Nutrition Flashcards
Book Ch. 28 ATI Ch. 39 & 54, also used green Nutrition ATI book
1
Q
What is the goal of “Healthy People 2020”?
A
To promote health & reduction of chronic diseases associated with diet & weight.
2
Q
How can nurses serve patients regarding their views on nutrition?
A
- Nurses should encourage favorable nutrition choices.
- Nurses can serve as informational resources for patients regarding health guidelines for healthy eating.
- Nurses should considers & incorporate the family’s nutritional habits to a patient’s individual plan of care.
3
Q
What are 2 established guidelines for healthy eating that patients & nurses can refer to?
A
- Dietary Guidelines for Americans
2. MyPlate.gov
4
Q
Describe the 5 color categories used in MyPlate.
A
Used to illustrate a healthy meal:
- red - fruits
- green - veggies
- orange - grains
- purple - protein
- blue - dairy
5
Q
MyPlate promotes healthy nutrition based on what?
A
USDA dietary guidelines for Americans 2015-2020:
- Food choices & variety
- Portion size
- Activity
- Tools for a successful nutritional lifestyle
6
Q
Define Nutrition.
A
- Study of food & how it affects the body & influences health.
- Adequate nutrition is essential to wellness.
7
Q
Define Nutrients.
A
- Building blocks for cells & tissues that:
- supply energy (macronutrients-kilocalories)
- help manufacture, maintain, & repair cells (micronutrients)
- Found in foods like carbs, proteins, & lipids.
- Are changed & used in the body through metabolism.
8
Q
What are the different types of nutrients?
A
- Carbohydrates (4 kcal/gram)
- Proteins (4 kcal/gram)
- Lipids/Fats (9 kcal/gram)
- Micronutrients
- Macronutrients (supply the body with energy)
- Water
- Any one food can contain a variety of nutrients.
9
Q
Describe Carbohydrates.
A
Primary energy source:
- Energy for muscle & organ function.
- Provide energy for the brain (average amount needed to fuel the brain in 130 g/day).
Sugars:
- Store glucose in liver & skeletal muscle tissue as glycogen.
- Glycogen converted back into glucose to meet energy needs.
10
Q
Describe Proteins.
A
- Essential for tissue growth, maintenance, & repair of body cells & tissues.
- Nitrogen Balance: intake & output are equal.
- Positive Nitrogen Balance - intake > output
- Negative Nitrogen Balance - intake < output
- Amino Acids: for protein synthesis to occur, every amino acid necessary to build that protein must be avaliable.
11
Q
Describe Lipids.
A
- Lipids = Fats
- Solid at room temperature are called fats.
- Liquid at room temperature are called oils.
- Phospholipids are a key component of lipoproteins.
- Back-up Energy Source
- Organ Insulation & Protection
12
Q
Describe Micronutrients.
A
- Needed only in small amounts.
- Vitamins & Minerals
- Critical in:
- Building & maintaining body tissues.
- Supporting our immune system so we can fight disease.
- Vitamins:
- Ensure healthy vision.
- Help our bodies break down & use the energy found in carbs, proteins, & lipids.
- Critical during periods of rapid growth, pregnancy, lactation, & healing.
- Minerals
- Inorganic elements found in nature.
- Major minerals - minerals the body needs in amounts of 100 mg/day or higher.
- Trace minerals - are essential but are in lower concentrations.
13
Q
Describe Water.
A
- Makes up about 1/2 of total body weight.
- 55-65 % in men b/c of muscle mass.
- 50-55% in women.
- Transports Substances.
- Basic solvent for body’s chemical processes.
- Form for Tissues (Fills in Spaces)
- Maintains Body Temperature.
14
Q
Define Energy Balance.
A
- Energy in nutrients measured in calories.
- Calories “in” must equal calories burned.
- Undernourished = too few calories in.
- Obesity = too many calories in.
- 2 Components:
1. Basal Metabolic Rate (BMR) - amount of energy required at rest in a neutral temperature environment.
2. Total Energy Needs - replacing calories used for BMR + physical activity.
15
Q
What are factors that affect nutrition?
