NCLEX: Nutrition and TPN Ch 12 & 13

High calcium diet

- Ca needed during bone growth and in adulthood to prevent osteoporosis and to facilitate vascular contraction, vasodilation, muscle contraction, and nerve transmission - primary sources of Ca are dairy products - lactose intolerant clients should incorporate nondairy sources of ca into their diet regularly

Complications of PN: Hyperglycemia causes

- Client receiving solution too quickly - not enough insulin - infection

Soft diet nursing considerations

- Clients w/mouth sores should be served foods at cooler temperatures - clients who have difficulty chewing/swallowing because of dry mouth can increase salivary flow by sucking sour candy - encourage clients to eat a variety of foods - provide plenty of fluids with meals to ease chewing/swallowing - drinking fluids through a straw may be easier than drinking from a cup - all foods and seasoning are permitted; however, liquid, chopped, or pureed doods or regular foods w/a soft consistency are tolerated best - foods with nuts or seeds, which can become easily trapped in the mouth and cause discomfort, should be avoided - raw fruits/vegetables, fried foods, and whole grains should be avoided - consider the client's disease/illness and how it may impact on nutritional status ***

Nursing considerations for vegetarian types of diets

- Ensure the client eats a sufficient amt of varied foods to meet nutrient and energy needs - clients should be educated about consuming complementary proteins over the course of each day to ensure all essential AA are provided - potential deficiencies include energy, protein, vitamin B12, zinc, iron, Ca, omega-3 fatty acids, and vitamin D if limited exposure to sunlight - Consume vitamin C and a good source of iron with eat meal to enhance absorption - Foods commonly eaten include tofu, tempeh, soy milk, and soy products, meat analogues, legumes, nuts and seeds, sprouts, and a variety of fruits and vegetables - soy protein is considered equivalent in quality to animal proteins

Discontinuing Parenteral Nutrition

- Evaluation of nutritional status by a nutritionist is done before PN DCed - If DC prescribed, GRADUALLY DECREASED FLOW RATE FOR 1-2 HRS WHILE INCREASING ORAL INTAKE (PREVENTS HYPOGLYCEMIA)*** - After removing the IV catheter, change the dressing daily until insertion site heals - Encourage oral nutrition - Record oral intake, body wt, and lab results of electrolytes and glucose levels

Continuous Parenteral Nutrition

- Infused continuously over 24hrs; most commonly used in hospital setting

Potassium-modified diet: indications for low-K and high-K diets

- Low K diet for hyperkalemia, which may be caused by impaired renal function, hypoaldosteronism, Addison's disease, ACE inhibitor meds, immunosuppressive meds, K-sparing diuretics, and chronic hyperkalemia - high K diet for hypokalemia, which may be caused by renal tubular acidosis, GI losses (diarrhea, vomit), IC shifts, K-wasting diuretics, antibiotics, mineralocorticoid or glucocorticoid excess resulting from primary or secondary aldosteronism, Cushing's syndrome, or exogenous corticosteroid use

Complications of PN: Air embolism prevention

- Make sure all catheter connections are secure - clamp the catheter when not in use (follow agency protocol for flushing and clamping the catheter) - instruct the client in the Valsalva maneuver for tubing and cap changes - For tubing and cap changes, place the client in the Trendelenburg position (if not contraindicated), with the head turned in the opposite direction of the insertion site; client shouold hold breath and bear down

Parenteral Nutrition Indications

- Severely dysfunctional or nonfunctional GI tracts who are unable to process nutrients - Can take some oral nutrition, but not enough to meet nutrient requirements - Multiple GI surgeries, GI trauma, severe intolerance to enteral feedings, or intestinal obstructions, or need bowel rest for healing - Severe nutritionally deficient conditions (AIDS, cancer, burns, malnutrition, chemotherapy) - PN is a form of nutrition and is used when there is no other nutritional alternative. Other forms of administering nutrition such as PO or GI tube are initiated FIRST ***

High-residue, high-fiber diet

- Used for constipation, irritable bowel syndrome when the primary symptoms is alternating constipation and diarrhea, and asymptomatic diverticular disease

food sources of vitamin B (thiamine)

pork, nuts, whole-grain cereal, legumes

food sources of chloride

salt

food sources of vitamin b6 (pyridoxine)

yeast, corn, meat, poultry, fish

Low-purine diet

- Used for gout, kidney stones, and elevated uric acid levels - Purine is a precursor for uric acid, which forms stones and crystals - Foods to restrict include anchovies, herring, mackerel, sardines, scallops, organ meats, gravies, meat extracts, wild game, goose, and sweetberries

