Nutrition rationales

Calorie increase required for the first 6 months of breastfeeding

500 kcal

Calorie increase AFTER the first 6 months of breastfeeding

400 kcal

Canned vegetables are high in _____

sodium

For a cancer pt with nausea/vomiting/decreased appetite, the nurse should encourage the pt to ___________.

eat small meals every 2 hours to make it easier to fight the nausea and vomiting.

add butter, cheese, oils or other high calorie condiments and drink milkshakes or smoothies to add calories to the diet to fight weight loss. Weight loss can delay cancer treatment.

Chemo patients with nausea should avoid warm/hot foods because ________

it is less appealing because warm foods have stronger senses of smell.

How should a chemo pt drink fluids with meals?

They should avoid drinking large amounts of fluid with each meal because they can fill up on fluids and take in less fluid. They need all of the calories they can get because chemo causes weight loss.

What is a realistic goal for weight loss?

5% of your current weight

How many calories equal 1 lb. of fat?

3500 calories

This is the calorie deficit you need in order to lose one pound

How does logging food in a journal help with weight loss?

-It helps you understand the clients eating habits

-Identify changes that can be made (like swapping whole milk for skim milk)

-provide accountability

-monitor calorie intake long term

A healthy weight loss plan includes __________

a reasonable weight loss goal, reduced calorie diet, physical activity, and a behavioral change plan. Changing or reducing calories are not effective enough.

Iron supplements should be taken ________

one hour before or one hour after consuming caffein.

For a pt who is at risk for aspirating is on continuous enteral feedings, what interventions can be done to prevent aspiration?

-confirm placement of tube before using

-keep the head of the bed elevated to 30 to 45 degrees

-assess for gastric residual contents every 4 hours

What can you do for a chemo/radiation pt who reports painful swallowing with the feeling of food getting stuck in the throat, plus a burning sensation in the throat and chest?

Avoid hot or spicy food and drinks (cool or room temp foods with a neutral pH)

Use a straw for soft foods and liquids because the straw propels food backwards, making less work for the pt to swallow

Eat soft foods because they don't distend/stretch the esophagus like other foods

Avoid thin liquids, because they are harder to swallow. Use pureed foods or thickened liquids.

Do not crush meds. Talk to the pharmacist about alternate ways to provide medications.

Eating and drinking foods high in __________ will help with iron absorption.

iron

Meat, poultry, dried fruit, and beans are good sources of ________.

iron

What are some things you should avoid when trying to lessen intestinal gas?

Do not chew gum between meals

Do not drink carbonated beverages

Pt should lessen or cut out smoking

Females of child bearing age should take __________ of folic acid per day, and increase to ________ while pregnant.

400 mcg, 600 mcg

Folic acid reduces ________.

the risk of neural tube defects in a fetus

Dietary sources of folate are found in

green leafy vegetables, oranges, legumes, fortified cereals, and foods made with white flour.

People with IBS should consume a diet that consists of ___________.

poultry, fish, cooked vegetables, whole grains, low fat yogurt, and egg whites.

Clients with IBS should avoid ________.

Red meat, high fiber, gas forming foods (such as beans, soda, broccoli, cauliflower, brussels spouts and cabbage), fried food, coffee, caffeine, and gluten (in some).

Carbs play an important role in a pregnant woman's diet because it is important in _________.

fetal brain development

In pregnancy, a high protein, low carb diet is associated with _______.

low fetal birth weight.

A baby with a cleft palate is at risk for ______.

Aspiration (Do not lay baby on right side while feeding to help prevent this)

What are some things you should do while feeding a baby with a cleft palate?

Feed the baby in an upright position

Hold baby upright for 30 min after feeding

Burp every 15 to 30 mL of fluid

How would you feed a baby who just had a cleft palate repaired?

Feed with a syringe placed on the inside of the mouth

What can a nurse suggest for a pt to do to prevent overeating?

for the pt to plan meals ahead of time

For pt with weight loss, loss of appetite, or early satiety, the _____________ should be consulted.

healthcare provider; the healthcare provider would likely need to order diagnostic testing and start treatment for the symptoms.

Lasix can cause loss in ________. The pt diet should include __________.

potassium; bananas and oranges because lasix removes potassium from the body.

A pt with osteoporosis needs to consume foods high in __________ which can be found in __________.

calcium; milk, yogurt, cheese, fish with edible bones, and green leafy vegetables.

