is that a. the loss of fat tissue lowers metabolic rate. b. a lighter body expends fewer calories than a heavier body when doing activity. c. fluid retention becomes an issue over time. d. a decrease in food intake means that fewer calories are used to metabolize food.
b
the nurse know her instructions about introducing solids into the infant's diet have been effective when the mother state a. babies should be introduced to solid foods at 1-3 months of age. b. new foods should be given for at least 2-3 days so that allergic responses can be easily identified. c. infants are more likely to accept infant cereal for the first time if it is mixed with breast milk or formula and given from a bottle. d. the appropriate initial serving size for solids is 1-2 tbsp.
b
when instituting nutrition therapy for a client diagnosed with AN, the priority is to a. teach the client about nutrient and calorie requirements b. halt or restore weight lost. c. normalize eating behaviors. d. halt purging behaviors
b
when is the period of "physiologic anorexia"? a. age 0-12 months b. age 1-2 years c. 2-3 years d. 3-4 years
b
which of the following calorie level ranges is considered appropriate for weight loss diets for most women? a. 1800 to 2000 cal/day b. 1200 to 1500 cal/day c. 1000 to 1200 cal/day d. 800 to 1000 cal/day
b
which of the following metabolic abnormalities are associated with refeeding syndrome? a. hyperphosphatemia b. thiamin deficiency c. hypocalcemia d. hyponatremia
b
which of the following strategies promotes adherence to exercise? Select all that apply. a. promote structure by encouraging the client to exercise at on-site or supervised exercise sessions. b. encourage the client to exercise in multiple short bouts (10 minutes each), instead of one long session. c. encourage a more active lifestyle, such as parking far away from the door when going to the mall or work. d. encourage the client to exercise at home.
b, c, d
Mrs. M., a 30 year old, presents at the labor and deliver suite in active labor. Her prenatal history reveals that Mrs. M was overweight at conception and has gained more than the recommended amount of weight during her pregnancy. What is her infant at risk for later in life? Select all that apply. a. iron deficiency anemia b. type 2 diabetes mellitus c. obesity d. asthma e. cancer
b, c, d, e
A woman trying to become pregnant was told by her physician to take daily supplements containing 400ug of folic acid. She asks why a supplement is better than eating folic acid through food. Which statement is the nurses' best response? a. there are few natural sources of folate in food. b. synthetic folic acid in supplements and fortified foods is better absorbed, more available, and a more reliable source than the folate found naturally in food. c. folate in food is equally as good as folic acid supplements. It is just easier to take it in pill form and then you don't have to worry about how much you are getting in food. d. if you are sure that you eat at least five servings of fruits and vegetables every day, you don't really need to take a supplement of folic acid.
b.
The client asks if it is okay for her to follow a low carb, atkins type diet in the short term to get her started on weight loss efforts. Which of the following would be the nurse's best response? a. no, low carb diets are not healthy and would only sabotage your weight loss efforts. b. an atkins type diet can help you lose weight as can many other types of diets. the important factor that determines whether you lose weight is the number of calories you eat, not the proportion of carbohydrates, protein, and fat you eat. c. a low carb diet is better than any other type of diet and is a good choice for you to use. d. a low fat diet is easier. try that instead.
b.
when should nutrition support be initiated in a critically ill patient who is at high nutrition risk upon admission to the ICU? a. within 24 hours b. within 24 to 48 hours c. within 3 days d. within the first week
b.
which of the following recommendations would be most effective at increasing potassium intake? a. choose enriched grains in place of whole grains. b. eat more fruits and vegetables. c. eat more seafood and poultry in place of red meat. d. because there are few good dietary sources of potassium it is best obtained by taking potassium supplements.
b.
which of the following statements indicates that the pregnant woman understands the recommendations about caffeine intake during pregnancy? a. i have to give up drinking coffee and cola. b. i will limit my intake of coffee to about 12oz a day and avoid other sources of caffeine. c. as long as i don't drink coffee, i can eat other sources of caffeine because they don't contain enough to cause any problems. d. caffeine is harmless during pregnancy, so I am allowed to consume as much as I want.
b.
which of the following would be the best snack for a 2 year old. a. popcorn b. banana slices. c. fresh cherries d.. raw celery.
b.
The client asks if the cholesterol in shrimp is the "good" or "bad" type. Which of the following would be the nurse's best response? -All cholesterol is bad cholesterol. -bad and good refer to how cholesterol is packaged for transport through the blood. The cholesterol in food is unpackaged and neither bad nor good. -Good cholesterol is found in plants; bad cholesterol is found in animal sources. -Shrimp has good cholesterol because it is low in saturated fat; foods high in cholesterol and saturated fat are a bad source of cholesterol.
bad and good refer to how cholesterol is packaged for transport through the blood. The cholesterol in food is unpackaged and neither bad nor good.
define glucose metabolism
balance between catabolism and anabolism
where does digestion of protein begins and where is the principal site of protein digestion
begins in the stomach, small intestine is the principal site of protein digestion
How are enteral formulas classified?
