64 notecards = 16 pages (4 cards per page)
1a- You are working w/a patient who is being discharged from the acute care unit after a heart attack (myocardial infarction). The patient's primary care provider has prescribed medical nutrition therapy, w/a diet that is low in sodium & saturated fat. The patient comes from family where food plays an important role in traditional culture practices.
To assist this patient & the family w/dietary planning, it is important to find out the following information:
1b- You are working w/a patient who is being discharged from the acute care unit after a heart attack (myocardial infarction). The patient's primary care provider has prescribed medical nutrition therapy, w/a diet that is low in sodium & saturated fat. The patient comes from family where food plays an important role in traditional culture practices.
Teaching about foods that are high in sodium & saturated fat is an important part of the plan for this patient. Reading labels & menus (if patient eats out) will help in the selection of appropriate foods. The pat. & family also may be informed about the possible substitutions for foods, spices, and oils that are high sodium & fat. Alternatives, such as polyunsaturated oils, lean meats & egg substitutes, may be incorporated into meal preparation. A separate meal plan for the patient is usually not necessary because flavorings, such as lemon, can make foods attractive (as well as healthy) for the entire family.
A pregnant woman is at the medical office for a prenatal checkup. What nutritional recommendations should be provided to this patient?
Nutritional recommendations for a pregnant patient included:
You are working in a home care agency & have a large older adult patient population. In planning care, what nutritional considerations should be taken into account for these patients?
Nutritional considerations for an older adult patient include:
As an occupational health nurse, you are concerned w/positive health behaviors for the employees. You have noticed that some of the workers are overweight. What should you include in a teaching plan to promote nutritional health for the employees?
The teaching plan for these employees should include:
Increase in blood glucose level
Breakdown of food products into smaller particles
Production of more complex chemical substances through the synthesis of nutrients
All biochemical & physiological processes by which the body maintains itself
Organic substances in food that are present in small amounts and act as coenzymes in biochemical reactions
Substances necessary for body functioning
Inorganic elements that act as catalysts in biochemical reactions
Breakdown of complex body substances into simpler substances
Decrease in blood glucose level
Measurement of size & makeup of body at specific sites
Identify an example of a nutrition objective from Healthy People 2010.
The goals are for individuals to increase their daily intake of fruits, vegetables, and grain products & decrease their intake of sodium & fat
A vitamin that is synthesized by the body is
Vitamin K is synthesized by the body
Identify whether the following represent carbohydrates, proteins, or fats.
a. Starches = Carbs
What information can you provide to an individual at a health fair who is interested in general nutritional guidelines?
Some general nutritional guidelines to share are:
Provide an example of an alternative dietary pattern.
Examples of alternative dietary patterns include vegetarians, ovolactovegetarians,and lactovegetarians. In addition, patients from diverse sociocultural backgrounds may have dietary patterns that are unique.
For each area of nutritional assessment, identify specific elements to pursue w/the patient.
For the nutritional assessment:
Which of the following are indicators of malnutrition? Select all that apply.
A nurse calculates a patient's body mass index (BMI) by dividing the weight in kg by the height in square meters. If the patient weighs 180lbs & is 6 feet tall, what is the BMI
The nurse calculates this individual's BMI as 24.5, within the expected range of 18.5 to 24.9 .
A neurogenic cause of dysphagia is:
Neurogenic causes of dysphagia include stroke, cerebral palsy, Guillan-Barre syndrome, multiple sclerosis, ALS, diabetic neuropathy, and Parkinson disease
A myogenic cause is:
Myogenic causes include myasthenia gravis, aging, muscular dystrophy, polymyositis, and dermatomyositis.
A common sign or symptom of food-borne illnesses is:
A common sign of food-borne illnesses is diarrhea, often accompanied by cramping, nausea & vomiting
A nurse on an acute care unit wishes to promote a patient's appetite. Identify at least 2 interventions that should be implemented by the nurse
To promote a patient's appetite in the acute care setting, the nurse should:
Identify the interventions that a nurse should implement for the patient who is experiencing dysphagia.
The patient w/dysphagia should be:
An advantage of enteral nutrition over parenteral nutrition is that enteral nutrition:
Advantages of enteral nutrition include the following: Decreased prevalence of hypoglycemia & electrolyte imbalances, increased utilization of nutrients, maintenance of structure & function of the GI tract, safer & less costly than parenteral nutrition.
Regarding complications of tube feedings:
The most serious complication associated w/tube feedings is aspiration, and this can be avoided by positioning the patient upright (head of bed elevated at least 30 degrees).
