Ati nutrition Ati nutrition Ati nutrition Ati nutrition Ati nutritionAti nutrition PDF

Title Ati nutrition Ati nutrition Ati nutrition Ati nutrition Ati nutritionAti nutrition
Course Nursing and Healthcare I
Institution Galen College of Nursing
Pages 22
File Size 238.5 KB
File Type PDF
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Ati nutrition Ati nutrition Ati nutrition Ati nutrition Ati nutrition Ati nutritionAti nutrition Ati nutrition Ati nutrition Ati nutrition Ati nutrition Ati nutritionAti nutrition...


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A nurse is teaching a client who has heart failure about reducing dietary sodium intake. The nurse should instruct the client that which of the following foods contain less than 300 mg of sodium per serving? (Select all that apply.) One (1) ounce part-skim mozzarella cheese One (1) medium beef hot dog Three (3) ounces Atlantic salmon Three (3) ounces roasted chicken breast Two (2) ounces smoked honey ham Correct Answers: A. One (1) ounce part-skim mozzarella cheese C. Three (3) ounces Atlantic salmon D. Three (3) ounces roasted chicken breast The nurse should instruct the client that 1 oz of part-skim mozzarella cheese contains 175 mg sodium. Three ounces of Atlantic salmon contains 37 mg sodium. Three ounces roasted chicken breast contains 146 mg sodium. Incorrect Answers: B. A medium beef hot dog contains 510 mg sodium. The nurse should instruct the client who has heart failure to avoid foods that contain high amounts of sodium, such as processed foods, to reduce the risk for fluid retention. E. Two ounces smoked honey ham contains 510 mg sodium. The nurse should instruct the client who has heart failure to avoid foods that contain high amounts of sodium, such as processed foods, to reduce the risk for fluid retention. Vital Concept: The nurse should instruct a client who has heart failure to restrict dietary sodium to 2,000 mg per day to reduce fluid retention, peripheral edema, and pulmonary congestion. The nurse should advise the client to avoid high-sodium foods, such as chips, seasoning packets, canned and dried soups, prepared sauces, smoked meats and fish, pickled foods, and processed foods. The following chart provides tips for reducing sodium intake when cooking at home or when eating out.

When eating at home

When eating out

Avoid adding salt when cooking. Cook most meals at home. Avoid premade frozen or instant foods. Check labels for sodium content. Rinse canned vegetables before cooking. Use herbs and spices to season foods. Choose products with reduced or no added salt.

Avoid ordering soup. Request unsalted foods. Order foods that are roasted, grilled, or baked. Ask that sauces are removed or placed on the side of the meal. Avoid fast-food restaurants. Order sandwiches without condiments or sauces. Ask for fruit for dessert.

A client with iron deficiency anemia asked the nurse about possible food sources of iron. Which of the following foods contain iron? (Select all that apply) Iceberg Lettuce Dried beans Tea Brown rice Egg yolks Correct Answers: B. Dried beans D. Brown rice E. Egg yolks Iron deficiency anemia is the most common type of anemia diagnosed. It is the result of an inadequate supply of iron in the body. Iron is needed by the red blood cells to synthesize hemoglobin. Common causes include blood loss and insufficient intake of iron. Symptoms such as pallor, weakness, dyspnea, and gastrointestinal disturbances are typical manifestations. Clients

are treated with supplementation with iron from either food or medication. Dietary sources of iron can be heme iron or nonheme iron. Heme iron and vitamin C promotes the absorption of nonheme iron. Heme iron can be found in egg yolks, beef, chicken, turkey, pork loin, clams, and oysters. Nonheme iron sources include oatmeal, dried beans, bran flakes, brown rice, and whole grain bread. Vital Concept: Iron deficient anemia is characterized as microcytic, hypochromic anemia. This refers to the small size of erythrocytes and the decreased iron content. It is a common type of anemia diagnosed in the United States and may be related to heavy menstrual bleeding, GI bleeding, inadequate dietary iron or inadequate absorption. What is the correct order of steps for gastrostomy irrigation? a. Gently instill 30-50 mL of water or NS (depending on agency policy) with an irrigation syringe b. Position the client with pillows behind the shoulders c. Assess placement before irrigating d. Pull back on the syringe plunger to aspirate gastric contents to check patency; repeat if the tube flow is sluggish e. Explain the procedure and its potential discomfort to the client f. Document the procedure (Use the following format: ABCD, all letters capitalized, no periods, commas, or spaces) Fill in the blank ebcda