by the type of protein they contain
Why may underfeeding critically ill patients be beneficial? a. because it provides less work for the GI tract to do b. because all methods of measuring a person's energy expenditure overestimate their needs so a lower calorie load is a prudent approach c. because it provides fewer substrates for the body to make proinflammatory molecules and has a positive effect on hyperglycemia d. because it causes stress hormone levels to drop
c
one of the treatments for obesity is behavior modification. which of the following is an aspect of behavior modification? a. stimulus recognition b. professional monitoring c. cognitive restructuring d. problem identification
c
what does a spike in C-reactive protein indicate in people with acute metabolic stress? a. protein needs are not being met b. protein intake is adequate c. an inflammatory response is occurring d. the inflammatory response has ended
c
what is the primary intervention in the initial postburn period? a. PN b. supplements of trace elements c. fluid and electrolytes d. a low carbohydrate diet to decrease CO2 production
c
when instituting nutrition therapy for a client diagnosed with BN, the priority is to a. teach the client about nutrient and calorie requirements b halt weight loss c. normalize eating behaviors d. provide sufficient calories for weight gain
c
which of the following strategies will increase protein density? a. using whipped cream in place of milk in coffee b. spreading cream cheese on hot bread c. using plain yogurt in place of sour cream d. using mayo in place of salad dressing
c
Which of the following statements is true? a. women who breastfeed almost always achieve their pre-pregnancy weight at 6 weeks postpartum. b. weight loss during lactation is not recommended because it lowers the quantity and quality of breast milk produced. c. breastfeeding women do not have to increase their intake by the full amount of calories it costs to produce milk because they can mobilize fat stored during pregnancy for some of the extra energy required. d. women do not need to increase their calorie intake at all during the first 6 months of breastfeeding because they can use calories stored in fat to produce milk.
c.
a client asks why eating less sodium is important for healthy people. the nurse's best response is a. low sodium diets tend to be low in fat and therefore may reduce the risk of heart disease. b. low sodium diets are only effective at preventing high blood pressure, so the time to implement a low sodium diet is when you are healthy. c. there is a positive relationship between higher sodium intake and the risk of high blood pressure lowering sodium intake may help prevent or delay high blood pressure d. low sodium diets are inherently low in calories and help people lose weight, which can help prevent a variety of chronic diseases
c.
a client with osteoporosis was advised to drink 3 glasses of milk daily to increase her calcium intake. She wants to know why she can't take calcium supplements. the nurse's best response is a. calcium supplements are a better idea than drinking more milk because milk provide calories. Just be sure to take the doses spread out over 3 meals. b. calcium supplements should be avoided because they raise blood levels of calcium to an unhealthy level. c. calcium is best obtained from foods, not pills, and fat-free milk is one of the best options. d. it is hard to consume enough calcium through pill form only.
c.
at her first prenatal visit, an overweight woman asks how much weight she should gain during the course of her pregnancy. what is the nurse's best response? a. you should not gain any weight during your pregnancy. You have adequate calorie reserves to meet all the energy demands of pregnancy without gaining additional weight. b. you should try to gain less than 15lbs. c. aim for 15-25 lb weight gain. d. the recommended weight gain for your weight is 25-35 lbs.
c.
the client ask if her 10 year old daughter needs a weight loss diet. Which of the following would be the nurse's best response? a. rather than a diet at this age, you should just forbid her to eat sweets and empty calories. b. because prevention of overweight is more effective than treatment, you should start to limit her calorie intake by only serving low-fat and artificially sweetened foods. c. ten year old girls are about to enter the grown spurt of puberty, and it is natural for her to gain weight before she grows taller. Diets are not recommended for children, although healthy eating and moderation are always appropriate. d. she needs extra calories for the upcoming growth spurt, so you should be encouraging her to eat more than she normally does.
c.
what should you tell the client about taking mineral supplements. a. most Americans are deficient in minerals, so it is wise to take a multimineral supplement. b. like water-soluble vitamins, if you consume more minerals than your body needs, you will excrete them in the urine, so do not worry about taking too much. c. if you do not have a mineral deficiency, taking supplements can lead to a potentially excessive intake that can cause adverse health effects. d. mineral deficiencies do not exist in the U.S., so you do not need to waste your money on them.
c.
which major mineral is the most abundant in the human body
calcium
list the major minerals
calcium, chloride, magnesium, phosphorus, potassium, sodium, sulfur
Fiber may impair the absorption of some minerals. Which minerals?
calcium, zinc and iron
what is a consistent carbohydrate diet
calories based on attaining or maintaining weight. high fiber intake, limited sodium.
what are amino acids composed of
carbon, hydrogen, oxygen, nitrogen
fat catabolism
catabolism of fatty acids increases with carbohydrate intake is inadequate (e.g. while on a very low-calorie diet) without adequate glucose, the breakdown of fatty acids is incomplete and ketones are formed which can lead to ketosis and acidosis
which trace mineral enhances the action of hormone insulin to help regulate blood glucose levels
chromium
what are modified consistency diets
clear liquids mechanically altered diets
what is the best source of n-3 fatty acid
cold water fish -plant forms are walnuts, soybeans, flaxseeds and canola oil
what contributes to obesity?
combination of genetic and environmental factors
What is food biotechnology?