Signs of an Adverse Reaction to Lipids

- chest/back pain, chills, cyanosis, diaphoresis, dyspnea, fever, flushing, HA, NV, pressure over the eyes, thrombophlebitis, vertigo - Infuse solution as prescribed - usually SLOWLY AT 1 mL/min INITIALLY - monitor VS q10min and observe for adverse rxns for 1st 30 mins. If signs of adverse rxn occur = STOP INFUSION and notify HCP

Complications of PN: Air embolism interventions

- clamp the catheter - place the client in a left side-lying position with the head lower than the feet - Notify the health care provider - administer O2

Amino Acid Component of parenteral nutrition

- concentration ranges from 3.5-20% - lower concentrations administered peripherally; higher concentrations administered centrally - Approx 15-20% of total energy needs should come from protein

Carb Component of parenteral nutrition

- strength of dextrose depends on nutritional needs, route of administration (central vs peripheral), and agency protocols - carbs typically provide 60-70% of calorie/energy needs

Low-residue, low-fiber diet

- supplies foods that are least likely to form an obstruction when the intestinal tract is narrowed by inflammation or scarring or when GI motility is slowed - Used for inflammatory bowel disease, partial obstructions of the intestinal tract, gastroenteritis, diarrhea, or other GI disorders

Administration of Parenteral Nutrition (Central Vein)

- administered thru central vein if client requires a larger concentration of carbs (greater than 10% glucose) - Subclavian (SJ) or internal jugular (IJ) vein is the insertion site for central access normally used when PN is SHORT TERM (<4 WKS) - When PN is anticipated for extended period (>4wks), a peripherally inserted central catheter (PICC) line, a tunneled catheter, or an implanted vascular access device is used

Parenteral Nutrition

- also termed TPN; supplies nutrients via the veins - Supplies carbohydrates in the form of dextrose, fats in an emulsion form, proteins in the form of AA, vitamins, minerals, electrolytes, and water - Prevents subcutaneous fat and muscle protein from being catabolized by the body for energy

Complications of PN: Air embolism s/s

- apprehension, chest pain, dyspnea, hypotension, loud churning sound heard over pericardium on auscultation, rapid and weak pulse, respiratory distress

Complications of PN: Air embolism causes

- catheter system opened or IV tubing disconnected - air entry on IV tubing changes

Protein-restricted diet

- Used for renal disease and liver disease - Provide enough protein to maintain nutritional status but not an amt that will allow the buildup of waste products from protein metabolism (40-60g of protein daily) - The less protein allowed, the more important it becomes that all protein in the diet be of high biological value (contain all essential AA) - An adequate total energy intake from foods is critical for clients on protein restricted diets (protein will be used for energy, rather than for protein synthesis) - Special low-protein products, such as pastas, bread, cookies, wafers, and gelatin made w/wheat starch, can improve energy intake and add variety to the diet - carbs in powdered/liquid forms can provide additional energy - veggies and fruits contain some protein and, for very low-protein diets, these foods must be calculated into the diet - foods are limited from the milk, meat, bread, and starch groups

Other Components that can be added to Parenteral Nutrition

- VITAMINS: usually contain standard multivitamins; individual vitamin preparations can be added PRN and as prescribed - MINERALS & TRACE ELEMENTS: available in various concentrations to promote normal metabolism - ELECTROLYTES: vary depending on body wt, presence of malnutrition/catabolism, degree of electrolyte depletion, changes in organ function, ongoing electrolyte losses, and disease process - WATER: amt of water needed determined by electrolyte balance and fluid requirements - REGULAR INSULIN: May be added to control blood glucose level bc of high glucose concentration in PN solution - HEPARIN: May be added to reduce the buildup of a fibrinous clot at the catheter tip

