Nurs 120 exam 3

NPO means nothing per os, or nothing by mouth

the patient is restricted from oral intake of food or fluid including water

The nurse is caring for multiple patients in the hospital. The nurse is assisting with the delivery of meal trays. Which meal will the nurse question?

A regular meal delivered to a patient newly diagnosed with a lower extremity infection.

Which statement made by the patient causes the nurse concern regarding NPO status?

"I can drink sips of water during the night while NPO."

Ob 10: discuss ways to implement a teaching plan.

- establish a comfortable temperature in a room without distractions Ensure that the patient is in a comfortable position and is not experiencing pain or discomfort Involve the patient in your teaching by asking questions, requesting feedback, and allowing the patient to ask questions, avoid lecturing the patient Explain why the patient needs to know the information, adults learn best when they understand the relevance of the information presented Have an interpreter present if needed so that the patient can understand the teaching Have the patients wear eyeglasses or hearing aids, if appropriate. Sit where the patient can see your lips as you speak, avoid positioning yourself in front of a window or light with glare

full liquid diet

A full liquid diet consists of all the liquids found in a clear liquid diet with the addition of all other opaque liquids and food items that become liquid at room temperature All clear liquids, cream soups, milk, cream, ice cream, yogurt, milkshakes, sherbert, custards/puddings, vegetable juices, pureed v

Ob 8: outline nursing responsibilities and appropriate interventions during the patient discharge process

Assist the patient in gathering their belongings, Make certain any assistive devices are placed with the belongings, check the safe, sign the receipt Discontinue any equipment and tubes that are to be removed before discharge, assess the patient's vital signs, document the patient's condition and vital signs, document the time the patient actually leave and method of transportation Alert the environmental service department for terminal cleaning of the patient room Assist the patient to their method of transportation

Acute: Chronic: Intermittent pain: Intractable pain: Referred pain: Radiating pain: Cutaneous pain: Visceral pain: Deep somatic pain: Neuropathic pain: Phantom limb pain:

Acute: comes on suddenly and has a short duration, less than 6 months Chronic: pain that lasts longer than 6 months Intermittent pain: pain that comes and goes in intervals Intractable pain: refers to pain that cannot be relieved, is incurable, or is resistant to treatment Referred pain: is pain felt in an area other than where the pain was produced Radiating pain: pain that begins at a specific site and shoots out from or extends to a larger area beyond the site of origin Cutaneous pain: pain that is more superficial or pertaining to the skins surface and underlying subcutaneous tissue Visceral pain: known as soft tissue pain, is the pain experienced from stimulation of deep internal pain receptors Deep somatic pain: known as osteogenic pain, is bone, ligament, tendon, and blood vessel pain. The pain may be diffuse and of longer duration than cutaneous pain Neuropathic pain: is the burning, stabbing, or sometimes deep ache that the patient describes when there is nerve compression cau

Ob 9: describe how to develop a teaching plan using the nursing process.

Assessment: identify the patients teaching needs- what they know, what is unclear, what information needs to be presented- assess patients readiness to learn Nursing diagnosis: deficient knowledge with descriptors, readiness for enhanced knowledge with descriptors Planning: how to teach the topic, find resources for materials to use as handouts, select a time and place for teaching, and decide how to present the material based on patients learning preferences Implementation Evaluation: have the patient restate the information you shared, ask questions covering the information you have presented, have the patient perform the skill while you watch, you may need to give a few verbal cues as the patient performs the skill

Functions:

B vitamins serve as coenzymes for metabolism throughout the body, and they help to stimulate appetite, maintain healthy nervous and integumentary systems, and assist with growth Vitamin C is essential in immune system functioning, helps the body absorb iron, and is vital to wound healing Vitamin B3 is used to treat hyperlipidemia Vitamin B6 is used to prevent peripheral neuropathy in patients taking the drug INH for tuberculosis

Ob 11: identify 6 disadvantages to the patient if they do not get adequate rest and restorative sleep

Fatigue, irritability, slow response time, blurred vision, headaches, forgetfulness, confusion

Ob 2: identify four common patient reactions to admission

Fear of the unknown Anxiety Loss of control Loss of identity

Ob 8: identify common eating disorders

Bulimia nervosa: is a disorder of eating binges accompanied by some type of behavior that will help to get rid of some of the calories that were ingested while binging Binge eating disorder: characterized by episodes of eating large quantities of food at one time with a loss of control while eating Anorexia nervosa: is characterized by an excessive leanness or wasting of the body known as emaciation