Hint there are 9 in total
A
- Developmental Stage (from infants to elders; lactating women; pregnancy & folic acid)
- Educational Level
- Knowledge of Nutrition
- Access to appropriate or adequate nutrition
- Lifestyle choices (dietary patterns; vegetarianism; dieting)
- Ethnicity/Culture
- Religious Practices
- Disease Processes (any illness, especially accompanied by fever, increases the need for protein, water, & calories to meet demands of an increased metabolic rate)
- Functional Limitations
16
Q
Identify the client with the greatest risk for developing protein-calorie malnutrition.
A. A client who has MS & is in a wheelchair.
B. A client weighing 300 lbs. who has entered the hospital for cardiac bypass surgery.
C. A client with a broken arm & femur from trauma who is running a fever of 101.5 F (38.6 C).
D. A client who is of Native American heritage.
A
C. A client with a broken arm & femur from trauma who is running a fever of 101.5 F (38.6 C).
- B/c the client would have the greatest increase in metabolic demand for energy & nutrients & run the greatest risk for not having those energy demands met when they have a fever.
17
Q
What are the 2 formulas to calculate BMI?
A
- Metric System
BMI = [weight (kg) / height (m squared)] - Imperial System
BMI = [weight (lbs.) / height (in. squared)] x 703
18
Q
1 kg = ? lbs.?
A
2.2 lbs.
19
Q
1 in. = ? cm.?
A
2.54 cm.
20
Q
What are the steps to determine BMI using the metric system?
A
- Determine the client’s weight in kg & height in m.
- Multiply the client’s height by itself to determine the m squared value.
- Divide the weight in kg by the height value in step 2. The result is the BMI.
21
Q
What are the classifications for weight in the US?
A
Underweight = BMI < 18.5 Normal Weight = BMI 18.6 - 24.9 Overweight = BMI 25.0 - 29.9 Obesity = BMI > 30 (3 classes of obesity) Class 1 = BMI 30.0 - 34.9 Class 2 = BMI 35.0 - 39.9 Class 3 = BMI > 40.0
22
Q
What are the 3 types of eating disorders?
A
- Anorexia Nervosa - psychiatric disorder characterized by self-starvation.
- Bulimia Nervosa - binge eating followed by self-induced vomiting or laxative use to purge food.
- Binge-Eating Disorder - binge eating without purging.
23
Q
What are some physical signs of eating disorders?
A
- Hair Loss
- Abnormal Weight Loss
- Cold Intolerance (they are always cold)
- Absent or Irregular Menstruation
- Low BP
- Weakness
- Atrophy of Breast Tissue
24
Q
What is the first thing we need to do in managing imbalances?
A
Planning
- Must identify the etiology of the imbalance.
25
What are 2 types of etiologies for nutritional imbalances?
1. Undernutrition
* Difficulty chewing or swallowing
* Alcoholism
* Metabolic disorders (DM, GI disorders)
2. Overweight & Obesity
* Overeating
* Lack of Exercise
* Endocrine Problems
26
What are some interventions for nutritional imbalnaces?
- Education on vitamins, minerals, healthy choices, medications, etc.
- Promote good oral hygiene b/c it increases appetite
- Prevent aspiration
- Therapeutic Diet
- Assist with meals
27
What are the 11 types of therapeutic diets?
1. Clear Liquid - liquids that leave little residue (clear fruit juices, gelatin, broth).
2. Full Liquid - clear liquids plus liquid dairy products, all juices. Some facilities include pureed veggies.
3. Pureed - clear & full liquids plus pureed meats, fruits, & scrambled eggs.
4. Mechanical Soft - clear & full liquids plus diced or ground foods.
5. Soft/Low-Residue - foods that are low in fiber & easy to digest (dairy products, eggs, ripe bananas).
6. High-Fiber - whole grains, raw & dried fruits.
7. Low Sodium - no added salt or 1 to 2 g of sodium.
8. Low Cholesterol - no more than 300 mg/day of dietary cholesterol.
9. Diabetic - balanced intake of proteins, fats, & carbs of about 1,800 calories.
10. Dysphagia - pureed foods & thickened liquid diet.
11. Regular - no restrictions.
28
How can we intervene with obesity?