Sodium-restricted diet

- Used for HTN, HF, renal disease, cardiac disease and liver disease - Individualized: can include 4g of Na daily (no-added salt diet), 2-3g of Na daily (moderate restriction), 1g of Na daily (strict restriction), or 500 mg of Na daily (severe restriction and seldom prescribed) - encourage intake of fresh foods, rather than processed foods, which contain higher amts of sodium - canned, frozen, instant, smoked, pickled, and boxed foods usually contain higher amts of sodium. lunch meats, soy sauce, and snacks such as potato chips, and pretzels also contain large amts of sodium - certain meds contain significant amts of sodium - salt substitutes may be used to improve palatability; most salt substitutes contain large amts of K and should not be used by clients w/renal disease

High-iron diet

- Used for anemia - Replaces iron deficit from inadequate intake or loss - includes organ meats, meat, egg yolks, whole wheat products, dark green leafy vegetables, dried fruit, and legumes

Clear liquid diet nursing considerations

- deficient in energy (calories) and many nutrients - easily digested and absorbed - clients may find it unappetizing and boring - minimal residue is left in the GI tract - As a transition diet, clear liquids are intended for short term use - liquids are relatively transparent to light and are liquid at body temperature are considered "clear liquids" such as water, bouillon, clear broth, carbonated beverages, gelatin, hard candy, lemonade, ice pops, and regular/decaf coffee or tea - limit caffeine intake: prevents upset stomach and sleeplessness - may consume sugar and salt - dairy products and fruit juices with pulp are not clear liquids - Monitor hydration status by assessing I&O, wt, edema, and s/s of dehydration ***

Mechanical diet nursing considerations

- degree of texture modification depends on individual need, including pureed, mashed, ground, or chopped - foods to be avoided in mechanically altered diets include nuts, dried fruits, raw fruits/vegetables, fried foods, tough smoked or salted meats, foods with coarse textures

Vegetarian (Lacto-Ovo vegetarian)

- does not consume beef, pork, poultry, fish, shellfish, or animal flesh of any kind, but does eat eggs and dairy products - a lacto-vegetarian does not eat eggs, but does eat dairy products - an ovo-vegetarian does not eat meat or dairy products, but does eat eggs

Foods low in Potassium

- foods that are low in K include applesauce, green beans, cabbage, lettuce, peppers, grapes, blueberries, cooked summer squash, cooked turnip greens, pineapple, and raspberries

Low-residue, low-fiber diet nursing considerations

- foods that are low in residue include white bread, refined cooked cereals, cooked potatoes without skins, white rice, and refined pasta - Foods to limit or avoid are raw fruits (except bananas), vegetables, nuts, seeds, plant fiber, and whole grains - dairy products should be limited to 2 servings a day

Mechanical diet

- foods that have been mechanically altered in texture to require minimal chewing - for clients who have difficulty chewing but can tolerate more variety in texture than a liquid diet offers - for clients who have dental problems, surgery of the head or neck, or dysphagia (requires swallowing evaluation and may require thickened liquids if the client has swallowing difficulties)

Intermittent Parenteral Nutrition

- in general, 12hr infusions are usually given at night - allows client requiring PN on a long-term basis to participate in ADLs during the day w/o inconvenience of IV bag and pump - monitor glucose levels closely bc of the risk for hypoglycemia

Cardiac diet

- indicated for atherosclerosis, DM, hyperlipidemia, HTN, MI, nephrotic syndrome, and renal failure - reduces the risk of heart disease - restricts total amts of fat, including saturated, trans, polyunsaturated, and monosaturated: cholesterol and sodium

Fat emulsion (lipids) and parenteral nutrition

- lipids provide up to 30% of calorie/energy needs; provide nonprotein calories and prevent/correct fatty acid deficiency - lipid solutions are isotonic; can be administered peripherally or centrally - may be administered as a SEPARATE IV LINE BELOW THE FILTER USING A Y-CONNECTOR or as a ADMIXTURE TO PN SOLUTION (3-IN-1 ADMIXTURE CONSISTING OF DEXTROSE, AA, AND LIPIDS) - glucose intolerant clients or DM clients may benefit from larger % of PN from lipids, which helps control blood glucose lvls and lower insulin requirements caused by infused dextrose - Examine the bottle for separation of emulsion or for accumulation of froth; if observed, DO NOT USE, RETURN TO PHARMACY - Additives should not be put in fat emulsion - Follow agency policy regarding filter size that should be used; usually 1.2 mcm filter or larger - Infuse solution as prescribed - usually SLOWLY AT 1 mL/min INITIALLY - monitor VS q10min and observe for adverse rxns for 1st 30 mins. If signs of adverse rxn occur = STOP INFUSION and notify HCP - If no adverse rxns occur, adjust the flow rate to the prescribed rate - monitor serum lipids 4 hrs after DCing the infusion - Fat emulsions (lipids) contain egg yolk phospholipids and should NOT BE GIVEN TO CLIENTS WITH EGG ALLERGIES ***

