NR228 EXAM 2 STUDY GUIDE
Diet as Tolerated
- Allows for postoperative diet progression on the basis of the patient's tolerance
Enternal nutrition
- Any time nourishment is provided directly to the gastrointestinal (GI) tract, the feeding is technically a form of enteral nutrition.
Tube Feeding
- Appropriate when gut is functioning - Accessible and safe to use when patient is unable or unwilling to consume adequate nutrients/kilocalories orally
clear liquid diet
- Foods that are clear and liquid at room or body temperature - Inadequate in energy and almost all nutrients except water - Contribute to hospital malnutrition - Should not be used for more than 8 to 24 hours
full liquid diet
- Foods that are liquid at room temperature - Often prescribed if patients have difficulty chewing or swallowing solid foods - Often prescribed if patients have difficulty chewing or swallowing solid foods
Mechanically altered diet
- For patients with chewing or swallowing difficulty - Tips to make food appealing - Food consistency altered only to the degree needed
BMI
- Normal BMI (18.5 to 24.9): 25 to 35 pounds - Underweight BMI (<18.5): 28 to 40 pounds - Overweight BMI (25 to 29.9): 15 to 25 pounds - Obese BMI (≥30): 11 to 20 pounds
A nurse is preparing an education program for a group of parents of adolescents. Which of the following should be included as indicators of nutritional risk among adolescents? Select all that apply.
-Skipping more than three meals per week -Eating without family supervision frequently -Frequently skipping breakfast
Food safety concerns
-preventing aspiration of food -reducing the risk of foodborne illness -assessing for food allergies -food-med interactions
Common foodborne illnesses
-salmonella-eating undercooked or raw meat, poultry, eggs, fish, fruit, and dairy.(manifestations: headache, fever, abd cramp, diarrhea, n+v, CAN BE FATAL)-Escherichia coli-raw/undercooked meat exp hamburger.(manifestations: severe abdominal pain/diarrhea)-shigella-poor personal hygiene and improper hand hygiene. Dairy products/salads(manifestations: diarrhea)-Listeria monocytogenes-soft cheese, raw milk prod, undercooked poultry, meat, seafood, n veggies. Significant problems for newborns/preg/immuno(manifestations: fever, diarrhea, headache, back pains, abd discomfort. STILLBIRTH OR MISCARRIAGE)
A nurse is providing nutritional teaching to the mother of a preschooler and is recommending food options to provide 1 ounce of grains. Which of the following foods should the nurse recommend?
1 cup ready to eat cereal flakes
Food safety requires (3)
1) proper food storage 2) proper handling 3) proper prep guidelines
A nurse is teaching a group of adults about nutrition. The nurse should include which of the following amounts as an appropriate daily intake of fiber for adult women? A. 5 to 10 g B. 10 to 15 g C. 20 to 35 g D. 40 to 50 g
20-35 grams
The nurse is working with a client who was recently diagnosed to be lactose intolerant. The client needs to adapt to a low-lactose diet. Which of the following should the client avoid? A) Powdered meal replacement supplements B) Rice milk C) Soy sour cream D) Yogurt
A
a nurse is assisting a postpartum client who had a cesarean birth with breastfeeding her newborn. Which of the following breastfeeding positions should the nurse suggest for this client? a- football hold b- modified cradle c- side-lying d- cradle hold
A
a nurse is discussing breastfeeding with a postpartum client. which of the following statements should the nurse include? a- initiate breastfeeding within 1st hour after birth b- the American academy of pediatrics recommends exclusive breastfeeding for the 1st 2 months c- breastfeeding is contraindicated for clients who have group B strep d- breastfeed your newborn on a strict schedule
A
a nurse is discussing the benefits of breastfeeding with a postpartum client. Which of the followings benefits to the newborn should the nurse include? a- reduces the risk for otitis media' b- reduces the risk for UTI c- reduces the risk for bleeding d- reduces the risk for dental caries
A
A nurse is caring for a group of clients. The nurse should recognize that which of the following clients is at risk for vitamin B6 deficiency?
A client that reports drinking hard liquor everyday
a low-lactose diet
A low lactose diet means eating foods that do not have very much lactose. Lactose is a sugar that is a normal part of milk products.
A nurse is providing teaching to a client who is planning on becoming pregnant about the changes she should expect. Identify the sequence of maternal changes. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.) -Quickening -Lightening -Goodell's sign -Amenorrhea
Amenorrhea, a presumptive sign of pregnancy, is one of the first physiological indications of pregnancy that occurs by 4 weeks of gestation. Goodell's sign, a probable sign of pregnancy, is the next of physiological indications to occur. Goodell's sign is the softening of the cervix that typically occurs at 5 to 6 weeks of gestation. Quickening, the mother's perception of the first fetal movement, is a presumptive sign of pregnancy that typically occurs between 16 and 20 weeks of gestation. Lightening is the last of these physiological signs of pregnancy to occur. As the fetus descends into the pelvic cavity the fundal height decreases, which typically occurs between 38 and 40 weeks of gestation.
