Nutrition

Vitamin B12 function (cobalamin)

-Building block of nucleic acids -Build RBCs -Facilitates nervous system function

Nutritional requirements to promote weight loss

500-1,000 calorie deficit from baseline to lose 5-10% of bodyweight in 6 months

Water-soluble vitamins

C, B complex

A nurse documents a patient's hemoglobin as 8 g/dL. What nutritional condition does this biochemical data signify? A. Dehydration B. Malnutrition C. Malabsorption D. Anemia

D. Anemia

Lactovegetarian diet

Diet that excludes meat and eggs, but includes dairy products

Primary prevention related to metabolism

Diet, exercise, healthy weight

Foods included in soft diet

Easily chewed and digested; low residue (low fiber); ground, mashed, puréed, moist

Nutrients definition

Elements necessary for body processes and function

Vitamin B6 function (pyridoxine)

Important for metabolism, formation of RBCs, protein synthesis

Nutrient density definiton

Proportion of essential nutrients to the number of kilocalories

Older adult nutrition needs

-Metabolic rate slows leading to a decreased need for energy -Vitamin and mineral requirements remain unchanged -Milk still important

Foods included in full liquid diet

-Milk -Puddings -Custards -Plain frozen desserts -Pasteurized eggs -Cereal gruels (i.e. cream of wheat) -Fruit and veggie juices -Milk and egg substitutes -All above in addition to clear liquids -Liquids that can be poured at room temp

Newborn nutrition needs

-110-120 calories/kg BW (breastmilk and formulas contain ~20 calories/oz) -Fluid requirements = 100-150 mL/kg BW

Nutrition attributes

-Adequate intake for development, energy, growth, repair -Ideal height, weight, BMI -Muscle tone, strength, agility, reflex response -Cognitive and food response -Albumin WNL -Hemoglobin and hematocrit WNL -Electrolytes WNL

Infant nutrition needs

-Breastfeeding/formula -Solid food (4-6 months) -Weight doubles by 6 months, triples by one year

Fat

-Calorie dense - 9 kcal per gram -Triglycerides - 3 fatty acids + glycerol -Fatty acids -Saturated, monounsaturated, polyunsaturated -Linoleic acid = only essential fatty acid in humans -Found in animal and plant foods

Recommended daily % of carbs, protein, and fat from dietary sources

-Carbs 45-65% -Protein 10-35% -Fat 20-35%

Foods included in clear liquid diet

-Coffee (no milk or creamer) -Tea -Water -Clear broths (bouillon or consomme) -Carbonated beverages -Strained and clear juices -Plain gelatin -Clear fruit juices (apple, cranberry, grape; no pulp) -Popsicles -Commercially prepped clear liquid supplements -Sports drinks

Vitamin C (ascorbic acid) function

-Collagen formation (wound healing) -Aids in iron absorption

Malnutrition definition

-Condition in which a person doesn't receive or is unable to use an adequate amount of nutrients for body function -Lack of necessary or appropriate food substances or excess intake

Iron deficiency anemia

-Condition where there's not enough iron in the body due to dietary deficiency, loss of iron through bleeding, or increased demand -Deficiency leads to decreased hemoglobin synthesis and consequent impairment of oxygen delivery

Young and middle adult nutrition needs

-Demands for most nutrients are reduced and energy needs begin to decline -Iron and calcium intake continue to be important -Obesity can become a problem -Special considerations - pregnancy, lactation

Vegetarianism

-Diet consisting predominantly of plant foods -Children at risk for vitamin and protein deficiencies

Adolescent nutrition needs

-Energy needs increase to meet greater metabolic demands -Calcium essential for rapid bone growth -Iron needed for menstrual blood losses and muscle development -Diet influenced by body image, desire for independence, peer pressure, fad diets -Fortified foods important sources of vitamins and minerals

Protein

-Essential for growth, maintenance and repair of body tissues -4 kcal per gram -Simplest form = amino acid -Essential AAs must come from the diet -Body can synthesize non-essential AAs -Complete proteins contain all essential amino acids -Involved in N balance

Folic acid/flovite function

-Formation of genetic material and protein for cell nucleus -Assists with intestinal functioning -Prevents selected anemia

School age nutrition needs

-Gradual decrease in energy requirements per unit of body weight -Growth is slower and steady -Increase in childhood obesity due to inactivity, diets rich in high calorie foods, genetic predisposition, food used as a coping mechanism

Nutrition positive outcomes

-Growth and tissue repair -Engage in physical activity -Physiological and psychological wellness -Homeostasis and adequate nutrition and hydration

Toddler nutrition needs

-Growth rate slower -Picky eaters -Needs increased amount of protein -Milk anemia (iron deficiency anemia from too much cows milk)

Niacin function

-In all body tissues, necessary for energy producing reactions -Assists nervous system

