Ch 19 Nutrition
A patient takes medication for hypertension and asks whether there is anything else he can do to help reduce his blood pressure. What is the best nursing response?
"Adequate calcium and potassium intake, as well as lower sodium intake, offers some possibility of helping your blood pressure. Eat plenty of fruits, vegetables, and low fat milk products."
A patient planning for pregnancy has heard that some experts recommend folic acid supplements for woman of childbearing age. The patient understands the need for this recommendation by making which statement?
"Folic acid may help prevent neural tube defects in my baby."
Which patient comment indicates to the nurse that more teaching is needed for the patient experiencing dumping syndrome after gastric surgery?
"I should use honey or jelly instead of butter."
A nurse is caring for a patient with obesity. The patient tells the nurse, "I drink so much water. I guess water also adds to my obesity!" What is an appropriate response by the nurse?
"The more fat your body has, the less water there will be."
A family member is sitting at the best side of a patient on clear liquid diet. When the nurse Springsteen the lunch tray, the family member asked the nurse how to tell if an item is on a liquid diet. How should the nurse respond?
"any liquid that you can see through is considered clear."
A 40-year-old patient recently received a diagnosis of type two diabetes. He is in the hospital for test and is receiving a diabetic diet. His wife expresses concern because she notices cookies on his lunch tray. Which response best describes current recommendations for the use of concentrated sweets in the diabetic diet?
"sugars and suites are permitted in moderation in the diabetic diet. The important thing is that the total carbohydrate content of the meal is controlled and balance with your husband's medication and nutrient needs."
A patient in the early stages of pregnancy is experiencing some nausea and vomiting. Which suggestions would be appropriate for the nurse to recommend?
- limit foods with strong odors, and avoid food order that bother you. -avoid foods with high fat content. -try consuming five or more smaller meals each day, and include a source of protein in each meal. - trying not to let your stomach get completely empty. Eat before you are overly hungry.
Which are the energy-providing food groups?
-Carbohydrates - Fats -Proteins
A nurse in a senior center is counseling a group of older adults about their nutritional needs and considerations. Which of the following information should the nurse include?
-Older adults are more prone to dehydration than younger adults are. - Older adults need the same amount of most vitamins and minerals as younger adults do. -Many older men and women need calcium supplementation.
The body has systems that work to keep the pH in the narrow range of normal. What body systems work to keep the pH in the narrow range of normal?
-The kidneys - The blood buffers -The respiratory system
A nurse is giving dietary advice to a patient with hypokalemia. The patient is not sure what foods to incorporate in the diet. What foods does the nurse emphasize in the patients diet for recovery?
-apricots - Orange juice -bananas -cantaloupe
A patient with a family history of osteoporosis is taking calcium supplements to help reduce her risk of developing osteoporosis. What recommendations can be made to prevent the development of reduce calcium balance?
-taking small doses of calcium throughout the day rather than one large dose. - choosing plenty of milk products, and avoiding -excessive caffeine intake. -increasing potassium intake. - consuming a diet that has moderate levels of sodium.
A person who is on a vegan diet lacks this vitamin.
B12
Pernicious anemia is a lack of this vitamin.
B12
The nurse is educating a patient on a vegan diet. What supplement will the nurse encourage this patient to take to avoid a deficiency?
B12
medical standard that defines overweight and obesity.
BMI
For patients receiving bolus enteral feedings, check ____________________ to determine dehydration.
BUN lab values
This is needed to assist in the digestion of fats.
Bile
When discussing the digestion and metabolism of fat, the nurse tells the patient who has a history of cholecystitis and who is on a low-fat diet that fat must be emulsified to be digested. What is the substance necessary for emulsification?
Bile
Examples of a Clear Liquid Diet
Bouillon, broth, gelatin, tea, coffee, ginger ale, popsicle Hard candy can be given to a patient on clear liquid diet.
A patient has been advised to increase fiber intake. Which food with the patient choose to boost fiber consumption?
