Nutrition

cal/d women cal/d men

1,200-1,500 1,500-1,800

Elderly diet calcium __ -__ mg/day vit D __ -____ min __-__ x/wk ___ cho, ___ fiber

CALCIUM: 1000-1500 mg/daily vit D: 15-20 min of exposure to the sun 3-4 x/wk complex cho, fiber >65 influenza yearly pneumococcal q5 hr

Na Restriction

CHF, nephrotic syndrome, ascites, meneires disease

CHF <___ L/d fluid restriction

<2L/d fluid restriction (include ivf)

protein restriction

A client who is on hemodialysis three times per week and has a creatinine level of 2.8 mg/dL (247.52 µmol/L)...kidney failure impairs the kidney's ability to excrete the nitrogenous byproducts that come from proteins A client whose urinalysis is positive for proteinuria and hematuria, but negative for white blood cells and bacteria....indicates glomerulonephritis, which can compromise kidney function; negative WBC and bacteria in urine differentiate UTI from glomerulonephritis A client with hepatitis and who is experiencing mild confusion and difficulty concentrating...proteins are deaminated by the liver and converted to urea for excretion; when liver does not function properly to convert deaminated protein, ammonia builds up, can lead to hepatic encephalopathy

Phosphorous

DAIRY products (milk, yogurt, cheese, pudding), organ meats, nuts, fish, poultry, whole grains, cola, peanut butter

Vit A

LIVER (avoid in pregnant), sweet potatoes, carrots, and dark leafy greens

Diverticular diseases uncomplicated vs acute

LLQ pain relieved by passing stool/flatus, constipation alt with diarrhea uncomplicated, etiology= constipation so avoid by: HIGH fiber (F/V), AVOID food with seeds (TOMATO/CUCUMBERS), nuts, corn/ popcorn, strawberries, and caraway seeds increase fluids, bulk laxatives, antispasmotics/ anticholinergics (dicyclomine) acute: bedrest, NPO, AVOID fiber if diverticulitis develops, progressing to oral fluids and semi-solids, IVF, NGT, Abx

gastroesophageal reflux disease (GERD) __ fat acidic/non-acidic? water with or in between?

LOW fat and NON-acidic foods (no OJ/tomato juice--apple juice is good alternative) , THICKEN foods sm/ freq meals. sip water WITH meals chewing gum (promotes salivation may neutralize acid) ie Broiled chicken, cream of broccoli soup, rice pudding, and apple juice. foods that exacerbate: BIG meals, FATTY foods, spicy, dairy, hot/cold, MINT/Peppermint, oil dressing (high fat), TOMATO, lemonade, carbonated beverages, chocolate, caffeine, alch, nicotine (Wt loss helps, decr gastric pressure, abdom breathing strengthens LES, elevate HOB)

Phenylketonuria (PKU) ____ phenylalanine diet save level range __-__mg/dL <12 yo infants: children: low __ diet (no ___, __, __, __) ___ blood test obtained no later than __ days after birth

LOW phenylalanine diet (NOT totally eliminated bc essential AA for normal development) safe level range 2-6 mg/dL <12yo infants- special formula with milk substitute (Lofenalac) low-protein diet for children (no meat, dairy, eggs, Nutrasweet) Guthrie blood test obtained after ingestion of protein, no later than 7 days after delivery

lower bowel surgery

LOW residue diet skinless vegetables, canned/cooked/seedless vegetables, refined grains (White bread) ok, ALL meats, poultry, fish must be BOILED OR BAKED NO RAW fruit/veg (sprouts, carrots, celery sticks, cabbage) NO beans/legumes (high fiber) NO WHOLE WHEAT, raisin bran/ whole gains NO fried chicken

Vit B12 risk for b12 def

MEAT pernicious anemia, vegan, on metformin, gastrectomy (no stomach to secrete intrinisc factor)

gout prevent recurrent attacks: avoid high __ foods: drink __-__ml/d __ carb diet alch? calcium? if overweight lose __ to __ lb/wk