Full liquid diet nursing considerations

- nutritionally deficient in energy (calories) and many nutrients - clear and opaque liquid foods, and those that are liquid at body temp - all clear liquid items, plain ice cream, sherbet, breakfast drinks, milk, pudding, custard, soups that are strained, refined cooked cereals, fruit juices, and strained vegetable juices - Use of a complete nutritional liquid supplement often necessary to meet nutrient needs for clients on a full liquid diet for more than 3 days - Provide nutritional supplements such as those high in protein for a client on a liquid diet ***

High-residue, high-fiber diet nursing considerations

- provides 20 to 35 g of dietary fiber daily - volume and weight are added to the stool, speeding the movement of undigested materials thru the intestine - diet includes fruits, vegetables, and whole-grain products - increase fiber gradually and provide adequate fluids to reduce possible undesirable SE such as abdominal cramps, bloating, diarrhea, and dehydration - gas forming foods should be limited

Clear liquid diets

- provides fluids and some electrolytes to prevent dehydration - used as an initial feeding after complete bowel rest - used initially to feed a malnourished person or a person who has not had any oral intake for some time - used for bowel preparation for surgery or tests, as well as postop and in clients w/fever, vomiting, or diarrhea

Enteral Nutrition

- provides liquefied foods into the GI tract via a tube - indicated when GI tract is functional but oral intake is not meeting estimated nutrient needs or for clients w/swallowing problems, burns, major trauma, liver or other organ failure, or severe malnutrition - clients w/lactose intolerance need to be placed on lactose-free formulas

Complications of PN: Hyperglycemia s/s

- restlessness, weakness, confusion, diaphoresis, elevated blood glucose lvl (>200 mg/dL), excessive thirst, fatigue, Kussmaul's respirations, coma (severe)

Fat-restricted diet nursing considerations

- restrict total amt of fat, including saturated, trans, polyunsaturated, and monounsaturated - clients with malabsorption may also have difficulty tolerating fiber and lactose - vitamin and mineral deficiencies may occur in clients w/diarrhea or steatorrhea - fecal fat test indicates fat malabsorption w/excretion of more than 6 to 8 g of fat (or more than 10% consumed) per day during the 3 days of specimen collection

Administration of Parenteral Nutrition (Peripheral Vein)

- typically administered in the arm thru a traditional IV catheter, or thru a midline catheter, which is placed in an upper arm vein (brachial/cephalic vein) with the tip ending below the lvl of the axillary line. - PN in peripheral vein delivers ISOTONIC OR MILDLY HYPERTONIC SOLUTIONS as compared to the solutions administered via central veins - Delivery of hypertonic solutions into peripheral veins can cause sclerosis, phlebitis, or swelling. Monitor closely for these complications ***

Full liquid diet

- used as a transition diet after clear liquids following surgery or for clients who have difficulty chewing, swallowing, or tolerating solid foods

Renal diet

- used for client w/acute kidney injury or chronic kidney disease and those requiring hemodialysis or peritoneal dialysis - controlled amts of protein, Na, K, Ca, Phos, and fluids may be prescribed; may also need modification in fiber, cholesterol, and fat based on individual requirements - Most clients receiving dialysis need to restrict fluids

Soft diet

- used for clients who have difficulty chewing or swallowing - for clients who have ulcerations of the mouth/gums, oral surgery, broken jaw, plastic surgery of the head or neck, or dysplastic surgery of the head or neck, or dysphagia, or for the client who has had a stroke

Carbohydrate-consistent diet

- used for clients with DM, hypoglycemia, hyperglycemia, and obesity - Recommended food guide: The exchange system for meal planning - The exchange system groups foods according to the amts of carbs, fats, and proteins they contain - Major food groups include carbs, meat and meat substitutes, and fat groups - MyPlate diet is also recommended

