NR228 Nutrition Carbs, Water and Wellness
The nurse is caring for a client with heart failure and who admits to eating more processed foods. On assessment, the nurse notes that the client is dyspneic, and crackles are audible on auscultation. What additional signs and symptoms would the nurse expect to note in this client if excess fluid volume (EVF) is present? Select all that apply.
shortness of breath increased blood pressure feeling bloated facial edema
The nurse is helping Mrs. Smith plan a diet that help keep her serum blood glucose levels consistent through the day. The nurse determines that Mrs. Smith understood the teaching when she selects snack to eat in each situation?
Consume crackers with peanut butter when feeling dizzy Consume raspberries for an afternoon snack For breakfast oatmeal with a pad of butter and blueberries
Mrs. Smith is concerned about an upcoming block party which will feature foods prepared by and shared with her neighbors. Which ideas for adhering to her dietary plan demonstrate her understanding of carbohydrates? Select all that apply.
"My daughter has agreed to nudge me if I put something on my plate that will increase my blood sugar." "I will start with a salad so I feel fuller and will not overeat things that would increase my blood sugar." "I will eat a bit less through the day without skipping meals." "I will select fresh fruits for dessert, rather than the neighbor's yummy chocolate cake."
While talking with the parent of a toddler about water and minerals the nurse recognizes that further education about safe sources of drinking water is needed when the parent makes which statement?
"We swim in the lake near our house and the kids drink it all day because it is clear and cold." Outdoor sources of water, such as lakes, rivers, and streams, should be purified before drinking because harmful chemicals and infectious agents may not be visible. The nurse should advise the parents to either bring clean water or a use a purification system. Hard water contains minerals, which may change the taste but should be safe to drink from taps in a home supplied with water from treatment plant. Lead pipes are significant source of lead poisoning and should be replaced. Careful use of lawn care products, such as fertilizers and weed control, is need to prevent contamination of nearby wells that supply potable water to others.
An older adult with a history of hypertension and coronary artery disease (CAD) lives alone on a fixed income. The client has been eating two (2) pre-packaged ramen noodles for lunch every day. How many grams of sodium is this client consuming at lunch time? Enter only a numeric value as a whole number.
2 Since each package is one serving and the client is eating two packages, the client is eating two servings of ramen noodles each day. Each serving contains 1030 mg of sodium, the client is receiving 2 grams of sodium at lunch each day.
The client ate one and a half (1.5) servings of cereal. What percentage of the recommended daily intake of dietary fiber has the client consumed? Enter only a numeric value rounded to the nearest one decimal.
37.5 The cereal provides 25% of fiber per one serving. Each serving provides 25% of the recommended intake of dietary fiber. 1.5 X 25 = 37.5 grams of dietary fiber.
When talking to a group of adolescents about healthy beverages, the nurse should include which statements about the benefits of water? Select all that apply.
According to the Mayo Clinic (2020), water moistens tissues in the eyes and nose, lessens burdens on the kidneys and liver, and helps dissolve minerals and nutrients so they can be used by the body. Water is lost throughout the day, including in the air that is exhaled, making adequate intake vital to good health. Water does not directly impact bone growth or blood sugar levels.
A male comes home 5 days after surgery, how do you prevent constipation
Adequate fluids and fiber in the diet are key to preventing constipation. Post-operative clients who are in pain may become dehydrated by medications, having trouble getting a drink due to pain or limited mobility, or decreased water intake on purpose so they need to urinate less often. For a male client, the AI is 3.1 L per day. One way for the client to track intake is to fill a 3-liter container early in the day with the goal of drinking it all before going to bed. Because the client will consume water in foods and other beverages, they will meet the AI with ease. High fiber foods should also be encouraged to help the stool remain bulky and retain water. Laxatives should not be used routinely for bowel elimination. They should be used only as a last resort, because clients may become dependent on them. A regular bowel evacuation schedule should be established. Drinking ½ gallon of water meets the AI for a woman, not a man. Since fiber supplements lack the full nutritional value of whole foods, it is recommended that this post-operative client meet fiber requirements from food sources.