AVOID high purine foods: RED AND ORGAN MEATS ie liver, SHELLFISH, oily fish with bones, sardines, seafood, meat soups, gravy, anchovies, spinach, peas, dried legumes, wild game drink at least 2,000-3,000mL/d fluid, increase urinary uric acid excretion HIGH carb diet enhances uric acid excretion (low carb causes formation of ketones that decr excretion) eliminate alcohol intake calcium NOT limited with gout lose 0.5 to 1 lb/ week, excessive weight loss may precipitate gouty arthritis (ie lose 3lb/wk)

Nephrotic syndrome ____ protein ___ sodium fluid restriction?? make foods fun and attractive (LOA with ascites)

Adequate protein, unless cannot tolerate protein, and LOW sodium, fluid restriction with severe edema make foods fun and attractive (LOA with ascites)

Iron

MEATS (red, beef, lamb, liver/organ meats, chicken giblets vs breast, pork) SHELLFISH/ MOLLUSCKS (oysters/clams/scallops, shrimp) egg yolk, dark leafy green veg (SPINACH, collards), broccoli, dried fruits (Raisins), dried beans (green beans not steamed) fortified cereal and grains (OATMEAL), brown rice limit milk intake in toddlers (16-24 oz/d) to ensure balanced diet

Chronic Kidney Disease (CKD) CHO protein K+ Phosphorous Na Ca Water __-__L/d

pasta/breads--grains are good source of CHO (incr CHO helps pt maintain energy requirements) protein with HIGH biological value is allowed (eggs, LEAN meat ie chicken breast, fish, poultry), protein intake determined on basis of impairment (GFR), too much will incr uric acid CKD causes hyperkalemia... cabbage and apples low in K+ CKD causes hyperphosphatemia CKD causes hypernatremia CKD causes HYPOcalcemia... consume calcium but still AVOID DAIRY bc dairy is high in phosphorous + will bind Ca 1-2 L water/day (maintain fluid balance and avoid retention of excess fluid that cannot be excreted by the compromised kidneys)

Diet to prevent seizures

ketogenic: high in fat, low in cho, mimics effects of fasting and places body in a constant state of ketosis

radium implant

low residue diet to decrease bowel movements

diarrhea

low residue, high calorie, protein avoid caffeine, roughage (Fresh fruit salad), and DAIRY products avoid honey, high-fructose corn syrup,wheat, spices, hot/cold, fatty, gas-producing (bananas, cabbage, onions, bagels, beans)

Hepatobiliary disease ___ fat ___ protein ___

low-fat hight protein diet vitamins

Fat: LOW fat:

marbled meats, cheeseburger, grilled cheese, avocado, milk, bacon, egg yolk, butter, peanut butter, bologna, potato chips bran flakes, skim milk (no fat), canadian bacon, egg whites, COLA (high in cho not fat), water-packed TUNA, backed tortilla chips and salsa

Protein

meat, fish, eggs, dried beans, almond butter milk/dairy (whole milk), milkshakes, fruit smoothies, yogurt, broccoli legumes= economical

Alcoholic

needs supplementation with all B vitamins, especially thiamine (vitamin B1); thiamine deficiency is the primary cause of alcohol-related changes such as Wernicke's encephalopathy and Korsakoff's syndrome

Fecal occult blood test avoid: food:___ ___, vit. ___ meds: __/___, ___, ___, ___

no red meat, vit. C for 3 days ASA/Ibuprofen, anticoag, iron, corticosteroids interfere

MAOI-s

no tyramine with MAOIs smoked/fermented, alcohol/wine, cheese (Cream cheese ok), chocolate, liver?, BANANAS, AVOCADOS, no yeast/yogurt (brown-rice ok), whole wheat bread likely to have yeast spinach and tuna are ok

Lithium ____ sodium intake ___ fluid intake (__-__L/d)

normal sodium intake, adequate fluid intake (2-3 L/d) avoid limiting sodium bc lithium is a salt and replace sodium in cells leading to lithium toxicity