High-calorie, high-protein diet

- used for severe stress, burns, wound healing, cancer, HIV, AIDS, COPD, respiratory failure, or any other debilitating disease - encourage nutrient-dense, high-calorie, high-protein foods such as whole milk and milk products, peanut butter, nuts and seeds, beef, chicken, fish, pork, and eggs - some high-calorie foods include sugar, cream, gravy, oil, butter, mayonnaise, dried fruit, avocado, and honey - Encourage snacks btwn meals, such as milkshakes, instant breakfasts, and nutritional supplements. - calorie counts assist in determining the client's total nutritional intake and can identify a deficit/excess intake ***

Fat-restricted diet

- used to reduce s/s of abdominal pain, steatorrhea, flatulence, and diarrhea associated w/high intakes of dietary fat, and to decrease nutrient losses in malabsorption disorders - used for malabsorption disorders, pancreatitis, gallbladder disease, and gastroesophageal reflux

The nurse is caring for a client with cirrhosis of the liver. To minimize the effects of the disorder, the nurse teaches the client about foods that are high in thiamine. The nurse determines that the client has the best understanding of the dietary measures to follow if the client states an intention to increase the intake of which food? 1. pork 2. milk 3. chicken 4. broccoli

1 The client with cirrhosis needs to consume foods high in thiamine. Thiamine is present in a variety of foods of plant and animal origin. Pork products are especially rich in this vitamin. Other good food sources include nuts, whole grain cereals, and legumes. Milk contains vitamin A, D, and B2. Poultry contains niacin. Broccoli contains vitamin C, E, and K, and folic acid.

The nurse instructs a client with chronic kidney disease who is receiving hemodialysis about dietary modifications. The nurse determines that the client understands these dietary modifications if the client selects which items from the dietary menu? 1. cream of wheat, blueberries, coffee 2. Sausage and eggs, banana, and orange juice 3. bacon, cantaloupe melon, tomato juice 4. Cured pork, grits, strawberries, orange juice

1 The diet for a client with chronic kidney disease is receiving hemodialysis should include controlled amts of sodium, phosphorus, calcium, potassium, and fluids, which is indicated in the correct option. The food items in the remaining options are high in sodium, phosphorusm or potassium.

A postoperative client has been placed on a clear liquid diet. The nurse should provide the client with which item(s) that are allowed to be consumed on the diet? Select all that apply. 1. Broth 2. Coffee 3. Gelatin 4. Pudding 5. Vegetable juice 6. Pureed vegetables

1, 2, 3 A clear liquid diet consists of foods that are relatively transparent to light and are clear and liquid at room and body temperature. These foods include items such as water, bouillon, clear broth, carbonated beverages, gelatin, hard candy, lemonade, ice pops, and regular or decaffeinated coffee or tea. The incorrect food items are items that are allowed on a full liquid diet.

MyPlate guidelines

1. Avoid eating oversized portions of foods 2. Fill half of the plate with fruits and vegetables 3. Vary the type of vegetables and fruits eaten 4. Select at least half of the grains as whole grains 5. Ensure that foods from the dairy group are high in calcium 6. Drink milk that is fat-free or low fat (1%) 7. Eat protein foods that are lean 8. Select fresh foods over frozen or canned foods 9. Drink water rather than liquids that contain sugar *** Always consider the client's cultural and personal choices when planning nutritional intake

A client is recovering from abdominal surgery and has a large abdominal wound. The nurse should encourage the client to eat which food item that is naturally high in vitamin C to promote wound healing? 1. milk 2. oranges 3. bananas 4, chicken

2 Citrus fruits and juices are especially high in vitamin C. Bananas are high in potassium. Meats and dairy products are two food groups that are high in B vitamins.

The nurse is conducting a dietary assessment on a client who is on a vegan diet. The nurse provides dietary teaching and should focus on foods high in which vitamin that may be lacking in a vegan diet? 1. Vitamin A 2. Vitamin B12 3. Vitamin C 4. Vitamin E

2 Vegans do not consume any animal products. Vitamin B12 is found in animal products, and therefore would most likely be lacking in a vegan diet. Vitamin A, C, and E are found in fresh fruits and vegetables, which are consumed in a vegan diet.