Excess:

Calcium: constipation, flatus, and kidney stones Chromium: liver damage Fluoride: teeth staining and nausea Iodine: nausea, burning of oral mucosa, diarrhea, inflammation of thyroid, and thyroid cancer Iron: missed periods, discoloration of skin, joint swelling and pain Magnesium: increased calcium excretion, weakness, malaise, GI symptoms Manganese: shaking/tremors, stiff muscles, hypertension, impaired memory, psychosis Molybdenum: diarrhea, joint swelling, anemia Phosphorus: muscle tetany, seizures, hypocalcemia Potassium: anorexia, fatigue, extreme muscle weakness, life threatening arrhythmias Selenium: hair loss, nail problems, increased irritability Sodium: edema, fluid retention, thirst, dry sticky mucous membranes, elevated BP Zinc: abdominal cramping and diarrhea

Decificenies:

Calcium: tetany of muscles, bone and tooth loss, osteoporosis Chloride: nausea, vomiting, diarrhea Chromium: may elevate blood glucose Copper: poor growth, fatigue, pallor, anorexia Fluoride: tooth decay Iodine: goiter, hypothyroidism, inhibited infant growth, mental sluggishness, weight gain Iron: pallor, fatigue, SOB, headache, increased irritability, anemia, fainting Magnesium: may cause elevated BP, agitation, restless leg syndrome, hypotension, muscle spasms, insomnia, arrhythmias Manganese: fainting, hearing loss, dermatitis, ataxia, slowed hair growth Molybdenum: difficulty seeing at night, gum problems, tachypnea, tachycardia Phosphorus: anorexia, fatigue, fragile bones, bone pain, bone loss, increased irritability Potassium: muscle weakness, cramping, malaise, fatigue, nausea, vomiting, numbness, tingling, life threatening arrhythmias, cardiac arrest Selenium: keshan disease Sodium: stomach cramps, nausea, vomiting, diarrhea, lethargy, headache, confusion, seizures caused by b

Catabolism: Anabolism: Metabolism: Digestion: Absorption:

Catabolism: breaking down phase of metabolism Anabolism: when the body uses components to build or reconstruct new components or tissue Metabolism: the chemical and physical processes in which body cells break down and use food, water and other chemicals needed to maintain life and the function of each body system Digestion: is the process by which food is broken down in the GI tract, releasing nutrients for the body to use Absorption: is the process by which nutrients are taken from the end products of digestion into the villi that contain capillaries

Ob 14: describe the process for and importance of checking placement of nasogastric and nasointestinal tubes and checking residual gastric volume

Checking placement: x-ray confirmation of NG tube location should always be performed immediately after the insertion of any type of enteral tube, whether it is placed for gastric decompression/analysis or administration so you know it is in the stomach instead of the lungs or any other area of the body Checking the gastric residual volume is the amount of formula that still remains in the stomach from the previous feedings, meaning that it has not been absorbed and it remains in the stomach and if you proceed to instill another feeding it can overfill the stomach causing reflux

Ob 7: list at least 6 guidelines to use in teaching patients with diabetes

Eat a well balanced diet Know the difference between simple and complex carbohydrates Eat three meals and an evening snack daily Do not skip meals Increase your fiber intake Reduce your fat intake by baking, broiling, or grilling foods Lose weight if you are overweight Wear a diabetic identification bracelet or necklace for emergencies

Functions of fiber:

Decrease in LDL cholesterol, which reduces the risk of coronary artery disease Promotion of normal bowel function and the prevention of constipation Increased absorption of minerals Lowered colon pH, which helps to discourage pathogen and cancer cell growth Support of GI tract normal flora by providing them with a good food source Promotion of weight loss

discuss protein deficiency and excess disorders

Deficiency: More commonly found in resource limited countries than in the US Severe protein deficiency results in a disease known as kwashiorkor, causes severe emaciation, a grossly swollen abdomen caused by ascites and liver enlargement, lethargy, failure to grow, and skin infections Excess: Does not result in additional muscle building Excess protein is metabolized and stored as fat to be used at a later time when an additional energy source is required Can play a role in the worsening of kidney disease

Ob 6: describe the nurses responsibilities for patients on special diets, including diabetics and their specific needs