combines plant science with genetics to improve food. GMO
how is nitrogen balance determined
comparing amount of nitrogen consumed with amount of nitrogen excrete. it reflects the state of balance between protein breakdown and proteins synthesis
what is the continuous drip method for EN
constant rate over 24 hours to maximize tolerance and nutrient absorption. most common for critically ill clients. should be interrupted every 4 hours for 20--30 mL of water to be infused into the line
what are cyclic feedings
continuous drip feedings over a constant rate of 8-20 hours. head of bed more than 30 degrees to prevent aspiration
where is access protein stored*
converted to fatty acid and stored in adipose tissue
List some polyunsaturated fats
corn, soybean, safflower, and cottonseeds oils, and fish
what are cardiovascular disease risk factors?
coronary heart disease stroke hypertension high blood cholesterol
The nurse knows that instructions have been effective when the client verbalizes that a source of complete, high-quality protein is found in -Peanut butter -black-eyed peas -cottage cheese -corn
cottage cheese
the nurse knows her instructions on healthy eating during pregnancy have been effective when the woman verbalized she should. a. avoid seafood because of its mercury content. b. eliminate coffee and other sources of caffeine. c. increase her intake of milk to 4 cups/day d. eliminate hot dogs and deli meats unless heated to steaming hot immediately before eating.
d
what causes refeeding syndrome in patients who are fed after being in a catabolic state a. a dramatic increase in fluid intake b. a dramatic increase protein intake c. a dramatic increase in fat intake d. a dramatic increase in carbohydrate intake
d
In a burned patient with a functional GI tract, why is enteral nutrition preferred over parenteral nutrition? A.) Because enteral nutrition can provide higher amounts of calories and protein B.) Because enteral nutrition is less likely to interfere with oral intake C.) Because enteral nutrition is less expensive D.) Because enteral nutrition has a lower risk of infectious complications
d.
a client says he never adds salt to any foods that his wife serves, so he believes he is consuming a low sodium diet. which of the following is the nurse's best response? a. if you don't add salt to any of your foods, you are probably eating a low sodium diet. continue with that strategy. b. even though you aren't adding salt to any of your foods at the table, your wife is probably salting food as she cooks. she should stop doing that. c. lots of foods are naturally high in sodium, such as milk and meat; in addition to not using a salt shaker, you must also limit foods that are naturally high in sodium. d. the major sources of sodium are processed and convenience foods. limiting their intake makes the biggest impact on overall sodium intake.
d.
nutrients most likely to be deficient in an adolescent's diets are a. vitamin a and folate b. protein and vit c c. zinc and phosphorus d. iron and calcium
d.
which statement indicates the mother understands the nurse's instructions about breastfeeding? a. breastfeeding should only last about 5 minutes on each breast. b. sometimes, babies cry just because they are thirsty, so a bottle of water should be offered before breastfeeding begins to see if the infant is just thirsty. c. the longer the baby sucks, the less milk I will have for the next feeding. d. the first breast offered should be alternated with each feeding.
d.
what determines the intensity of the stress response
depends to some extent on the cause and/or severity of the initial injury
How are ingredients listed on a food label?
descending order by weight
what are nutrient content claims
describe the level or amount of a nutrient in food product
define nutritional screening
detects actual or potential malnutrition based on criteria quick look at a few variables to judge a client's relative risk for nutritional problems
What is glucose also known as?
dextrose
What does DAT stand for?
diet as tolerated
how are disaccharides digested
disaccharidase enzymes split disaccharides into monosaccharides
how often is the DGA published
every 5 years
what strategies promote exercise adherence
exercise at home exercise in multiple short bouts (10 minutes each) adopt a more active lifestyle
Comprehensive lifestyle treatment for obesity is appropriate only when body mass index (BMI) is =< 30.
false
People with a BMI >30 who are not ready to make lifestyle changes should be treated with medication to achieve weight loss.
false
True/False Coloring tube-feeding formulas with food dye helps to prevent aspiration
false
True/False. Drugs and supplements are regulated and marketed in the same manner.
false
True/False: Food label serving size is equivalent to the serving size from MyPlate
false
for weight loss, it is better to cut carbohydrates than to cut fat grams
false
t/f "Natural" vitamins are superior to "synthetic" ones.
false
t/f A high protein intake over time leads to kidney damage.
false
t/f Daily use of a multivitamin reduces the risk of cardiovascular disease and cancer.
false
t/f Natural folate in foods is better absorbed than synthetic folic acid added in foods.
false
t/f Protein is found in all MyPlate groups.
false
t/f Protein is the nutrient most likely to be deficient in a purely vegetarian diet.
false
t/f Sugar causes hyperactivity in kids.
false
t/f Sugar is higher in calories that starch
false
t/f The safety of nonnutritive sweeteners is questionable.
false
t/f U.S. Pharmacopoeia (USP) on a label of vitamin supplements means that the product is safe.
false
t/f Vegetarian diets are not adequate during pregnancy
false
t/f With vitamin supplements, the higher the price, the better the quality.
false
t/f adequate weight gain during pregnancy ensures delivery of a normal-weight baby.
false
t/f high-fat, low carbohydrate EN formulas are recommended for patients with acute respiratory failure because they yield less carbon dioxide when metabolized than standard formulas.
false
t/f in critically ill patients, bowel sounds must be present before EN support can begin.
false
t/f it is recommended that overweight women who gain less than the recommended amount of their BMI increase their weight gain to decrease the risk of adverse pregnancy outcomes.
false
t/f vitamins provide energy
false
true/false A dietary intake of "fish oils" is essential.