Sickle cell crisis

oral and IV fluids high cal high protein FOLIC ACID (help produce new RBC needed due to hemolysis) multivitamin WITHOUT iron (often require blood transfusions and run risk of iron overload if iron is supplemented) IV/oral hydration, narcotics, O2 avoid COLD- promotes sickling

bottle-fed infant is allergic to cow's milk

predigested formulas .... formulas that use enzymatic hydrolysis to break down or predigest the casein protein into its amino acids NOT SOY-based formulas (cow's milk allergy due to cross-reactivity to soy) NOT goat's milk (has cross-reactivity with cow's milk protein, is deficient in folic acid, is inadequate as the only caloric source)

vit K

produced by bacteria in large intestine GREEN veg, pork, rice, yogurt, cheeses, FISH, EGG

Hypoglycemic and conscious: __-__ oz ___ or ___ milk

15 g CHO: Drink 1/2 cup fruit juice followed by peanutbutter crackers drink 4-6 oz OJ/ LOW-fat milk

iron/d women men pregnant

18 mg/d W 10 mg/d M 30 mg/d preg

Hypoglycemia unconscious and cant swallow

1mg glucagon SQ/IM (SE: nausea) 25-50 mL 50% dextrose IV (se: HA, pain at site, ensure patency of IV line)

Hypoglycemia 15 g CHO

3-4 glucose tablets 4 to 6 oz juice or regular soda (not diet) (ie 125 mL of apple juice) 2-3 tsp sugar/honey 6-10 hard candies 1/2 cup plain pasta 1/2 cup of canned fruit NOT.... 2 tsp of sugar= 8.5 g of CHO 1 cup of whole milk= 11 g of CHO 8 ounces of regular soda= 26 g of CHO retest in 15 min, retreat if <70 or if sx persist >10-15 min. Provide snack with protein and CHO unless plan to eat a meal (give milk and crackers or ifOJ/ simple sugar is given, should be followed w/ a meal/ protein)

prevent odor with colostomy

Drink cranberry juice and buttermilk, eating parsley and yogurt is also helpful Eat crackers, toast, and yogurt. (prevent gas) chewing gum, skipping meals, drinking beer, and smoking contribute to the production of flatus Use a commercially prepared deodorizer inside the pouch (eliminate odor)

Prevent dumping syndrome eat high __ and high __ foods, and ___ cho avoid high __ foods, ___ sugars, and___ drink fluids __ meals

EAT HIGH PROTEIN HIGHT FAT FOODS (remain in stomach longer), low carb and sugar-free AVOID HIGH CHO foods, simple sugars, AVOID FIBER??? drink fluids in between meals (1 hr before/ after) smaller frequent meals

Potassium

OJ, oranges, citrus fruits, bananas, coconut, watermelon, cantaloupe squash, potatoes, tomato, broccoli, spinach, avocado, dried fruits, dried apricots, raisins, prunes, celery (low in Na), salt substitute, caesar salad low K+: alfa sprouts, cabbage, lettuce, grapefruit,

Fiber

RAW, fresh, and dried fruits/ vegetables, GREEN BEANS, split pea soup, CELERY, pears (NOT cucumber), raspberries, prunes, sweet corn, SALAD bar, CARROTS whole-grains, WHOLE-WHEAT BREAD, WHEAT BRAN, breakfast cereals, oatmeal eight to ten glasses of fluid daily

While performing care for the elderly client, the nurse notices that the client has a dry, parched mouth and tongue. The nurse should take which action?

Rinse the client's mouth with room-temperature tap water before and after meals. glycerin swabs/ commercial mouthwash (with alch) will dry mucous membranes

ferrous sulfate (Feosol) (iron)

SE: constipation increase intake of fruits, fiber, fluids (10-12 cups/d) ie fresh fruits and whole-grain bread give BETWEEN MEALS, WITH CITRUS JUICE calcium/dairy consumed 2 hrs before or 1 hr after iron supplements (decr absorption) (other SE: gastric irritation, N/V/D, abdominal cramps, anorexia, and dark/black/green/tarry colored stools) place medicine in back of mouth (temporary staining of teeth), use dropper/straw keep no more than 1 mo supply, lethal/toxic

cholestyramine SE:___ and ___ deficiency

SE: constipation, depletes fat soluble vitamines consume milk (vit A, D), and green leafy veg (E and K) and encourage high-fiber and fluids