Diabetes: monitor the amount eaten and the patient's tolerance of the meal and the blood glucose levels, know the symptoms of hyperglycemia and hypoglycemia

Ob 5: describe diets modified for diseases and preferences

Diabetic: used to manage calorie and carbohydrate intake for patients with DM, and insulin dependent Calorie restricted: used for those patients who must lose weight Sodium restricted: used for those patients with hypertension, heart failure, or kidney or liver failure for those who require help to prevent or correct fluid retention Fat restricted: used for patients who are experiencing problems with fat malabsorption Fiber restricted: used during the acute phase of intestinal disorders when the presence of fiber may exacerbate intestinal pain, produce diarrhea, or cause an intestinal blockage Renal: used to manage or limit fluids and electrolytes for patients with renal insufficiency or disease Protein restricted: used to manage protein intake for those patients with liver or kidney disease High calorie, high protein: used to increase calorie and protein intake those patients with increased need related to wound healing, growth promotion, and increasing or maintaining weight 5-6 small

Ob 3: describe the role that endorphins play in pain perception and relief

Endorphins are natural body chemicals produced by the brain in response to pleasant thoughts or feelings, exercise, laughter, sex, and massage They act similarly to morphine and produce feelings of euphoria, well-being, and pleasure. They bind to the opiate receptor sites, which help close the gates and block the transmission of pain to the central nervous system

Ob 4: describe factors that affect learning.

Environment: find a place that is quiet, no distractions, and offers privacy Comfort: the patient will be unable to accomplish learning goals if they are in pain, drowsy, hot or cold, hungry or uncomfortable. Readiness: it is difficult to learn the information if you are not ready to hear it Language: patients cannot learn if the teaching is not provided in a language that they know Senses: patients cannot learn if they have visual or hearing impairments that interfere with their ability to see and hear the information being presented Cultural or religious beliefs or practices: it is important it incorporate the patient's specific cultural background and religious beliefs into your teaching for them

Ob 3: describe therapeutic nursing interventions that will demonstrate respect and compassion for common reactions to admission

Establish a rapport and trusting relationship with the patient Inform the patient and calm any fears they might have Walk in with a smile on your face- makes a positive impression with the patient Avoid sighing, rolling eyes, pinching lips together, grinding teeth Speak kindly and respectfully Shake the patient's hand and make brief eye contact, address the patient by their surname

Ob 4: explain the importance of making the patient feel welcome during the admission process

Establish rapport and a trusting relationship, Make the patient feel as if they are not a burden and are welcome Making the patient feel welcome will establish a sense of trust and allow the patient to express what they feel, and what is wrong

Ob 12: explain how to teach patients about internet sources.

Explain that preferred sites for healthcare information end in ".org", ".gov", ".edu" Encourage patients to avoid reading blogs concerning disease processes or treatment Encourage patients use familiar sites like mayo clinic and NIH.gov Urge patients to avoid using sites like wikipedia, because anyone can post information Explain that the author's credentials and education background should be listed Tell patients to check the date of the most recent posting Explain that commercial web sites promoting a product with extremely positive claims are not reliable sources of factual information and should be considered doubtful unless other corroborating factual information can be found Give patients alternatives to the internet for finding quick, accurate information, encourage them to call their pharmacist if they have questions about medications

Functions: of minerals

Forming the structure of the hard parts of the body (bones, teeth, nails) Assisting in water metabolism and fluid and electrolyte balance Activating enzymes and hormones Assisting in acid-base balance Nerve cell transmission Muscle contraction

Deficiency:

Generally a result of malabsorption disorders that prevent the vitamins from being absorbed and used by the body- Crohn's disease, Celiac Disease, Pancreatitis May also be a resort of poor nutritional habits Vitamin A: infections and vision problems Vitamin D: rickets (children), bone softening and deformity (adults) Vitamin E: peripheral neuropathy and ataxia Vitamin K: excessive bleeding Vitamin B1: weakness, confusion, fatigue, heart problems, paralysis, edema, death, beriberi and wernicke disease Vitamin B2: fatigue, GI problems, cracks at mouth corners, swollen and discolored tongue Vitamin B3: canker sores, indigestion, vomiting, fatigue, 4 d's (dermatitis, diarrhea, dementia, death) Vitamin B6: asymptomatic dermatitis, cracks at mouth corners, glossitis, weak immune system, depression, confusion Vitamin B12: sore tongue, dandruff, heart palpitations, pallor, nervousness, peripheral neuropathy, forgetfulness, macrocytic anemia Vitamin C: scurvy: bleeding gums, dry skin, pet

Ob 11: describe three ways to evaluate patient teaching.