The client ate two cups of cereal. How many kilocalories (kcal) from fiber did the client consume? Enter only a numeric value rounded to the whole number.
Each serving is one cup and contains 13g of fiber. The client ate two cups, which is two servings. As a carbohydrate fiber contains 2 kcal per gram.term-25 2 x 13 x 2 = 52 kcal from fiber. Note: When calculating fiber intake, use only the Dietary Fiber value from the food label. If the amount of soluble or insoluble fiber is listed, that amount is included in the Dietary Fiber value.
When planning education for client admitted with dehydration, the nurse should include what information on preventing dehydration? Select all that apply.
Eat foods with high amounts of water. Drink mostly water. Drink more water when sweating. Limit intake of alcohol
Understanding of fiber and carb diet
Eating whole grains Sweet potatoes Eating frozen fruit when can't eat whole fruit Choosing whole fruit
The nurse providing water safety education to parents of a toddler recently treated for lead poisoning determines that more education is needed when one parent makes which statement?
I will use hot water for cooking indicates the client requires additional education. The client should use cold water for cooking because it contains fewer dissolved solids from the pipes. The client should also run through water in the morning for up to five minutes. This will allow the pipes in the house to be adequately flushed. Water conservation and flushing the pipes can be achieved simultaneously by washing clothes or taking a bath prior to obtaining water to drink.
When caring for a hospitalized client, the healthcare provider prescribes to increase oral fluid intake. Which actions should the nurse include on the nursing plan of care? Select all that apply.
Keep fresh water within the client's reach. Offer the client fluids they prefer. Suggest the client's family bring in fresh fruits and vegetables for snacking. Encourage the client to avoid sugary and caffeinated beverages. Educate the client and family on the need to increase fluids. The plan of care should include assessing the client's fluid preferences and always having those available; education the client and family on the reason the increased fluids are important to their health; keeping fresh water available; encouraging the client to limit their intake sugary and caffeinated beverages that have diuretic properties; and encouraging the client to each fruits and vegetables that have an increased water content. Because the client is hospitalized and the fluids are prescribed, the client and family should not need to pay for beverages. Unless the client has a health condition that requires them to avoid consuming food and liquids at the same time, there is not a need to limit fluid intake with meals.
Carb Cultural Influences
Middle Eastern: Hummus African Americans: black eyes peas and rice Mexican: kidney beans Caribbean: Rice and Beans
The nurse is determining the order in which to assess clients recently admitted to the emergency department. Which client should the nurse see first? Click on the item to select your answer.
Older Adult confined to bed with no urine output for 14 hours
For dinner, a client ate three servings of cereal. How many grams of carbohydrates were consumed? Enter only a numeric value rounded to the nearest whole number.
One serving of cereal contains 26g of carbohydrates. The client ate 3 servings. 3 x 26 = 78 grams of carbohydrates This total reflects only carbohydrates contained in the cereal. If the client added milk and sugar the total carbohydrate intake for that meal is higher. This is well within the recommended daily intake of carbohydrates for a healthy adult, which is 225-325 grams per day.
The client has a dry mouth dry and mucus membranes and reports being thirsty. Based on these cues the nurse interprets that the client is
Oral rehydration solutions (also known as sports drinks) contain water, minerals, and electrolytes commonly lost as a person becomes dehydrated. The cues of thirst and dry mouth/mucous membranes indicate that the individual is experiencing mild to moderate. Clear soda and hot tea do not contain the electrolytes needed to replace those lost. Sparkling, or carbonated water, contains salt (sodium chloride) to improve taste, but no other minerals. Dehydration is divided into three stages: 1) mild, 2) moderate, and 3) severe. Mild and often even moderate dehydration can be reversed or put back in balance by oral intake of fluids that contain electrolytes (or salts) that are lost during activity. Severe dehydration may require intravenous fluid administration.