- Assisting with calorie calculations & meal planning.
- Encourage exercise & lifestyle changes.
- Encourage to weigh weekly & keep a food diary.
29
How can we intervene with undernutrition?
- Encourage patient to seek counseling for eating disorder management.
- Devise strategies to improve patient's appetite.
- Enteral nutrition
- Parenteral nutrition
30
A nurse is caring for a client who is at high risk for aspiration. Which of the following actions should the nurse take?
A. Give the client thin liquids.
B. Instruct the client to tuck their chin when swallowing.
C. Have the client use a straw.
D. Encourage the client to lie down & rest after meals.
B. Instruct the client to tuck their chin when swallowing.
- Tucking the chin when swallowing allows food to pass down the esophagus more easily.
A. Incorrect b/c thin liquids increase risk for aspiration.
C. Incorrect b/c using a straw increases risk for aspiration.
D Incorrect b/c sitting for an hour after meals helps prevent gastroesophageal reflux & possible aspiration of stomach contents after a meal.
31
A nurse is preparing a presentation about basic nutrients for a group of high school athletes. She should explain that which of the following nutrients provides the body with the most energy?
A. Fat
B. Proteins
C. Gylcogen
D. Carbohydrates
D. Carbohydrates
- Carbs are the body's greatest energy source; providing energy for cells is their primary function. They provide glucose, which burns completely & efficiently without end products to excrete. They are also a ready source of energy, and they spare proteins from depletion.
32
A nurse is caring for a client who requires a low-residue diet. The nurse should expect to see which of the following foods on the client's meal tray?
A. Cooked barley
B. Pureed broccoli
C. Vanilla custard
D. Lentil soup
C. Vanilla custard
- A low-residue diet consists of foods that are low in fiber & easy to digest. dairy products & eggs (custard & yogurt) are appropriate for a low-residue diet.
33
A nurse is caring for a client who weight 80 kg (176 lbs.) and is 1.6 m (5ft. 3 in.) tall. Calculate BMI & determine whether this client's BMI indicates a healthy weight, underweight, overweight, or obese.
BMI = weight(kg) / height (m squared)
Step 1. Client's weight (kg) and height (m) = 80 kg and 1.6 cm.
Step 2. 1.6 cm x 1.6 cm = 2.56 m squared.
Step 3. 80 kg / 2.56 m squared = 31. 25 BMI
A BMI greater than 30 identifies obese.
The client is considered to be in the obesity class 1
34
A nurse in a senior center is counseling a group of older adults about their nutritional needs & considerations. Which of the following information should the nurse include? (Select All That Apply.)
A. Older adults are more prone to dehydration than younger adults are.
B. Older adults need the same amount of vitamins & mineral as younger adults do.
C. Many older men & women need calcium supplements.
D. Older adults need more calories that they did when they were younger.
E. Older adults should consume a diet lower in carbs.
A. Older adults are more prone to dehydration than younger adults are.
- Sensations of thirst diminish with age, leaving older adults more prone to dehydration.
B. Older adults need the same amount of vitamins & minerals as younger adults do.
- These requirements do not change from middle adulthood to older adulthood. However, some older adults need additional vitamin & mineral supplements to treat or prevent specific deficiencies.
C. Many older men & women need calcium supplements.
- If older adults ingest insufficient calcium in the diet, they need supplements to help prevent bone demineralization (osteoporosis).
35
A nurse is delivering an enteral feeding to a client who has an NG tube in place for intermittent feedings. When the nurse pours water into the syringe after the formula drains from the syringe, the client asks the nurse why the water is necessary. Which of the following responses should the nurse make?
A. "Water helps clear the tube so it doesn't get clogged."
B. "Flushing helps make sure the tube stays in pace."
C. "This will help you get enough fluids."
D. "Adding water makes the formula less concentrated."
A. "Water helps clear the tube so it doesn't get clogged."
- Flush the tube after instilling the feeding to help keep the NG tube patent by clearing any excess formula from the tube so that it doesn't clump & clog the tube.
