Peds-Diet

A health care provider prescribes a minimal-residue diet for a client with an acute exacerbation of ulcerative colitis. Which food selected by the client provides evidence that the nurse's dietary instructions are understood?

Eggs Rationale: Eggs are low in residue and will reduce colon irritation. Milk contains lactose, which may irritate the colon. Orange juice contains cellulose, which is not absorbed and irritates the colon. Creamed soups contain lactose, which may irritate the colon.

A client reports experiencing nausea, dyspnea, and right upper quadrant pain unrelieved by antacids. The pain occurs most often after eating in fast-food restaurants. Which diet should the nurse instruct the client to follow?

Low fat Rationale: The presence of fat in the duodenum stimulates painful contractions of the gallbladder to release bile; fat intake should be restricted. Carbohydrates do not have to be restricted. A reduction in spices and bulk is not necessary. Although a high protein and kilocalories diet might be desirable as long as the protein is not high in saturated fat, a high-calorie diet generally is not prescribed.

The postoperative diet prescription for a client who had a colostomy states, "Diet as tolerated." Which principle should the nurse include in the teaching plan to help guide the client with food choices?

A return to a regular diet as soon as possible promotes physical rehabilitation. Rationale: A regular diet is recommended after a colostomy because individuals will discover their own food intolerances. Each individual reacts differently to foods. A low-residue diet is not necessary; once healing occurs, a diet with adequate residue promotes peristalsis and colostomy functioning. Rigid dietary regulations usually increase anxiety; return to previously tolerated foods provides security.

A nurse is caring for a client with Addison disease. What should the nurse teach the client to do regarding an appropriate diet?

Add extra salt to food Rationale: Because of diminished mineralocorticoid secretion, clients with Addison disease are prone to develop hyponatremia. Therefore, the addition of salt to the diet is advised. Intake of calories and fluid is determined on an individual basis, not because the client has Addison disease. Protein is not omitted from the diet; ingestion of essential amino acids is necessary for optimum metabolism. Fluids are not restricted for clients with Addison disease.

After gastrointestinal surgery, a client's condition improves and a regular diet is prescribed. Which food, included on a regular diet, generally is tolerated best with little discomfort?

Baked fish Rationale: Baked fish is a low-residue, low-fat, high-protein, and non-gas-producing food that usually is tolerated well. Fresh fruit has fiber that irritates the gastrointestinal tract. Bran cereal has fiber that irritates the gastrointestinal tract. Whole milk irritates the gastrointestinal tract and stimulates mucus production.

A nurse is instructing a client with peptic ulcer disease (PUD) about the diet that should be followed during the acute phase. The nurse should stress that the diet most likely will consist of:

Bland foods Rationale: A bland, nonirritating diet is recommended during the acute symptomatic phase. Low carbohydrate foods do not decrease gastric acid secretion. Clients should be instructed to avoid substances that increase gastric acid secretion such as coffee, tea, and cola. Bed time snacks should be avoided because they may stimulate gastric acid secretion as well. Gluten free foods do not decrease gastric acid secretion.

A health care provider prescribes dietary and medication therapy for a client with the diagnosis of gastroesophageal reflux disease (GERD). What is most appropriate for the nurse to teach the client about meal management?

Divide food into four to six meals a day. Rationale: The volume of food in the stomach should be kept small to limit pressure on the cardiac sphincter. Foods should be neither cold nor hot; foods should be tepid when ingested. The last meal should be eaten at least three hours before bedtime; individual bedtimes vary. Peppermint promotes reflux because it relaxes the cardiac sphincter (lower esophageal sphincter), allowing food to be regurgitated into the esophagus.

Which dietary selection by the client leads the nurse to determine that teaching about a low-residue diet is understood?

Lean roast beef, buttered white rice with egg slices, white bread with jelly, tea with sugar Rationale: Lean roast beef, buttered white rice with egg slices, white bread with jelly, and tea with sugar do not contain high-residue fruits, vegetables, or whole grains, which are irritating to intestinal mucosa, cause bulk, and increase peristalsis. Baked fish, macaroni with cheese, strained carrots, fruit gelatin, and milk include vegetables and grain, which leave increased residue. Stewed chicken, baked potato with butter, strained peas, white bread, plain cake, and milk include vegetables and grain, which leave increased residue. Creamed soup with crackers, omelet, mashed potatoes, bran muffin, orange juice, and coffee with milk include whole grain foods, which increase residue.

A nurse teaches a client about the foods allowed on a 2-gram sodium diet. What foods does the client identify that indicates that the teaching is understood?

Orange and apple juices Rationale: Orange and apple juices each contain 1 mg of sodium per 100 grams. Dried apricots contain 8 mg of sodium per 100 grams. Peas contain 35 mg of sodium per 100 grams; both items contain more sodium than orange and apple juices. Carrots contain 47 mg of sodium per 100 grams. Celery contains 126 mg of sodium per 100 grams; both these items contain more sodium than orange and apple juices. Tomato juice contains 200 mg of sodium per 100 grams. Grape juice contains 2 mg of sodium per 100 grams; both these items contain more sodium than orange and apple juices.

A nurse is caring for a client who is scheduled for a gastric bypass to treat morbid obesity. Which diet should the nurse teach the client to maintain because it will help minimize clinical manifestations of dumping syndrome?

Small, frequent feeding schedule Rationale: Small feedings reduce the amount of bulk passing into the jejunum and therefore reduce the fluid that shifts into the jejunum. Although a diet high in roughage may be avoided, a low-residue, bland diet is not necessary. Total fluid intake does not have to be restricted; however, fluids should not be taken immediately before, during, or after a meal because they promote rapid stomach emptying. Concentrated sweets pass rapidly out of the stomach and increase fluid shifts; the diet should be low in carbohydrates. Protein is needed to promote tissue repair.

When reviewing an appropriate diet for a client with diabetes, the client expresses a dislike for sweet potatoes. What should the nurse suggest is a safe equivalent for sweet potatoes?

White bread Rationale: A sweet potato is equivalent to a serving of bread. One cup of skim or nonfat milk is a serving of milk. A slice of avocado is equivalent to a serving of fat. One teaspoon of mayonnaise is equivalent to a serving of fat.

A nurse is providing dietary teaching for a client who is receiving a high protein diet while recovering from an acute episode of colitis. What should the nurse include in the rationale for this diet?

Repairs tissues Rationale: Protein is required for the building and repair of intestinal tissues. Increased protein will not affect peristalsis significantly. Anemia may result from chronic bleeding; usually, it is corrected with increased iron and adequate protein intake. Once tissues are repaired, muscle tone may improve eventually.

The mother of an 8-month-old who was recently diagnosed with celiac disease asked for information as to what foods contain gluten. Select all that apply.

Wheat, Oatmeal, Cream of Wheat Rationale: Celiac disease is known as gluten enteropathy. Symptoms become apparent as foods containing gluten are introduced. Sources of gluten are wheat, oats, rye, and barley. Yogurt and apple juice do not contain gluten and therefore do not need to be avoided.