Unit 3 Revision - Nutrition
The nurse should include which of the following foods as the best source of vitamin C?
-1 medium guava
The recommended range for BMI is ___ to ___.
-18.5-25 - >18.5 - underweight - <25-30 - overweight - <30 - obese - <40 - morbidly obese
Functions of water:
-50-69% of adult body. -1mL/cal of intake. -Intake should = output +500ml
A nurse is reinforcing teaching for a client about snacks that are appropriate on a low-fat, low-sodium, low-cholesterol diet. Which of the following client choices indicates the need for further teaching?
-A slice of cheese (high fat and sodium).
Diets for bowel health:
-Adequate fluid intake -Fiber: 25g/day for women, 38g/day for men. -RDA of fruits, vegetables, and grains.
Diets for neurological health:
-Adequate levels of B-complex vitamins, especially thiamin, B6, B12, and niacin. -RDA of calcium and sodium.
Diet considerations for hindu patients:
-Avoid dairy products. -Do not consume beef or pork products.
Preventing food borne illness:
-Avoid unpasteurized dairy products. -Keep cold food <4.4C (40F). -Discard leftovers after 24hr -Wash raw vegetables thoroughly in clean water. -Keep cooked foods above 60C (140F).
When developing a program about strategies to prevent food borne illnesses for a community group, which recommendations should be included?
-Avoid unpasteurized dairy products. -Keep cold food temperatures below 4.4C. -Reheat leftovers before eating. -Wash raw vegetables thoroughly in clean water.
Older adults have decreased cellular function and reduced body reserves, leading to decreased absorption of what 3 nutrients?
-B12 -Folic Acid -Calcium
List the 7 major minerals:
-Calcium -Magnesium -Sodium -Potassium -Phosphorus -Sulfur -Chlorine
Diet considerations for patients with cancer:
-Cancer may cause anorexia, increased metabolism, and negative nitrogen balance. -↑ Caloric intake; 25-35cal/kg depending on client needs. -↑ Protein; increased requirements of 1.0-2.5g/kg. -Vitamin and mineral supplementation based on client needs.
What are the components of the large intestine? What digestive processes take place here?
-Cecum, ascending, transverse, descending, and sigmoid colon; rectum, and anus. -Absorbs fluid and electrolytes; eliminates waste products. -1.5m long, 2.5-7cm diameter.
A nurse is educating a patient who is at risk for iron-deficiency anemia. The nurse should explain that which of the following sources of iron is easiest for the body to absorb? -Spinach -Cantaloupe -Chicken -Lentils
-Chicken Rationale: Food sources of iron fall into two categories - heme iron (from lean red meat, poultry, and fish) and nonheme iron (from fruit, vegetables, grains, and dried peas and beans). The body more easily absorbs heme iron.
A nurse is providing teaching to a client with cancer about foods that prevent protein-energy malnutrition. Which of the following foods should the nurse include in the teaching? (Select all that apply.) -Cottage cheese -Milkshakes -Tuna fish -Strawberries and bananas -Egg and ham omelet
-Cottage cheese (protein-rich) -Milkshakes (protein-rich) -Tuna (protein-rich) -Egg and ham omelet (protein-rich) Rationale: Strawberries and bananas do provide essential nutrients, but they are not protein-rich.
Diet considerations for cholecystitis:
-Decrease fat intake, as the gallbladder releases bile that aids in digestion of fats. -Avoid coffee, broccoli, cauliflower, Brussel sprouts, cabbage, onions, legumes, and excessive seasoning.
Sources of complete protein:
-Eggs -Meat and fish -Soy products -Dairy products
Excessive protein intake can damage ___ and ___.
-Kidneys; must rid the body of excess waste products resulting from an increased protein intake. -Liver; strained with the excess load of protein it must metabolize.
List 3 sources of heme iron:
-Lean red meat -Poultry -Fish
Diet considerations for chronic pancreatitis:
-Low fat; prevents stimulation of the pancreas and steatorrhea. -High protein/carbohydrate -At risk for malnutrition, should increase caloric intake to maintain weight. -Avoid alcohol completely. -May include supplements of Vitamin C and B complex. - nutritional therapy for chronic usually includes a low fat, high protein, and high carbohydrate diet. it can include providing supplements of vitamin C and B complex vitamins
Functions of carbohydrates:
-Main source of energy (should make up 60% of caloric intake, 90% of that should be complex carbs). -Needed to regulate protein and fat metabolism. -Fight infection and promote growth of body tissues. -4cal/g
Diets for bone health:
-RDA of calcium, magnesium, and phosphorus. -Weight-bearing physical activity.