Prepared formula should be within _______ of the start of feeding and within ________ preparing if left at room temperature.

1 hour, 2 hours

Prepared, powdered formula can be left in the fridge for up to _______.

24 hours

When beginning a health assessment, a nurse noticed a pt is overweight. What is the first thing she should do?

Ask the pt how they feel about their current weight.

The serving size per child is _________.

one tablespoon per year

What should you do for a pt who has had diarrhea the last few days with no change to formula or feeding message?

obtain a stool sample to test for illnesses because no changes have been made to trigger diarrhea.

Change feeding rates because client could have motility issues causing poor absorption of water and nutrients which is triggering diarrhea.

To treat clients with dumping syndrome, __________ can be added to feedings..

dumping

gastric venting

letting gas out of the stomach via tube to relieve gas or abdominal pain after feedings.

When a school aged child restricts calories, it could lead to __________.

nutritional deficiencies in the growing child

What can an adult do to lose 1 lb per week?

Cut out 500 calories per day

Why should you never encourage a child to skip meals?

It does not teach healthy eating habits.

Which diet is used for dehydration, bowel prep, or transitioning from one diet to another, but is too restrictive for long term use?

Clear liquids

Which type of diet would be suitable for a pt who has difficulty swallowing?

full liquid, pureed, and mechanical soft

An older pt has gained 2 lbs since the day before, what should the nurse assess for more information?

Input and output. Fluid retention would be the reason a pt would gain weight in one day. Weigh increase from caloric intake would take several days to reflect.

A mother is worried about her child's unhealthy food choices and preferences, what could you do to help encourage healthier eating?

encourage the client to participate in food shopping and meal preparation.

Overweight children are more likely to ________.

skip breakfast

Nursing recommendation: stick to an eating schedule; 3 balanced meals and 2 healthy snacks

If a child is not eating their packed lunch, it may be because _____.

They may be getting food through vending machines, snack bars or other sources.

Nursing tip: Sit down with the child and explain why it is important to make healthy decisions while choosing foods.

Overweight children are likely to become ______.

Overweight adults

Why is this statement about a child's weight false?

"Once the growth spurt occurs, the weight will balance out the height."

It is impossible to predict if the growth spurt will be enough to balance out the weight.

Childhood obesity has been linked to

diabetes mellitus and cardiovascular disease

What are some ways the spouse of a cancer patient can help them with nausea/vomiting due to chemotherapy?

-pt can eat toast or dry crackers with no fluids first thing in the morning

-eat smaller meals throughout the day

-suck on hard candy, popsicles or ice during treatments

Nursing tips for chemotherapy patient with nausea:

Encourage the pt to discuss antiemetic medication with their healthcare provider

Drink a lot of fluids and eat dry toast or crackers before treatment.

Clients with sudden flare ups in the first metatarsophalangeal joint (

big toe) is a sign of _________.

Gout

Gout can affect ____________.

Feet, hands and elbows

What should a client with gout do to prevent flare ups?

reduce the consumption of foods high in purine such as meats, alcohol, and sugar sweetened foods.

Can you have spinach in your diet if you have gout?

Spinach is high in purine but is not linked to gout flare ups. It is high in vitamin C, which is known to lower the levels of uric acid.

Avocados are not high in purines but are high in ______.

potassium and unsaturated fats.

A pregnancy vegan can meet protein needs during pregnancy by ____.

eating beans, nuts, grains and leafy vegetables

Vegans may consume a lot of fiber, so they need to drink a lot of water to _____.

decrease the risk of constipation

Where may a vegan find omega-3 fatty acids?

chia, seaweed, hemp, flax seeds, nuts and beans.

Vegans only eat non-heme (plant-based) iron, which is not absorbed as easily as heme iron. What should the vegan pt do in order to absorb adequate iron?

eat with plenty of ascorbic acid (vitamin C)

Where can a vegan client find zinc in their diet?

legumes, soy, nuts, and seeds.

Where can a vegan find iodine in their diet?

seaweed, iodized table salt, fortified whole grains, milk

Where can a vegan find calcium?

green leafy vegetables such as broccoli

Where can a pregnant vegan obtain adequate vitamin D?

through sunlight, breakfast cereals, and a prenatal supplement

Where can a vegan find vitamin B12?

fortified cereals, soy products and some plant milks. B12 is only found in meat sources. Supplements are often suggested for pregnant women who are vegan.