36
A nurse is caring for a client who is receiving continuous enteral feedings. Which of the following nursing interventions is the highest priority when the nurse suspects aspiration of the feeding?
A. Auscultate breath sounds
B. Stop the feeding
C. Obtain a chest x-ray
D. Initiate oxygen therapy
B. Stop the feeding
- The greatest risk to the client is aspiration pneumonia. The first action to take is to stop the feeding so that no more formula can enter the lungs.
37
A nurse is preparing to instill an enteral feeding for a client who has an NG tube in place. Which of the following actions is the nurse's highest assessment priority before performing this procedure?
A. Check how long the feeding container has been open
B. Verify the placement of the NG tube
C. Confirm that the client does not have diarrhea
D. Make sure the client is alert & oriented
B. Verify the placement of the NG tube.
- The greatest risk to the client receiving enteral feedings is injury from aspiration. The priority nursing assessment before initiating an enteral feeding is to verify proper placement of the NG tube.
38
A nurse is caring for a client in a long-term care facility who is receiving enteral feedings through an NG tube. Which of the following actions should the nurse complete prior to administering the tube feeding? (Select All That Apply.)
```
A. Auscultate bowel sounds
B. Assist the client to an upright position
C. Test the pH of gastric aspirate
D. Warm formula to body temperature.
E. Discard any residual gastric contents
```
A. Auscultate bowel sound
- B/c the client's GI tract might not be able to absorb nutrients. Then withhold feedings & notify provider.
B. Assist the client to an upright position
- Place client in an upright position with HOB elevated 30 degrees. upright positioning helps prevent aspiration.
C. Test pH of gastric aspirate.
- Before administering enteral feedings, verify the placement of the NG tube. the only reliable method if x-ray confirmation, which is impractical prior to every feeding. Testing the pH of gastric aspirate is an acceptable method between x-ray confirmations.
39
A nurse is preparing to insert an NG tube for a client who requires gastric decompression. Which of the following actions should the nurse perform before beginning the procedure? (Select All That Apply.)
A. Review the signal a client can use if feeling any distress.
B. Lay a towel across the client's chest.
C. Administer oral pain medication.
D. Obtain a Dobhoff tube for insertion.
E. Have a petroleum-based lubricant available.
A. Review the signal a client can use if feeling any distress.
- Establish a means for the client to communicate that they want to stop the procedure before inserting an NG tube.
B. Lay a towel across the clients chest.
- Place a disposable towel across the client's chest tp provide for a clean environment & protect the client's gown from becoming soiled.
40
What is the formula to calculate BMI using the Imperial System?
BMI = (weight in pounds / height in inches squared) x 703
41
BMI Imperial System Example:
209 pounds = 95 kilograms
6 feet 2 inches = 1.88 cm
What would this BMI be classified as?
6 ft. x 12 in. = 72 in. + 2 in. = 74 in.
74 in. x 74 in. = 5,476 in. squared
(209 lbs. / 5,476 in. squared) x 703 = 26.83 = 26.9
Overweight (25.0-29.9)
42
Joe weighs 189 lbs. and is 5 ft 6 in tall.
What is his BMI?
What would this BMI be classified as?
5 ft. x 12 in. = 60 in. + 6 in. = 66 in.
66 in. x 66 in. = 4,356 in. squared
(189 lbs. / 4,356 in. squared) x 703 = 30.50 = 30.5 BMI
Obese Class 1 (30.0-34.9)
43
Alice weighs 155 lbs. and is 5 ft 3 in tall.
What is her BMI?
What would this BMI be classified as?
5 ft. x 12 in. = 60 in. + 3 in. = 63 in.
63 in. x 63 in. = 3,969 in. squared
(155 lbs. / 3,969 in. squared) x 703 = 27.45 = 27.5 BMI
Over weight (25.0-29.4)
44
Frank weighs 230 lbs. and is 6 ft tall.
What is his BMI?
What would this BMI be classified as?
6 ft. x 12 in. = 72 in.
72 in. x 72 in = 5,184 in. squared
(230 lbs. / 5,184 in. squared) x 703 = 31.19 = 31.2 BMI
Obese Class 1 (30.0-34.9)
