Principles of Nutrition
State one of the 7 components of nutritive sources
Carbohydrates/Fiber: Monosaccharides, Disaccharides, Polysaccharides
Protein: Complete, Incomplete, complementary
Lipids/fats: Triglycerides, Phospholipids, Sterols
Vitamins: B, C, A, D, E, K
Minerals: Na, K, Cl, Ca, Mg, P, S; Fe, I, Fl
Water: H2O :)
See DB - Nutrition on vitamins and minerals (complete it)
A client has been prescribed a level 3, moderately thick, for liquids. Describe the consistency of the fluids this client would be drinking.
Smooth texture, no lumps, consumed from a cup or spoon.
Level 0: Thin, flows like water.
Level 1: Slightly thick, thicker than water but can be sipped through a straw.
Level 2: Mildly thick. Drink with a spoon or wide straw. Cannot maintain its own shape when poured.
Level 4: Extremely thick. Must be eaten with a spoon, and does not require chewing. Maintains its shape.
Go to the "Nutrition" discussion board. Place the information into the correct reply.
1. Heart Healthy
2. Diabetes
3. Cancer
4. Kidney Disorders
1. Find a recipe on the assigned website.
2. Provide two statements on how the recipe includes the nutritional guidelines with nurse intervention as found in your ATI nutrition book (~p. 78, 87).
3. Provide an educational statement on one of the following sections:
-Ordering tips
-Good menu choice
-Fast food
-ethnic food
-how it relates to alterations in nutrition
4. State the medical diagnosis your recipe is intended for.
State two (2) risk factors for undernutrition.
Chronic disease, acute illness, injury;
Polypharmacy
Food insecurity
Restrictive eating: chronic dieting, disordered eating, food beliefs, fad diets
Alcohol abuse*
Depression, bereavement, loneliness, social isolation
Poor dental health
Decreased knowledge or skills about food prep and recommendations*
Age: premature infants, adults over 80.
*Also risk for overnutrition!
The nurse is completing a 24-hour diet recall from a client who is losing about 1.5 pounds per week. What are the most appropriate questions for the nurse to ask this client about the diet consumed? (Select all that apply).
A. "When was the first time you ate yesterday?"
B. "How much water did you drink yesterday?"
C. "What nutritional supplements did you take yesterday?"
D. "What did you have for breakfast?"
E. "What was the first thing you ate yesterday?"
A, C, D, E
A, D, and E address food intake directly.
C addresses mineral and vitamin intake as a supplement
B: Provides info about hydration status
A client who has the ability to eat appropriately and has no SES disadvantages, has a negative nitrogen balance and protein deficiency. Albumin results are 1 g/dL. State a nursing intervention to address these issues.
-Add skim milk powder to whole milk
-Use whole milk in recipes
-add: Cheese, Peanut butter, chopped hard-boiled eggs, or yogurt
-Dip meats in eggs or milk and coat with breadcrumbs before cooking
-Add nuts and dried beans to meals
-Dietitian collaboration
Protein is used faster than it is synthesized [catabolism faster than anabolism].
Albumin range: 3.5-5 g/dL
A client had major surgery yesterday. The client's current dietary order is "clear liquid diet" with a second order that states "Advance diet as tolerated". What must the nurse assess for before advancing the diet?
Bowel function: Flatus, bowel sounds.
24-hour Meal Plan: A nurse is assisting the dietician on a meal plan for clients who just migrated to your area. Create a 24-hour meal plan, place the information into the discussion board.
* 3 meals & 2 snacks
(HINT: use your ATI Nutrition book ch. 6).
1.Hispanic female client- prefers Mexican meals, practices Catholicism, and is currently pregnant with a toddler at home.
2.Caribbean male client- prefers Soul food, practices Hindu, and has an adolescent at home.
3.Eastern African client – prefers American food, practices Islam, and has an older parent at home.
4.Central Asian female client – prefers vegetarian food, practices Buddhism, and has a preschooler at home.
5.British client – prefers Chinese foods, practices Judaism, and has an infant and school-age children at home.
State an expected finding for a client with normal nutritional status. Choose one of the following:
1. Vitals signs
2. Skin, hair, nails
3. Eyes, nose, mouth
4. Neurological
5. Respiratory
6. Cardiovascular
7. Abdomen
8. GU
9. Musculoskeletal
1. WNL
2. Elastic, dry, intact, smooth texture & even color. Evenly distributed. Smooth and pink.
3. Clear, bright, evenly set in socket. Smell intact, membranes pink & moist. Oral mucosa: pink, moist, intact, no bleeding, taste intact, with present gag reflex.