Carbs

-Main source of energy -4 kcal per gram -Primary source = plant foods -2ndary source = milk -Simple carbs from sugar -Needed to spare protein as an energy source

Water

-Makes up 60-70% of body weight -Muscle contains more water than any other tissue except blood -Present in liquids and foods high in water (fruits, veggies) -Fluid input should = output in a healthy person

Nutrition negative outcomes

-Malnutrition (insufficient intake) -Failure to thrive -Obesity (excess intake) -Altered hydration status -Low energy, fatigue, depression, isolation -Growth or development delay -Decreased bone density -Delayed or inadequate healing -Illness -Muscle wasting -Death

Nitrogen balance related to protein

-N balance = intake - loss -Positive balance - increase in total body protein; associated with periods of growth, pregnancy, hypothyroidism, and tissue repair -Negative balance - amount of protein excreted > protein ingested; associated with burns, hyperthyroidism, serious tissue injuries, fevers, wasting diseases, and during periods of fasting

Nutrition antecedents

-Normal alimentary tract and associated organs -Adequate ingestion of nutrients and water -Normal temp -Normal pH

Vitamins

-Organic substances in small amounts in food -Essential to normal metabolism -Catalysts in biochemical rxns -Dependent on dietary intake

Pantothenic acid function

-Promotes use of carbs, fats and proteins -Essential for formation of specific hormones and nerve regulating substances

Vitamin B1 function (thiamine)

-Promotes use of sugar for energy -Required for health of heart and nervous system

Mechanically altered diet

-Regular diet with modifications for texture -Excludes most raw fruits and vegetables and foods with seeds, nuts, and dried fruits -Foods are chopped, ground, mashed, or soft

Biotin function

-Synthesis of fatty acids and energy production from glucose -Required for chemical reactions.

Vitamin A function

-Vision (night blindness), skin, bones -Promotes health of eyes, teeth, gums

Ovolactovegetarian diet

A diet that excludes all meat but includes the consumption of eggs and dairy products

Fat-soluble vitamins

A, D, E, K

A patient comes to the clinic complaining of pain in the epigastric region. What assessment question during the health interview would most help the nurse determine if the patient has a peptic ulcer? A. "Does your pain resolve when you have something to eat?" B. "Do over-the-counter pain medications help your pain?" C. "Does your pain get worse if you get up and do some exercise?" D. "Do you find that your pain is worse when you need to have a bowel movement?"

A. "Does your pain resolve when you have something to eat?"

When teaching a patient with iron deficiency anemia about appropriate food choices, the nurse will encourage the patient to increase the dietary intake of which of the following foods? A. Beans, dried fruits, and leafy green vegetables B. Fruits high in vitamin C, such as oranges and grapefruits C. Berries and orange vegetables D. Dairy products

A. Beans, dried fruits, and leafy green vegetables

After reviewing the patient's chart, the nurse notes that the patient has been ordered a clear liquid diet. Which meal tray would the patient be allowed to eat? A. Bouillon, apple juice, and gelatin B. Fat-free broth, ginger ale, and custard C. Cream of wheat, cranberry juice, and milk D. Clear broth, hot tea, and yogurt

A. Bouillon, apple juice, and gelatin

Brock Nichols, a 4-year-old preschooler, is being seen in the ED where you practice nursing. His mother reports that Brock has been vomiting for 3 days and is unable to "keep anything down." What poses the greatest danger to Brock? A. Dehydration B. Anorexia C. Nausea D. Choking on increased salivation

A. Dehydration

Upon assessment, the nurse determines the patient has a body mass index (BMI) of 45. This finding indicates the patient is which of the following? A. Extremely obese B. Underweight C. Normal weight D. Obese

A. Extremely obese

A client is receiving total parenteral nutrition (TPN). The nurse will assess for complications related to what? A. Fluid and electrolyte levels B. Ability to reposition C. Pain level during infusion D. Nausea or vomiting

A. Fluid and electrolyte levels

A male patient with cerebrovascular accident (CVA) is prescribed medication to treat the disorder. The patient wants to know what other measures may help reduce CVA. Which of the following is an accurate suggestion for the patient? A. Reduce hypertension and high blood cholesterol levels. B. Increase body weight moderately. C. Increase the intake of proteins and carbohydrates. D. Increase the fluids and hydration.

