Fundamentals Nutrition

The nurse is preparing to administer an intermittent tube feeding to a client. The nurse aspirates 90 mL of residual from the tube. What should the nurse do?

Document the amount of residual, and reinstill the residual and administer the feeding. Unless otherwise instructed or if the residual contents appear abnormal, an amount of less than 100 mL is reinstilled; then a normal amount of prescribed tube feeding is administered. The amount of residual should be documented. It is important to return the contents to the stomach to prevent electrolyte imbalances. The feeding is not held, and the residual is not sent to the laboratory. The tube feeding should continue at the prescribed rate.

The nurse has conducted dietary teaching with the client diagnosed with iron deficiency anemia. The nurse determines that the client understands the information if the client states the intention to increase intake of which foods?

Oysters, spinach, kidney beans.

The nurse needs to increase the calcium in the diet of a client who is lactose intolerant. Which food items should the nurse encourage?

Tofu, broccoli, sardines, mustard greens.

A client has been diagnosed with pernicious anemia. In planning care for the client, the nurse anticipates that the client will be treated with which vitamin or mineral?

Vitamin B12

When reinforcing dietary instructions to a client with irritable bowel syndrome whose primary symptom is alternating constipation and diarrhea, the nurse should tell the client that which foods are best to include in the diet for this disorder?

apples and whole grain bread

The nurse is instructing a client with osteomalacia about appropriate food items to include in the diet. Which food items should be included in the client's diet?

milk and wild caught salmon Osteomalacia is the softening of bone tissue characterized by inadequate mineralization of osteoid. It is the adult equivalent of rickets and vitamin D deficiency in children. Of the food items presented, milk, which has vitamin D added, provides the best source of vitamin D. Oily fish, especially wild caught such as salmon and mackerel, are also rich in vitamin D. Citrus fruits are high in vitamin C. Bread products are high in niacin. Green, leafy vegetables are high in folic acid.

The nurse employed in a well-baby clinic is reinforcing nutrition instructions to the mother of a 1-month-old infant. Which instruction should the nurse provide the mother?

offer breast milk or formula as the main food.

The nurse caring for a client with a neurological disorder is assisting in planning care to maintain nutritional status. The client has had a swallowing study done that shows the client is at risk for aspiration and is able to feed self. The nurse should review which interventions with the unlicensed assistive personnel (UAP)? Select all that apply.

Add the prescribed thickener to liquids and observe patient for episodes of coughing or choking.

The nurse reviews a client's serum sodium level and notes that the level is 150 mEq/L (150 mmol/L). The primary health care provider prescribes dietary instructions for the client based on the sodium level. Which food items should the nurse instruct the client to avoid? Select all that apply.

Bacon, Salami, processed oat cereals.

A low-sodium diet has been prescribed for a client with hypertension. Which food selected from the menu by the client indicates an understanding of this diet?

Baked turkey

A postoperative client has been placed on a clear liquid diet. Which items is the client allowed to consume?

Broth, coffee, gelatin

A client has a diagnosis of hyperphosphatemia. The nurse reinforces instructions by telling the client to eliminate which items from the diet?

Chicken and fish. Foods naturally high in phosphates should be avoided with hyperphosphatemia. These include fish, chicken, eggs, milk products, vegetables, whole grains, and carbonated beverages. Coffee, tea, and cocoa are not high in phosphates.

The nurse is reinforcing instructions to a client about complete/high quality protein foods. Which food choices would indicate the client understood the teaching?

Complete/high-quality proteins are proteins that contain all essential amino acids and are found in a variety of meats, eggs, and dairy products. Beans are incomplete/lower-quality proteins as are some cereals. Oranges and broccoli contain vitamins and minerals and minimal protein.

A hospitalized client is a lacto-vegetarian. Which food item should the nurse remove from the meal tray?

Eggs

A client who has recently been started on enteral feedings begins to complain of abdominal cramping, followed by passage of two liquid stools. The nurse notes that the client has abdominal distention as well. The nurse reviews the nutritional content on the label of the can to see if it contains which ingredient?

Lactose

The nurse reinforces instructions to a client to increase the amount of riboflavin in the diet. The nurse should tell the client to select which food item that is high in riboflavin?

Milk Food sources of riboflavin include milk, lean meats, fish, and grains. Tomatoes and citrus fruits are high in vitamin C. Green leafy vegetables are high in folic acid.

