Nutrition

Question 1

Water-Soluble Vitamins

Answer 1

• Folic acid
  
  • green leafy vegetables, liver, beef, fish, legumes, grapefruit, orange3s
• Niacin
  
  • meats, poultry, fish, beans, peanuts, grains
• Vitamin B1 (thiamine)
  
  • pork, nuts, whole-grain cereals, legumes
• Vitamin B2 (riboflavin)
  
  • Milk, lean meats, fish, grains
• Vitamin B6 (pyridoxine)
  
  • Yeast, corn, meat, poultry, fish
• Vitamin B12 (cobalamin)
  
  • meat, liver
• Vitamin C
  
  • Citrus, tomatoes, broccoli, cabbage

Question 2

Fat-Soluble Vitamins

Answer 2

• Vitamin A
  
  • liver, egg yolk, whole milk, green or orange vegetables, fruits
• Vitamin D
  
  • Fortified milk, fish oils, cereals
• Vitamin E
  
  • Vegetable oils, green leafy vegetables, cereals, apricots, apples, peaches
• Vitamin K
  
  • Green leafy vegetables, cauliflower, cabbage

Question 3

Low-fiber diet

Answer 3

• Used for IBS, partial obstructions, gastroenteritis
• Avoid raw fruits (except bananas), vegetables, nuts, seeds, plant fiber, whole grains

Question 4

High-fiber diet

Answer 4

• 20-35 g fiber daily
• Used for constipation
• Avoid gas-forming foods
  
  • apples, artichokes, barley, beans, bran, broccoli, brussels sprouts, cabbage, celery, figs, melons, milk, molasses, nuts, onions, radishes, soybeans, wheat, yeast

Question 5

Measures to relieve thirst

Answer 5

• Chew gum or suck hard candy
• Freeze fluids
• Add lemon juice to water
• Gargle with refrigerated mouthwash

Question 6

Low-purine diet

Answer 6

• Used for gout, kidney stones, and elevated uric acid levels
• Avoid anchovies, herring, mackerel, sardines, scallops, organ meats, gravies, meat extracts, wild game, goose, sweetbreads

Question 7

Parenteral Diet - Adverse reactions of lipids

Answer 7

• Infuse slowly, monitor vitals Q10 minutes
• Reactions
  
  • Chest and back pain
  • Chills
  • Cyanosis
  • Diaphoresis
  • Dyspnea
  • Fever
  • Flushing
  • HA
  • N/V
  • Pressure over the eyes
  • Thrombophlebitis
  • Vertigo
• Shouldn’t be given to patients with egg allergies

Question 8

Parenteral Nutrition - Air Embolism

Answer 8

• Symptoms
  
  • Apprehension
  • Chest pain
  • Dyspnea
  • Hypotension
  • Loud churning sound heard over pericardium on auscultation
  • Rapid, weak pulse
  • Respiratory distress
• Interventions
  
  • Clamp all ports of the IV catheter
  • Place client in left side-lying position with head lower than the feet
• Prevention
  
  • Instruct client in the valsalva maneuver for tubing and cap changes
    
    • Place client in trendelenburg position with head in the opposite direction of insertion side, client should hold breath and bear down

Question 9

Parenteral Nutrition - Other considerations

Answer 9

• Medications and blood not given through PN line
• With severely malnourished clients, monitor for “refeeding syndrome” (rapid drop in potassium, magnesium, phosphate)
  
  • electrolyte shift can cause cardio, respiratory and neurological problems
• PN solutions should be stored under refrigeration and administered within 24 hours from the time they are prepared (remove from refrigerator ½-1 hour before use)
• PN solutions that are cloudy or darkened should not be used
• Weight gain of more than 3 lbs/week should be reported