false
true/false Menu items described as being "cooked in vegetable oil" are trans fat free.
false
true/false The risk of consuming mercury from fish outweighs any potential benefits for the general population.
false
true/false All oils are predominately unsaturated fats
false,
t/f consuming at least 1/2 of grain servings from whole grains can lower the risk of atherosclerotic cardiovascular disease by 10%-15%.
false, 14%-23%
a general calorie target to produce weight loss in men is 1200 to 1500 cal/day.
false, 1500-1800
t/f Protein accounts for 30% of adult weight.
false, 20%
t/f predictive formulas are just as accurate as indirect calorimetry in determining a patient's calorie requirements.
false, IC is the gold standard for determining calore requirements; however, it is not routinely performed. predictive formulas are not routinely performed. A simple weight based formula such as 25-30 cal/kg is often used.
A weight loss of 10% of initial weight is needed to achieve improvements in cardiovascular disease risk factors.
false, as little as 3-5%
true/false the majority of foodborne illnesses are caused by parasites
false, by bacteria
t/f People should cut down on sodium and potassium.
false, cut down on sodium, increase potassium
t/f All vitamins need to be consumed on a daily basis.
false, fat soluble vitamins are stored and do not need to be consumed daily. Water soluble vitamins are not stored and need to be consumed daily.
t/f Recent studies suggest that nutritional deficiencies during the second trimester increase the risk of chronic diseases later in the infant's life.
false, first trimester.
t/f Obese women should not gain weight during pregnancy.
false, gain about 11-20 lb
true/false All fats are bad fats.
false, good fats- polyunsaturated and monounsaturated fats
t/f Everyone should decrease fiber and sugar in their diet.
false, increase fiber and decrease sugar
True/False: The %DV listed on food labels is accurate for everyone.
false, it is based on a 2000 calorie diet
t/f Healthy adults are in a state of positive nitrogen balance.
false, neutral
T/F: Cholesterol is an essential nutrient
false, not an essential nutrient
t/f Maltose is abundant in natural foods.
false, not found naturally in food
t/f incomplete proteins lack 3 or more amino acids*
false, one of more amino acid
t/f pregnant and lactating women are advised to eliminate fish and seafood from their eating patterns to avoid mercury contamination.
false, only select fish
t/f Maltose is naturally found in foods.
false, out of the disaccharides lactose and sucrose are naturally found in foods.
t/f Trans fat raises LDL and HDL
false, raises LDL and lower HDL
t/f It is common to need mineral supplements
false, rare to need mineral supplements
t/f Protein-energy malnutrition PEM kwashiorkor occurs secondary to chronic disease.
false, results mainly from acute critical illness. aggressive nutritional support is used.
True/False. Supplement strength is standardized.
false, strength and dosages is not standardized
t/f to get enough calcium during pregnancy, women need to double their usual intake of milk.
false, the RDA does not increase
t/f The body stores extra amino acids in muscle tissue.
false, the body is unable to store amino acids for later
t/f All minerals consumed in excess of need are excreted in the urine.
false, the body rids itself of some excess minerals such as sodium and potassium through urinary excretion, homeostasis of other minerals is achieved by adjusting the rate of mineral absorption
t/f A protein classified as "high quality" has the majority of calories provided by protein with few fat or carbohydrate calories.
false, the quality of a protein is determined by the balance of essential amino acids provided
t/f Serum levels of the proteins albumin and prealbumin are used to identify malnutrition in critically ill patients.
false, they change in response to inflammation
t/f Too much trace minerals are more deadly than too little.
false, too little of trace mineral can be just as deadly as too much
True/False. Supplements require warning labels
false, warnings are not required.
t/f patients with burns covering 10% of total body surface area have calorie and protein requirements that are too high to be met with an oral intake alone.
false, when TBSA exceeds 20% EN is needed
t/f Women and men are equally likely to be iron deficient.
false, women are more likely
t/f A chronically low intake of calcium leads to hypocalcemia
false.
t/f calcium supplements are a safe and effective way to ensure an adequate calcium intake.
false.
t/f in previously well-nourished patients, it is better to overfeed than underfeed when initiating feedings during critical care.
false.
t/f like vitamins, the mineral content of food can be destroyed by light, heat, or acids during food preparation.
false.
t/f all plants are sources of incomplete proteins
false. all plants except soy and quinoa proteins
t/f Sodium is the most plentiful mineral in the body. *
false. calcium.
True/False The terms fiber and residue are synonymous.
false. fiber refers to carbohydrates not digested in the GI tract. Residue is composed of fiber along with undigested food, intestinal secretions, bacterial cell bodies, and cells from intestinal lining.
True/False Osmolality is primary consideration in selecting appropriate enteral formula.
false. for most people, osmolality does not affect tolerance.
t/f adults need eight 8oz glasses of fluid daily to meet their requirement for fluid,
false. hydration is unconsciously maintained over a wide range of intakes with ab lib access to water.
t/f Protein is the nutrient most needed when solids are introduced into the diet.
false. iron is the nutrient most needed when solids are introduced into the diet.