What can the nurse suggest for a pregnant woman who has nausea and vomiting throughout the day?

drink ginger juice or ginger tea

eat dry carbs like rice or noodles

For nausea and vomiting, pregnant women cannot take ________ because it can affect the development of the fetus.

antiemetic meds

Pregnant women with nausea should reduce _________________.

fluids during meal times to reduce gastric volumes. They should drink small volumes throughout the day to stay hydrated.

The DASH diet recommends that no more than ____ servings of sweets be eaten per week.

5

What is a major source of calcium and protein in the DASH diet?

fat free or low fat (1%) milk products

What proteins are included on the DASH diet?

lean meats, poultry and fish

What solid foods are appropriate for a 4 month old baby?

infant rice cereal; if tolerated well pt could try watered down oatmeal in a bottle. Strained fruits should not be tried until 6-8 months of age.

Cow's milk should not be introduced until ____.

1 year of age

What should the nurse do when administering medications through a clients gastrostomy tube?

Flush feeding tube with 30 mL of water before and after medicine is administered to prevent drug-formula interactions.

Fish oil supplements are generally safe to use, but should be discussed with a healthcare provider first because ______.

They can lead to an increase in LDL (bad cholesterol). They can have interactions with medications such as anticoagulants, blood pressure meds, contraceptives and weight loss drugs. They can also lead to GI symptoms, rash, increased bleeding or stroke, and immune issues.

Pt with bulimia nervosa should avoid finger foods because:

It can precipitate a binge.

What interventions could a nurse plan for a pt with anorexia nervosa?

correct nutrition, food, and weight misconceptions and facilitate social dining

What interventions could a nurse plan for a pt with bulimia nervosa?

plan meals every 3-4 hours to prevent being overly hungry

A pt on verapamil (Calan) for hypertension should be told by a nurse that:

Do not consume grapefruit or grapefruit juice while taking this medicine.

This medication works by relaxing blood vessels and increasing supply of oxygen and blood to the heart.

Avoid taking alcohol with this medication.

This will not cure your hypertension, only treat it.

It can cause gingival hyperplasia

What are the dietary needs of a client with a stage IV pressure ulcer?

Protein, zinc, and vitamin C for wound healing

Foods high in sodium

processed meats and cheese

canned foods

Fruits and vegetables are low in

sodium

A pt taking a diuretic (furosemide/Lasix) and a cardiac glycoside (digitalis/Lanoxin) is at risk for developing a _________

low serum potassium level

albumin level should be

3.5-5

A client with peripheral edema and a low serum albumin would need what intervention?

increased protein

Low albumin causes a decrease in _________.

osmotic pressure which causes a shift of fluid into the tissues.

An older client with renal failure and arthritis has lost 10% of body weight in the last 6 weeks. The nurse should _______.

Do a 24 hour diet recall to understand if the amount of calories the pt is taking in is sufficient enough.

Citrus fruits are known to interact with _________________.

antihypertensive meds

In a pt with hypertension, vegetables should be __________

fresh or frozen, not canned or processed.

__________ should be suggested instead of salad dressing.

simple vinegarette

hyperlipidemia is particularly high in the __________ community.

hispanic

hyperlipidemia can lead to

atherosclerosis, hypertension and cardiovascular disease (MI, CVA)

One way to treat hyperlipidemia by changing the diet is ___________

to incorporate grilled foods over fried foods, and to add more fruits and vegetables to the diet.

How much physical activity is important to control high cholesterol?

150 minutes of moderate activity or 75 minutes of vigorous activity per week.

How much weight is someone who is overweight supposed to gain during pregnancy?

15-25 lbs

Symptoms of anemia

fatigue, feeling cold, curved fingernails and glossitis

___________ can be describe as an increase in stool over 200 mL in 24 hours.

diarrhea

If a pt with dementia is suspected to have food allergies, the nurse could _________

ask family members of any known allergies

If a pt with diarrhea is on miralax, ___________

it should be placed on hold. If the pt continues to put out adequate stools, it should be discontinued altogether.

If a pt who is put on continuous feeding is experiencing diarrhea, they are not ___________-

tolerating continuous feeds. Intermittent or bolus feedings should begin once pt tolerates continuous feeds.