Brown rice
Periods of binge eating
Bulimia nervosa
Patients at risk for aspiration
CVA (cerebrovascular or stroke patient, patient after mouth/laryngeal surgery, after general anesthesia, with difficulty swallowing and prolonged episodes of coughing)
Careful attention to carbohydrate consumption can improve metabolic control of diabetes. The nurse teaches a meal planning approach that focuses on the total amount of carbohydrates eaten at a meal. What is this meal planning approach called?
Carbohydrate counting
A nurse is preparing a presentation about basic nutrients for a group of high school athletes. She should explain that which of the following is the body's priority energy source?
Carbohydrates
Used in the treatment of obesity and in the prevention of excess weight gain
Kilocalorie-controlled and low-kilocalorie diets
able to tolerate small amounts of milk products like cheese and yogurt.
Lactose deficiency
_____________ The GI tract is unable to break down lactose.
Lactose intolerance
The nurse has assessed a patient's body mass index (BMI) to be 19.6. This assessment of weight versus height indicates that this patient's weight category is in which category?
Low health risk
Diet for gout, kidney stones and elevated uric acid levels Foods to restrict includes anchovies, mackerel, scallops, organ meats, goose, sweetbreads.
Low-Purine Diet
All fats limited, regardless of saturation ( diet used for gallbladder disease)
Low-fat diets
_________is similar to the soft diet but also includes restrictions on milk, because it leaves more residue in the colon
Low-residue diet
__________________ It may occur after surgery in which a portion or all of the stomach is removed.
Dumping syndrome
The patient who had a gastrostomy complains to the nurse about frequent episodes of dumping syndrome. What can the nurse recommend to this patient to decrease this problem?
Eat small, frequent meals
What is the body's storage form of carbohydrates, usually found in the liver with some storage in the muscles?
Glycogen
At approximately 4 to 6 months of age, solid food is introduced to a baby. What foods with high iron content should be recommended by the nurse?
Fortified cereals
________________ is more nutritionally complete than a clear liquid diet but is still lacking in some nutrients such as iron, zinc and fiber.
Full liquid diet
The nurse is explaining the activity recommendations from the USDA's new MyPlate plan. What is the minimum amount of moderate weekly exercise needed to balance nutritional intake?
2 hours and 30 minutes
To demonstrate the energy-producing potential of different foods, the nurse explains that 3 g of lean meat produces 12 kcal/g. How many kcal/g does 3 g of fish oil produce?
27 kcal/g
Normal PH -
4 or less
How many kcal/g does 1 g of alcohol provide?
7 kcal/g
Which of the following is a fat-soluble vitamin?
A
A patient asks a nurse to explain what a kilo calorie it is. What is the nurses best response to these patients question?
A kilo calorie is a measurement of energy.
What is a monosaccharide?
A simple sugar
What is the term for stored fat that insulates the body and serves as a cushion to protect organs?
Adipose tissue
Total Parenteral Nutrition
Administration of hypertonic solution (parenteral nutrition) into superior vena cava.
A fit, young woman was at zero nitrogen balance. The nurse discovers that this patient is now pregnant with her first child. For what is this patient at risk?
Anabolism
Self-imposed starvation, distorted body image and denial of problem
Anorexia nervosa
What eating disorder is characterized by body image distortion, excessive exercise, and vicarious enjoyment of food?
Anorexia nervosa
A healthy 35-year old patient wishes to lose weight because her BMI is 27. Which suggestion would be most appropriate for her?
Appropriate weight loss is possible with a healthy, reduced calorie diet and incorporating at least 30 minutes of physical activity each day.
Cholesterol is synthesized where?
Cholesterol is synthesized in the liver and is found in foods of animal origin. Cholesterol provides no energy.
_________________ is a nonirritating diet consisting of liquids that are easily digested and absorbed and leave little residue in the GI tract
Clear Liquid Diet
A patient who has hypertension is complaining about the lack of taste with the low- sodium diet that has been prescribed. What should the nurse emphasize that sodium may do?