4. Awake, alert, oriented x3 (4), sensation intact, extremities movement WNL.
5. Breath sounds WNL, LSCTA
6. S1, S2 regular-regular. CRT <3 seconds.
7. Soft, non-tender, non-distended, without masses. Regular BSx4Q. Soft brown stool without difficulty.
8. Non-odorous, light & pale in color, more than 30 mL/hr or 0.5 mL/kg.
9. No deformities or tenderness.
The nurse performed a nutritional and physical assessment on an adult client. The client has yellow subcutaneous fat deposits around the eyes. The nurse would anticipate which laboratory test to be ordered.
A. Albumin level
B. Iron level
C. Complete blood count
D. Cholesterol level
D. Cholesterol level would be obtained in a lipid panel
Albumin measures circulating protein levels
Iron indicates total iron binding capacity of hemoglobin
CBC evaluate RBC and WBC.
State a biophysical risk factor for inadequate nutrition.
Medical disease/conditions: HTN, HF, HIV/AIDS, Crohn's, Inflammatory bowel, COPD
Surgery
Medications & supplement usage
Genetics: lactose intolerance, osteopenia, osteoporosis
Lifespan: Age, Pregnancy
[pause jeopardy, complete matching of Social Determinants of Health]
A nurse has multiple clients with tube feedings.
Client A is receiving continuous infusion from a prefilled bag. Both were changed 22 hours ago.
Client B is receiving intermittent tube feedings with 2 cans every 6 hours. The tubing was changed 24 hours ago.
Client C will begin their cyclic feeding in an hour. The tubing was changed 20 hours ago.
State the order in which the nurse will plan to care for the three clients. Provide the rationale for your decision.
All need new tubing.
Client B needs new tubing before receiving an intermittent tube feeding (q4-6 hours, 30-60 min time).
Client C will need new tubing before their cyclic feeding begins to minimize interruptions (done overnight-ish, 8-20 hours).
Client A will get a new tube and new prefilled bag in 2 hours (at max) (continuous 24-hour).
Match: Subjective Nutrition Questionnaire
In 5 groups of 5. Match the subjective questions.
First group who matches correctly = piece of candy.
State one clinical manifestation when a deficit or excess is present of a trace mineral, see the following:
1. Iron deficiency anemia
2. Iodine
3. Fluoride
1. Increase in respiratory, heart rate, cardiac murmurs. Nails: concave (inward curve) & pallor, atrophic lingual papillae (smooth, glossy w/ red or pink background of the tongue), fatigue, lethargy, cold intolerance, headache. Pale conjunctiva. Children: short attention span, poor intellectual performance before anemia.
2. Thyroid manifestations: goiter, hyperthyroid (excess) or hypothyroid (deficient)
3. Deficiency: dental caries, osteoporosis. Chronic excess: fluorosis (ligament calcification, teeth mottling/discoloration), itching, chest pain.
The nurse is teaching the adult client about myPlate. Which statement by the client indicates learning has occurred?
A. "This aids in group teaching."
B. "This reflects an individualized approach to nutrition."
C. "It teaches me how to have a low intake of carbohydrates."
D. "It tells me that I only need to eat two servings of grains daily."
B. "This reflects an individualized approach to nutrition."
State 1 of the six core elements and the plate percentage per meal as according to Dietary Guidelines for Americans per "www.myplate.gov"
Vegetables 2.5c/day (1/4 plate)
Fruits 2 c/day (1/4 plate)
Grains 6 oz/day (1/4 plate)
Protein 5.5 c/day (1/4 plate)
Dairy 3 c/day (1 cup)
A client has a jejunum tube in place and is complaining of dizziness, sweating, and lightheadedness. The nurse observes a rapid pulse and pallor skin. State the complication the client might be experiencing.
State a nursing action for this complication.
Dumping syndrome.
Anticipate: a formula change, Decreased flow rate, total and/or Volume of infusion to change.
Ensure the nutrition is at room temperature.
Prevent bacterial contamination.
Each group will research the health benefits of the following spices/seasonings.