A nurse at a providers office is providing teaching to a client who is receiving chemotherapy and losing weight. Which of the following should the nurse recommend to increase calorie and protein intake? -Top fruits w/ yogurt. -Add cream to soups. -Use milk instead of water in recipes. -Increase fluids during meals. -Dip meats in egg and bread crumbs before cooking.
-Top fruits with yogurt. -Add cream to soups. -Use milk instead of water in recipes. -Dip meats in egg and bread crumbs before cooking.
Vegans may have a diet deficient in what 7 vitamins and minerals?
-Vitamin B6, B12, D -Iron, Zinc, Calcium -Riboflavin
Manifestations of metabolic syndrome:
-Weight gain in the abdomen -Elevated BG -Elevated triglycerides
At what age should an infant double and triple their birth weight?
-double=6 months -triple=12 months
Diet considerations for patients with ostomies:
-↑ Fluids -↑ Soluble fiber -Encourage foods that decrease gas (yogurt) -Avoid foods that cause gas (beans, eggs, carbonated beverages). -Avoid foods that cause stomal blockage (nuts, raw carrots, popcorn). -Avoid foods that produce odor (eggs, fish, garlic). -During healing of new stoma site, encourage the client to increase intake of calories and protein to promote healing.
A person is underweight if they have a BMI < ____.
18.5
A client who is prone to kidney stones should drink ___ to ___ liters of fluid/day.
3-4L
Solids should be introduced at ___ to ___ months.
4-6 months
The average DRI for protein for an adult is:
46-56g
Does the body absorb heme iron or nonheme iron more easily?
Heme iron
The condition in which the insufficiency is protein alone, with adequate energy is known as ________.
Kwashiorkor; seen in developing countries after an infant is weaned to a diet that contains mostly grains.
In children, an inadequate intake of protein ad kcal leading to impaired growth and development, stunting height and brain development is known as:
Marasmus
Where is vitamin B12 absorbed?
Stomach
Diets for cancer prevention:
-↑ high-fiber pant-based foods. -Limit saturated and trans fat, while emphasizing foods with polyunsaturated fats, such as omega-3 fatty acids. -↓Sodium -Avoid excess alcohol intake
Diet considerations for nephrolithiasis:
-↓ sodium (increases risk of stone formation). -Avoid tea (contains oxalate). ↓ protein (a high intake of animal protein increases the excretion of oxalate, calcium, and uric acid. Those factors plus the reduction in urinary pH that results from high protein intake increases the risk for the formation of kidney stones. -Drink 3-4L of fluid/day.
List 5 sources of nonheme iron:
-Fruits -Vegetables -Grains -Dried peas and beans
Functions of fiber:
-Increases bulk in stool; proper intestinal function and elimination. -Delays absorption of carbs and cholesterol. -Decrease absorption of fat. -21-38g/day -Skins of fruits, vegetables, and legumes; grains/cereals.
Diet considerations for babies:
-Introduce strained, mashed, or pureed foods from the ages of 6mo-1yr. -Fruit juice at 6-8mo. -Eggs and cheese should not be introduced in the first year. -Sequence of introducing foods: fruit>vegetables>meats
Expected findings w/ PUD:
-Iron deficiency anemia d/t blood loss -Tarry stools d/t intestinal bleeding -Epigastric pain
Manifestations of dumping syndrome:
-Tachycardia -Dizziness -Sweating -Hypotension -Diarrhea
List 3 foods that impair iron absorption when consumed with nonheme iron.
-Tea -Milk (d/t calcium) -Dried beans (d/t phytase)
What are the components of the small intestine? What digestive processes take place here?
-Duodenum, jejunum, ileum. -Food is mixed with secretions from liver and pancreas, completes digestion, absorbs nutrients. -6m long, 2.5cm diameter.