Vit B1, Thiamine

cereals, nuts, beans, and many other vegetables

cholecystitis avoid ___ and ___-___

avoid fatty (Avocado, bagel, eggs, chips) / gas-forming foods (broccoli, onions, cucumber, beans) ie barbecue chicken, salad, baked potato, rice,

morning sickness: ___, __, __ beverages ___ meals high-___ snack before bedtime/ in morning foods/drinks with ____ high in vit. ___ (__,__,___)

clear, cold, carbonated beverages BETWEEN meals high-protein snack before bedtime/ in morning foods/drinks with GINGER and high in vit. B6 (nuts, seeds, legumes)

Calcium

beans, dark green veg (spinach, kale, broccoli), calcium-fortified juices and cereals

acute pancreatitis between attacks: during acute phase:

between attacks pt needs high protein, high carb, low fat NPO during acute phase because pancreatic secretion is increased by food/fluid intake

Gas forming foods (4)

broccoli, onions, CUCUMBER, beans, cabbage, cauliflower BANANA BAGELS

Child with gastroenteritis once rehydration has occurred/ dehydration is not evident

child's normal diet should be resumed; continued feeding or early reintroduction of nutrients as in a normal diet is without adverse effects, decreases the duration and severity of the illness, and improves weight gain compared to gradually reintroducing foods

a client who follows a vegan diet. The nurse is aware that the client may become deficient in which nutrients

calcium- dairy products vitamin D -in dairy foods vitamin B12 because they do not eat meat iron is found in muscle meats and in fortified cereals and grains

Sodium

canned soup, tomato juice, broth, cold cuts, bread, carbonated beverages, canned foods, baked beans, coleslaw, pickles, creamed sauces, MILK (skim milk too), meat/fish that is smoked, pickled, cured, canned, Chinese food/ MSG/ soy sauce, fast food, ceasar salad instant oatmeal has added Na, quick breads, biscuits lemonade= low good choice if restricted

Cushings syndrome ___ protein, ___ carb, ___ sodium, ___ potassium, ___ cal diet, fluid restriction?

high protein, low carb, low sodium, high potassium, low cal diet, fluid restriction

Cholesterol

dairy/milk, beef

low HCT, low Hgb

diet for iron def anemia

Pt takes phenytoin (Dilantin)... when providing nutritional counseling, the nurse should include which of the following foods in the patient's diet?

diet high in folic acid, calcium, vit. D anticonvulsants can cause folate and vitamin D deficiencies (se= osteoporosis) folate are green leafy vegetables, legumes, tomatoes, and various fruits such as oranges and cantaloupe; good sources of vitamin D include milk

Prevention for renal calculi fluids ___-___ml/d avoid foods high in ___ (__, __, __) limit __, __ ,__ if calcium calculi: ___ sodium

diet, medications, fluids: 3,000 to 4,000 ml/day, incr fluids in warm/hot enviro to prevent dehydration avoid high in oxalates (spinach, asparagus, and cabbage) limit coffee, cola, tea dietary changes only helpful if you know composition of stones calcium calculi: (ie reduce the amount of dairy products and eggs in your diet) eat diet LOW SODIUM, high sodium will incr calcium excretion

Menieres disease ___sodium avoid __, __, __ meds: ___,__, __, ___ __ body movements

disease of inner ear from accumulation of endolymphatic fluid- incapacitation vertigo, tinnitus, sensorineural loss LOW sodium diet (2,000mg/d) AVOID caffeine, nicotine, alcohol meds: diuretics, antiemetics, antihistamines, antivertigo meds (also SLOW down body movements bc jerky mvmnt precipitates attack, LIE down during attack)

Cirrhosis

early: high protein, high carb, vit. B complex supp advanced stated: fiber, protein, fat, sodium RESTRICTIONS, protein of HIGH biological value, high cal, sm freq feeds fluid restriction avoid alch high cal (malnutrition serious complication): 3,000 calories/day