A client with a burn injury is transferred to the nursing unit, and a regular diet has been prescribed. The nurse encourages the client to eat which dietary items to promote wound healing?

Protein and vitamin C are necessary for wound healing. Poultry and milk are good sources of protein. Broccoli and strawberries are good sources of vitamin C. Peanut butter is a source of niacin. Gelatin and jelly have no nutrient value. Spaghetti is a complex carbohydrate.

The nurse is providing dietary instructions to a client with gout. The nurse should tell the client to avoid which food item?

Scallops Scallops should be omitted from the diet of a client who has gout because of the high purine content. The food items identified in the remaining options have negligible purine content and may be consumed by the client with gout.

The nurse is developing a nutritional plan for an assigned client. Which is the most critical piece of data to collect before formulating the plan?

The presence of food allergies.

The nurse reinforces instructions regarding diet for a client at risk for hypokalemia. The nurse determines there is a need for further teaching when the client selects which foods as sources high in potassium?

bread and butter, carrots and peas, peppers and onions. Clients taking thiazide or loop diuretics need to have adequate potassium intake and benefit from dietary teaching about the potassium values of foods. Bread and butter, carrots and peas, and peppers and onions are relatively low sources of potassium. Meats and certain fruits and vegetables are high in potassium and include beef and potato salad and avocados and mushrooms.

A child with leukemia is experiencing nausea related to medication therapy. The nurse, concerned about the child's nutritional status, should offer which items during an episode of nausea?

cool, clear fluids

A client who has calcium phosphate kidney stones tells the nurse, "Tell me what I can do, so that I never have this pain again." Which instructions should the nurse plan to include in the reinforcement of dietary instructions?

decrease sodium intake, limit the intake of whole grains, limit protein to 5 to 7 servings per week.

The nurse is preparing to administer an intermittent tube feeding to a client. The nurse aspirates 90 mL of residual from the tube. What should the nurse do?

document the amount of residual, and reinstill the residual and administer the feeding.

The nurse instructs a client at risk for hypokalemia from thiazide diuretic therapy about foods that are high in potassium. The nurse determines that there is a need for further teaching if the client states that which foods are high in potassium and should be included in the diet plan?

eggs, and white bread with butter. The client was incorrect to state that eggs and bread and butter are good sources of potassium. One large egg provides 66 mg of potassium. White bread and butter is approximately 120 mg. One-half cup of raisins contains 700 mg of potassium. Four ounces of beef contains 420 mg, and 4 ounces of pork contains 525 mg of potassium.

The nurse teaches the family of an infant with spina bifida that the infant should not be given which baby foods that may trigger a latex-type food allergy?

kiwi, banana, avocados

The nurse is preparing to administer an intermittent tube feeding to a client. The nurse aspirates and is unable to obtain any residual tube feeding. Which action should the nurse take next?

turn the client to the side and try to aspirate again.

A client with hypertension has been prescribed a low-sodium diet. The nurse reinforcing instructions about foods that are allowed should include which foods in a list provided to the client?

fresh tomato and summer squash.

A newly pregnant client is asking how to prevent neural-tube birth defects. The nurse reinforces which food choices to include in the diet?

Grapefruit, oranges, and broccoli. Folic acid (folate) helps prevent neural tube birth defects; it is found in green, leafy vegetables; liver, beef, and fish; legumes; and grapefruit and oranges. Peanuts are high in protein and niacin. Milk is high in calcium and vitamin D. Egg yolks are high in vitamin A, iron, and cholesterol.

A client receiving total parenteral nutrition (TPN) asks the nurse if he has developed diabetes when the capillary blood glucose level is monitored and he is given insulin. The nurse explains that which is the reason for monitoring glucose levels and administering insulin?

TPN contains concentrated carbohydrates and raises blood glucose.

The nurse is asked to assist with preparing a client who will be receiving a continuous total parenteral nutrition (TPN) solution via a central line. The nurse plans to institute which interventions for this client related to the TPN? Select all that apply.

The client receiving TPN is at an increased risk for fluid and electrolyte imbalance, hyperglycemia, and infection. The central line dressing is changed according to protocols set up to prevent infection. The TPN rate of infusion needs to be closely regulated with use of an electron infusion pump. The TPN contains increased concentration of glucose, so the blood glucose levels are monitored around the clock. Blood laboratory values are monitored often (3 times per week) because the electrolyte balance is totally dependent on the prescribed TPN solution. The TPN formula is adjusted and prescribed according to the client's laboratory results. Administration of TPN does not involve monitoring central venous pressure although that is possible through a central intravenous line. The client will be able to ambulate and so SCD are not required but may be prescribed for other reasons.