Contribute to hypertension
The nurse is counseling a patient about the difference between type 1 and type 2 diabetes. What should the nurse stress that patients with type 2 diabetes are required to receive on a daily basis?
Regular carbohydrate-controlled meals
The nurse is educating a group of high school students regarding nutrition. How should the nurse respond when the students ask what occurs when protein, mineral, iron, and fat combine?
Tissue is built and repaired
____________________ is a disease in which the body does not produce or properly use insulin. Insulin is a hormone found in the pancreas that is needed to convert sugar into energy for daily life.
Diabetes Mellitus
What has replaced the USDA's Recommended Dietary Allowance (RDA)?
Dietary Reference Intake (DRI)
Fluid is restricted to 500 to 750 mL per day plus an amount equal to daily urine output during end-stage renal disease.
Fluid-modified diets
The nurse recognizes that when a patient is unable to consume adequate nutrition by mouth, an alternative route such as a feeding ostomy may be used. What is the proper term for feeding a patient by this method?
Enteral
The body uses 22 common amino acids, but 9 of them must be obtained from protein in the diet. What are these proteins considered?
Essential
What are elements that are found in food and necessary for good health but that the body cannot make?
Essential nutrients
What happens to access dietary fat in our body?
Excess dietary fat will be stored as adipose tissue in our body.
To prevent and treat atherosclerosis, heart disease, and hyperlipidemia
Fat-controlled diets
The patient complains to the nurse that he feels terrible since he has been taking several different kinds of vitamin preparations. What should the nurse assess for indications of vitamin toxicity?
Fatigue
The nurse makes nutrition a focus in the care plan. Where does nutrition play the most important role?
Health maintenance
The nurse explains that a patient with a heart problem should follow a decreased sodium diet. What will this diet help reduce the risk for or prevent?
Heart attacks
What foods are good to lower cholesterol?
High fiber (oatmeal), fish (omega-3), nuts (walnuts,almonds)
__________________ It is used for the treatment of some GI disorders like constipation
High-Fiber Diets
Diet should provide increased amounts of kilocalories and protein in small volumes.
High-kilocalorie and high-protein diets
________________________ consumption of inadequate carbohydrates causes the blood sugar to drop.
Hypoglycemia (low blood sugar)
The nurse cautions a patient with a pancreatic disorder that will interfere with the digestion of fats and may lead to a clotting disorder. What is the cause of these potential problems?
Inability to use vitamin K
The term insoluble means?
Incapable of being dissolved
_____________softens stools, speeds transit of foods through the digestive tract, and reduces pressure in the colon.
Insoluble fiber
A nurse is caring for a client who is at high risk for aspiration. Which of the following is an appropriate nursing intervention?
Instruct the client to tuck her chin when swallowing.
Parenteral nutrition or hyperalimentation is the term used for
Intravenous (IV) feedings
A school nurse is teaching a group of adolescents about adequate nutrition. What increased intake should the nurse encourage?
Iron and calcium
A nurse caring for a patient who is prescribed a full-liquid diet recognizes that this diet lacks some nutrients. What nutrients are lacking?
Iron and fiber
A patient is controlling his blood cholesterol through diet. He is familiar with four sources of saturated fat and cholesterol but is confused about transfatty acids. The nurse should explain that which group of foods contributes the most transfatty acids?
stick margarine, shortening, deep-fried restaurant food, and commercially prepared baked goods.
___________________________ eliminates foods that are difficult to chew or swallow.
Mechanical soft diet
The nurse reminds the male patient with lactose intolerance that he can avoid the unpleasant symptoms of nausea, bloating, flatulence, and diarrhea, if he will avoid certain foods. What product should the patient be instructed to avoid?
Milk
This is a byproduct of protein metabolism.
Nitrogen
When reviewing a patient's dietary intake, the nurse recommends that sugar consumption be reduced to the recommended daily level. What is this level?