Correct Answer: EBCDAF Before performing any procedure, the nurse needs to explain the processes and benefits to the client in order. The client has the right to know about treatments and medications. Assess if the tube is in place after setting pillows behind the client. Check tube patency before starting the irrigation as per agency policy. Finally, document the date, time, secretion, and client’s condition. Do not use the syringe to aspirate the irrigating solution unless ordered

to do so; ordinarily, all solution used to irrigate and clear the tube will be returned in the suction drainage. Vital Concept: Gastrostomy devices are used for long-term nutritional support of 6-8 weeks or more.The tubes can be placed through the abdominal wall into the stomach using either a surgical or laparoscopic procedures or, in the case of percutaneous endoscopic gastrostomy (PEG), the tube is placed using an endoscope to visualize the inside of the stomach and puncture an opening through the skin and subcutaneous tissues, through which the PEG tube is inserted.

The nurse sees a 37-year-old man with a Body Mass Index (BMI) of 27. Which of the following statements made by the nurse is most appropriate? “Your BMI shows that you are obese. You need to eat healthier.” “Your BMI is in the normal range, keep doing what you are doing.” “Your BMI is in the overweight range. Let’s talk about what we can do to get you as healthy as possible.” “Your BMI is in the obese range. How much do you exercise?” “Your BMI is in the overweight range. There are things you can do to lose weight.”

Correct Answer: C. “Your BMI is in the overweight range. Let’s talk about what we can do to get you as healthy as possible.” Overweight BMI= 25-29.9. This statement takes a collaborative approach with the client. Incorrect Answers: A. Obesity is defined as a BMI of 30 or greater B. A BMI of 18.5-24.9 is considered normal D. Obesity is defined as a BMI of 30 or greater E. The client is overweight but this statement is not helpful to the client. Vital Concept: Obesity is a risk factor for diabetes, cardiovascular disease, and some cancers. Nurses can intervene with overweight clients by discussing weight and offering advice on nutrition and weight management. Weight loss interventions can be effective even when small changes are made, but the success of the intervention

is dependent in part on the client's motivation and readiness to make changes A nurse is providing teaching to a client who has a prescription for a mechanical soft diet. Which of the following food selections indicates to the nurse the client understands the teaching? (Select all that apply.) Raw broccoli Ground turkey Mashed carrots Fresh strawberries Cottage cheese Correct Answers: B. Ground turkey C. Mashed carrots E. Cottage cheese Ground meats require minimal chewing before swallowing and are appropriate for a mechanical soft diet. Mashed carrots require minimal chewing before swallowing and are appropriate for a mechanical soft diet. Cottage cheese requires minimal chewing before swallowing and is appropriate for a mechanical soft diet. Incorrect Answers: A. Raw broccoli is excluded from a mechanical soft diet due to potential chewing difficulty. D. Fresh strawberries are excluded from a mechanical soft diet due to seeds and potential chewing difficulty. Vital Concept: Mechanical soft diets are often prescribed for clients who have limited swallowing or chewing ability. Foods that are easily cut with a fork, blended, or chopped are among those that are permitted on this type of diet. What is the priority action for a nurse who notes an obstructed feeding tube when caring for a client? Instill a carbonated soda into the tube. Aspirate the tube with a small-bore syringe. Flush the tube with warm water and aspirate

Install a commercial solution of digestive enzymes into the tube. Correct Answer: C. Flush the tube with warm water and aspirate Enteral feeding tubes can become obstructed by thick feeding formulas or by inadequately crushed or diluted medications. The likelihood of successfully unclogging a feeding tube decreases as time passes, so it is important to initiate intervention quickly. The obstructing contents can be dislodged by flushing the tube with a large-bore syringe with a large barrel, followed by aspiration. A gentle pattern of flushing and aspiration is most likely to be successful by providing a back-and-forth motion to dislodge the material. Incorrect Answers: A. Use of a carbonated beverage is not an appropriate way to dislodge a bolus of clogged material from a feeding tube. Carbonated colas have high acidity and low pH, which may worsen the obstruction. B. Use of a small-bore syringe may create significant pressure and cause damage to the feeding tube. D. Initial attempts to unclog the tube should be made using warm water and a back-and-forth motion, before using a commercial enzyme solution. If it becomes necessary to use a commercial enzyme solution, then it typically must be left in the tube for 3060 minutes before flushing. Vital Concept: Improperly crushed or diluted medications can obstruct an enteral feeding tube. If this occurs, it's important to act quickly to relieve the obstruction. Using a large syringe, the nurse should flush the tube, then aspirate, repeating until the obstruction is relieved by the gentle back and forth movement. At the end of life, a client refuses fluids. Her spouse is concerned that the client's poor fluid intake will be harmful. What should the nurse tell the spouse about hydration at the end of life? Giving intravenous fluids at the end of life prolongs the dying process. Artificial hydration at the end of life can provide comfort to the dying client. The decision to provide intravenous hydration after withdrawal of other life support measures should be made in consideration of the client’s wishes. Intravenous fluids are prescribed for clients who are unable to swallow.