Have the patient restate what has been taught, Ask questions to determine understanding, Ask the patient to give a return demonstration of a new task

Ob 12: explain how sleep requirements vary by age groups

Newborns: 16-18 hours per day Infants up to 2 years: 12-14 hours per day plus naps Children 3-6 years: 12 hours per day, including naps Children 7-12 years: 10 hours per night Adolescents: 8.5-9.5 hours per night Young adults: 7.5-8 hours per night Older adults: gradually decreases to 5.5-6 hours per night, nay begin to nap

Ob 8: identify non pharmacological methods used to relieve pain

Hot and cold packs: good sources of relief for musculoskeletal pain and discomfort Massage and effleurage: cutaneous relief measures such as massage and effleurage are simple to provide but can be extremely effective in some painful conditions. Transcutaneous electrical nerve stimulation: TENS unit is a battery powered device that you apply to the skin over the painful area, the device delivers electrical stimulation to the large diameter nerve fibers and is through to work similarly to massage Acupressure and acupuncture: acupressure involves applying fingertip pressure, and acupuncture if the insertion of ultrafine needles into specific body areas, both are thought to stimulate endorphin production Relaxation: progressive relaxation is a systematic process of using the mind to actually relax the patient's muscles from the tip of the head to the toes. Guided imagery is another method of using the mind to help control the body and guide the patient toward a more relaxed state Distracti

Sources of minerals

Inorganic compounds that come from the earth

Ob 6: discuss components of the admitting procedure

Introduction: meeting the patient, orient the patient to the room, and meeting the patient (if a shared room), show them how to work the objects in the room (bed etc.), how to locate other amenities Admission kit: provide any supplies needed at admission, giving the patient a mug for water, putting a gown on the patient Personal belongings inventory: complete an inventory of clothing and personal items (eyeglasses, dentures, hearing aids), send valuables home, review the hospitals policy for storing valuables, use general descriptions, document that the valuables were placed in the valuables envelope and put in the safe Data collection: includes both objective and subjective data and is completed by interviewing the patient and performing the physical assessment of all body systems Analyze data: assist with compiling and analyzing the collected data to identify the actual problems the patient has, in addition to any potential problems the patient is at risk for developing

Ob 3: explain how to monitor intake and output and why it is important

Means to measure and record all fluids taken and all fluid volumes that are lost Intake includes fluids taken by mouth, those administered IV, enteral/parenteral feedings Output includes all bodily fluids that are lost, urine, emesis, liquid stool, blood, suctioned gastric contents, drainage from devices Balance is optimal to health and recovery from illness and injury, ensuring adequate fluid intake is even more important that ensuring consumption of food

Non essential amino acids: Essential amino acids: Complete proteins: Simple carbohydrates: Complex carbohydrates:

Non essential amino acids: are produced by the liver and thus are not essential to be included in our diet Essential amino acids: are the most important, they must be obtained from food sources because the body is unable to produce them Complete proteins: proteins that contain all 9 of the essential amino acids Incomplete proteins: proteins that do not contain all nine of the essential amino acids Simple carbohydrates: simple sugars, are chemically made up of one or two sugar molecules that are absorbed rapidly- Glucose, Fructose, Sucrose, Lactose Complex carbohydrates: starches and fiber

Transfer within the facility:

Obtain the HCP order for transfer Explain the reason for the transfer to the patient and their family Reconcile meds Gather the patients personal belongings, medications, and nursing supplies Complete a transfer summary form- which is used to document the patient's condition and the reason for transfer, and a comprehensive list of the patient's condition Phone a full report of the patient condition and plan of care to the receiving nurse on the new unit

Transfer to another facility:

Obtain the physicians transfer order A transfer summary form is prepared that contains information about the patient's condition and vital signs at a time of discharge, discharge instructions that include the list of medications, diet, activity restrictions, patient teaching that was done, follow up appointments, time of transfer, method of transportation Discharge summary is completed, the physician completes this, summarizes the patient's condition, diseases, pertinent diagnostic results, medications and treatments, and where the patient is to go after discharge and follow up treatment plans Any valuables in the hospital safe should be sent with the patient and notification made in the hospital chart and the transfer record Make certain that the patient has signed consent to release medical information to third parties to comply with HIPAA

