Nutrition

A nurse is caring for a client who states, "I feel like I don't have to eat a varied diet when I take my multivitamin." Which of the following responses should the nurse make?

"A multivitamin should not be used in place of a nutritious diet."

BMI of pt whose height 5'6'' and 325lbs

52.4

A nurse is caring for a client who has renal disease and must limit potassium intake. Which of the following foods should the nurse instruct the client to avoid because they are high in potassium? (Select all that apply).

Bananas Dried beans Spinach Tomatoes

A nurse is preparing to assist with feeding a client who is at risk for aspiration. Which of the following actions should the nurse take?

Cut the client's food into small bites.

Additional Sociocultural Factors Affecting Nutritional Intake

Illiteracy Language barriers Knowledge of nutrition Lack of caregiver or social support Social isolation Limited ability to obtain or purchase food Lack of or inadequate cooking and/or food preparation arrangements

Which nursing diagnosis would be most appropriate for a pt with BMI of 18?

Imbalanced nutrition: Less than body requirements

A nurse is caring for a client who is receiving tube feedings via PEG. Which of the following actions should the nurse implement in order to help prevent the client from aspirating?

Keep the client's head elevated to at least 30° for a minimum of 1 hr after a feeding.

Developmental Considerations

Pg 1289

A nurse is reviewing a client's medical record and notes that their BMI is 25.5. How should the nurse interpret this finding?

The client is overweight.

A nurse is assessing a pt who has been NPO prior to ab surgery. The pt is ordered clear liquid diet for breakfast. Which assessments would indicate to the nurse that the pt's diet should NOT be advanced?

The pt reports fullness and diarrhea after breakfast

Micronutrients

vitamins and minerals regulate body processes

A nurse is discussing macronutrients with a client. Which of the following statements should the nurse make?

"Macronutrients include carbohydrates, proteins, and fats, which make up the majority of a person's diet."

A nurse is caring for a client who is prescribed a low glycemic index diet. The client states, "I don't understand what this means." Which of the following responses should the nurse make? (Select all that apply.)

"The glycemic index of a food relates to its ability to increase the blood glucose level.""You should eat foods such as whole grains, fruits, and vegetables.""Try to limit or avoid potatoes due to their high glycemic index.""Foods with a high glycemic index will cause your blood glucose to increase rapidly."

Alcohol

Need for Vitamin B increases because they are used to metabolize alcohol

Biochemical data

Pg 1294

A nurse is caring for a nondiabetic client who has a new prescription for a fasting blood glucose check. The nurse checks the client's blood glucose and it is 67 mg/dL. Which of the following actions should the nurse take next?

Provide the client with a 15-g carbohydrate snack.

A nurse is feeding a pt who states that she is feeling nauseated and can't eat what is being offered. What would be the most appropriate initial action of the nurse in this situation?

Remove the tray from the room

A nurse is administering a tube feeding for a pt who is post bowel surgery. When attempting to aspirate the contents, the nurse notes that the tube is clogged. What would the next action be?

Use warm water or air and gentle pressure to remove clog

A nurse is a caring for a client who has a new prescription for a clear liquid diet. The client asks the nurse, "How long will I have to be on this type of diet?" Which of the following responses should the nurse make?

You should not be on this diet for more than a few days."

A nurse is caring for a client whose provider prescribed a heart-healthy diet. Which of the following information should the nurse include for the client regarding heart-healthy diets? (Select all that apply.)

"You should limit saturated fats in your diet.""Eat foods with whole grains in your new diet.""It's important to eat larger portions of fruits and vegetables.""Limiting high-calorie food intake will promote adherence to your new diet."

A nurse performs pre surgical assessments of pts in an ambulatory care center. Which pt would the nurse report to the surgeon as possibly needing surgery to be postponed?

A 43 yr old pt who takes ginko biloba and aspirin daily

A nurse is evaluating pts to determine their need for parenteral nutrition. Which pts would be the best candidates for this type of nutritional support?

A pt with ibs who has diarrhea pt with celiac disease not absorbing nutrients from GI tract pt with burns who has not been able to eat adequately for 5 days

Increase BMR

Growth, infections, fever, emotional tension, extreme environmental temperatures, elevated levels of certain hormones

A nurse is caring for client who reports having daily constipation. Which of the following information should the nurse provide to the client regarding fiber intake? (Select all that apply.)

Increasing daily fiber intake can help alleviate the issue of constipation.Eating more whole grains can promote regular bowel movements.

A nurse is preparing to measure a nasogastric tube for insertion. The nurse recalls that the client's xyphoid process should be used as the last place of measurement. Which of the following landmarks should the nurse measure before the xyphoid process?