The nurse is planning to teach a client with malabsorption syndrome about the necessity of following a low-fat diet. The nurse develops a list of high-fat foods to avoid and should include which food items on the list? 1. oranges 2. broccoli 3. cream cheese 4. broiled haddock

3 Fruits and vegetables tend to be lower in fat because they do not come from animal sources. Broiled haddock is also naturally lower in fat. Cream cheese is a high-fat food.

A client who is recovering from surgery has been advanced from a clear liquid diet to a full liquid diet. The client is looking forward to the diet change because he has been "bored" with the clear liquid diet. The nurse should offer which full liquid item to the client? 1. Tea 2. Gelatin 3. Custard 4. Ice pop

3 Full liquid items include items such as plain ice cream, sherbet, breakfast drinks, milk, pudding, custard, soups that are strained, refined cooked cereals, and strained vegetable juices. A clear liquid diet consists of foods hat are relatively transparent. The food items in the incorrect options are clear liquids.

The nurse is instructing a client with hypertension on the importance of choosing foods low in sodium. The nurse should teach the client to limit intake of which food? 1. apples 2. bananas 3. smoked sausage 4. steamed vegetables

3 Smoked foods are high in sodium, which is noted in the correct option. The remaining options are fruits and vegetables that are low in sodium.

The nurse is teaching a client who has iron deficiency anemia about foods she should include in her diet. The nurse determines that the client understands the dietary modifications if she selects which items from her menu? 1. Nuts and milk 2. Coffee and tea 3. Cooked rolled oats and fish 4. Oranges and dark green leafy vegetables

4 Dark green leafy vegetables are a good source of iron and oranges are a good source of vitamin C, which enhances iron absorption. All other options are not food sources that are high in iron and vitamin C.

A client with hypertension has been told to maintain a diet low in sodium. The nurse who is teaching this client about foods that are allowed should include which food item in a list provided to the client? 1. tomato soup 2. broiled shrimp 3, instant oatmeal 4. summer squash

4 Foods that are lower in sodium include fruits and vegetables (summer squash), because they do not contain physiological saline. Highly processed or refined foods (tomato soup, instant oatmeal) are higher in sodium unless their food labels specifically state "low sodium". Saltwater fish and shellfish are high in sodium.

A client has a triple lumen central venous catheter that is being used for the administration of parenteral nutrition, medications, and laboratory draws. The nurse is preparing to administer medication through the catheter, and the port being used for medication administration is sluggish and is not flushing properly. What should the nurse do?

Difficulty with flushing the catheter indicates that the catheter is blocked. Possible causes of a blockage include a clamped or kinked catheter, the tip of the catheter against the vein wall, thrombosis, or a precipitate buildup in the lumen. The nurse should not try to force the flushing because this could dislodge a clot or disrupt the integrity of the catheter. If the catheter becomes fully blocked, it may not be usable. The nurse should ASSESS FOR AND ALLEVIATE CLAMPING OR KINKING. The nurse should also instruct the client to CHANGE POSITIONS, RAISE THE ARM, AND COUGH. If the blockage is due to a positional issue, this will correct it. The nurse should ATTEMPT TO FLUSH AGAIN TO SEE IF THE PROBLEM HAS BEEN CORRECTED. If it has not, this difficulty should be reported to the necessary personnel (health care provider or IV nurse) so that full functionality can be regained. FLUOROSCOPY may be performed to determine the cause of the blockage and ANTICOAGULANT OR THROMBOLYTIC MEDICATIONS may be instilled into the catheter as prescribed to alleviate blockage.

Calculating BMI

Divide the clients wt (kg) by height^2 (m) - ex: 75 kg/(1.8 m^2) = 23.15

food sources of vitamin D

fortified milk, fish oils, cereals

Food sources of fructose

fruits, honey

A client has been placed on a fluid restriction due to acute kidney injury. The client complains of thrist and asks what can be done to relieve this discomfort. What measures should the nurse tell the client to take to relieve thirst while adhering to the fluid restriction?