No more than 8% of total daily kilocalories
The young woman who is breastfeeding will need an increase of calories and protein. What foods should the nurse suggest as sources of protein?
Nuts
Dietary cholesterol is highest in which types of meat?
Organ
The home health nurse is caring for a patient that has undergone removal of a part of the stomach. For what should the nurse carefully assess this patient?
Pernicious anemia
A patient taking a diuretic is assessed by the nurse as having an erratic pulse and muscle weakness. What should the nurse suspect is deficient?
Potassium
Intake may be restricted with end-stage renal disease and other kidney disease; blood levels could increase to the point of causing arrhythmias and sudden cardiac arrest.
Potassium-modified diets
A patient diagnosed with renal failure is unable to excrete protein waste products and develops a condition that requires a protein-restricted diet. The nurse instructs the patient that azotemia can be diminished by substituting other food groups for protein. What is an example of a food that this patient can substitute for protein?
Potatoes
Which nutrients build and repair tissue?
Protein, calcium, phosphorus, iron, and fat
These types of fats increase a person's cholesterol levels.
Saturated fats
May be used to treat hypertension, water retention, edema, and congestive heart failure
Sodium-Restricted Diet
___________ is generally low in fiber; includes foods from all five food groups and is nutritionally adequate except for fiber.
Soft diet
Examples of a Full Liquid Diet
Strained cereals and soups, plain ice cream, puddings, custard, milk, milkshakes, and fruit juices
What is a nursing intervention to decrease the thirst of a patient who is on a fluid restriction?
Sucking on occasional ice chips
One nurse has been assigned a patient with an IV infusing be a pump at 100 mL/hour. The nurse just calculating intake and output and realizes that the Apple for the patient is 275 mL of urine in a 24-hour period. What can the nurse and Fer about the patient's condition?
The kidneys may not be functioning properly
The primary healthcare provider has requested that a patient be tested for Trousseau sign. Which action indicates the test is being performed correctly?
The nurse applies and inflates a blood pressure cuff and observes for carpal spasms.
A patient's urine output was found to be 25 mL/HR. On further assessment the nurse found the serum potassium level to be 6 mEq/L. Which intervention should the nurse follow while caring for the patient?
The nurse should administer sodium polystyrene sulfonate (kayexalate) as prescribed.
What are essential nutrients?
They are nutrients that the body cannot make.
The nurse is providing information about high cholesterol levels. What is the rationale for avoiding saturated fats?
They increase blood cholesterol
The nurse teaches a patient who has a nonfunctioning or dysfunctional GI tract that total parenteral nutrition (TPN) will be infused. Where will the infusion occur?
Through the superior vena cava
TPN means
Total Parenteral Nutrition
It should involve both behavioral and psychological goals
Treatment of obesity
________________ is administration of nutritionally balanced liquefied foods or formula though a tube inserted into the stomach, duodenum, or jejunum by way of a nasogastric tube (through the nose) or a feeding ostomy (surgical opening in the abdominal wall)
Tube Feedings
____________________often occurring in children. Body does not produce insulin. Patients will take daily insulin injections for life.
Type 1 diabetes
_________________ adult onset . Body's inability to make enough or properly use of insulin.
Type 2 diabetes
A nurse is caring for a client who is on a low-residue diet. The nurse should expect to see which of the following foods on the client's meal tray?
Vanilla custard
Patient may experience excessive thirst:
suck on ice chips, rinse mouth with cold mouthwash, lemon in cold water, freezing fluids, cold fruits and vegetables, breath mints or hard candies, and brushing teeth.
A newly diagnosed patient type 1 diabetic is being educated about the disease and self care at discharge. Which statement, if made by the patient, indicates teaching has been effective?
When i begin to sweat, feel nervous, or dizzy, i will eat.
