ATI Nutrition Exam Study Guide
• Age-related macular degeneration (AMD) (eyes)
o Increase lutein (carotenoid found in vit A) foods - kale, spinach, collards, mustard greens
o Increase antioxidants, vit E & B12
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ATI Nutrition Exam Study Guide
• Age-related macular degeneration (AMD) (eyes)
o Increase lutein (carotenoid found in vit A) foods - kale, spinach, collards, mustard greens
o Increase antioxidants, vit E & B12
• Anorexia nervosa
o Weight pt. DAILY @ the same time
o Stay w/ pt. during and 1hr after meal (prevent vomit)
o RN sched meals
o Privileges based on direct wt. gain
• Atorvastatin
o Lipitor (tx high cholesterol)
o Okay to take w/ OJ, coffee, milk
o Contraindicated w/ grapefruit juice (clinical signs (cx) increased serum level)
• Braden scale
o Very poor (1) very poor nutrition
o Probably inadequate (2) ½ meals & sometimes sup
o Adequate (3) >1/2 & refuses sometimes
o Excellent (4) eats q meal & between meals
• Breast feeding
o No water f/ baby ONLY milk
o No sup formula d/t nipple confusion
o Feed on demand x8-12/day
o x5min feed on each breast 1st day after birth
o breast milk is all that is needed f/ 1st 6mo (nutritionally complete)
o no cow's milk until 1yr
o cottage cheese is a complete protein, eat when lactating
o incomplete proteins - legumes, peanut butter, & whole grain cereal
o storage - discard after feeding (cannot refreeze/use), store f/ 6-12mo, do not thaw in microwave
• Bronchitis
o Enteral feeding - high protein, fat, & calorie; low carbs (breakdown prod CO2)
• Calcium
o Almonds highest
o Yogurt 315mg
o Cheese 214mg
o Egg 25mg
o Spinach 122mg
• Cancer
o Sensitivity to odor ∴ decrease aromatic foods to decrease NV
o Avoid hot foods d/t odor
o Small, frequent meals q2hr
o Increase citrus food, pickles, & mouth wash to produce more saliva to decrease metallic taste
o Increase calcium & protein but not TOO high cal (cx cancer)
o Eat 2.5 cups fruit to maintain wt.
o Exercise >150min/wk.
o Limit alcohol male (2) & female (1)/day
o Use plastic utensils (decrease metallic taste)
o Inc fluid & tart f/ taste
o Prevention - 4-5 servings (2.5 cups) fruits & veggies/day; limit alcohol; increase whole grain not refined; limit processed meats d/t increased sodium level; increase lean cuts w/out skin
• Captopril
o Limit potassium rich foods (cantaloupe)
• Carbohydrate
o Starchy vs non-starchy veggies
o 3-5 carbs/meal (45g)
o portion size effects carbs
o carb not r/t calorie amt
• Cardiovascular
o Increase K to decrease risk HTN
o Increase fiber to decrease cholesterol
o Decrease trans fats
o x2> fatty fish/wk. to decrease HTN
o Limit alcohol & sodium
• Celiac
o No gluten (wheat, barley, rye)
• Child
o Decrease choke ∴ peanut butter & celery, whole grapes, pretzels
o <2y/o whole milk
o >2y/o low fat milk
• Crohn's Disease
o Decrease fiber, lactose, fructose
o Eat eggs (easily digest & high protein)
• Cirrhosis + ascites
o Limit sodium intake 2000mg / 2g
o Limit fluids to 1.5L
o 0.8-1.2g/kg protein prevent malnutrition
o consume vit K d/t decrease prothrombin prod by liver ∴ @ risk clots
• Cleft lip
o Feed upright
o Nipple to side of mouth to prevent enter nasal passage
• Colostomy
o Clinical signs (cx) loose stool ∴ thicken w/ pectin
o return regular diet 6 wk. post op
o fiber w/ cx obstruction
• Constipation
o Increase calcium decrease peristalsis
• COPD
o 6 small meals/day
o drinks w/ increase protein/cal between meal