The client with acute kidney injury may be palced on fluid restriction because of decreased renal function and glomerular filtration rate, resulting in fluid volume excess. To allow the kidneys to rest, decreased fluid consumption may be indicated. When a client is placed on this restriction, increased thirst may be a problem for them. The nurse should instruct the client in measures to relieve thirst in order to promote adherence to the fluid restriction. These measures include CHEWING GUM OR SUCKING HARD CANDY, FREEZING FLUIDS SO THEY TAKE LONGER TO CONSUME, ADDING LEMON JUICE TO WATER TO MAKE IT MORE REFRESHING, AND GARGLINING WITH REFRIGERATED MOUTHWASH.

food sources of vitamin K

green leafy vegetables, cauliflower, cabbage

Pescatarian

abstains from eating all meat and animal flesh with the exception of fish

Sodium-free spices and flavorings

allspice, almond extract, bay leaves, caraway seeds, cinnamon, curry powder, garlic powder or garlic, ginger, lemon extract, maple extract, marhoram, mustard powder, nutmeg

food sources of sodium

american cheese, bacon, butter, canned food, cottage cheese, cured pork, hot dogs, ketchup, lunch meat, milk, mustard, processed food, snack food, soy sauce, table salt, white and whole-wheat bread

Food sources of cholesterol

animal products, egg yolks, liver, organ meats, shellfish

Gas forming foods

apples, artichokes, barley, beans, bran, broccoli, brussels sprouts, cabbage, celery, cherries, coconuts, eggplant, figs, honey, melons, milk, molasses, nuts, onions, radishes, soybeans, wheat, yeast

Food sources of Cellulose

apples, beans, bran, cabbage

Food sources of sucrose

apricots, granulated table sugar, honeydew, cantaloupe, molasses, peaches, peas, corn, plums

food sources of potassium

avocado, banans, cantaloupe, carrots, fish, mushrooms, oranges, pork, beef, veal, potatoes, raisins, spinach, strawberries, tomatoes

food sources of magnesium

avocado, canned white tuna, cauliflower, cooked rolled oats, green leafy vegetables, milk, peanut butter, peas, pork, beef, chicken, potatoes, raisins, yogurt

Food sources of folic acid

green leafy vegetables, liver, beef, fish, legumes, grapefruit, oranges

Food sources of starch

barley, beets, carrots, peas, corn, oats, potatoes, pasta, rye, wheat

food sources of saturated fats

beef, butter, hard yellow cheeses, luncheon meats

Food sources of protein

bread, cereal, dairy products, dried beans, eggs, meat, fish, poultry

food sources of iron

breads, cereals, dark green vegetables, dried fruits, egg yolks, legumes, liver, meats

Food sources of Calcium

broccoli, carrots, cheese, collard greens, green beans, milk, rhubarb, spinach, tofu, yogurt

Food sources of glucose

carrots, corn, dates, grapes, oranges

food sources of vitamin C (ascorbic acid)

citrus fruits, tomatoes, broccoli, cabbage

Flexitarian/semivegetarian

consumes mostly a vegetarian diet, but occasionally eats meat

raw vegan/raw food diet

consumes unprocessed vegan foods that have not been heated above 115F (46C)

macrobiotic

consumes unprocessed vegan foods, such as whole grains and fruits and vegetables, and occasionally consumes fish; also consumes Asian vegetables, such as daikon, and sea vegetables, such as seaweed

food sources of trans fats

cookies, cakes, candy, chips, crackers, fried foods, frozen pies, pot pies, waffles, pizza, margarine, packaged cake mixes, soups

food sources of polyunsaturated fats

corn oil, safflower oil, sunflower oil

vegan

does not consume meat of any kind and also does not eat eggs, dairy products, or processed foods containing these or other animal-derived ingredients such as gelatin

food sources of monosaturated fats

duck, goose, eggs, olive and peanut oils

food sources of zinc

eggs, leafy vegetables, meats, protein-rich foods

food sources of phosphorus

fish, nuts, organ meats, pork, beef, chicken, whole grain breads and cereals

Water soluble vitamins

folic acid, niacin, vitamin B1 (thiamine), vitamin B2 (riboflavin), vitamin B6 (pyridoxine), vitamin B12 (cobalamin), vitamin C (ascorbic acid)

food sources of vitamin A

liver, egg yolk, whole milk, green or orange vegetables, fruits

food sources of vitamin b12 (cobalamin)

meat, liver

Food sources of niacin

meats, poultry, fish, beans, peanuts, grains

food sources of lactose

milk

food sources of vitamin b2 (riboflavin)

milk, lean meats, fish, grains

food sources of vitamin E

vegetable oils, green leafy vegetables, cereals, apricots, apples, peaches

Fat soluble vitamins

vitamin A, vitamin D, vitamin E, vitamin K