Opiate/Opioid analgesics (narcotics): Patient controlled analgesia: Adjuvant analgesics:

Opiate/Opioid analgesics (narcotics): work by binding with opiate receptors and stimulating the brain production of enkephalin and beta-endorphin, compounds that decrease pain perception Patient controlled analgesia: allows the dose of an opioid or opiate to be administered as determined by the patient Adjuvant analgesics: are classes of medication that produce pain relief either through a mechanism different than traditional analgesics or by potentiating or increasing the effects of opiates, opioids, and nonopioid drugs

Ob 8: define the concept of teachable moments.

Patients ask you questions about their illness or treatment You hear or observe misinformation or an incorrect procedure and you give correct information You point out a cause and effect connection to the patient Bathing and personal care: how to perform skin care and foot care Daily weights: when weight gain is caused by fluid not food intake Ambulation: the benefits of mobility for all body systems Meals: intake and output, benefits of water intake, and nutritional needs Toileting: benefits of fiber/water intake, I&O, and signs of constipation and dehydration Treatments: the purpose, expected outcomes, and how to perform the treatment if appropriate Medication administration: reasons for the medications, possible side effects, and when to report side effects

Ob 12: discuss how feeding tubes are placed and used to provide nutrition

Prepare supplies Have the patient flex the neck, Insert the tube through the nose until they gag/cough, retract the tube about ⅓ in, have patient extend neck and continue inserting tube until gastric contents comes out, secure the tube to the nose, verify placement, instill formula Sometimes patients are too weak or ill to eat, or have a disease that impairs their ability to eat, and they will need nutritional support Enteral nutrition uses the GI tract as a delivery system and involves tube feedings that usually replace all oral intake

Ob 14: describe interventions to help promote sleep for your patients

Prepare the environment: prepare the patient's room by adjusting the room temp to the patient preference, provide blankets/pillows, clear a pathway from the bed to the door, nightlight, close the room door to reduce noise Comfort: washing the patients face and hands, detangling/brushing the hair and teeth, moistening the lips, offer a snack or water/milk, assist with toileting, reposition and support with pillows Relaxation: back massage, ROM exercises, soft/relaxing music, meditation, validation of feelings/needs Pain relief: pain must be relieved in order for a patient to sleep soundly and deeply Sleep medications: some patients can't sleep when hospitalized- no matter the interventions you try, most healthcare providers offer sleep medication that can be used PRN

The nurse works in a clinic with patients diagnosed as having an eating disorder. Which sign of a bulimia nervosa will the nurse recognize?

Regurgitation of gastric juices

The nurse is reviewing dietary information with a patient recently diagnosed with diabetes mellitus. The patient asks for clarification about why complex carbohydrates are healthier than simple carbohydrates. Which fact should the nurse present to the patient?

Simple carbohydrates will cause a rapid rise in blood glucose levels.

The nurse provides education about simple and complex carbohydrates to a patient with newly diagnosed type 1 DM. Which finding best indicates understanding of the teaching?

The child chooses oatmeal instead of chocolate cereal for breakfast.

The nurse is planning to review nutrition with a patient who is a vegetarian. Which important information will the nurse include for this patient?

Soy protein is the only complete protein not from an animal source.

Ob 10: discuss ways to implement a teaching plan.

Speak clearly and distinctly, not loudly, if the patient wears hearing aids Sit near the patient during teaching, avoid standing over the patient Present one piece of information at a time, allowing the patient time to absorb it before moving on Arrange the present information in a simple to complex format Explain how to perform a task and then demonstrate as you explain it a second time Give frequent positive feedback, avoid saying anything that discourages the patient or indicates that you thought the patient was ignorant Provide written materials for easy reference that are appropriate to the patients age and reading level, use visual aids like pictures

Ob 2: discuss methods to assist with meals and improve the patient eating experience in the hospital