o add gravy/sauce to prevent dry mouth
o soft diet will decrease SOB w/ chew
• DASH diet
o Dec Na to 135-145mEq/L
o Glucose 70-110mg/dL
o Total cholesterol <200mg/dL
• Dehydration
o Continue infusion enteral feeding to prevent high carb load w/ each IM feed
• Diabetes mellitus
o Goal HgbA1c <7% - shows avg glucose level over past few mo ∴ >7% = not follow diet & avg high sugar level
• Dumping syndrome
o avoid liquid during meals to slow movement
o Complex carbs better than simple
o associate w/ fat or protein content of food
o Lie down after eating to slow food movement via GI
o Dec fiber to slow gastric emptying
• Dysphagia
o Palpate throat & chin during swallow
o High fowler 90 degrees
o Assess food pockets
o Allow rest b4 meal
o Do not hyper extend neck
o Neck to chest to pv aspiration
o S/s - painful swallow, change in voice
o @ risk if drool
o do not drink via straw
o place food on unaffected side of mouth
o limit disruptions during eating
o take sm bites
o mechanical soft diet - fruits & veggies easy to chew, thickener f/ liquids, altered texture (mashed potatoes)
• Electrolyte imbalance
o Dec sodium - confusion, headache, N, dizzy, abd cramp
o Inc sodium - confusion, thirst, weakness
o Inc phos = dec Ca - numb/tingle, tetany
o Dec K - irregular HR, muscle weak, leg cramp, anorexia
o Inc K - VD, dysrhythmias, muscle weak
o Dec Cl - lack of emotion, anorexia, muscle cramp
o Inc Cl - Vomiting
• End-stage kidney disease (ESKD)
o Limit potassium intake d/t dec kidney excretion of K
• Enteral (w/in GI) tube feed
o Place in fowlers position
o Verify tube placement
o Check residual
o Flush w/ 30mL water
o Admin @ room temp; cold induce cramp/D
o Admin @ full strength
o Bolus IM feeding over 15-30min
o IM feeding over 30-60min
o Promote tolerance - inc vol each feeding f/ 1st 4-6hr
o Discard open cans in 24hr
o Feed in sm, freq
o Switch to high cal to pv D
o Dec abd distention risk to pv aspiration - ambulate, turn pt. on R side (inc GI movement), avoid inc rat, switch to low fat formula (NOT high fat)
o If tube clogs switch to less cal dense formula
o Tube feeding stops - flush 30-50mL warm water to re-establish flow
o Pv aspiration w/ monitor gastric residuals q4hr, HOB 30-45 degrees, check tube placement w/ x-ray once @ beginning
o Maintain patency by flushing 30-50mL water b4 & after Rx
o Dec D - low fat formula, con’t feed, warm to room temp b4 admin, dec rate to inc abs
• Failure to thrive (toddler)
o Dec distraction during feeding
o Con’t feed regardless of behavior
o Limit fruit juice 4oz/day
o Schedule meals @ same time each day
o Maintain unhurried meal time 20-30min inc positive eat habit
• Fasting RN? s
o Exempt f/ fast during illness
o Fasting mean no liquids
o Fasting certain hours of day
o Fasting only apply to certain type(s) food
• Female dec risk HTN
o Low fat milk
o 4-5 servings unsalted nuts
o <=1 alcohol/day
• Ferrous sulfate (iron)
o Take between meals w/ JUICE
o Dec absorption w/ eggs, milk, caffeine
o Do not take w/ Ca sup d/t dec abs Fe
o Inc abs w/ vit C (tomato / orange juice)
• Fiber
o Bran cereal 8.8g
o Apple w/ skin 3.3g
o Banana 3g
o Oatmeal 2g
o Replace meat entree w/ main dish peas/beans
o Add 2tbs or ¼ cup brain
o Leave skin on when eating fruit
o Inc fluid intake w/ inc fiber intake
• Fluid Overload
o Dilutional hyponatremia <135mEq/dL
o Decreased Hct male 42-52% & female 37-47%
o Decreased urine specific gravity 1.005-1.030 bc less concentrated
