Ch 35 Nutritional Support Products, Vitamins, & Minerals
A client diagnosed with iron deficiency has been taking oral ferrous sulfate for the past several days. When the nurse is assessing for therapeutic effects, what question is most warranted? "Is your skin feeling itchy when you're at rest?" "Do you feel like you're able to see a bit more clearly now?" "Are you having any leg spasms or restless legs at night?" "How is your energy level compared with a few days ago?"
"How is your energy level compared with a few days ago?"
The nurse instructs a client on the use of prescribed B-vitamin supplements. Which client statement indicates that the teaching was effective? "I'll take the niacin supplement at bedtime." "I can prevent flushing by taking an aspirin after taking thiamine." "A capsule of extended-release thiamine can be opened and sprinkled on food." "It's safe to drive my car after taking the niacin supplement."
"I'll take the niacin supplement at bedtime."
A female client presents to the health care provider's office for her yearly physical examination. When the nurse asks about her current drug regimen, she states that she self-administers megadoses of vitamin C to prevent cancer. Which statement is an appropriate response? "Large doses of vitamin C will also prevent cardiovascular disease." "Large doses of vitamin C will also prevent HIV." "Large doses of single vitamins do not prevent cancer." "You require large doses of multiple vitamins to prevent cancer."
"Large doses of single vitamins do not prevent cancer."
The nurse has just administered oral niacin to a client. What is the most important instruction the nurse can give to this client at this time? "Lie down for about 30 minutes, and then be careful when you sit and stand up." "If your face becomes flushed, it is important not to take any type of medication." "You can expect to feel very cold for the next ten minutes. This will subside in about 10 minutes." "This medication has better absorption if you go for a brisk 10-minute walk."
"Lie down for about 30 minutes, and then be careful when you sit and stand up."
A male client tells the nurse that he obtains all of his nutrients from vitamins. What is the correct explanation the nurse would give this client? "Nutrients are best obtained from foods." "The effectiveness of the vitamins depends on the brand." "You should consult your health care provider for the correct strength of the vitamins." "You cannot obtain enough vitamin B6 from vitamins."
"Nutrients are best obtained from foods."
A nurse is caring for 2-year-old boy who has been admitted for treatment of severe dehydration. The health care provider has ordered IV fluid and electrolyte therapy. When the child's mother asks whether the child can be treated with Pedialyte instead, how should the nurse respond? "I'll see if the provider will allow it." "As soon as this bag of fluids has been infused, we can switch to Pedialyte." "He needs to continue receiving the IV fluids, but I can give him some Pedialyte, too." "Pedialyte isn't a suitable replacement for his current therapy."
"Pedialyte isn't a suitable replacement for his current therapy."
A client asks the nurse about fat-soluble vitamins. Which statement should the nurse include when discussing fat-soluble vitamins with a client? "The body stores fat-soluble vitamin excess to use later." "B1, B3, and B6 are part of the fat-soluble vitamins." "Organic fat-soluble supplements are the best." "Fat-soluble vitamins are only available by supplements."
"The body stores fat-soluble vitamin excess to use later."
An elderly client postoperative hip replacement is experiencing signs of hyponatremia. The nurse checks the client's electrolyte levels. Which of the following serum sodium levels confirms this diagnosis? 150 mEq/L 145 mEq/L 135 mEq/L 130 mEq/L
130 mEq/L
The nurse is admitting a healthy 35-year-old woman to the outpatient surgery department for the removal of a plantar wart. The patient consumes approximately 2,000 cal/day. What is the patient's recommended intake of water? 1,500 mL of fluid per day 1,000 mL of fluid per day 2,000 to 3,000 mL of fluid per day 3,000 to 4,000 mL of fluid per day
2,000 to 3,000 mL of fluid per day
The normal serum value for potassium is 96 to 106 mEq/L. 3.5 to 5.5 mEq/L. 135 to 145 mEq/L. 8.5 to 10.5 mg/dL.
3.5 to 5.5 mEq/L.
The nurse is assessing a client in the clinic who admits to taking megadoses of vitamins, but he is not sure which ones he has been taking. The client presents with hair loss, double vision, headaches, and nausea and vomiting. The nurse suspects that this client has taken a toxic amount of which vitamin? D E A C
A *The symptoms of vitamin A toxicity are double vision, headache, vomiting, hair loss, and dry, itching skin*
It is not always necessary for people to take a vitamin supplement. Who is least likely to need a vitamin supplement? A moderately active adult An elderly woman living alone A housewife on a low-calorie diet A pregnant teenager
A moderately active adult
Water is a vital element for the human body. What is one of its functions? Decreases structure in cells Provides energy for metabolism Serves as an emulsifier for vitamins and glucose Aids in digestion and absorption
Aids in digestion and absorption
An elderly client has been ordered magnesium 483 mg daily orally. The student nurse is about to administer that dose when the nursing instructor questions it. The student states that the regular dose is 54 to 483 mg/day. Why did the instructor question this dose? Because older adults may need a reduced dosage as a result of decreased renal function. To ensure that the student knows medication values well. To be cautious because magnesium interacts poorly with several other drugs. The student should be dividing the single dose in several administrations to improve processing of the medication.