Abdominal Aortic Aneurysm (AAA)

encourage fluid intake and dietary fiber... prevents constipation and the need for straining with bowel movements that may cause increased intra-abdominal pressure and risk of rupture (dont wear seatbelt, dont lift heavy object, dont elevate feet above heart level-inr abdominal pressure)

CAPD, continuous ambulatory peritoneal dialysis

high protein, well-balanced diet (fluid and protein loss) may need stool softener and high fiber to prevent constipation (main cause of insufficient dialysate flow)

Renal Failure ___ cal ___ protein

high-cal, low protein diet, as allowed by kidney function

Ileostomy

ileostomy= small intestine (smaller stoma, 1in or less) follow LOW-residue diet (low fiber) to prevent obstruction of narrow lumen F/V should be pitted, peeled, cooked AVOID: HIGH-FIBER: popcorn, coconut, brown rice, multigrain bread stringy vegetables: celery, broccoli, asparagus seeds or puts: olives, strawberries edible peels: apple slices, cucumber, dried fruit

Liver disease

increased carbohydrates, low protein, and low sodium

TB diet ___, ___, vit. ___ and vit. __

iron, protein, vitamin B, vit C

Pregnant balanced diet, esp containing (6)

folic acid (B9), iron, protein, calcium, whole grains, omega 3-FA AVOID: unpasteurized milk, unwashed F/V, undercooked meat, Deli meat (risk Listeria), hot dogs (unless steaming hot), raw fish/meat, and fish high in mercury (swordfish, king mackerel, shark, tilefish) and excessive vit A (in liver).... avoid Listeria and toxoplasmosis

CROSS REACTIVE FOODS WITH LATEX ALLERGY

foods to avoid include apple, apricot, AVOCADO, BANANA, carrot, celery, cherry, CHESTNUT, fig, GRAPE, KIWI, melon, nectarine, passion fruit, papaya, PEACHES, pear, pineapple, plum, POTATO, and TOMATO also lips swell with balloons, hands itch/burn after gloves greatest latex allergy RF: long-term multiple exposures, 93% pt spina bifida

Bipolar

frequently undernourished/dehydrated. give "on the run" foods ie sandwiches, smoothies, milkshakes, ice cream bars, fresh fruit, chips, pizza slices, burritos, fruit juices, granola bars with high nutritional density

lactose intolerance

fresh yogurt can be used in situations of lactose intolerance because it has a lactase enzyme

child with adrenoleukodystrophy (ALD) give...

give Lorenzo's Oil treatments.

celiac no __, __, __, __ replace __-soluble vit, __, ___ __

gluten-free no BROW: barley, rye, oats, wheat processed foods (chocolate/hot dogs), modified starch, malt, soy sauce = hidden sources deficient vitamins (fat-soluble), iron, folic acid, should be replaced

Folic Acid preg need ___-__mcg/d

green leafy veg, beans, rice, fortified grain products* (cereal, bread, pasta), liver 400-800 mcg/d

Folate

green leafy vegetables, legumes, tomatoes, and various fruits such as oranges and cantaloupe

Magnesium

green veg, nuts bananas oranges, peanut butter and chocolate

Burn victim __ cal __ protein __ cab vit. __, vit. __, ___

high cal, high PROTEIN, high carb, vit B, C, iron (H2 histamin blocker and antacids to prevent curling ulcers, and NGT) Cheeseburger, fruit-flavored yogurt, carrots, and milk. (all contain protein except carrots)

Crohn's/ Ulcerative colitis __ cal ___ protein ___ fat ___ fiber ___ residue diet

high cal, high protein, low-fat, low-fiber, low- residue diet, skinless vegetables, canned/cooked/seedless vegetables, refined grains (White bread) ok, NO RAW fruit/veg (sprouts, carrots, celery sticks), NO beans/legumes (high fiber), NO raisin bran/ whole gains

