Ch. 18: Nutrition for Patients with Disorders of the Lower GI tract and Accessory Organs

The nurse is meeting with a client and his caregiver to assess the client's progress with a gluten-free diet. The caregiver appears upset and, when asked, says that the client "cheats" and occasionally eats snacks that contain gluten. The client angrily replies, "I don't get sick, do I? Once in a while, it doesn't hurt." What additional teaching can the nurse provide to this client and caregiver?

"Gluten will damage the villi even if there are no symptoms."

The nurse reviews actions to improve a client's intake of fiber. Which client statement indicates that teaching has been effective?

"I should select whole wheat bread instead of white bread."

The nurse is meeting with a group of student nurses to discuss the importance of reading food labels. The nurse stresses the importance of clients on a low-fiber diet limiting their daily intake of beverages with high-fructose corn syrup to what amount?

12 oz (350 mL)

The nurse is aware that each client has a different definition of the term "constipation." The nurse recognizes that fewer than how many bowel movements in one week meets the criteria for constipation?

3

The nurse is reviewing the diet recommendations with a patient who is going home after receiving an ileostomy. How much fat should this patient's daily diet include?

50% to 60%

The nurse is seeing a client in the clinic who reports unresolved constipation despite following a high-fiber diet. After discussing the situation with him, the nurse determines that the client might not be drinking enough fluids. How much fluid is recommended daily?

64 oz

A client with chronic pancreatitis is prescribed a low-fat diet. Which menu item should the nurse remove from the tray before providing it to the client?

Bacon

The nurse reviews the meal tray for a client experiencing diarrhea. Which item should the nurse remove before delivering the tray to the client?

Coffee

Inflammatory bowel disease (IBD) primarily refers to several chronic inflammatory GI disorders. The nurse recognizes that which of the following is disorders are in this category of bowel disorders?

Crohn disease

The nurse notes that a client with a history of malabsorption syndrome has had two episodes of kidney stones over the last six months. What should the nurse recommend to this client?

Increase the intake of oral fluids

The nurse is aware that an oil is recommended as a source of calories for patients with short bowel syndrome. Which of the following is that oil?

MCT oil

The nurse is aware that Crohn disease and ulcerative colitis are both considered IBD. Which of the following signs and symptoms are found in ulcerative colitis but are not found in Crohn disease? Select all that apply.

Only the intestinal mucosal layer is affected. It is confined to the rectum and colon.

A client desires to increase the amount of fiber in the diet but does not like to eat vegetables. What should the nurse suggest to this client?

Plan meals using legumes

The mother of a 15-year-old client with celiac disease is concerned that her son is not paying attention to what he is eating. The mother says, "When he is with friends, he doesn't want to appear 'different,' so he eats whatever they're eating. Sometimes he gets sick, and sometimes he doesn't." How should the nurse respond?

Reinforce to the client the dangers of eating gluten.

A client with malabsorption syndrome has a poor appetite. Which action should the nurse take for this client?

Schedule small frequent meals

A client has come to the office for a follow-up visit after an exacerbation of his cirrhosis. The nurse notes that he has a 3 percent weight change since he was discharged from the hospital last week. The nurse realizes that this can mean which of the following?

The weight is inaccurate due to the client's hydration status.

A client is being treated for an intestinal bacterial overgrowth. The nurse is aware that the client should be monitored for a deficiency of which nutrient related to this bacterial overgrowth?

Vitamin B12

The nurse is aware that patients with Crohn disease should be monitored for a deficiency involving which nutrient due to the involvement of the ileum?

Vitamin B12

A client has been diagnosed with celiac disease and is meeting with the nurse to discuss treatment options. The nurse should tell the client to anticipate which of the following treatment interventions?

a gluten-free diet.