(T/F) Major minerals are more important for health than trace minerals.
false. it refers to the relative quantity, not the importance.
true/false the water temperature does not mater for a water flush with EN feeding
false. it should be warm water
true/false Patient tolerance is improved when oral intake progresses slowly after surgery from a clear liquid diet to regular diet.
false. most patients can tolerate a regular diet by the first or second postoperative meal.
true/false It is ok to give medications at the same time as tube feeding
false. stop feeding and flush with 10-30 mL of water. only give 1 drug at a time
t/f the 2015-2020 Dietary Guidelines for Americans do not apply to children, only adolescents and adults.
false. the 2015-2020 Dietary Guidelines for Americans are intended for all healthy Americans over the age of 2 years.
True/False The biggest source of calories in parenteral nutrition infusions is protein.
false. the biggest source of calories in PN infusions is carbohydrates.
t/f Peanut products should not be introduced in the diet until after the age of 12 months to reduce the risk of allergy.
false. to reduce the risk of allergy, it is recommended peanut products be introduced in the diet between 4 and 11 months of age in infants with high risk of allergy.
true/false One of the criteria for the diagnosis of severe malnutrition in a patient with chronic illness is a weight loss of >5% in the previous 6 months.
false. weight loss of >5% in the previous 1 months.
Are vitamins A, D, E, and K fat-soluble or water-soluble?
fat-soluble
what is an alternative source of omega-3 fats
fish oil pills
what is the priority of the initial postburn period
fluid and electrolyte replacement to maintain adequate blood volume and BP
which trace mineral helps developing tooth enamel
fluoride
How can diet quality be assessed?
following dietary recommendations healthy eating patterns
When are hydrolyzed enteral formulas used?
for malabsorption problems. nutrients are partially or completely broken down to simplest form
what do completely hydrolyzed formulas contain for protein
free amino acids
Which sugar is easily digested and converted to glucose
fructose "Fruit sugar"
What combines with glucose to form lactose?
galactose
which organ produces bile to break down fat
gallbladder
what are long term enteral accesses
gastrostomy jejunostomy
what is the component of all disaccharides
glucose
whatcarbohydrate is the brain dependent on for energy
glucose
what is starch made of
glucose not used by plants
List 3 monosaccharides
glucose, fructose, galactose
what is a common symptom of iodine deficiency
goiter
What food groups provide carbohydrates
grain, veggies, fruits, and dairy
Where is Vitamin A found?
green leafy forages and animal sources
What are the functions of protein
growth, maintenance, antibodies, acid/base, transport, energy, fluid/electrolyte balance, blood clotting, building body compounds
What is the difference between structure/function claims v. health claims on food labels?
health claims requires approval from the FDA and must show proof that is can do what it is saying. structure/function claim does not need approval but cannot state that the product will help with a disease.
What are the four of the 10 leading causes of death in the US related with dietary excesses?
heart disease cancer stroke diabetes
what is the best predictor for weight maintenance after loss?
how long someone has kept his or her weight off
define nutritional assessment
in-depth analysis of a person's nutritional status
Why are saturated fats bad?
increase LDL
how much should a woman increase her iron during pregnancy
increase from 18 to 27 mg/day during pregnancy
what is the best diet?
individualized
Are minerals organic or inorganic?
inorganic
what are complications of obesity?
insulin resistance type 2 diabetes hypertension dyslipidemia cardiovascular disease stroke gallstones cholecystitis sleep apnea respiratory dysfunction increased risk of cancer
what is needed to assess adequacy of water intake
intake and output
What is bolus feeding?
intermittent feeding delivered with a syringe into the stomach within 5-15 minutes. no more than 500 mL at a time
what are the nutrients of concern for vegetarians
iron, zinc, calcium, vitamin D, omega-3 fatty acid, and iodine
what happens to glucose when is has no where to go?
it is converted into fat
Is there laboratory test that can prove malnutrition?
laboratory values may help support a diagnosis but there is no single test that can prove malnutrition
what are the underlying concepts of healthy eating
limiting calories nutrient density portion size serving size variety
why is glucose released?
liver releases glucose to maintain blood sugar levels.
define food deserts
living more than 1 mile from a supermarket in an urban area and more than 10 miles from a supermarket in a rural area
What is LDL
low-density lipoprotein
What does unsaturated fat do?
lower LDL cholesterol
What do fish oils do?
lower risk of heart disease by the anti-inflammatory, anti-clotting, and anti-arrhythmia effects
what is the function of vitamin D
maintains blood calcium and phosphorus levels -important for immune function
where would you find heme iron
meat, fish and poultry
List 3 sources of consumer confusion with healthy nutrition
media, the internet, and the food industry
What is a common issue after bariatric surgeries?
micro-nutrient deficiencies
What food allergens must be listed on a food label
milk eggs fish shellfish tree nuts peanuts wheat soybean
what foods contribute riboflavin
milk and dairy
MNA-SF stand for
mini nutritional assessment short form
what type of diet is a dysphagia diet
modified consistency
what does glutamine do after illness or injury
modulate the inflammatory response and helps prevent organ injury
what plan does the nurse take after an nutritional assessment?
monitoring evaluating education
what is the only form of carbohydrates that the body is able to absorb intact?
monosaccharides
What are the classifications of carbohydrates
monosaccharides, disaccharides, polysaccharides
Can the signs of malnutrition be used as a diagnostic?
