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NR 228 Nutrition Exam 2 TEST 91quiz
2025 Questions With Full Answers.
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Pregnancy weight gain for normal weight
25 - 35 lbs
*due to breast feeding and amniotic fluid
Dietary Guidelines for pregnant women
- Avoid foods such as raw eggs, raw meats, excessive amounts of coffee (only one cup per day)
Vitamins that should not increase during pregnancy are
- Vitamin C (hypercalcemia)
- Vitamin E (fetal heart defect)
- Vitamin K (prolong jaundice)
Preeclampsia nutrition related concerns
- Patient will be put on the DASH diet (hypertension diet) to help lower BP
- Limit and avoid trans fats, sat. fats, sugar, salt, no fast food, no coffee
- Increase foods rich in potassium, magnesium, and vitamins, fruits and vegetables, whole grain, protein
Gestational Diabetes Mellitus
Recommended foods to prevent GDM include carbohydrates, iron, calcium, protein, and fat sources. (simple carbs, fruits and veggies)
Maternal PKU
Lack of proper dietary therapy during pregnancy. Findings in infant: microcephaly, mental retardation, growth retardation, congenital heart defects.
- Pregnant women should not eat foods high in phenylalanine (should only consume 1-4 mg per day)
- Avoid fish, meat, diet soda, eggs, wheat
- Fruit, vegetables, and low protein foods are okay to eat
Lactation
750 - 1000mL of breast milk daily
- 500 kcal for producing breast milk daily
*avoid foods such as garlic, citrus (lemon/limes), broccoli, spices, and cauliflower because it may alter taste of breast milk
Infancy birth weight and breast feeding
- first 6 months of life infant should consume breast milk.
- second 6 months of life infant should consume a combination of breast milk and baby food
Infant Dietary Guidelines
Preschoolers: 4-6 years old diet
- environmental influencer eaters
- avoid eating sugary foods while watching tv
- healthy plate contains: veggies, fruits, whole grain, healthy protein, water, healthy oils
School age children: 7-12 years old diet
- Concerns are: 10% skipping breakfast and type of diet they are consuming
- Risk for diabetes and obesity
Adolescence: 13-19 years old diet
- iron, fiber, calcium, protein, and vitamins are important nutrients to consume
- Calcium intake = 1300 mg daily (3 to 4 servings of dairy products)
- Adolescents reach maximum bone density levels during this time
- Foods high in CA: milk, sardines, cheese, yogurt
Adulthood diet
- important to exercise and eat a balanced diet to avoid cardiovascular diseases
- calcium is an important vitamin to consume due to bone health
Older adult diet concerns
- arthritis is the most common factor of prevention of eating well
- decrease in calorie needs
- decrease in nutrient absorption(vitamin B12, B9 (folic acid), and calcium)
- decrease in mass and tone
- oral problems caused by dentures
- medical conditions
Nutritional Guidelines for balanced diet (eldery)
- 40 - 55% carbohydrates
- 10 - 20% fat
- consume whole grains such as brown rice, oat meal, and whole wheat bread
- avoid added sugars especially in fruits
- avoid coconut oil due to high in sat. fat
Elderly Population prevention
- exercise and strength training
- increase water intake for hydration
- weight bearing exercises, increase sun exposure, and consumption of vitamin D reduces risk for osteoporosis
Primary nutritional deficiency
inadequate intake of nutrients
2% in 1 week = severe wt loss
- 5 in 1 month = moderate wt loss
5 in 1 month = severe wt loss
Normal BMI
18.5-24.
Overweight BMI
25 - 29.
Obese BMI
30 - 39.
Severely Obese BMI
35 - 39.
Morbidly Obese BMI
greater than 40
Males that are high risk for cardiovascular disease and diabetes have a waist circumference of
greater than 102 cm
Females that are high risk for cardiovascular disease and diabetes have a waist circumference of
greater than 88 cm
Clinical values that measure adequate nutrition intake are
- fluid intake and output
- calorie count = most accurate measure
- hemoglobin levels: low levels = patient is not eating enough nutrients such as protein
Albumin Levels
3.5-5 g/dL
monitors long term protein consumption
- good for patients who are going in for a scheduled surgery
Prealbumin Levels
16 - 40 mg/dL
- short term indicator of protein consumption from the last two days
- Drawn for patients with traumas, infection, and stress
- low levels require supplementation
Consuming foods high in protein, amino acids, and vitamin B6 can cause effect on
Levodopa (Parkinson's Disease Med)
- interaction with protein and vitamin B
- energy drinks and supplements that contain B6 may decrease levodopa effects and cause exacerbation in Parkinson's causing tremors and balance problems
Tyramine rich foods interact with
MAOI's: hypertensive crisis
- age cheese, bleu cheese, smoked meats, wine, and dark chocolate contain tyramine.
clear liquid diet
provides rest for GI, see through liquids
- water, coffee, tea, broth
full liquid diet
careful planning provides adequate nutrition
- yogurt, ice cream, pudding,
Blenderized (pureed) diet
blending food into liquid form for patients who cannot chew. Good for patients with fractured/wired jaws
mechanical soft diet
is recommended for people with difficulty in chewing or swallowing.