o Decreased albumin 3.5-5g/dL bc follows ^
• Folate
o Liver 770 mcg
o Chickpeas 141mcg
o Orange 47mcg
o White bread 47mcg
• Gastric bypass
o 3 meals & 2 snacks/day - limit portion
o begin each meal w/ protein 60-120g/day
o eat slowly & stop when feel full
• Older patient nutrition
o Req less cal d/t dec metabolism
o Req inc protein d/t inc strength, immune function, heal
o Protein intake 20-25% of cal intake
o Ca sup w/ meal (inc abs) to maintain healthy bones
o Vit D sup d/t dec ability to activate it ∴ @ risk dec Ca level
• Glycemic index
o Potato - 90
o Corn - 60
o Macaroni - 45
o Peanuts - 14
• Gout
o Dec purine foods (organ meats & seafood)
• HIV
o Infection s/t HIV tx w/ inc nutrition d/t inc metabolic rate
• Hyperkalemia
o Cx V
• Hyperglycemia
o Abd cramps, NV, acetone breath, rapid shallow RR (Kussmaul), polydipsia, vomiting, ketonuria
• Hypoglycemia
o s/s diaphoresis, irritability, tremors, tachycardia, hunger
• Hyperlipidemia
o <3g fat f/ cheese
o limit egg & yolk to 2-3/wk.
o 90% lean beef
o limit meat to 5oz/day
• Hypermagnesium
o Cx D & cramp
• Ileostomy
o Inc Na to inc fluid retention to combat fluid loss
o Inc pasta/thickening agents
o Prep meals on schedule to promote reg BM
o B12 necessary to pv anemia
• Infec (dec risk w/ chemo) (needs to be reviewed)
o Thaw food in fridge, not room temp
o Discard leftover after 3-4days
o Eat canned goods w/in 1 yr.
o Cook canned good f/ 10min b4 eat
o Heat food >140 degrees
• Inflammatory bowel disease
o Hydrolyzed formula - protein in simplest form for simple digestion
o NOT polymeric, milk-based, modular formula
• Irritable Bowel Syndrome
o Dec High fructose
o Inc probiotics
o Peppermint oil f/ exacerbations
o Glucose is better than fructose (honey)
• Kosher
o No pork/shell fish
o No combine meat + milk
o Can eat meat & milk separate of each other
• Lactose intolerance
o Flatulence, bloating, cramping
• Lipid panel
o Niacin dec LDL & triglycerides
o Total cholesterol <200mg/dL
o HDL male >45mg/dL & female >55mg/dL
o LDL <100mg/dL
o Triglycerides <150mg/dL
• Low residue
o No whole gains, fatty meats, high fiber, fruits w/ seeds
o Eggs & banana are low residue menu options
• Malnutrition
o Dec albumin (3.5-5g/dL) = dec protein & dec wound heal
o 1.5K cal f/ proper wound heal
o s/s dry skin, ankle edema (low protein), dec reflex, weak grip, dry eyes
• MAOI Rx
o Tyramine cx HTN crisis (inc BP, headache, sweating)
o aged Cheese has tyramine, smoked meats, dried fish, overripe avocados
• Mucositis (cancer tx breaks down GI lining)
o Inc fluid intake f/ hydration & peristalsis
• Nifedipine
o Ca channel blocker
o No grapefruit juice d/t inc Rx level & inc risk AE
• Nutrient dense
o Pasta w/ red is better than white
o No sweet yogurt
o Canned pinto better than refried
o Canadian bacon is better than sausage f/ protein
• Obese
o 1st tx is 24 diet recall
• Osteomalacia
o 20mcg vit D sup daily
o inc antioxidant foods (vit C, E, & beta-carotene) dec free radicals
o 15mg vit E f/ antioxidant
• Pancreatitis
o Dec Ca
o Inc bilirubin
o Inc glucose (d/t dec insulin prod by pancreas)
o Inc Alk Phos
w/ low fat, high carb and protein with vit c and b
• Parkinson's Disease
o Inc metabolic rate (muscle spasms) ∴ inc cal need
o Drooling inc risk dysphagia/aspiration
o Levodopa-carbidopa abs dec w/ protein intake ∴ consume w/ low protein (wheat bread)
o High protein - yogurt, cheese, peanut butter crackers
• Pregnant