most signs cannot be considered diagnostic
define protein sparing
need to consume adequate carbohydrates
define fat anabolism
newly absorbed fatty acids recombine with glycerol to form triglycerides that end up stored in adipose tissue
What are some nursing interventions with poor nutrition?
nutrition therapy client teaching monitoring and evaluation
What are some health problems related to dietary excesses?
obesity hypertension hypercholesterolemia
what are some monounsaturated fats
olives, olive oil, canola oil, peanut oil, avocado, cashews, almonds, and other nuts
Are vitamins organic or inorganic?
organic
What is obese BMI?
over 30
What color of urine signals that intake is adequate
pale yellow
what do partially hydrolyzed formulas contain for their protein
partially broke down protein
what are protein isolates
partially broken down proteins
enteral nutrition is a way of providing nutrition for people who have an inadequate oral intake. What is the other criteria for enteral nutrition?
partially functioning GI tract
what factors influence how and what is used to feed patients with EN
patient's calorie and protein requirements ability to digest nutrients feeding route characteristics of formula equipment available method of delivery
What are PEG tubes
percutaneous endoscopic gastrostomy
what kind of diet is suggested for optimal fat intake
plant based diet with fruit, veggies, whole grains, legumes, and nuts with adequate amounts of fat-free dairy products and lean meats. 8oz or or more of seafood
where would you find nonheme iron
plants
what is a major function of zinc
plays important roles in immune system functioning and in wound healing
define major minerals
present in the body in amounts greater than 5g
Why is folic acid important during pregnancy?
prevents neural tube defects
what would qualify a client for tube feeding
problems chewing and swallowing prolonged lack of appetite obstruction, fistula, or altered motility in the upper GI tract are in coma have high nutrient requirements
where do Americans get most of their sodium
processed foods
what makes food organic
produced without fertilizers or pesticides and no antibiotics or hormones.
What are dietary supplements?
products that contain one or more dietary ingredients including vitamins, minerals, herbs or botanicals, amino acids, and other substances
What is albumin used to assess in regards to nutrition?
protein status
define nitrogen balance
protein synthesis is occurring at the same rate as protein breakdown
describe the healthy vegetarian eating plan
proteins from eggs, soy products, legumes, nuts, and seeds high in whole grains, calcium, and fiber less vit d
function of fat
provide energy, insulation, protection, and promotes absorption of the fat-soluble vitamins
Define a healthy diet.
provides enough of all essential nutrients to avoid deficiencies but not excessive amounts
Why is iron important during pregnancy?
provides iron for fetal liver storage, which sustains the infant for the first 4-6months of life
what does the dietary guidelines for americans do
put forth federal policies on nutrition, dictating how education, communication, and food assistance programs are conduced
what does the USP stamp ensure
quality of supplements, but safety or benefits
what are the four most basic questions for a nutritional screening?
recent weight loss recent food intake current BMI disease severity
what can oral diets be categorized as
regular modified consistency therapeutic
What is required for a grain to be considered enriched
required to be fortified.
describe a healthy mediterranean style eating pattern
resembles a mediterranean diet lower in calcium and vit d high in unsaturated fat, fruits, seafood
What can a deficiency in vitamin D lead to?
rickets and osteomalacia
which of the following are the best sources of omega-3 fatty acids? -salmon and trout -flaxseed and walnuts -olive and canola oils -cod fish and haddock
salmon and trout
What should be limited in a person's diet
saturated fat, trans fats, and sugars
A client asks why lowering saturated fat intake is necessary for lowering serum cholesterol levels. Which of the following is the nurse's best response? -saturated fats raise the "bad" cholesterol levels more than any other dietary fat. -sources of saturated fat also provide monounsaturated fat, and both should be limited to control blood cholesterol levels. -saturated fat is high in calories, and excess calories from any source increase the risk of high blood cholesterol levels. -saturated fats make blood more likely to clot, increasing the risk of heart attack.
saturated fats raid the "bad" cholesterol levels more than any other dietary fat.
List the trace minerals
selenium, fluoride, iodine, chromium, manganese, iron, zinc, copper, molybdeum
what are some behavior modification strategies
self monitoring goal setting stimulus control problem solving cognitive restructuring relapse prevention
serving size vs portion size
serving size is the amount recommended Portion size is the amount frequently assumed
List what is included on the food labels
servings per container servicing sizes calories per serving %DV (fats, cholesterol, sodium, total carbohydrate, sugar, protein) Vitamins foot note explain %DV based off 2000 calorie diet
What fish should pregnant women avoid?
shark, swordfish, king mackerel and tilefish. large game fish
what is a clear liquid diet
short term, composed only of fluids that are transparent and liquid at body temperature
who is encouraged to increase their vitamin C intake
smokers
Which mineral is responsible for regulating fluid in the body?
sodium
best source of magnesium
spinach
List 3 types of polysaccharides
starch, glycogen and fiber
Name some polysaccharides
starch, glycogen, fiber
What are some reasons for malnutrition
starvation chronic disease acute disease
What is the definition of health?
state of complete physical, mental, and social well-being, not just absence of disease
how do you transition from EN feeding to an oral diet
stop feeding 1 hour before meal increase meal frequency slowly up to 5 small meals intake should be recorded tube feeding should only be given nightly once oral intake reaches 500-700 cal/day stop tube feeding when client consumes 2/3 of protein and calorie needs and 1000 mL fluid orally for 3 straight days
List 3 disaccharides
sucrose, lactose, maltose
what is SIRS
systemic inflammatory response syndrome, caused by infection and may lead to sepsis
who sets the health care standards and accredits health care facilities?