Correct Answer: C.

The decision to provide intravenous hydration after withdrawal of other life support measures should be made in consideration of the client’s wishes. There are complex issues surrounding decisions to provide artificial nutrition and hydration to a dying person. At the end of life, the client may stop drinking. It's important to reassure family members that the client is not thirsty or uncomfortable. This is a normal part of dying and may be beneficial, as dehydration results in relief of endorphins that provide a comforting or calming feeling. The nurse can provide oral care with small amounts of fluid to relieve dry mouth. Provision of artificial hydration through intravenous infusion at the end of life can cause discomfort. As the body shuts down, excess fluids cause edema and pulmonary congestion. The client's wishes should take precedence over any other issues at that time, as the client retains control of the right to determine the course of care. If the client is incapacitated, that right may fall to a family member or surrogate, who should act in the desire to carry out the preferences of the client. Incorrect Answers: A. There is no evidence that providing artificial hydration will prolong the dying process or that withholding artificial hydration at the end of life will speed dying. Clients who receive artificial hydration live the same length of time on average as those who receive intravenous hydration. B. Dying individuals do not appear to feel more comfortable after receiving intravenous hydration. IV hydration can potentially cause respiratory distress, urinary urgency requiring catheterization, and diarrhea. D. At the end of life, most providers of hospice or palliative care do not routinely recommend instituting IV hydration. Vital Concept: Family members may be upset when a client refuses fluids in the final days of dying. The client's wishes at the end of life take precedence over other considerations. The nurse should reassure the family that the refusal is a normal part of the dying process and forcing fluids may cause discomfort to the client.

A nurse is caring for an older adult client who is in a skilled nursing facility. The nurse should understand that older adults have decreased absorption of which of the following nutrients? (Select all that apply). Calcium Chloride Vitamin B12 Magnesium Phosphorus Correct Answers: A. Calcium C. Vitamin B12 Changes in the ability of the intestines to absorb nutrients occurs with aging due, in part, to decreased blood flow to and from the intestinal microvilli. The uptake of calcium and vitamin D are diminished in the older adult, resulting in a risk for deficiency. Gastrointestinal changes that occur with aging include a decrease in the ability of the stomach to manufacture intrinsic factor. Intrinsic factor is an important component in the uptake of vitamin B₁₂, resulting in a risk for the development of pernicious anemia. Incorrect Answers: B. Older adults do not have decreased absorption of chloride. D. Older adults do not have decreased absorption of magnesium. E. Older adults do not have decreased absorption of phosphorus. Vital Concept: Age-related changes in the gastrointestinal system include decreased gastric acid and intrinsic factor production, as well decreased blood flow to and from the intestinal microvilli. These changes can result in alterations in nutrition. A decrease in intrinsic factor results in decreased absorption of vitamin B₁₂, and the changes in blood flow to the microvilli can alter the absorption of calcium and vitamin D. Low levels of calcium and vitamin D can lead to osteoporosis and low bone density. A nurse is providing teaching about various types of enteral nutrition formulas to a client who has a new prescription for continuous-drip tube feedings. What information should the nurse include in the teaching?

A modular formula is used as the initial feeding solution. Standard formula contains whole protein. Hydrolyzed formula is recommended for a fully functioning gastrointestinal (GI) tract. High-calorie formula has increased water content. Correct Answer: B. Standard formula contains whole protein. A standard formula contains whole protein, such as milk, meat, or eggs, and requires a full-functioning GI tract. This type of formula is designed to be like a regular diet. Incorrect Answers: A. A modular formula is not used frequently. It provides one single nutrient, such as protein, fat, or carbohydrates and is usually added to another formula C. Hydrolyzed formula is recommended for a partially functioning digestive tract or for clients who have impaired ability to digest and absorb foods. D. High-calorie formula is low in water content. Vital Concept: No matter the route of access the type of tube-feeding formula, it is important to begin the feeding at full strength. The older practice of beginning the tube-feeding by dilution of the formula can result in an inadequate time frame of poor nutritional support. A client informs a nurse at a clinic visit that he has been taking megadoses of vitamin A on the advice of a friend. Which of the following does the nurse understand is true concerning vitamin A? The body has a large vitamin A requirement but can synthesize it as needed. Vitamin A is toxic in small amounts. The liver stores vitamin A easily in large amounts. Vitamin A is a fat soluble vitamin Correct Answer: D. Vitamin A is a fat soluble vitamin Vitamin A is one of the fat-soluble vitamins, which also include D, E, and K. They are necessary for bodily functions and are stored in the liver and adipose tissues. Because they are stored and not needed in large doses, they can be toxic and cause serious health problems when taken in megadoses. Water-soluble vitamins,