- soft and easy to eat: ground meats, smashed carrots, and soft cheese.
- good for mouth sores from radiation therapy on head/neck cancer patients
soft diet
low in fiber (easy to chew & digest), used for GI tract getting back to normal because unable to digest. no raw vegetables, no beef
diet as tolerated
Ordered when the client's appetite, ability to eat, and tolerance for certain foods may change
- gradual progression to normal eating or dietary pattern
Nursing Measurements to take before determining correct diet plan are:
- assess bowel function before advancing diet
- ongoing assessment parameters
- document nutritional intake (I's and O's)
- education and support for diet therapy
EN administration methods
- head of bed is raised to 30-45 degrees to help reduce aspiration
- placement of feeding tube should be check before feeds by checking apirating gastric contents in a syringe and testing pH levels. Contents should be between levels of 1-4.
gastric residual volume
the volume of formula and GI secretions remaining in the stomach after a previous feeding
- checked Q4H - first 48 hrs for all patients and critical
- routinely Q6-8hr for noncritical patients
- 250 - 500mL notify physician
Phenytoin and Theophylline
medication interactions with tube feedings. May decrease or increase effects.
*stop feeding 2 hours before administration and for 2 hours after medication is recieved
Most common complication of EN is
diarrhea
- decrease infusion rate if this occurs
Prevention of food poisoning for EN patients
- frequently washing hands before, during, and after handling tube
- refrigerate unused portion for up to 24 hr
- change ET tube/equipment Q24H
Transition to tube feeding to regular feeding
- stop feeding 1 hour before and after meals
- full liquid diet initially follow by purred to soft diet
Weaning occurs as oral intake increases:
- decrease tube feeding vol. until 6 meals/day are eaten
- oral intake is 500-750kcal/day
- cyclic feeding at nighttime
Discontinue tube feeding:
- consumes 2/3 of protein and calorie needs for 3-5 days
Home Enteral Nutrition
- Homemade blenderized formulas is strongly discourage because it can clog the tube
- recommended to stay on a feeding schedule
Parenteral Nutrition (PN)
method of supplying nutrients to the body by an intravenous route.
- 1200 - 1500kcal/day
- Protein = 150g/day
- postivie nitrogen balance
Central PN (TPN)
- high protein and caloric requirement
- HYPERtonice soluction
- used for long term care of supplment support
TPN care/nursing management
- keep solution in the fridge until 1 hr before use
- DONT interrupt existing TPN infusion: it will cause hypoglycemia
- Glycosuria: first few days of TPN
- infuse 10-20% dextrose if need to
- catheter site dressing change with strict aseptic technique
Complications of TPN are
hyperglycemia
hypoglycemia
septicemia
fluid overload
clogged tubing
infection r/t catheter
Q6 accu checks
home parenteral nutrition
cyclic infusion
Transition: oral/tube feeding
- reduce infusion rate 50% for 1-2 hours before stopping
- provide sips of diluted fruit juice to maintain GI function
- stop TPN if oral intake is >60% of total energy and protein requirements
signs and symptoms of dysphagia
choking, drooling, decrease food intake, coughing, watery eyes, clearly throat, excessive tongue movement
- elderly = at risk
- complications: aspiration pneumonia, dehydrations, malnutrition
nutrition therapy to decrease aspiration
- using thicken agencies (foods such as apple sauce, mash potatoes, chocolate pudding)
- minimize distractions
- encourage dry swallows and coughing
- sit upright with chin to chest
- dont rush
- use spoons when dealing with fluids to decrease liquid amount
- encourage small bites
Peptic Ulcer Disease (PUD)
- Risk factor: increase use in NSAIDS and ibuprofen
common in elderly
- h.pylori is 80% of cases and treated with antibiotic and antacids
- main concern is bleeding, pain
causes: stress, alcohol, family hx, excessive use of meds
Nutrition Therapy for PUD
- individualize diet plan: consume foods as tolerated
avoid foods: coffee, soda, spicy food, high sugar foods, fried foods
consume: raw honey. avocados, spinach, kale, cabbage, celery, and Brussel sprouts
Dumping syndrome
common in gastric bypass patients
cause: consuming contents too fast
Dumping syndrome S/S
- Can occur 15-30 mins after consumption of food:
Fullness, faintness, diaphoresis, tachycardia, palpitations, hypotension, nausea, abdominal distinction, cramping, diarrhea, weakness, and syncope.
**Concern = hypoglycemia
Nutrition therapy for dumping syndrome is
- avoid drinking fluids during meals
- lie down for 30 min after meal
intake more complex carbs(peas, beans, whole grains, vegetables) and avoid simple carbs
celiac disease symptoms
gas
diarrhea
stomach pain
fatigue
joint pain
weight loss
itchy skin
celiac disease diet
Consume:
fruits
vegetables
eggs
quinoa
rice