o Vegetarian diet okay (w/milk I think)
o Inc protein
o Inc iron (30mg sup)
o Dec fat/sat fat
o Norm wt. gain 25-35lb w/ norm BMI
o 11-20lb wt. gain w/ abnormal BMI or obese
o dec morning sickness - drink/eat separate to dec abd distention, eat carbs to raise sugar quickly & dec N (eat cereal or crackers b4 get out of bed), dec fat (inc fat cx delay gastric empty & inc N), no caffeine (l/t heartburn)
o Dec constipation - drink 240mL water/day, inc fiber, exercise regularly
o Dec NV - eat sm amt food freq
• Ramadan
o Only eat during nighttime hours (after sunset) & before dawn
o Caffeine prohibited @ any time
o Drinks consumed after meals (not with)
• Semi Solid food w/ 4-month-old
o 1-2tsp @ each feeding
o majority of cal f/ milk
o fruit juice starts @ 6mo (limit to 4oz/120mL)
o start new food q 4-7days - monitor f/ allergy (1 food at a time)
and try 8-15 to encourage baby to accept
• Somogyi phenomenon
o Fasting hyperglycemia that occur in morn d/t hypoglycemia @ night
o Monitor by check glucose during night
• Stomatitis
o Food @ room temp to dec irritation
o Avoid acidity, citrus, spicy, salty
avoid coarse and dry
o Drink high cal/protein meal substitutes
• Stress management
o exercise
• Total parenteral nutrition (banana bag)
o PO must be 60% total cal b4 TPN can be D/C
o Must maintain consistent rate
o Infuse dextrose 10/20 with water until next bag arrive d/t high sugar concentration - avoid hypoglycemia
o Do not abruptly stop d/t metabolic comp and rebound hypoglycemia
o TPN effective w/ prealbumin 19-38mg/dL
o Lipid emulsions made of egg phospholipid ∴ monitor egg allergy and also soybean oil and safflower oil
• Vegetarian
o Low fat cheese f/ protein sup
o Low vit b12 d/t lack of animal meat ∴ may req sup
o Dec fat rather than cal
o Nutrient dense food to avoid protein breakdown f/ energy
o x2 servings nuts/flaxseed per day f/ omega 3 FA
• Vision
o Vit A, lutein, carotenoid
• Warfarin
o Limit foods rich in vit K (green leafy veggies)
• Wt. management
o Do not taste food during prep
o Portion b4 excluding food
o 3-5 meal/day ∴ do not skip
o make a list b4 grocery shop
o limit sodium to 1500mg/day
o lose wt. @ ½ to 1lb/week
o egg yolk x3/week or <
o restrict meat to 5oz/day (deck of cards)
o cheese <3g fat/serving
o butter <2g saturated fat/tbs
• Zinc diet
o BEEF, pinto beans
Energy-yielding
• Carbs, fats, & proteins
Carbs main function
• Provide energy
130g/day is the minimum amount
45-65% of calories
4cal/g of energy
Monosaccharides
• Simple carbs such as glucose & fructose
Disaccharides
• Simple carbs such as sucrose and lactose
Polysaccharides
• Complex such as starches, fiber & glycogen
Proteins
• Provided by plant and animal sources
9 amino acids
Aids in tissue building
10% of intake
4cal/g of energy
Complete Protein
• Comes from animal sources (cheese)
Incomplete Protein
• Comes from plants
Fat Sources
• Dark meat, poultry skin, dairy, added oils
Saturated Fats
• Come from animal sources
Unsaturated Fats
• Come from plant sources
Fat
• 20-35% of intake
9cal/g of energy
Children under the age of 2 need a higher amount to form brain tissue
Water Soluble Vitamins
• Vitamins C & B
Low Density Lipoproteins (LDLs)
• Carry cholesterol to the tissues
BAD
High Density Lipoproteins (HDLs)
• Good cholesterol
Fat Soluble Vitamins
• A, D, E, & K
Vitamin C Deficiency
• Causes scurvy
Vitamin C Sources
• Oranges, lemons. tomatoes, peppers, green leafy vegetables and strawberries