Measure from the tip of the nose to the earlobe.

A nurse is assessing a client who is experiencing digestive issues. Which of the following findings should the nurse expect? (Select all that apply).

Nausea Abdominal pain Diarrhea Reports of bloating

medication

Nutrient absorption may be altered by drugs that (1) change the pH of the GI tract, (2) increase GI motility, (3) damage the intestinal mucosa, or (4) bind with nutrients, rendering them unavailable to the body. Nutrient metabolism can be altered by drugs that (1) act as nutrient antagonists, (2) alter the enzyme systems that metabolize nutrients, or (3) alter nutrient degradation.

A nurse is caring for a newly placed gastronomy tube of a postoperative pt. Which nursing action is performed correctly?

The nurse dips a cotton-tipped applicator into sterile saline solution and gently cleans around the insertion site

A nurse is helping a client calculate how many net carbohydrates they consumed in their last meal. The client's food had a total of 72 g of carbohydrates and 9 g of fiber. How many net carbohydrates did the client consume?

63

Fats

95% triglycerides Most Veggies unsaturated fats (remain liquid at room temp). Saturated fats raise serum cholesterol levels, unsat fat lower levels

A pt who is moved to a hospital bed following throat surgery is ordered to receive continuous tube feedings through a small-bore ng tube. Following placement of the tube, which nursing action would the nurse initiate to ensure correct placement of the tube?

Obtain an order for a radiographic exam of tube

A nurse is feeding a pt who is experiencing dysphagia. Which nursing intervention would the nurse initiate for this pt?

Provide a 30 min rest period prior to mealtime

A nurse is feeding an older adult pt who has dementia. Which intervention should the nurse perform to facilitate this process?

Stroke the underside of the pt chin to promote swallowing

Major function of protein

to maintain body tissues that break down from normal wear and tear and to support the growth of new tissues 10-35%

A nurse is caring for a client who has a new prescription for parenteral nutrition. The client states, "I am scared that I will be on this therapy for the rest of my life." Which of the following responses should the nurse make?

"This type of nutrition can be lifelong, but it can also be temporary depending on how your nutritional needs change."

A nurse is caring for a client who states, "I have been getting a lot of cavities lately, but I don't know what is causing them." Which of the following responses should the nurse make?

"Drinking sugary beverages can make you prone to cavities."

Fat-soluable Vitamins

A, D, E, K Pg 6

A nurse is evaluating a pt following the administration of an enteral feeding. Which findings are normal and are criteria that indicate pt tolerance to the feeding

Absence of nausea, vomiting Bowel sounds within normal range Absence of diarrhea and constipation

Decrease BMR

Aging, prolonged fasting, and sleep

A nurse is assessing a client's hair and notes that it is brittle. Which of the following should the nurse determine about the client's nutritional intake?

The client has insufficient protein in their diet.

A pt has been admitted to the alcoholic referral unit in the local hospital. Based on an understanding of the effects of alcohol on the GI tract, which is a priority concern related to nutrition.

Vitamin B malnutrition

A nurse is caring for a client who states, "I only eat a diet high in protein and carbohydrates." Which of the following responses should the nurse make?

"A nutritious diet should include carbohydrates, protein, fiber, and healthy fats."

A pt who has COPD is refusing to eat. Which intervention would be most helpful in stimulating appetite in this pt?

Encouraging food from home when possible

Water-soluable vitamins

Vitamin C, Vitamin B-Complex Pg 5

Macronutrients

carbohydrates, proteins, and fats Supply energy

A nurse is caring for a client who has a high phosphorus level. Which of the following instructions regarding food should the nurse provide?

"You should eat white bread."

A nurse nutritionist is collecting assessment data for a pt who complains of tiredness and appears malnourished. The nurse orders tests for hemoglobin and hematocrit. What condition might theses tests confirm?

Anemia

A nurse is caring for a client who routinely eats a regular diet and is scheduled to have surgery with sedation in the morning. The nurse receives a new NPO diet prescription for the client. Which of the following should the nurse identify as the rationale for the provider's prescription?

The client is at risk for aspiration due to the upcoming surgery.

Cholesterol

fat-like substance found only in animal products. It is NOT an essential nutrient, the body makes enough. Cholesterol is an important component of cell membranes and is especially abundant in brain and nerve cells. It also is used to synthesize bile acids and is a precursor of the steroid hormones and vitamin D. Although cholesterol serves many important functions in the body, high serum levels are clearly associated with an increased risk for atherosclerosis.

BMI

underweight: <18.5 normal: 18.5-24.9 overweight: 25-29.9 obese: >30