A nurse is caring for a client following the surgical placement of a colostomy. Which of the following statements indicates the client understands the dietary teaching?
-Eating yogurt can help decrease the amount of gas that I have. Rationale: Yogurt reduces odors and gas.
A nurse at is monitoring a client who is receiving a parenteral lipid infusion. Which of the following findings is the highest priority for the nurse to report to the charge nurse? -Elevated temperature -Hyperlipidemia -Periorbital edema -Erythema at the insertion site
-Elevated temperature Rationale: Potential sign of an allergic reaction or fat overload syndrome.
Functions of fat:
-Essential nutrient, supplies concentrated form of energy. -9cal/g -Spares protein from being burned for energy. -Source of fatty acids. -Dissolves and transports fat-soluble vitamins. -25-30% of total calories (20-30g/day). -Unsaturated fat is healthy.
Functions of protein:
-Essential to build and replace tissue and cells. -Plays role in maintaining fluid balance and acid-base balance; transporting nutrients; and producing antibodies, enzymes, and hormones. -Sources of energy (4cal/g) -RDA 0.8g/kg
A nurse is caring for a client who is 4 weeks s/p liver transplant and weighs 65kg. When discussing nutritional requirements, which of the following statements by the client indicates a need for further teaching? -Caloric intake increased to 115% above basal energy expenditure. -Carb intake comprises ~60% of my total daily caloric intake. -Fluid intake has been ~3 liters/day s/p surgery. -Protein intake is about 100g/day.
-Fluid intake has been ~3 liters/day s/p surgery. Rationale: Should be 30-35mL/kg; therefore she is drinking too much.
Diet considerations for gastroesophageal reflux:
-Meals and high-fat foods should be avoided w/in 3hr of bedtime. -Avoid caffeine and chocolate -Eat slowly
What are the functions of the liver? Gallbladder? Pancreas?
-Produces and secretes bile into small intestine for digestion of fats. Plays major role in digestion of fats, carbohydrates, and proteins. -Stores and concentrates bile. Fatty foods stimulate release of bile. -Secretes digestive juices into the small intestine for digestion of carbohydrates, proteins, and fats; also secretes insulin.
Diets for cardiovascular health:
-Saturated fat = 10% of calories (7%) -Cholesterol to 300mg/day (200) -If ↑LDL, increase monounsaturated fats and soluble fiber.
What 3 lab values are used to indicate whether the patient is at risk for malnutrition, anemia, or dehydration?
-Serum albumin -Hgb -Hct
A nurse is assisting with the development of an education program for a group of parents of adolescents. Which of the following should be included as indicators of nutritional risk among adolescents? (Select all that apply.) -Skipping more than 3 meals/week. -Eating fast food once/week. -Hearty appetite. -Eating w/o family supervision frequently. -Frequently skipping breakfast.
-Skipping more than 3 meals/week. -Eating w/o family supervision frequently. -Frequently skipping breakfast.
A nurse is collecting data from a client who has hypocalcemia. Which of the following findings should the nurse expect? -Decreased deep tendon reflexes -Skeletal muscle weakness -Hypoactive bowel sounds -Tingling of the lips
-Tingling of the lips Rationale: Tingling and twitching int he extremities and face (lips, nose, and ears) are consistent with hypocalcemia; interventions necessary to prevent tetany. The other 3 options are consistent with HYPERcalcemia.
A nurse is providing teaching about dietary recommendations to a client who has iron-deficiency anemia. Which of the following dietary recommendations should the nurse include as a food that enhances iron absorption when consumed with nonheme iron? -Tomato juice -Tea -Milk -Dried beans
-Tomato juice Rationale: Food sources rich in Vitamin C enhance nonhdme iron absorption. Tomato products contain vitamin C; therefore, tomato juice is appropriate to include as a food that that enhances iron absorption when consumed with nonheme iron.
Diet considerations for Crohn's Disease:
-↑ Protein: At risk for malnutrition; therefore they should eat a diet high in protein to help maintain their weight. -↓ Fiber: Avoid fresh fruits and vegetables because the skin/seeds can increase intestinal spasms, pain, and passage of stool. -↓ Fat; high fat diets can increase intestinal spasms and pain. -Avoid lactose, as it may lead to osmotic diarrhea.