Vitamin B Deficiency
• Thiamin (b1) =beriberi
Vitamin B6 Sources
• Organ meats and grains
Folic Acid
• Prevention of neural tube defects in utero
Examples: liver, dark green leafy veggies, citrus fruits, whole grains, and legumes
Vitamin B12
• Production of RBCs
Found in animal sources such as beef liver and shellfish
Clients who have liver disease...
• Should be careful not to take more than the daily recommended amount of fat soluble vitamins
Vitamin D Deficiency
• Rickets
Vitamin K
• Assists in blood clotting and bone maintenance
Deficiency: Increased bleeding time
Examples: broccoli, cabbage, bananas
Vitamin C increases the absorption of...
• Iron
Good Source of Magnesium
• Nuts
Metabolic Rate
• Rate at which food energy is burned
BMR
• Amount of energy used when body is at rest
Thyroid tests may be used as an indirect measure of BMR
Nutritional Concern during Acute Stress
• Protein deficiency
HDL range
• Above 40
LDL range
• Less than 130
Total cholesterol
• Less than 200
Sodium intake amount with hypertension
• 2400 mg
Sodium intake amount with heart failure
• 2000 mg
DASH Diet
• Used for people with hypertension
Decreased sodium, increased potassium & calcium
Acute Diverticulitis Diet
• Low fiber
Diverticulosis Diet
• High fiber
Avoid foods with seeds or husks such as corn, popcorn, berries, and tomatoes
Mechanical Soft Diet
• Clients who have minimal swallowing or chewing, poorly fitted dentures, dysphagia
Require minimal chewing
Examples: ground meats, canned fruits, soft cooked veggies
Interventions for Tube Displacement
• Position in high fowler's
Aspirate to collect gastric contents
Test pH-should be 4 or less
Confirm placement with X-ray
If the tube is not in stomach, advance it 5 cm (2in) and repeat placement check
First solid food to be introduced
• Iron fortified cereal
Cow’s Milk should not be introduced until...
• 1 years of age
Heme Iron
• Found in meats, fish, & poultry
Non-Heme Iron
• Found in grains, legumes, and veggies
Negative Nitrogen Balance Signs
• Decreased muscle tissue
Impaired organ function
Increased susceptibility to infection
Increased metabolism
Ways to Increase Protein & Calories
• Add skim milk powder to milk
Sub whole milk for water
Add cheese, peanut butter, chopped hard boiled eggs or yogurt to foods
Height Measurement for Children
• Should be lying down on a firm, flat surface
Normal BMI
• 18.5-24.9
Overweight BMI
• 25-29.9
Obese BMI
• 30 or above
Protein
• 3.5-5.0
Prealbumin
• 23-43
More susceptible measure used to assess critically ill patients who are at a high risk for malnutrition
Vegetarian Diet
• Consume a variety and correct amount of foods to meet caloric needs
Vegan
• Excludes ALL meats and animal products
Lacto Vegetarian
• No Dairy products
Lacto Ovo Vegetarian
• No Dairy products and eggs
Nutrients for Vegans
• Protein, iron, zinc, calcium, B12, and Vitamin D
Common Food Allergies
• Milk, peanuts, fish, eggs, wheat
Orthodox Jewish
• Kosher Diet
Muslims and Mormons
• Avoidance of stimulants (coffee, tea, soda)
Muslim
• Ramadan-fasting for religious holidays
Offer a snack at bedtime
Seventh Day Adventists
• Vegetarianism
African American "Soul Food"
• Frying & cooking with added animal fats
Increased milk consumption
Use of packaged meats
Encourage frying lightly with canola or olive oil
High in fat, protein, and sodium
Low in potassium, calcium & fiber
Asian American "Chinese Food"
• Spices are important
High sodium intake!