Cystic Fibrosis __ calorie, __ protein, __ fat diet __ sodium __ fluids supp vit __, __, __, __ oral pancreatic enzymes: __coated so. take with meals. sprinkle on ____, ____, or ___, __, ___/ __-temp foods with pH <____ DONT __/ __ them or take with ___

high calorie, high protein, high fat INCR sodium in diet incr fluid (remove secretions) (impaired intestinal absorption) fat soluble vit supp A D E K oral pancreatic enzyme supplementation: enteric coated. take WITH meals (sprinkle on applesauce, yogurt, acidic, soft, cool/ room-temp foods with <pH 4.5) DONT crush/chew DONT take with milk, enzymes curdle it...excessive intake can cause fibrosing colonopathy

Hepatitis

high carb, high cal fluids 2,500-3000 mL/d sm freq meals, big breakfast (Anorexia lowest in morning) encourage lean meat, F/V, cereals low fat, low protein no alch

Anemia high in __, __, and ___

high in protein, iron, and vitamins

wound healing/ post-op diet

high protein, high cal, iron, vit. C, multivitamins aid in wound healing and RBC formation, B6 and B12 important for collagen synthesis high protein + high cal to remain anabolic state ie Chicken breast, peas, mashed potatoes, orange, and ice cream. Hamburger, boiled potatoes, corn, pudding, and grapefruit juice. Salmon steak, baked potato, lima beans, tangerine, and milk.

Addison syndrome ___ protein, ___ carb, ___ sodium, ___ potassium diet

high protein, high carb, high sodium, low potassium diet

hypothyroidism: __ protein ___ calories ___ fluids ___ fiber

high protein, low cal (overwt), incr fluids, incr fiber/ high-cellulose foods (constipated)

The client is diagnosed with a flaccid bladder following a spinal cord injury. The nurse teaches the client about dietary changes. Which beverage, if selected by the client, indicates to the nurse that teaching is effective? which diet?

promote ACIDIC urine (minimizes risk of UTI and stone formation), 1000 mg vit. C (ascorbic acid) prune juice cranberry juice tomato juice bouillon HIGH fiber, LOW fat diet AVOID alkaline urine... avoid CITRUS juices, OJ, lemonade, excessive amt of milk, and carbonated beverages

Toddler

provide with finger foods no carrots/hot dogs/sticky pb/slippery

Vit. C

red pepper, broccoli, oranges, salad, POTATO

dental caries cariogenic foods: cariostatic (inhibit caries) foods:

refined simple sugars, sticky, sweet foods, dried fruit/candy milk, dairy, yogurt, F/V/ whole grain, sugar free gum w/ xylitol finish meal with high-protein food

Elevated BUN restrict ___

restrict Protein (decreased production of urea nitrogen can be achieved by restricting protein; metabolic wastes cannot be excreted by the kidneys)

Hepatitis A. The client complains of fatigue, anorexia, and intolerance to odors.

small and freq feedings. encourage client to eat all meals and snacks; if client has nausea later in the day, offer morning meals that are rich in nutrients should eat protein sources such as milk, meat, and eggs should increase calories to 2,000 to 3,000 calories per day to meet energy needs do not ingest alcohol during episode of hepatitis and for SIX MONTHS after recovery protein restricted if impending hepatic coma

Stomatitis

soft, bland, nonacidic, and cool liquids and foods will help eating process be more comfortable; spicy foods, hot liquids, and citrus juices cause mucosal irritation commercial mouthwash should be avoided because of high alcohol level that causes a burning feeling in the irritated oral mucosa; warm saline or hydrogen peroxide are mouthwashes that can be used instead nystatin is an antifungal agent in oral suspension; should be swished around in the mouth and then swallowed

Vitamin D

sun, dairy foods, vit d fortified juice (OJ), fortified milk, fortified cereal, fish oil, oily/ salt water fish (SARDINES, SALMON, TUNA), egg YOLK,

Isoniazid

supp with vit. B6 (pyridoxine) for peripheral neuropathy/ataxia/dizziness side effects of INH

PUD/ gastric/ duodenal ulcers

taking histamine blocker- small freq feedings are NOT necessary avoid: coffee/caffeine, ASA/NSAIDS/ advil, alcohol, smoking cigs, diet rich in milk/cream, meat extracts -all stimulate acid production