the Joint Commission
What should the nurse tell the client who likes fish but refuses to eat it because the fear of mercury poisoning? -you are justified to be concerned. To be safe, use fish oil supplements instead. -you can eat as much fish as you want because most fish are not contaminated with even small amounts of mercury. -the benefits of eating 8oz/week of variety of fish outweigh any potential risks from mercury. -as a compromise, eat 4oz of fish per week instead of 8oz.
the benefits of eating 8oz/week of variety of fish outweigh any potential risk from mercury
how long should an infant be exclusively breastfed for
the first 6 months
what organ is considered the clearinghouse of protein metabolism
the liver. It retains amino acids and regulates the release of amino acids into the bloodstream. Removes nitrogen from amino acids. converts protein to fatty acids. forms urea from protein
define nutrient density
the most nutrient form of food with the least calories
What is dumping syndrome?
the rapid emptying of the stomach into the small intestines, causing gas, abdominal pain and dizziness
How would you ensure an adequate calcium intake
three daily servings of milk, yogurt, or cheese plus nondairy sources of calcium
where is sugar absorbed
through the intestinal mucosa cells
what is the primary function of fat
to fuel the body
when would a clear liquid diet be used
to maintain hydration to prep for bowel surgery and procedures when oral intake resumes after a prolonged period
what is the priority of nutrition therapy with burn patients
to meet calorie and protein needs -calorie and protein needs increase if complications develop
why is it best to underfeed after a stress response
to prevent refeeding syndrome,
why do food manufacturers add antioxidants or hydrogenate to food.
to prolong shelf life
What is the most consistent benefit of consuming adequate fiber
to relieve or prevent constipation -linked to decrease in heart disease, cancer, diabetes and obesity.
what are short term enteral accesses
transnasal nasogastric nasointestinal
What are the 3 classes of lipids
triglycerides, phospholipids, sterols
Bulimia poses fewer nutritional problems than anorexia does.
true
Changes in metabolism that occur after weight loss make it more difficult to maintain weight loss, especially in the short term.
true
If a person will try only one strategy, lowering calories is more effective at promotion short-term weight loss that increasing activity is.
true
Micro nutrient deficiencies are common after bariatric surgery.
true
Respiratory dysfunction is one of the most common complications of obesity.
true
True/False A continuous drip delivered by a pump is recommended for administering tube feedings to patients who are critically ill.
true
True/False Adult malnutrition may be related to starvation, chronic disease or acute illness or injury.
true
True/False Ingredient listings and Nutrition Facts labels are reliable and accurate by law.
true
True/False Parenteral nutrition can be infused through a peripheral or central vein.
true
True/False Supplements are regulated by the FDA as food.
true
True/False The patient's ability to digest nutrients is a primary consideration when deciding the type of enteral formula to use.
true
True/False. Function claims need to have a disclaimer on their product stating the statement has not been evaluated by the FDA.
true
True/False: Once a product is marketed, the responsibility lies with the FDA to prove danger.
true
people who successfully lose weight are advised to participate in a long-term comprehensive weight loss maintenance program.
true
t/f The body cannot produce as much water as it needs
true
t/f All food fats contain a mixture of saturated, monounsaturated, and polyunsaturated fatty acids.
true
t/f Another name for glucose is dextrose, and it is the sugar into which the body makes all digestible carbohydrates.
true
t/f Because under consumption is linked to adverse health outcomes, Americans' low intake of vitamin D is a public health concern.
true
t/f Carbohydrates provide the majority of calories in almost all human diets.
true
t/f Deficiencies of essential fatty acids are rare in healthy people
true
t/f Enteral Nutrition (EN) is the preferred method of nutrition support in critically ill patients if the gastrointestinal (GI) tract is functional.
true
t/f FDA labeling must include trans fat
true
t/f For most critically ill patients, protein requirements are proportionately higher than calorie requirements.
true
t/f In the U.S., protein-energy malnutrition (PEM) occurs most often in hospitalized patients, especially older patients,
true
t/f Insulin is a hormone.
true
t/f Most Americans eat more than their Recommended Dietary Allowance (RDA) from protein.
true
t/f The quality of soy products is comparable to or greater than that of animal proteins.
true
t/f There is no dietary source of glycogen
true
t/f Under optimal conditions, vitamin D is not an essential nutrient because the body can make all it needs from sunlight on the skin.
true
t/f an important source of folic acid is ready-to-eat breakfast cereal
true
t/f complete proteins have complete amino acids*
true
t/f lactation increases calorie requirements more than pregnancy does
true
t/f minerals cannot be destroyed by light, air, heat, or acids during food prep.
true
t/f most vitamins function as co enzymes to activate enzymes
true
t/f protein is a component of every living cell
true
t/f regardless of pregnancy BMI, it is recommended all women gain 1-4lb curing the first trimester
true
t/f thirst is a good indicator for the need for fluid in most lactating women.
true
t/f underfeeding may be adequate to maintain gut integrity in critically ill patients who are at low to moderate nutrition risk.