Encourage moderate salt intake
Calories are increased during pregnancy
• Extra 340 calories during 2nd trimester
Extra 452 calories during 3rd trimester
Pregnancy Weight Gain
• Normal weight: 1 pound/week for a total of 23-35 pounds
Underweight: Just more than 1 pound/week for a total of 28-40 pounds
Overweight: o.66 pounds/week for a total of 15-25 pounds
Nausea during Pregnancy
• Eat dry crackers and toast
Constipation during Pregnancy
• Increase fluid intake and fibers
Maternal Phenylketonuria (PKU)
• Genetic disease in which high levels of phenylalanine pose danger to fetus
PKU diet at least 3 months prior to pregnancy and continue throughout the pregnancy
Breastfeeding
• Should occur for the first 6 months and can continue for as long as the mother and baby desire
Cow’s Milk
• Should NOT be introduced until after 1 year of age
Breastfeeding Teaching
• Offer breast milk immediately after birth
8-12 feedings in a 24-hour period
Nurse up to 15-20 minutes per breast
Infant will empty a breast within 5-10 minutes
Frequent feedings every 2 hours
After 4 hours without feeding, mother should wake up the baby for feeding
Breast milk can be in fridge for up to 10 days or frozen for 6 months
Do NOT freeze thawed milk
Solid Foods after...
• 6 months
New foods should be introduced...
• one at a time over a 4-5-day period
Do NOT feed infants honey due to risk of...
• Botulism
Finger Foods
• Ripe bananas
Graham crackers
Cheese cubes
Noodles
Peeled chunks of apples
Pears
Peaches
Colic
• Persistent crying last for 3 hours or longer per day
Increased Risk for Choking Foods
• Hot dogs
Peanuts
Grapes
Raw carrots
Celery
Peanut butter
Tough meat
Candy
Iron Deficiency Anemia
• Most common nutritional deficiency in children
Older adults have decreased...
• Calcium & folic acid
Iron-rich Foods
• Beans, fish, dairy, lean red meats
Hypoglycemia S/S
• Diaphoresis, irritability, and tremors
Zinc Source
• 4oz ground beef patty
A1C level
• Should be less than 7
Used for IBS
• Peppermint oil to relax smooth muscle of GI tract
Intermittent Enteral Feeding Order
• Fowler's position
Verify placement
Check gastric residual
Flush with 30 mL of water
Calcium can cause...
• Constipation
Example of a high glycemic food
• Baked potato
Acute Pancreatitis sign
• Increased serum glucose
Pancreas produces glucose
Lactose intolerance findings
• Flatulence, bloating, cramping
Client with intermittent enteral feeding experiencing diarrhea intervention:
• Feed in small, frequent meals
Crohn's Disease clients
• Can eat eggs which are easy to digest and are high in protein
Nursing action: Enteral nutrition by intermittent tube feeding
• Increase volume over the first 4-6 feedings
New colostomy teaching
• Increase intake of foods containing pectin
When can TPN be discontinued?
• When oral intake exceeds 60% of estimated daily caloric requirements
Pregnant women should avoid taking what two things together?