The method of choice for long-term enteral feeding is:
The method of choice for long-term enteral feeding is a gastrostomy
The pH of the gastric aspirate for a patient who has been fasting is:
The pH of gastric aspirate for a fasting patient is usually between 1 & 4
A parenteral nutrition formula that is hyperosmolar (greater than 10% dextrose) should be administered through a(n) __________ venous line.
A central venous line is used for a hyperosmolar solution
A patient will be receiving parenteral nutrition (PN). Identify the following:
a. PN is used because the patient is unable to ingest or digest enteral feedings.
Identify a dietary measure that should be implemented for a patient without teeth or with ill-fitting dentures.
For patients without teeth or with ill fitting dentures, a soft diet may be ordered. Patient preferences for foods should be taken into account, as well as consistencies, flavors, and colors.
Identify a nursing diagnosis and goal for patient who is underweight.
*Imbalanced nutrition: less than body requirements is indicated.
True or False
Childhood obesity has doubled in the last 20 years.
Unsaturated fatty acids have a minimal effect on blood cholesterol.
Identify an example of an antioxidant vitamin.
Vitamins A, C, E & beta-carotene are antioxidants.
What interventions should be implemented for a patient who is receiving enteral feedings?
The correct interventions for the patient receiving enteral feedings are:
A nurse is working w/a patient who requires an increase in complete proteins in the diet. The nurse recommends:
A nurse is talking with a community resident who has gone to the health fair. The resident tells the nurse that he takes a lot of extra vitamins every day. Because of the greater potential for toxicity, the resident is advised not to exceed the dietary guidelines for:
1 Vitamin A
A nurse is working w/a patient who is a lactovegetarian. The food that is selected as appropriate for this dietary pattern is
A patient states that he does not eat fish anymore. An appropriate follow-up question by the nurse is which of the following?
2. "What caused you to lose interest in fish?"
A nurse is preparing to insert a nasogastric tube for enteral feedings. The nurse recognizes that this intervention is used when the patient:
4. Is not able to ingest foods
A nurse is preparing the enteral feeding for a patient who has a nasogastric tube in place. The most effective method that the nurse can use to check for placement of a nasogastric tube is to:
1. Perform a pH analysis of aspirated secretions
A female patient who has gone to a family planning center is taking an oral contraceptive. This patient should increase vitamin B6 & niacin intake. The nurse recommends that the patient consume more:
2. Whole grains
A patient has heard on TV that zinc is an important element in the body's immune response. The patient asks the nurse what foods contain zinc. Because of its zinc content, the nurse recommends:
A nurse is assigned to make home visits to a number of patients. Of the patients that the nurse visits, the patient w/the greatest risk of a nutritional deficiency is the patient with:
2. An alteration in dietary schedule
After surgery, a patient is having her dietary intake advanced. After a period of NPO, the patient is placed on a clear liquid diet. What food does the nurse request for the patient?
While completing an assessment during a home visit, a nurse discovers that the patient has a history of congestive heart failure and is taking digoxin 0.25 mg daily. Being aware that medications may influence the patient's dietary patterns, the nurse is alert to the patient experiencing:
A patient on the unit has an enteral tube in place for feedings. When the nurse enters the room, the patient says that he experiencing cramps & nausea. The nurse should:
4. Decrease the administered rate
Which of the following statements made by the parent of an infant indicates the need for additional teaching?
3. "I'll add a little honey to the baby's bottle to help him digest the formula."
A nurse instructs a patient who is a vegan to specifically include which supplement in the diet?
3. Vitamin B12
The individual w/the highest percentage of water in the body is a(n):
A patient w/a gastrostomy has an excessive residual volume. The nurse should:
4. Maintain the patient in high-Fowler's position
A nurse is monitoring a patient's laboratory reports. Which of the following, if decreased, is indicative of anemia?
4. Hemoglobin level
A nurse instructing the family of a patient who is on an National Dysphagia Diet Task Force (NDDTF) dysphagia puree diet to include:
1. Mashed potatoes
A nurse recognizes that a patient on a low cholesterol diet requires additional teaching if he indicates that he eats which of the following?
A realistic weight loss goal for the patient who is overweight is:
1. 1lb per week
To prevent the presence of E. Coli in food, a nurse specifically instructs a patient & family to:
3. Cook ground beef well
A nurse is visiting a patient in the home & notes that additional teaching is required if the patient is observed:
2. Thawing frozen foods at room temperature
Tube feedings are ordered for a patient w/a nasogastric tube. Unless the agency specifies otherwise, the nurse should:
3. Begin w/150 to 250mL at a time