Minerals called electrolytes dissolve in water. The nurse understands that which electrolyte influences water balance within the body? Select all that apply.
Sodium and potassium are two examples of electrolytes that carry an electric charge and dissolved in water. It is important to mention that these two electrolytes highly influence fluid movement in the body. Folic acid is a B vitamin. Copper is a metal.
When asking an sodium restricted individual questions which water type should you question further?
Soft water Water filtration systems produce what is called soft water. Soft water has certain minerals removed and replaced with sodium. It is imperative for the nurse to recognize that soft water may adversely affect clients who are sodium sensitive, including those with hypertension, heart failure, or those who take lithium. Although the level of sodium used to soften water is relatively low, clients on a low-sodium diet should include this amount in the daily intake totals.
The client asked the nurse why he stills feels thirsty after drinking carbonated beverages made with real sugar. What information should the nurse provide to explain what is happening in the body? Place the sequence of events that occur in the body that result in thirst, starting with the first.
Sugar beverage consumed Sugar is absorbed into bloodstream Sugar and sodium levels rise water pulled from salivary glands dry mouth sensation thirst is recognized Once a sugary beverage is consumed the sugar is immediately absorbed into the bloodstream. The quick absorption of sugar alters the balance of fluids and electrolytes in the blood stream and the body compensates for the increase in sodium by pulling water from the salivary glands and the colon. Dry mouth is the result of fluid loss from the salivary glands. If the client drinks water homeostasis returns to the blood stream. If the client continues to drink a sugary beverage, they will continue to experience thirst. During the process, the kidneys may excrete more water and the cortisol level may rise, but the underlying mechanism that creates the sensation of thirst is the shift of water from the salivary glands.
Which individuals are at risk for dehydration?
The 18-year-old who drank 5 cups of water in one day is at risk of dehydration, regardless of their gender. Based on recommendations for Adequate Intake (AI) of water in a 24-hour period this is less than 50% of the recommended daily 9 cup (72 ounces, 2.1 liters, 0.5 gallon) intake for women and about 33% of the 13 cups (104 ounces, 3.1 liters, 0.8 gallon) that men require. Signs and symptoms that the nurse may observe are dry skin and decreased urine output. The 28-year-old male and 66-year-old female both exceeded their AI. Unless they are prone to fluid overload due to health issues, this amount of fluid should not affect their well-being. The 34-year-old client consumed just under the AI for her gender.
The nurse is assessing a school-aged child brought to the urgent care center. The parents explained that the child has been vomiting for 19 hours and has not taken any food or fluids in that time. Based on the parents' statement, what physical assessment findings does the nurse anticipate? Select all that apply.
dry mouth and tongue cool extremities mild irritability
Kevin and his friends attended their college football team's first home game this afternoon. They drank a lot of soda and ate way too many hotdogs, popcorn, pizza, and pretzels.
feeling bloated, Clothing, Increased sodium intake Decrease pain, decrease bloating Based on the foods that Kevin ate, the nurse determines that Kevin's sodium intake was higher today than usual. The salty foods combined with drinking a "large amount of soda" cased bloated, or edema within his abdomen. Kevin's presenting cues included feeling bloated (subjective data) and the need to change tight pants for a looser option. The nurse explains this to Kevin to help him understand what is happening in his body and why. The nurse also provides information on what to expect as his body responds to the changes in sodium and fluid, including decreased abdominal pain, less bloating, and feeling less restricted by his clothing. In addition, the nurse will advise Kevin of factors that indicate his condition is becoming more serious, including shortness of breath and worsening of current symptoms.
The nurse observes tooth decay on the lower central incisor of the toddler's mouth whose parent denies giving the child candy. The nurse should inquire about which item that promotes tooth decay in young children?
milk it contains lactose which is sugar xylitol actually prevents cavity formation and is a sugar alcohol
Which food doesn't have a low glycemic index?
the rice White rice has the highest glycemic index and would indicate the diabetic client required additional dietary education. Leafy greens, apples, and walnuts contain fiber which lowers their glycemic index.