A client is having problems with blood clotting. Which food item should the nurse encourage the client to eat?

green, leafy vegetables

The mother of an infant newly diagnosed with cystic fibrosis is being taught proper nutritional needs for the infant. The nurse determines that the mother understands nutritional needs when the mother gives which response?

"I know I need to monitor my infant's stools, and if there are more than four stools a day, I will increase the pancreatic enzyme." Cystic fibrosis is an inherited condition involving exocrine (mucus producing) gland dysfunction and causing multisystem problems, especially involvement of the respiratory and gastrointestinal systems. Cystic fibrosis requires a high-calorie, high-protein diet with pancreatic enzyme replacement therapy. The infant needs to remain on the predigested formula until 1 year of age when formula can be discontinued, and then fat-free milk is consumed. The pancreatic enzyme should not be mixed with warmed foods because this inactivates the enzyme. Stools must be monitored, and pancreatic enzymes are administered based on the stool pattern.

The nurse reviews a client's serum sodium level and notes that the level is 150 mEq/L (150 mmol/L). The primary health care provider prescribes dietary instructions for the client based on the sodium level. Which food items should the nurse instruct the client to avoid?

Bacon, Salami, processed oat cereals. The normal serum sodium level is 135 to 145 mEq/L (135 to 145 mmol/L). A serum sodium level of 150 mEq/L (150 mmol/L) is indicative of hypernatremia. Based on this finding, the nurse should instruct the client to avoid foods high in sodium, such as processed foods including cereals and meats (bacon and salami). Summer squash and tomatoes are low in sodium.

The nurse is assigned to assist in caring for a client who is receiving parenteral nutrition with fat emulsion. The nurse is instructed to monitor the client for signs of fat overload. The nurse monitors for which signs and symptoms of this complication?

fever and pruritic urticaria

The nurse is reinforcing dietary instructions to a client with tuberculosis who has lost weight. The nurse reinforces instructions for the client to increase intake of protein and vitamin C. The nurse determines that teaching has been effective when the client selects which food items in the daily diet?

hamburger and oranges

A client has a serum sodium level of 151 mEq/L (151 mmol/L), and the nurse reinforces dietary teaching about the types of foods to avoid. The nurse determines that there is a need for further teaching if the client states that which food choices are good?

sauerkraut and american cheese. The client's laboratory value reflects hypernatremia because the normal serum sodium level is 135 to 145 mEq/L (135 to 145 mmol/L). Based on this finding, the nurse should instruct the client to avoid foods high in sodium. Sauerkraut and American cheese are high in sodium content. These should include foods from animal sources, which contain physiological saline, and highly processed meats and other foods that often have sodium added as a preservative. Spinach and rhubarb are good food sources of calcium. Cabbage is low calorie and a good source of vitamin C. Fish is high in phosphorus.

The nurse has completed diet teaching for a client who has been prescribed a low-sodium diet to treat hypertension. The nurse determines that there is a need for further teaching when the client makes which statement?

"Fresh foods such as fruits and vegetables are high in sodium." A low-sodium diet is used as an adjunct to antihypertensive medications for the treatment of hypertension. Sodium retains fluid, which leads to hypertension secondary to increased fluid volume. Fresh foods such as fruits and vegetables are low in sodium.

A 17-year-old pregnant client is being seen at the obstetric clinic. The nurse is reviewing the following laboratory results, which were obtained 2 hours after breakfast: hemoglobin 10 g/dL (100 mmol/L), sodium 140 mEq (140 mmol/L), glucose 110 mg/dL (6 mmol/L), potassium 4.1 mEq (4.1 mmol/L). Which dietary instruction should the nurse reinforce for this client?

Increase the amounts of red meats. This client's hemoglobin level is low; red meats are a good source of iron. The normal hemoglobin for a female is 12 to 16 g/dL (120 to 160 mmol/L). The normal sodium level is 135 to 145 mEq/L (135 to 145 mmol/L). normal serum glucose fasting is 70 to 110 mg/dL (4 to 6 mmol/L), and a 2-hour postprandial is less than 140 mg/dL (8 mmol/L). Based on the laboratory results, there is no reason for the client to increase her milk intake or limit the number of bananas consumed daily. The normal potassium for an adult is 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L).