Because older adults may need a reduced dosage as a result of decreased renal function.
Understanding the absorption of fat-soluble vitamins, what substance is necessary to facilitate absorption from the intestine with dietary fat? Mucus Bile salts Dextrose Hepatic enzymes
Bile salts
Trace minerals in the body, though small in quantity, play large roles in its functioning. Trace minerals have been hard to study because of what factor? Bioavailability varies within the context of the total diet Reliable and valid indicators of trace element status are readily available The comparability of trace mineral content of foods is high Food composition data are not necessary for all trace minerals
Bioavailability varies within the context of the total diet
A nurse is caring for a client who is to receive IV potassium. Which action would be appropriate? Inject potassium directly into the client's vein. Use the veins in the back of the hand. Administer the potassium before meals. Ensure that potassium infuses in no less than 4 hours.
Ensure that potassium infuses in no less than 4 hours.
What information should be included in the teaching of a client prescribed enteral nutrition? Select all that apply. It requires the insertion of a feeding tube into the mouth, nose, or directly in the stomach. This nutrition is used when the gastrointestinal (GI) tract is nonfunctional. Tablets should be crushed and mixed with the tube feeding formula before being introduced into the feeding tube. Enteral nutrition contains with a mixture of fluid and nutrients.
Enteral nutrition contains with a mixture of fluid and nutrients. It requires the insertion of a feeding tube into the mouth, nose, or directly in the stomach. It can be safely prescribed for clients experiencing liver failure.
The nursing instructor is discussing dietary needs as they relate to age. According to the instructor, adequate intake of what vitamin is especially important in sexually active women of childbearing age to prevent severe birth defects? Vitamin B12 Vitamin K Vitamin D Folic acid
Folic acid
The nurse is reviewing the lab results for a client with congestive heart failure. The report is as follows: sodium, 142 mEq/L; potassium, 2.5 mEq/L; calcium, 5 mEq/L; and chloride, 98 mEq/L. Which electrolyte disturbances should the nurse report? Hypokalemia Hypochloremia Hyponatremia Hypocalcemia
Hypokalemia
A health care provider orders intravenous magnesium sulfate to control convulsions in a pregnant client. When will the preparation take effect? Three to six hours following administration Two to three hours following administration Immediately following administration One to two hours following administration
Immediately following administration
A nurse is caring for a client prescribed warfarin for chronic atrial fibrillation. Which information should be included in this client's medication teaching plan? Keep intake of vitamin K foods constant. If you miss a dose, take a double dose. Schedule annual laboratory appointments. Call the provider for additional information.
Keep intake of vitamin K foods constant.
There is one vitamin that is used in megadoses to lower serum cholesterol. Which vitamin is it? Niacin Riboflavin Thiamine Folic acid
Niacin
The nurse is planning care for a client who will require administration of medications through a feeding tube. What intervention should the nurse include in the plan? Provide ample fluids when having the client swallow medications. Withhold medications that cannot be administered parenterally. Aspirate the residual drug 15 minutes after administration through the feeding tube. Obtain liquid forms of medications whenever possible.
Obtain liquid forms of medications whenever possible.
A senior-level nurse is teaching a course on lifespan considerations when administering magnesium infusions. Which of the following information would the nurse include while teaching the subject? Older adults may need a reduced dose because of decreased renal function. Older adults may need a reduced dose because of increased liver function. Older adults may need a reduced dose because of decreased liver function. Older adults may need an increased dose because of increased renal function.
Older adults may need a reduced dose because of decreased renal function.