Feeding tube is given to patients when:
a patient is unable to chew or swallow, has no appetite, or severe malnutrition
A patient with cancer has anorexia and weight loss. Which suggestion is most likely to help him increase intake and prevent weight loss?
suggest that the patient's snack often on high calorie foods.
Tube formula should be in room
temperature.
The primary healthcare provider has ordered on arterial blood gas (ABG) test on your patient. The pH level on the test comes back asked 7.29. Why does this result considered?
acidic
The nurse is reviewing a patient's dietary intake. Which patient behavior reflects compliance with a 2-g sodium restricted diet?
avoiding use of salt in cooking.
TPN is usually used for
the patient with a nonfunctioning or dysfunctional GI tract
In reviewing the laboratory reports of a patient who is on diuretic therapy, the nurse finds that the patients serum potassium level is 3 mEq/L. Which for sure the nurse include in the patients diet to restore the potassium levels?
cantaloupes
Which nutrients provides energy?
carbohydrates and proteins: 4 kcal/gram Fats: 9kcal/gram
The 6 classes of essential nutrients are?
carbohydrates, fats, proteins, minerals, water, vitamins
A 14-year-old trauma patient has just been started on nasogastric tube feedings. Shortly after the formula begins, the patient complains of nausea and abdominal cramps. What is the appropriate nursing action?
check the formula rate, strength, or volume; any of this could possibly be too high.
The healthcare provider has recommended that a patient increase the amount of fiber in her diet to help control her blood cholesterol levels. Which guidelines are most appropriate for increasing water soluble fiber in the diet?
choose foods that are closer to their home state rather than refined or processed, including more fruits, oats, and legumes to increase soluble fiber, and drink plenty of water.
Protein-Restricted Diet are used for
chronic renal failure and cirrhosis of the liver
A patient with iron deficiency anemia started taking iron supplements. What recommendation can the nurse give the patient to increase iron absorption?
consumed vitamin C rich foods at the same meal with iron containing foods.
A hospitalized diabetic patient receives a dose of insulin for an elevated blood sugar level. Two hours after that ministration of the drug, the patient begins to complain of weakness, dizziness, vision disturbances, and headaches. The nurse also notices some disorientation, sweating, and a shallow breathing pattern. The nurse recognizes that the patient is experiencing which condition?
hypoglycemia
A nurse is caring for a patient recently diagnosed with type two diabetes. The patient asked the nurse to tell her about the dietary changes she will need to make. Which actions are appropriate and within the scope of practice for a nurse?
discuss the rationale for and the general principles of the diabetic diet with the patient, and then communicate the patient's concerns to the registered dietitian and healthcare provider.
A prescription has been written for the patient to consume a minimum of 2000 mL of fluid daily. Which is the best approach for the nurse to use in an effort to encourage fluid intake?
encourage the patient to consume the fluid
Feeding is sometimes referred to as
enteral nutrition.
Once _________ stores are full, further excess is converted to adipose tissue.
glycogen
The nurse determines that a hypertensive patient understands the DASH diet when the patient chooses which items from a sample menu used in dietary teaching?
grilled chicken sandwich, strawberries, and lettuce salad.
A teenage patient recovering from a sports injury asks the nurse, "I want to be a competitive athlete. How many grams of protein should I take?" What is an appropriate response by the nurse?
healthy protein intake is about 46 g 56 g of protein a day
Position patient on ________________when inserting NG tube.
high Fowlers
Of other electrolyte disorders, which disorder is considered the most dangerous and potentially fatal?
hyperkalemia
A medical - surgical nurse is caring for a patient with a diagnosis of renal calculi. What is essential intervention should be added to the patient care plan?
increase daily fluid intake
Patient is admitted with a diagnosis of dehydration. Which type of intravenous fluid month the nurse expect the primary healthcare provider to prescribe to expand the bodies fluid volume grapes patient is admitted with a diagnosis of dehydration. Which type of intravenous fluid might the nurse expect the primary healthcare provider to prescribe to expand the bodies fluid volume?
isotonic solution
To simplify food values, the measurement of energy obtained by food is defined as the_______________
kilocalorie
Which dietary recommendations should the nurse include in the discharge instructions of a client in whom coronary artery disease is diagnosed?
limit intake of egg yolks.