A client has been diagnosed with IBS and is meeting with the nurse to discuss nutrition therapy. Which of the following will the nurse discuss with this client?

an elimination diet

The nurse is teaching a nutrition class to a group of student nurses. The students were instructed to plan a gluten-free meal. Which of the following menus BEST follows a gluten-free diet?

baked salmon, wild rice, steamed carrots and broccoli, fresh mixed fruit, black tea

The nurse has suggested that a client avoid certain foods while recovering from diarrhea. Which of the following foods should be avoided?

caffeine

The nurse has cautioned a client to be careful of certain foods that can have a laxative effect. Which of the following foods should the nurse caution the client about?

figs

The nurse is meeting with a support group for clients with IBS to discuss dietary changes. The nurse explains that which of the following appears to be a major trigger for IBS?

fructose

A client has been admitted for an exacerbation of his Crohn disease. The nurse explains that he will be receiving enteral feedings to allow his bowel time to rest and recover. The nurse is aware that the hydrolyzed formula will be fortified with which of the following to help minimize fecal volume?

glutamine

A client is to start a low-FODMAP diet to treat her IBS. The nurse stresses the importance of restricting which of the following from the client's diet? Select all that apply.

honey onions legumes

The nurse is encouraging a client to eat a high-fiber diet to help relieve his chronic constipation. The nurse should encourage the client to which of the following?

increase fiber gradually.

The nurse has warned a client that a potential problem with a low-fiber diet is constipation. Which of the following remedies should the nurse suggest to prevent this problem?

increasing fiber in the diet as tolerated

A client is very frustrated that the reason for her GI complaints has not been determined. "How many more tests before someone knows something?" she asks. The nurse suspects that the client's symptoms of bloating, flatus, and diarrhea are MOST likely related to which of the following problems?

inflammatory bowel syndrome.

A client is following a low-fat diet because of chronic pancreatitis. The nurse is aware that the client needs to be monitored for which of the following nutrients to ensure that a deficiency does not develop?

iron

A client has come to the clinic with a report of constipation. After assessing the client and reviewing her history, the nurse determines that which of the following may be the potential cause of the constipation?

iron supplements

A patient is concerned about how he will be able to get enough nutrition if the surgeon removes portions of his bowel. The nurse explains that the major source of nutrition initially after surgery will be which of the following?

parenteral nutrition.

The nurse is seeing a client who would like suggestions for food sources of fiber other than fruits and vegetables. Which of the following can the nurse recommend for this client who is eating a high-fiber diet?

popcorn

A client presents at the clinic with muscle weakness, a 2 week old wound with poor healing , and pedal edema. Laboratory work reveals hypoalbuminemia. The nurse realizes that this client is possibly suffering from malabsorption of which of the following nutrients?

protein.

A client has been faithfully following a gluten-free diet as prescribed but experiencing constipation as a result. The nurse should encourage the client to include which of the following to increase fiber intake? Select all that apply.

quinoa flax seed amaranth

The nurse is meeting with a group of student nurses to discuss high-fiber diets. After the discussion, the nurse asks the students to plan a high-fiber meal. Which of the following menus BEST follows the high-fiber diet guidelines?

roast lamb, brown rice, steamed asparagus, tossed salad, herbal tea, fresh strawberries

The nurse is admitting a patient to the unit with suspected chronic pancreatitis. The nurse recognizes that the hallmark feature of this condition is which of the following?

severe, intermittent epigastric pain often made worse by eating.

The nurse is prepping a patient for a hemicolectomy due to inflammatory bowel disease (IBD). The nurse cautions the patient that which of the following problems may develop secondary to the surgery?

short bowel syndrome

A client is concerned about consuming enough calcium since discovering that she is lactose intolerant. She is having difficulty swallowing calcium supplements. Which of the following sources of calcium is a good substitute for milk?

soy milk

A client is trying to understand what is causing her lactose intolerance. The nurse explains that it is most likely related to which of the following causes?

the enzyme lactase being absent or deficient.

The nurse has been sharing menu ideas with a client who must follow a low-fiber diet after going home. Which menu shows that the client understands the guidelines of a low-fiber diet for a simple lunch?

white rice, sliced turkey breast, cooked carrots, and tea

The nurse is discussing with a group of clients ways to increase fiber in a diet. When reading nutrition labels, the nurse should recommend which of the following should be the first ingredient when trying to increase dietary fiber content?

whole wheat