Which of the following is a correct route of administration for potassium? Intramuscular IV (intravenous) push Oral Subcutaneous
Oral
The nurse is caring for a client who is receiving an iron supplement for treatment of anemia. What food/liquid will the nurse offer the client to take with the iron that will increase the iron's absorption? Milk Orange juice Water Toast
Orange juice
The nurse knows to monitor the IV site for which of the following complications during parenteral management of body fluids? Pain in the most proximal body part Pain in the most distal body part Potassium and chloride Phlebitis and/or thrombosis
Phlebitis and/or thrombosis
A 69-year-old client, who has been prescribed a daily diuretic, is admitted to critical care with a cardiac arrhythmia. Which electrolyte should be monitored due to its' effect on heart rate and excretion or retention during diuretic therapy? Plasma 0.9% NACL Potassium TPN
Potassium
Many people throughout the world are practicing vegetarians. Their diet is rich in fruits and vegetables so it is also likely to be rich in: Iron Potassium Iodine Sodium
Potassium
A nurse would suggest the need for vitamin supplements to which clients? Select all that apply. Pregnant woman Alcoholic client Constipated older adult client Client with HIV/AIDS A client with an ankle fracture
Pregnant woman Alcoholic client Constipated older adult client Client with HIV/AIDS
The nurse is comparing the recipe for a TPN with the health care provider's orders for an adult male, aged 35. How will the nurse administer vitamin K? Included in the TPN order Separately by injection Separately orally Monthly subcutaneously
Separately by injection
The nurse is caring for a critically ill client in the unit who has an IV dedicated to fluid and electrolyte replacement. To prevent imbalances and adverse reactions, what should the nurse closely monitor? Serum albumin levels Hemoglobin and hematocrit levels Serum electrolyte levels BUN and creatine levels
Serum electrolyte levels
A client is receiving an IV potassium infusion. During the infusion, the client develops an irregular pulse. The nurse would take which action (s)? Continue to monitor the pulse rate every 15 to 30 minutes until the infusion is complete, then notify the primary care provider. Continue to monitor the blood pressure every 30 to 60 minutes until the infusion is complete, then notify the primary care provider. Measure intake an output at the start of the irregular pulse, then notify the primary care provider. Slow the infusion to keep the vein open and notify the primary care provider and apply a cardiac monitor
Slow the infusion to keep the vein open and notify the primary care provider and apply a cardiac monitor
What is a major electrolyte in extracellular fluid that influences the distribution of water and maintains acid-base balance and nerve function? Sodium Phosphorus Calcium Potassium
Sodium
You administer a single intramuscular (IM) injection of Vitamin K to each newborn in your nursery. What is the reason for the injection? To prevent hyperkalemia To promote normal vision To increase absorption of fats To prevent hemorrhagic disease
To prevent hemorrhagic disease
If you were told to eat more vitamin E, what would you want to eat more of? Lean meat Skim milk Egg whites Vegetable oils
Vegetable oils
Vitamins are organic compounds that differ in function and availability. What statement best describes vitamins? Vitamins are composed of long chains of molecules linked together Vitamins exist in only one active form Vitamins provide energy Vitamins are susceptible to destruction by factors such as heat, air, and light
Vitamins are susceptible to destruction by factors such as heat, air, and light
When do vitamins act as drugs in the body? When they are taken in minidoses When they are prescribed by a health care provider When they are taken in megadoses When they are taken in combination with other vitamins
When they are taken in megadoses
Which factors should the nurse monitor when evaluating the effectiveness of a client's enteral nutrition therapy? Select all that apply. constipation serum albumin client satisfaction daily weight complete blood count (CBC)
daily weight serum albumin
The nurse is conducting a physical assessment on a client. For which finding will the nurse ask the client about the intake of iodized salt? nausea and vomiting enlarged thyroid gland weakness ataxia
enlarged thyroid gland
A client has just presented for care after a positive OTC pregnancy test. When performing health education with this client, the nurse should emphasize the need for supplementation with what nutrient? potassium folic acid vitamin C vitamin E
folic acid
The nurse would assess a client receiving which medication for signs and symptoms of hypokalemia? digoxin lisinopril spironolactone furosemide
furosemide
Which medication, being taken regularly by a client, may create a need for oral potassium supplementation? omeprazole loratadine diltiazem furosemide
furosemide
A nurse administers calcium IV slowly based on the understanding that rapid IV administration of calcium can lead to which adverse effects? vasoconstriction tachycardia hypoglycemia hypotension
hypotension
A client who is exsanguinating from the gastrointestinal tract is prescribed vitamin K. By which route will the nurse prepare to administer this supplement? intravenous oral subcutaneous intramuscular
intravenous
Which location might the nurse use to assess the condition of an insertion site for a central venous access device? over the fourth intercostal space the back of the hand over the jugular vein below the sternum
over the jugular vein
The health care provider has ordered immediate (STAT) administration of vitamin K for a client who accidently overdosed on a medication. The nurse knows that the client overdosed on what drug? ferrous sulfate vitamin A warfarin heparin
warfarin