Vitamin and Mineral, provide the function and two high sources of food that is rich in that vitamin/mineral. (ATI ch. 1 p. ~5)
Then place your information in the Discussion board "Nutrition" --> "Spices and seasonings (not the OTC tablet forms)".
1. Paprika + Vitamin A
2. Turmeric + Vitamin D
3. Cinnamon + Vitamin C
4. Garlic + Vitamin B1
5. Lemon + Vitamin B2
6. Pepper +Vitamin B3
7. Cayenne Pepper +Vitamin B5
8. Cumin +Vitamin B6
9. Ginger +Vitamin B7
10. Nutmeg + +Vitamin B9
11. Clove + +Vitamin B12
12. Iron + Iodine
13. Sulfur + Fluoride
State one clinical manifestation when a deficit or excess is present of a fat-soluble vitamin, see the following:
1. Vitamin A
2. Vitamin D
3. Vitamin K
4. Vitamin E (rare to be deficient)
1. Skin: flaky, scaling, hyperkeratosis (abnormal thickening of skin). Papilledema, headache, dizziness, lethargy. Vision changes: Night vision decreases, xerophthalmia (cornea dryness & hardening). GI disturbances, ascites. [Toxicity from supplements, retinoids: creams, lotions]
2. Musculoskeletal deformities, bone demineralization --> rickets, osteomalacia. Infant: teeth not erupting. [Excess: Hypercalcemia].
3. Blood clotting & bone maintenance: Purpura (purple spots under skin), increased bleeding time (aPTT, PT).
4. Antioxidant for cell membrane preservation of lung & RBC. Anemia; infant: edema, skin lesions
The nurse is performing a nutritional assessment on a 76-year-old healthy woman who has lost 10 pounds in the last 5 months without significant past medical history. What is the most appropriate action for the nurse to perform next?
A. Assess respiratory status.
B. Ask about bowel patterns due to the aging changes.
C. Educate on the need to increase her calories by substituting whole milk for water.
D. Assess financial difficulty related to a fixed income.
D. Assess financial difficulty related to a fixed income.
There is no significant medical history - so A & B should be removed. Without addressing financial aspects, it might be for not when teaching about substituting milk + as we age, the calorie intake decreases.
State one primary education statement that a nurse should conduct to decrease the incidence of foodborne illnesses.
-perform frequent hand hygiene
-refrigerate food products when necessary
-When preparing food, avoid cross-contamination
-To kill unwanted bacteria*, heat the food to recommended temperatures: roast/steak 145F, Ground beef/egg products 160F, chicken 165F
*Responsible for most deaths from foodborne illness & includes salmonella, E. coli, and listeria monocytogenes.
A nurse is caring for a client with anorexia bulimia who will be started on total parenteral nutrition (TPN) in a PICC line through the right arm. BMI for this client is 14. State the complication this client is most at risk for.
State client manifestations for this complication.
Refeeding syndrome.
EDEMA! Fatigue, weakness, shallow respirations, difficulty breathing, confusion, seizures, elevated blood pressure, cardiac rhythm changes, fluid retention, acidosis.
Results in heart failure manifestations and death.
Creatively demonstrate client manifestations of the following:
HINT: Utilize your ATI Adult Medical Surgical (ch. 1 & 2) and Nutrition books ch. 5
1.Hyperthyroidism
2.Hypothyroidism
3.Salmonella foodborne illness
4.Escherichia (E.) coli foodborne illness
5.Listeria monocytogenes foodborne illness
6.Norovirus foodborne illness
7.Food allergy
State one clinical manifestation when a deficit is present of vitamin C.
Skin lesions,
weak immune system with the potential of petechiae, swollen bleeding gums, and purpura.
Scurvy: hemorrhagic disease - diffuse tissue bleeding, painful limbs, joints, weak bones, & swollen gums, loose teeth
Iron deficiency symptoms
severe = sudden cardiac death
Aids in tissue building, metabolic reactions to heal, form collagen, iron absorption, immune system.
A client does not consume calcium products and is concerned with not having enough bone density. The nurse should plan to prepare the client for which prescribed diagnostic study.
A. Waist circumference measurements
B. Dual x-ray absorptiometry
C. Venipuncture for albumin and iron levels
D. 24-hour diet recall.
B. This is our Dexa Scan. It evaluates bone density and lean body mass.
A. Measure risk for CV disease
C. Hemoglobin capacity and protein stores
D. Tells us about our dietary intake