Caregivers of an infant with a feeding button style gastrostomy tube mention to the nurse there is leaking present. What action should the nurse take?
Assess if the leakage is coming from valve failure or from the peristomal area. The nurse should assess the source of the leakage because intervention will vary depending on the cause. Leakage should not be treated as normal until interventions have failed to remedy the source of the leaking.
A nurse is caring for a client following a CVA and observes the client experiencing severe dysphagia. The nurse notifies the provider. Which of the following nutritional therapies will likely be prescribed? A. NPO until dysphagia subsides B. Supplements via nasogastric tube C. Initiation of total parenteral nutrition D. Soft residue diet
B
The most appropriate diet for a child with celiac disease is: A. salt free. B. low gluten. C. phenylalanine free. D. high calorie, low protein, low fat.
B - (Celiac disease is characterized by intolerance to gluten, the protein found in wheat, barley, rye, and oats. A low-gluten diet is indicated.)
What are common causes of constipation?
Common causes of constipation include insufficient water intake, poor dietary habits, chronic laxative use, ignoring the urge to defecate, lack of exercise, and certain medications.
A nurse is caring for a client who has bilateral eye patches in place following an injury. When the client's food tray arrives, which of the following interventions should the nurse take to promote independence in eating?
Describe to the client the location of the food on the tray
Good fats
Foods high in good fats include vegetable oils (such as olive, canola, sunflower, soy, and corn), nuts, seeds, and fish.
Foods good in thiamine
Foods high in thiamin include pork, fish, seeds, nuts, beans, green peas, tofu, brown rice, squash, asparagus, and seafood.
Infant 2 month old
ONLY BREAST MILK
A nurse is developing a plan of care for a client who practices Islam. Which of the following actions should the nurse include in the plan?
Request a meal tray without pork
Vitamin B6 deficiency
Scaly dermatitis, depression, confusion, convulsions, anemia
A nurse is preparing a teaching plan for a client who has chronic constipation secondary to irregular bowel habits. Which of the following should the nurse plan to include in the teaching?
The client should follow a high-fiber diet to establish bowel regularity
vitamin d
To maintain the normal range of calcium and phosphorus in the blood.
Calcium rich foods
Vegetables can provide calcium too, like kale, collard greens, turnip greens, mustard greens, chicory, bok choy and Broccoli.
What are all the fat soluble vitamins?
Vitamins A, D, E and K.
A client is recovering from a gastric resection for peptic ulcer disease. Which outcome indicates that the goal of adequate nutritional intake is being achieved 3 weeks following surgery? The client:
a) increases food intake and tolerance gradually. Weight gain will be slow and gradual because less food can be eaten at one time due to the decreased stomach size. More food and fluid will be tolerated as edema at the suture line decreases and healing progresses. The remaining stomach may stretch over time to accommodate more food.
The Adequate Intake for dietary fiber is set at 14g/1000 kcal.
a.) true
iron deficiency anemia
anemia caused by inadequate iron intake - Children ages 12 to 36 months are at risk due to consuming a diet high in cow's milk without adequate intake of foods high in iron.
Vitamin E benefits
as an antioxidant, protects cells from free radical damage
A nurse has been teaching a client about a high-protein diet. The teaching is successful if the client identifies which meal as high in protein?
baked beans, hamburger, and milk
Symptoms of thiamine deficiency
fatigue, irritability, poor memory, loss of appetite, sleep disturbances, abdominal discomfort, and weight loss
Recommended dietary requirement for proteins
for adults, 10% of intake, or 46g/day for women and 56g/day for men
reliable source of Vitamin B12 for a vegan
fortified soybean milk
iatrogenic malnutrition
inadvertently caused by treatment/diagnostic procedure in hospital
iatrogenic
inadvertently causes by treatment or diagnostic
Essential Nutrients
nutrients necessary for normal body functioning that must be obtained from food
vitamin A
organic molecule that helps regulate body processes
Vitamin K benefits
promotes healthy blood clotting
Vitamin D benefits
supports calcium absorption and maintenance, cell growth and immunity
A nurse is providing teaching about nutrition to a group of clients. The nurse should include that which of the following foods contains the highest level of thiamine per serving? A. 1 hard-boiled egg B. 1 cup dried pears C. 1 cup whole grain wheat flour D. 1 cup Brussel sprouts
whole grain wheat flower
Nursing Care of Iron Deficiency Anemia
◯ Provide iron supplements for preterm and low-birth-weight infants by the age of 2 months. ◯ Provide iron supplements to infants who are exclusively breastfed by the age of 4 months .◯ Recommend iron-fortified formula for infants who are not being breastfed. ◯ Modify the infant's diet to include high iron, vitamin C, and protein content.
Dietary sources of iron
☐ Infants - iron-fortified cereals and formula ☐ Older children - dried beans and lentils; peanut butter; green, leafy vegetables; iron-fortified breads and flour; poultry; and red meat