Spend time getting to know the patient, be warm and compassionate If the patient is nauseated or hurting, provide appropriate medication before mealtime Make certain the patient is prepared for mealtime by getting the patient comfortable in the bed or chair, providing a wet washcloth for washing hands and face, clear the table of clutter and unpleasantries to provide room for the meal tray Wash hands before passing out meal trays Ensure that each meal is assessed for the correct diet and appropriate temperature of food Open all containers (juice, utensils, milk cartons, packaging) on the tray Take your time while feeding patients Be certain that assistive personnel know how to safely assist those patients who require assistance Help the patient identify factors that would improve their eating experiences, choosing a food they like, comfortable environment, arranging for early or later mealtimes If the patient's appetite is limited, provide smaller meals more frequently throughout the d

Digestion of carbohydrates:

Starchy carbs are reduced to glucose during digestion, salivary amylase and maltase in the small intestine break down the starches to glucose, absorption takes place in the duodenum through the intestinal wall into the bloodstream

identify sources of vitamins

Supplements, fruits and vegetables, the environment (sunlight)

The nurse provides care for a 24-year-old patient who presents with nausea and fatigue for 2 weeks. Initial laboratory test results indicate early pregnancy. Which nutritional information would the nurse include when educating the patient on methods to promote healthy fetal development during pregnancy?

Taking a daily multivitamin with folic acid

Ob 7: explain how nurses acknowledge and accept the patients pain

The first step in assisting your patient to obtain maximum pain relief is letting the patient know that you believe that they are in pain The patient is the expert about whether or not they are suffering, not the healthcare provider, you should be the expert in relieving the pain Listen to how the patient describes the discomfort and verbally acknowledge that you understand they are hurting

Ob 10: discuss the significance of medication reconciliation as part of the discharge process

The medication list must be reconciled with the prescription and over the counter medications the patient was taking at home and with their health care providers orders while the person was a patient in the facility Make sure there are no duplications in ordered medications Dosages are correct and any differences or changes in dosage were intended The patient is aware of dosage changes All previous home medications have been either continued or discontinued, not overlooked, and the patient is aware of all discontinued medications A written list of current medications and images is provided to the patient

Functions of carbohydrates

primary source of energy for the body, particularly the cardiovascular, musculoskeletal and nervous system, are more quickly digested

The nurse is caring for multiple patients. When delivering meal trays, which patient does the nurse recognize as having a diet modified by preference?

The patient who is vegetarian

The nurse is caring for a patient under medical treatment for an eating disorder. Which clinical finding supports the diagnosis?

The patient's current body mass index (BMI) is 17.5.

Ob 2: explain the gate control theory

The theory purports that the transmission of pain impulses to the central nervous system is controlled by a gate that opens and closes in response to sensory input. The gate must be open for the pain impulse to be transmitted to the brain and interpreted as pain. When the gate is closed, the nerve impulse for pain is blocked from transmission

Ob 7: identify two primary purposes of patient teaching.

To instruct patients on health promotion and wellness strategies To explain disease processes, treatments, and care

Excess:

Usually caused by overuse or inappropriate use of dietary supplements Vitamin A: nausea, dizziness, headache, dermatitis, coma, death Vitamin D: nausea, vomiting, anorexia, kidney stones and damage, mental and physical growth retardation Vitamin E: no side effects, some can feel it acts as an anticoagulant Vitamin K: no toxicity symptoms reported Vitamin B1: no toxicity symptoms reported, excess elimination in urine Vitamin B2: no toxicity symptoms reported Vitamin B3: flushing caused by capillary dilation, liver damage, gastric ulcers, nausea, vomiting Vitamin B6: peripheral neuropathy Vitamin B12: no toxicity symptoms reported Vitamin C: rare but can cause diarrhea, abdominal cramping, nausea

Ob 3: explain ways to address learning styles during patient teaching.

Verbally explain information, but you may need to provide written information that is appropriate for the patients reading level in addition to videos If you are teaching a task, you will need to demonstrate what the patient is to do then let the patient perform the task while you watch

Visual distraction: Auditory distraction: Tactile distraction: Intellectual distraction:

Visual distraction: watching television or reading a good book Auditory distraction: listening to music or someone reading aloud, an infant will respond to soft whispering or singing close to the ear while being held or rocked Tactile distraction: receiving a back rub, having hair brushed, rocking, receiving hugs, holding a pet, playing with a toy, taking a warm bath Intellectual distraction: conversing with another individual, working, or doing a sudoku, crossword, or other type of puzzle, or playing card games

Ob 2: identify three primary learning styles.

