Nutrition (47) Flashcards
Which of the following nursing diagnoses is most appropriate for a client with a body mass index (BMI) of 35?
- Imbalanced Nutrition: Less Than Body Requirements
- Obesity
- Overweight
- Deficient Knowledge
2. Obesity
A BMI of 30 to 40 indicates moderate to severe obesity.
A BMI of less than 18.5 indicates underweight (option 1).
The nursing diagnosis of Overweight is defined by a BMI of 25–29.9. (option 3).
There is no evidence to support a diagnosis of Deficient Knowledge (option 4).
An adult reports usually eating the following each day: 3 cups dairy, 2 cups fruit, 2 cups vegetables, 5 ounces grains, and
5 ounces meat. The nurse would counsel the client to:
- Maintain the diet; the servings are adequate.
- Increase the number of servings of dairy.
- Decrease the number of servings of vegetables.
- Increase the number of servings of grains.
4. Increase the number of servings of grains.
This client needs more grains in the diet. The client should have 6 to 7 oz grains per day, 3 cups/week dark green vegetables, 2 cups/week orange vegetables, 3 cups/week legumes, 3 cups/ week starchy vegetables, 1.5 to 2 cups fruit per day, 5 to 6 oz meat and beans per day, and 3 cups milk, yogurt, and cheese per day.
Which of the following are allowed on a full liquid diet? Select all that apply.
- Scrambled eggs
- Chocolate pudding
- Tomato juice
- Hard candy
- Mashed potatoes
- Cream of Wheat cereal
- Oatmeal cereal
- Fruit “smoothies”
2. Chocolate pudding
3. Tomato juice
4. Hard candy
6. Cream of Wheat cereal
8. Fruit “smoothies”
A full liquid diet contains only liquids or foods that turn to liquid at body temperature. Pudding, juices, hard candy, Cream of Wheat cereal, and fruit smoothies are permitted on a full liquid diet.
Scrambled eggs (option 1), mashed potatoes (option 5), and oatmeal cereal (option 7) are not permitted until the client advances to a soft diet.
What is the best indication of proper placement of a nasogastric tube in the stomach?
- Client is unable to speak.
- Client gags during insertion.
- pH of the aspirate is less than 5.
- Fluid is easily instilled into the tube.
3. pH of the aspirate is less than 5.
Gastric secretions are acidic as evidenced by a pH of less than 6. If the tube were improperly placed in the client’s airway, speaking would usually be impaired (option 1).
Gagging during insertion is common and does not indicate that the tube is in the stomach (option 2).
Ability to easily instill fluid into the tube does not relate to its placement. The lungs would offer no resistance to the flow of liquid (option 4).
What is the proper technique with gravity tube feeding?
- Hang the feeding bag 1 foot higher than the tube’s insertion point into the client.
- Administer the next feeding only if there is less than 25 mL of residual volume from the previous feeding.
- Place client in the left lateral position.
- Administer feeding directly from the refrigerator.
1. Hang the feeding bag 1 foot higher than the tube’s insertion point into the client.
For proper flow, the feeding container hangs 1 foot above the tube insertion.
Feedings may be administered if there is less than 90 to 100 mL of residual volume (unless agency policy specifies otherwise) (option 2).
To prevent or reduce the risk of aspiration, the client should be placed in Fowler’s position during feeding (option 3).
The feeding should be warmed to room temperature before administration to decrease cramping and diarrhea (option 4).
A 55-year-old female is about 9 kg (20 lb) over her desired weight. She has been on a “low-calorie” diet with no improvement. Which statement reflects a healthy approach to the desired weight loss? “I need to:
- Increase my exercise to at least 30 minutes every day.”
- Switch to a low-carbohydrate diet.”
- Keep a list of my forbidden foods on hand at all times.”
- Buy more organic and less processed foods.”
1. Increase my exercise to at least 30 minutes every day.”
The Dietary Guidelines recommend 30 minutes of physical activity on most days of the week to achieve optimal weight. Some individuals benefit from a low-carbohydrate diet, but no particular diet is the solution for all individuals (option 2).
A reasonable diet emphasizes balance and portion control rather than forbidding or requiring any specific foods (option 3).
Fresh and chemical-free foods may be healthier than preserved foods but do not automatically assist with weight loss (option 4).
An older Asian client has mild dysphagia from a recent stroke. The nurse plans the client’s meals based on the need to:
- Have at least one serving of thick dairy (e.g., pudding, ice cream) per meal.
- Eliminate the beer usually ingested every evening.
- Include as many of the client’s favorite foods as possible.
- Increase the calories from lipids to 40%.
3. Include as many of the client’s favorite foods as possible.
Always inquire into the client’s favorite foods when planning a diet. Dairy may not be indicated for this client due to the high incidence of lactose intolerance in individuals of Asian heritage (option 1).
Beer can be a source of calories and, in moderation, is not harmful, and may maintain the client’s satisfaction with the dietary changes. The nurse will need to assess the ability to swallow beer safely, however (option 2).
Calories from lipid sources should be kept below 35% and, when enhanced wound healing is indicated (not so with a stroke), increased protein and carbohydrates are needed rather than fats (option 4).
Two months ago a client weighed 195 pounds. The current weight is 182 pounds. Calculate the client’s percentage of weight loss and determine its significance.
- % weight loss
- Not significant
- Significant weight loss
- Severe weight loss
This client has lost 13 pounds which is 6.7%: (195 – 182)/195. If the weight loss has been steady during the past 2 months, that would indicate a 3.3% loss per month. Less than 5% loss in 1 month is not significant, but if this loss continues, the client will reach a 10% loss in 3 months, which is a severe loss. A more detailed assessment is indicated to determine the client’s nutritional status.
Which of the sites on the diagram below indicates the correct location for the tip of a small-bore nasally placed feeding tube?
2
A small-bore nasal feeding tube tip is most commonly placed in the stomach.
Option 1 indicates the esophagus. A tube tip placed there can lead to aspiration.
Option 3 indicates the postpyloric duodenum. Small-bore nasal tubes can be advanced to this location if desired but such a placement is less common than gastric placement.
Option 4 indicates the jejunum where feeding tubes can be placed but usually not from a nasally placed tube.
Which of the following meals would the nurse recommend to the client as highest in calcium, iron, and fiber?
- ) 3 ounces cottage cheese with 1/3 cup raisins and 1 banana
- ) 1/2 cup broccoli with 3 ounces chicken and 1/2 cup peanuts
- ) 1/2 cup spaghetti with 2 ounces ground beef and 1/2 cup lima beans plus 1/2 cup ice cream
- ) 3 ounces tuna plus 1 ounce cheese sandwich on whole-wheat bread plus a pear
4.) 3 ounces tuna plus 1 ounce cheese sandwich on whole-wheat bread plus a pear