• Calcium and iron because it can interfere with iron absorption
Dysphagia with oral feedings
• Gently palpate client's throat during swallowing
High fowler's
Allow client to rest for 30 minutes before a meal
HDL Ranges
• Men: greater than 45
Women: greater than 55
High calcium
• 1/2 cup of roasted almonds
Kosher Diet
• Can eat dairy products combined with non-meat products at the same meal
No pork
Dumping Syndrome Teaching
• Consume liquids between meals to slow movement of food from starch
Clear Liquid Diet Examples
• Water, tea, coffee, fat-free broth, carbonated drinks, clear juices, ginger ale, gelatin
Full Liquid
• Liquid at room temp
All clear liquid plus milk, soups, strained foods/veggies, vegetable and fruit juices, eggnog, plain ice-cream, sherbet, puddings
Mechanical Soft Diet
• LOW fiber, lightly seasoned
Mashed potatoes
Action to take for a client with dysphagia
• Add thickener to liquids
Indicates that a client is ready to transition from NPO to oral intake
• Passing of flatus
Trans-nasal tubes are used for...
• Short term use (4-6 weeks)
Standard Formula
• Contains WHOLE protein
Hydrolyzed Formula
• Contains proteins that are broken down
Higher in osmolarity
Continuous Drip
• Continuous rate over a 16-24-hour period
Used for the critically ill
Cyclic Feeding
• Given over an 8-16-hour period, often during sleeping hours
Bolus Feedings
• Large volume formula given over a short time, less than 15 minutes, 4-6 times per day
Delivered directly into stomach
Mother's milk in infants
Enteral Nutrition
• Placement should be checked by X-ray
Flushed routinely with warm water
Gastric residual checked every 4-6 hours
HOB at least 30 degrees for at least 30-60 minutes after
Begin with a small volume of full-strength formula--increase in intervals as tolerated
Give at room temperature to decrease GI discomfort
Monitor BUN, electrolytes, creatine, serum minerals, and CBC
Feeding should be stopped prior to administering meds
Tubing should be flushed with water (15-30 mins) before and after med is given
EN to Oral: Slowly increased frequency of meals until client is eating 6 small meals per day
Unclog with gentle pressure with 50 mL of water in piston syringe
Regular insulin and Heparin may be added to...
• TPN solution
TPN
• Provides a nutritionally complete solution. Given in central vein only
PPN:
• Given into a peripheral vein
Limited nutritional intake
Lipid emulsions may be added
Insulin & heparin can be added
Daily weight gain up to 1kg/day and increase in albumin are desired outcomes
Jaw Surgery Diet
• Liquid diet
Tuck chin down when swallowing-surgery
Highest priority to observe during meal time
• Parkinson's patient due to risk of aspiration
Abdominal Obesity
• Men: greater than 40 inches in waist
Women: greater than 35 inches in waist
Increased Blood Pressure
• Systolic: greater than 130
Diastolic: greater than 85
What should a fasting glucose be?
• Greater than or equal to 110
Hypertension
• Greater than 140/90
MI diet
• After an MI, a liquid diet is best for the first 24 hours
Small, frequent meals
B12 food sources
• Fish, meats, chicken, eggs, milk
B12 deficiency findings: numbness in hands and feet
Dumping Syndrome
• Contents of stomach are rapidly emptied into small intestine
GERD
• Instruct clients to avoid items that reduce lower esophageal sphincter (LES)
Potassium is essential...
• For clients with pre-stage CKD
Potassium is restricted when on...