Visual learning: learning by seeing, reading, and watching. Auditory learning: learning by hearing and listening Kinesthetic learning: learning by touching and doing

The nurse is reviewing the daily recommended intake of water with a patient. The patient understands the need for 6 to 8 eight-ounce glasses of water daily, but asks when the amount should be increased. Which answer by the nurse is incorrect?

When fluid is being retained due to cardiac function.

Ob 7: discuss the importance of completing an admission orientation checklist and personal belongings inventory

With proper orientation you allow the patient to maintain a better sense of control over the hospital experience, which is conducive to healing and a sense of well-being

Restorative sleep: Circadian rhythm:

allows an individual to awaken feeling rested, refreshed, rejuvenated, and energized, ready to meet new challenge during which body metabolism and functions increase and decrease in rhythmic patterns

The nurse is providing education to a patient on sources of complex carbohydrates. Which food sources should be included in the education?

brown rice, pasta

The nurse is teaching a patient about the importance of reducing saturated fats in a cardiac diet. Which oils should the nurse recommend as options?

cottonseed oil peanut oil olive oil

The nurse is providing care for a patient with a nasogastric (NG) tube. The nurse is preparing to administer medications through the NG tube. Which finding should the nurse report before medication administration?

he indelible ink mark on the tube is several inches from the nares.

A regular diet A clear liquid diet is

is appropriate for patients without special nutritional needs, this diet provides 2,000 cal per day and is a balanced meal plan ordered to provide hydration and calories in the form of simple carbohydrates that help meet some of the body's energy needs- diluted with water enough so you can read through it (Water, broth, black coffee, tea, carbonated drinks, clear fruit juices, popsicles, clear sports drinks, electrolyte drinks)

Effleurage:

is the repetitive gentle, gliding stroke of your fingertips over the surface of the skin

Adjuvant:

means to assist or aid another treatment therefore increasing the effectiveness

Which of the following food items can be included in a full liquid diet?

milk water broth pudding

digestion of proteins

most occurs in the small intestine, begins in the stomach where hydrochloric acid breaks down large proteins into amino acids, which are partially digested by the enzyme pepsin

The nurse is reviewing the medical record of a patient admitted for a severe calcium deficiency. Which common symptoms does the nurse expect to see when reassessing the patient?

muscle spasms primarily of the hands and feet.

functions of proteins

new tissue production Formation of antibodies, enzymes, and hormones Necessary component for heat, and energy production Component to assist in maintaining fluid balance between cells and bloodstream Maintaining acid base balance

Protein types:

non essential amino acids, essential amino acids, complete proteins, incomplete proteins

A pureed diet is

one that is processed in a blender or food processor All liquids, scrambled eggs, pureed meats, pureed vegetables, pureed fruits, mashed potatoes, gravy, applesauce, baby foods

Controlled substances: Patient controlled analgesia (PCA):

opium and its derivatives, known as opiates, also come in synthetic forms known as opioids allows the dose of an opioid or opiate analgesic to be administered as determined by the patient

To promote wound healing, the nurse is teaching a patient about choosing foods containing protein. Which foods should be encouraged?

peanuts, beef, cheese, beans

The nurse is preparing to review nutrition information with a patient. The nurse wants to reinforce the macronutrients needed in the patient's daily diet. Which macronutrient will the nurse review as the most important?

proteins

Types of carbohydrates:

simple and complex

Types of fiber:

soluble (digested it attracts water to form a gel like substance, remains in the stomach longer, and makes you feel fuller longer) and insoluble (not digested but passes through the intestines, acting like a bulk laxative and drawing water to the intestines)

The nurse is preparing to reinforce teaching with a patient who is prescribed an anticoagulant drug. Which food will the nurse advise the patient to avoid? Select all that apply.

spinach, asparagus, beans

A mechanical soft diet is is

the diet of choice for patients with acute or chronic difficulties with chewing, like jaw problems, missing teeth, poorly fitting dentures, weakness or fatigue All liquid and pureed foods, all soups, ground/finely diced meats, cottage cheese, soft cheeses, mashed or rice potatoes, rice, oatmeal, grits, pancakes, soft breads, soda and graham crackers, cooked/soft vegetables, cooked/canned fruits, bananas, soft pastries

The nurse is caring for an adolescent patient who states, "I take a lot of vitamin A to help my acne clear up." Which factor about vitamin A will prompt the nurse to investigate the patient's statement further?

too much vitamin A can cause vitamin toxicity.