including B complex and C vitamins, are eliminated more rapidly than fat-soluble vitamins, making fat-soluble vitamins a greater risk. Vitamin A, also known as retinol, is important for cell division, immune system regulation, and prevention of some cancers (due to antioxidant properties); it plays a role in reproduction and gene expression, helps with vision when the light changes, and also is important for the growth of bones and teeth. Sources include foods like fish, liver, and dairy products. Carrots, winter squash, and dark green vegetables are also rich in beta-carotene, a precursor that is converted to vitamin A by the body. Incorrect Answers: A. The requirement for vitamin A is not large, and the body is unable to synthesize the precursor of vitamin A, so one or both forms are necessary to maintain an adequate supply. B. Vitamin A can usually be supplied without supplements through the diet, but small amounts to meet the daily requirement are not toxic. C. The liver and adipose tissues store excess vitamin A. But, in large amounts, vitamin A toxicity can cause dizziness, dry and itchy skin, nausea, blurred vision, slowed growth, birth defects in a fetus, and an increased risk for hip fracture. Vital Concept: Fat-soluble vitamins D, A, E, and K are stored in the body in liver and adipose tissues, so clients who take large doses of these vitamins may develop toxicity. Vitamin A toxicity can result in dizziness, dry and itchy skin, nausea, blurred vision, slowed growth, birth defects in a fetus, and an increased risk for hip fracture. A school nurse is teaching a group of adolescents about selecting healthy foods for snacks. Which of the following foods should the nurse include in the teaching? (Select all that apply). Carrot sticks with low-fat cottage cheese Skim milk cheese and whole-grain crackers Air-popped popcorn Potato chips Hot dogs Correct Answers: A. Carrot sticks with low-fat cottage cheese B. Skim milk cheese and whole-grain crackers

C. Air-popped popcorn Nutrition concerns for adolescents include the poor quality of food choices made for meals as well as snacks. A study by Reddy & Krebs-Smith (2010) identified that up to 40% of calories consumed by children and adolescents consists of empty calories, primarily solid fats and foods with added sugar. The nurse should recommend foods that provide energy as well as needed nutrients to the group of adolescents. Carrot sticks with low-fat cottage cheese provide protein and complex carbohydrates for energy as well as calcium, magnesium, zinc, and vitamins C and A. Poor-quality food choices can have detrimental effects on adolescent health and have been linked to the development of hypertension, obesity, cholecystitis, fatty liver disease, dyslipidemia, and metabolic syndrome or diabetes. While lifestyle modifications such as increasing exercise and reducing sedentary activities can limit the effects or prevent obesity, healthy food choices play a central role in adolescent health as well. Snacks such as cheese made from skim milk and whole-grain crackers provide protein and complex carbohydrates for energy needs as well as fiber, iron, calcium, and vitamin A. Finding foods that are appealing as well as healthy can help the adolescent meet calorie needs and curb hunger between meals. Air-popped popcorn is a healthy snack selection, providing fiber, iron, phosphorus, and potassium. The nurse should instruct the adolescents that air-popping is preferred over oil-popped or packaged microwave popcorns because these contain unnecessary additional fats. Incorrect Answers: D. While potato chips can provide carbohydrates for energy, they are not a healthy food choice because they are high in fat and sodium. A healthier alternative to potato chips would be dryroasted mixed nuts, which can provide protein and carbohydrates for energy, along with calcium, magnesium, potassium, phosphorus, niacin, and vitamins A and E. E. Proteins provide energy and alleviate hunger. Healthy protein snack choices include lean meat such as turkey or chicken. Processed meats such as hot dogs are not a healthy food choice because they are high in sodium, nitrites, and fat. Vital Concept: Adolescents begin to take on more responsibility for food...


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