• Dialysis
Kidney Stone teaching
• Avoid foods high in oxalate such as spinach, strawberries, beets, nuts, tea, chocolate, and wheat bran
Diabetes Mellitus
• Blood glucose levels are used for DX
Type 1: occurs under the age of 30, absence of insulin production
Blood glucose less than 70 requires immediate attention
Hyperglycemia: over 250
Hypoglycemia: clients should have absorbable carbs readily available such 2 or 3 glucose tablets, 8 lifesavers, 1/2 cup of juice or soda (OJ is good), or 1 tbsp of honey or brown sugar
Diet: high in fiber, low in saturated fats, trans fat and cholesterol
One alcoholic beverage for women, 2 for men is okay
Artificial sweeteners are okay
Sugar is okay as long as adequate insulin is given and sugar is under control
Viral infections can cause type 1
Somogyi Phenomenon
• Morning hyperglycemia in response to overnight hypoglycemia
Bed time snack and insulin can prevent this
Cancer teaching
• Encourage to eat more on days when feeling better. "On good days"
Protein needs are increased
Do NOT eat prior to radiation
HIV Associated Wasting Syndrome
• Weight loss of 10% and at least one concurrent problem such as diarrhea or fever for at least 30 days
Kosher Diet Food
• Mac & cheese
Enteral Feeding high in calories for...
• A client with chronic bronchitis
Absorption of Levodopa
• Decreased protein
1 slice of whole wheat toast
TPN is used for...
• Treatment for cancer, bowel disorders, trauma, or burn patients
Birth Weight
• Doubles by 4-6 months and triples by one year
Commercial Infant Formula
• Provides an alternative to breast milk
Iron fortified formula
Breast milk is ALWAYS preferred
Heart Healthy Diet
• Low fat, low cholesterol
Parentheses (numbness) of hands and feet=B12
Cholesterol less than 200mg
Conservative used of red wine
Increased fiber and CARB intake
Reduction in red meat and increased omega 3 fatty acid
Potassium Sources
• Oranges, dried fruit, tomatoes, avocados, dried peas, meats, broccoli, bananas
Obesity GI complication
• GERD
Constipation Prevention
• Exercise, high fiber diet. Promote fluid intake
Caring for a Client with a Continuous Drip
• Continuous gavage feeding given to infants via an infusion pump tends to decrease total milk fat concentration.
Residuals measured every 4-6 hours
Flush every 4 hours
Acute Stress
• Causes an increase in metabolism, blood glucose, and protein
Older Adult Nutrition
• Select whole grains
Select orange and dark leafy veggies
Select fresh, dried, canned fruits
1/2 of diet must consist of veggies and fruits
Use lean meats
Use vegetables oils (except palm)
Supplemental vitamins
Hypoglycemia S/S
• Shakiness
Confusion
Sweating
Palpitations
Headache
Decreased coordination
BLURRED VISION (answer)
Seizures
Anorexia during radiation
• Eat small amounts of high protein foods loaded with calories and nutrients
Stomatitis Interventions
• Use a soft toothbrush
Avoid mouth washes that contain alcohol
Omit acidic, spicy, dry, or coarse foods
Include cold or room temp foods
Cut food into small bites
Try using straws (answer)
Radiation
• Avoid eating foods that are well tolerated and liked prior to treatment
Diabetes Management
• Increased fiber, low in fat
Carb intake=130 g
Cholesterol=200-300
Promote fiber
Encourage to promote self-monitoring of glucose
Which sweetener will add calories to a diabetic client's intake?
• Sorbitol
Which type of oil contains saturated fat?
• Coconut
Strategies to prevent foodborne illnesses
• Avoid unpasteurized dairy products
Keep cold food temps below 4.4 degrees Celsius (40 degrees Fahrenheit)
Reheat leftovers before eating
Wash raw veggies thoroughly
Low potassium foods
• Orange juice
Yogurt
Total fat intake per day
• 30%
Low Potassium Diet
• Any food that does not contain animal products does not contain cholesterol
BEANS are a good source
Interventions for ascites and cirrhosis
• Decrease fluid intake
Caloric Intake for Older Adults
• Reduce caloric intake
Nutrient Needs for Older Adults
• Select whole grains
Select orange & green leafy veggies
Select fresh, dried, canned, or juices
Use lean meats
Meats can be baked, grilled, or broiled
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