true
t/f unsaturated fats lower LDL
true
t/f vitamins are susceptible to destruction.
true
t/f: fiber is not digested by the human digestive tract
true
true/false All sources of fat are a blend of saturated and unsaturated fatty acids.
true
true/false Fat provides more than double the amount of calories as an equivalent amount of carbohydrate or protein.
true
true/false Irradiated food need to be labeled as such.
true
true/false The 2015-2020 Dietary Guidelines for Americans does not include a recommendation to limit cholesterol intake
true
true/false The body makes two or three times more cholesterol than the typical American consumes.
true
true/false. organic foods are regulated by the FDA.
true
true/false: Enteral nutrition can be used with an oral diet
true
true/false: Nutritional screenings can be custom designed for particular populations or disorders.
true
true/false Tub margarine is healthier than butter.
true, because it is lower in saturated fat
t/f Drinking fluids should not be delayed until the sensation of thirst occurs with elderly and children.
true, drinking fluids should be done before this happens
t/f calorie needs do not increase during pregnancy until the second trimester.
true, second semester is an additional 340, third trimester is an additional 452
t/f It is not beneficial for well nourished adults to take multi-vitamin supplements.
true, supplements of individual vitamins may be ineffective or potentially harmful.
t/f For most people, thirst is a reliable indicator of fluid needs.
true.
t/f Stress hormones promote the breakdown of stored nutrients and lean body mass.
true.
t/f foods high in sodium tend to be low in potassium, and foods high in potassium tend to be low in sodium.
true.
t/f like adults, children and adolescents under consume potassium, vitamin D, calcium, and fiber because they do not eat enough fruits, vegetables, dairy, and whole grains.
true.
t/f overweight and obese youth are at risk for the same complications from overweight that afflict adults-namely, type 2 diabetes, high blood pressure, and metabolic syndrome.
true.
t/f trace mineral balance is strongly influenced by interactions with other minerals and dietary factors.
true.
true/false. a client can have EN with a partially functional GI tract
true.
t/f Protein-energy malnutrition PEM marasmus occurs secondary to chronic disease.
true. and nutritional therapy is started slowly.
t/f children who regularly skip breakfast have lower intakes of vitamins and minerals than children who normally eat breakfast.
true. children who regularly skip breakfast have lower intakes of vitamins and minerals than children who normally eat breakfast.
true/false you have to dilute liquid medication with tube feeding
true. dilute with 30 mL of water
t/f If breastfeeding is discontinued before the infant's first birthday, iron-fortified infant formula should be given until 12 months of age.
true. if breastfeeding is discontinued before the infant's first birthday, it should be replaced with iron-fortified infant formula. Cow's milk is not recommended before the age of 1 year.
t/f iron deficiency in young children may be related to drinking too much milk
true. milk can displace the intake of iron-rich foods increasing the risk of iron deficiency.
t/f iron-fortified infant cereal should be the first solid introduced
true. overfeeding is a potential problem with early introduction of solid foods because younger infants are unable to communicate satiety, the feeling of fullness.
t/f Infants have higher requirements per kilogram of body weight for calories and most nutrients than adults do.
true. the amount of calorie and protein needed per unit of body weight is greater for infants than for adults because growth in the first year of life is more rapid than any other times in the life cycle (ecluding the fetal period).
Which of the following sources of protein is lowest in fat? Eggs Ground chicken 80% lean ground beef Turkey breast without skin
turkey breast without skin
what are complementary proteins
two proteins that when combined provide adequate amounts and proportions of all essential amino acids needed to support protein synthesis
what does the healthy us style eating pattern focus on
types and proportions of foods Americans typically consume but in nutrient dense forms and controlled amounts reduced meat and poultry reduced vit d, vit e, potassium and cholrine
How much weight should a woman gain during pregnancy?
underweight- 28-40lb normal weight- 25-35lb overweight- 15-25lb obese 11-20lb
does unprocessed/unrefined foods or processed/refined foods have more minerals?
unrefined/unrpocessed
how should the head of a client be for tube feeding
up 30 degrees min. preferably 45
what are therapeutic diets used for
used for the purpose of preventing or treating disease or illness
what is the purpose of irradiating food?
used to reduce or eliminate pathogens that cause foodborne illness
what is the mini nutritional assessment short form
validated tool for screening older adults
what does healthy eating patterns consist of?
variety balance moderation individually appropriate no foods are prohibited
Are B complex vitamins and vitamin C fat-soluble or water-soluble?
water-soluble
Characteristics of adult malnutrition
weight loss over time inadequate food and nutrition loss of fat mass local or general fluid accumulation measurably reduced hand grip strength
function foods definition
whole foods along with fortified, enriched, or enhanced foods that have a potentially beneficial effect on health when consumed as part of a varied diet
How soon does the nutritional screen need to be done after a pt is admitted to the hospital?
within 24 hours
Which statement indicates the client understands about choosing low-fat foods from MyPlate? -all items within a food group have appropriately the same amount of fat. -you don't have to consciously select low-fat items because the empty calorie allowance will account for higher fat choices. -it is best to eliminate as much fat from the diet as possible. -within each food group, the foods lowest in fat should be chosen most often.
within each food group, the foods lowest in fat should be chosen most often.
when is glycogen depleted during stress responses
within the first 24 hours after the injury