A. Reduce hypertension and high blood cholesterol levels

The nurse maintains the head of the bed elevated 30° for a client who is receiving continuous tube feedings to prevent what? A. Residual B. Aspiration C. Coughing D. Leakage

B. Aspiration

What food can the nurse suggest to the client at risk for osteoporosis? A. Carrots B. Broccoli C. Chicken D. Bananas

B. Brocolli

A client on prolonged bed rest has developed a pressure ulcer. The wound shows no signs of healing even though the client has received skin care and has been turned every 2 hours. Which factor is most likely responsible for the failure to heal? A. Inadequate vitamin D intake B. Inadequate protein intake C. Inadequate massaging of the affected area D. Low calcium level

B. Inadequate protein intake

A client has just had abdominal surgery, and the nurse is consulting with him about his diet now that he is allowed to eat. Which nutrient is most important for wound healing? A. Carbohydrates B. Protein C. Fats D. Vitamins

B. Protein

Which vitamin is found only in animal foods? A. Vitamin C B. Vitamin B12 C. Vitamin A D. Vitamin D

B. Vitamin B12

Vitamin K function

Blood clotting

Obese definition

Body weight exceeds IBW by >20%

Overweight definition

Body weight exceeds ideal body weight (IBW) by 1-20%

A nurse is caring for a client with chronic anemia. Which of the following should be included in the diet of this client? A. Dairy products B. Citrus fruits C. Red meat D. Yellow vegetables

C. Red meat

Over nutrition definition

Caloric intake in excess of daily energy requirements resulting in increased adipose tissue

Nutritional status definition

Condition of the body resulting from its use of essential nutrients available to it

A parent brings a 7-month-old infant to the well-baby clinic for a check-up. The parent feeds the infant formula whenever the infant is hungry but is concerned that the infant is overweight. What instructions should the nurse give the parents? A. Give the infant 2% milk formula and add vitamins. B. Use skim milk because it is high in protein and lower in calories. C. Decrease the amount of formula feedings to 16 oz (480 ml) daily and supplement with juice and water. D. Bring a 3-day record of the infant's intake back for further evaluation.

D. Bring a 3-day record of the infant's intake back for further evaluation

A nurse is performing health education with a patient who has a history of frequent, serious dental caries. When planning educational interventions, the nurse should identify a risk for what nursing diagnosis? A. Ineffective Tissue Perfusion B. Impaired Skin Integrity C. Aspiration D. Imbalanced Nutrition: Less Than Body Requirements

D. Imbalanced nutrition: less than body requirements

Which client is at greatest risk for inadequate nutrition? A. the client with diabetic peripheral neuropathy B. the client recovering from a femur fracture C. the client who is breastfeeding D. the client with burns to 45% of the body

D. The client with burns to 45% of the body

Total parental nutrition (TPN) should be used cautiously in patients with pancreatitis due to which of the following? A. They are at risk for gallbladder contraction. B. They are at risk for hepatic encephalopathy. C. They can digest high-fat foods. D. They cannot tolerate high-glucose concentration.

D. They cannot tolerate high-glucose concentration

A client who has bleeding tendencies has a deficiency in which vitamin? A. Vitamin A B. Vitamin B C. Vitamin C D. Vitamin K

D. Vitamin K

The nurse is aware that which of the following nutrients promotes normal blood clotting? A. Magnesium B. Vitamin C C. Zinc D. Vitamin K

D. Vitamin K

Dysphagia

Difficulty swallowing or inability to swallow

Foods included in pureed diet

Food consistency for patient having difficulty swallowing Soft, moist, smooth (look and texture of pudding)

Minerals

Inorganic elements essential as catalysts in biochemical reactions

Under nutriton definition

Intake of nutrients insufficient to meet daily energy requirements

Definition of nutrition

Process by which the body ingests, absorbs, transports, uses, and eliminates nutrients and wastes

Vitamin B2 function (riboflavin)

Promotes use of carbs, proteins, and fats by releasing energy to cells required for tissue integrity

Vitamin E function

Protects fatty acids and promotes the formation and functioning of RBCs, muscles, and other tissue

Vitamin D deficiency causes _____

Rickets

Vitamin D function

Stimulation of calcium and phosphorus - promotes strong teeth and bones

Obesity related complications

•Diabetes (type 2) •Hypertension •Hyperlipidemia •Coronary artery disease (CAD) •Sleep apnea •Depression •Urinary incontinency •Back pain •Osteoarthritis

Psychological factors of nutrition

•Emotional status •Food seen as reward or punishment •Nutritional psychosocial disorders (anorexia nervosa, bulimia nervosa, depression)

Physiological factors of nutrition

•Health •Prescribed diets •Alcohol abuse •Dysphagia •Digestive problems •Metabolic disorders •Medications and therapy

Factors affecting nutrition needs for older adults

•Income •Health •Dental hygiene •Decreased thirst sensation

Factors affecting nutrition

•Lifestyle •Family •Culture •Religion •Economics •Developmental stage

Ways to promote appetite

•Provide choices •Provide good oral hygiene •Environmental factors (clean, odor-free) •Maintain comfort •Provide social interaction

Ways to assist with feedings

•Sit at bedside •Feed slowly •Food at palatable temperatures •Allow to finish each bite before another •Excellent time for teaching •Protect safety, independence and dignity

Pharmacologic agents for nutrition

•Weight loss medications •Antilipid agents •Vitamin supplements •Micronutrient supplements •Parenteral nutrition - partial, total