Nurse should always ____________________before administering feeding to determine delayed gastric emptying.
measure gastric residual
Vitamin B12 is found in?
meats & fish
With Diabetes Carbohydrate intake should be
monitored and controlled.
There are two types of carbohydrates what are they?
monosaccharides & dissaccharides
A nurse is teaching a group of students about active and passive transport. The nurse gives an example of raisins kept in water overnight. The raisins absorbs water and are large in size the next day. What kind of movement to the students identify in that example?
osmosis
PPN means
peripheral parenteral nutrition.
A homeless patient arrives at the emergency room via ambulance. The nursing assessment reveals leg cramps, hyporeflexia, diminished deep tendon reflexes, paresthesia, and decreased bowel sounds. Which medication should the nurse anticipate will be given?
potassium chloride (KCI)
A nurse is caring for a visually impaired patient, and it is meal time. What is the best method to describe the location of the different food items on the plate to the patient?
potatoes are at 9 o'clock, chicken is at 12 o'clock, and carrots or at 3 o'clock.
Elevate head of bed in Fowler's position at least 30-45 degrees to
prevent aspiration.
For client with limited hand movement
provide an adaptive feeding device to patient.
A patient with gastrointestinal illness is having 6 to 8 watery stools a day. Which intervention should the nurse refrain from implementing, if listed on the patient's nursing care plan by mistake?
provide three dairy snacks daily
The nurse is assessing a patient who is a strict vegetarian. Which complication does the nurse most likely suspect in the patient due to vegetarianism?
reduce Vitamin B 12 levels
A nurse is preparing to administer tube feeding to a patient. The placement of the tube is confirmed when the nurse aspirates 20 mL of gastric contents. The patient asked the nurse why the fluid is being replaced back into the tube. What should the nurse tell the patient?
replacing the fluid prevents an alteration in body electrolytes.
A patient presents with slow and shallow breathing. The patient reports haviness in the chest and difficulty breathing. What is an appropriate interpretation by the nurse?
respiratory acidosis
patient has been admitted to intensive care unit (ICU) with dyspnea, tachycardia, tremors, lethargy, and disorientation. There was sorts of arterial blood gas testing showed pH 7.28, Paco2 60 mm Hg, and HCO3 22 mEq/L. What condition is suspected?
respiratory acidosis
While completing discharge teaching for a patient with elevated cholesterol levels, the patient ask how to distinguish between an unsaturated fat and a saturated fat. Which statement is most accurate?
saturated fats are generally from plant sources and are solid at room temperature.
The nurse is caring for a patient with hyperkalemia who has been prescribed polystyrene sulfonate (kayexalate). What should the nurse monitor to provide effective care of and treatment to the patient?
serum sodium levels
PPN is used for
short periods
Diet therapy involves giving __________________that are higher in protein and fat and lower in carbohydrates and low fiber.
small frequent meals
A nurse is completing a health history and physical assessment on a patient. Vital signs reveal a slightly elevated blood pressure. The patient admits to having a family history of arthritis, breast cancer, and hypertension. Based on the patient's history and blood pressure, which dietary restriction can the nurse anticipate the primary healthcare provider will implement for this patient?
sodium
A patient with a rare titis arrives at the intensive care unit with a potassium level of 7. The nurse can conclude that which drug would most likely be prescribed to prevent complications?
sodium Polystyrene sulfonate (Kayexalate)
Enteral tube feeding with diluted formula is
to treat diarrhea.
An obese patient arrives for a clinic appointment. The patient asked the nurse, "I am so fat, do you think that I can lose the weight?" What is the best response the nurse can give to the patient?
with diet, exercise, and other therapies you may lose weight.
The most accurate way to check placement is
x-ray.
