ATI Nutrition Final Review – Flashcards
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Name 3 nursing interventions for a client with a gastrointestinal disorder:
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Monitor weight & weight changes Monitor laboratory values Assess bowel sounds Monitor elimination patterns Monitor and record I & O
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Select foods that meet the criteria for a low-residue diet (all that apply) A. Butter B. brown rice C. Apple juice D. Lean beef E. Pasta
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The correct answers are: Butter, apple juice, and lean beef. Meats are fine as long as they are lean, tender, and soft. Eggs would also be okay. Oils and condiments are generally safe, as are fruit juices without pulps. Brown rice, pasta, whole grains, raw fruits and veggies, seeds and nuts should all be avoided.
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Name one reason a client may be put on a low-residue diet:
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Acceptable answers: Short term management of diarrhea, malabsorption syndrome, flare ups of IBD or diverticulitis
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How many grams of fiber must be in a serving of food for it to be considered "high-fiber"?
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More than 5 grams.
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What are 3 potential causes of nausea and/or vomiting?
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Decreased gastric secretion; decreased intestinal motility; allergy to food(s); bacterial or viral infection; increased intracranial pressure; liver, pancreatic or gall bladder disorders; adverse effect of some medications
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Name one nursing intervention for a client with nausea and vomiting:
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Teach clients to avoid liquids with meals as they promote a feeling of fullness; promote good oral hygiene with toothbrushing, mouth swabs, mouthwash, and ice chips; elevate the head of the bed; discourage hot and spicy foods; serve foods cold or at room temperature; avoid high-fat foods if they contribute to nausea b/c they are difficult to digest
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Name 3 nursing interventions for caring with a client with anorexia (not the same as anorexia nervosa):
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Decrease stress at meal times assess for adverse medication effects Administer medications to stimulate appetite Get rid of unpleasant odors remove gross stuff-garbage, tissues, soiled linens provide small, frequent meals Avoid high-fat meals provide liquid supplements between meals ensure meals are appealing assess for changes in bowel status position to increase gastric motility (sitting up) provide mouth care before/after meals
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A client with constipation should be encouraged to consume ___ grams of fiber daily if they're a male and ___ grams of fiber a day if they're female.
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38 g/day men 25 g/day women
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The preferred treatment for constipation is:
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To increase fiber, fluid and exercise. Chronic laxative use should be avoided.
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Name 3 common causes of diarrhea:
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emotional stress physical stress GI disorders malabsorption disorders infections certain drug therapies (such as antibiotics)
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What are 2 nursing interventions for a client with dysphagia?
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Evaluate medications being taken-anticholinergics can cause dryness and contribute to dysphagia; Place client in high-Fowler's Provide oral care prior to eating to enhance sense of taste Allow adequate time Provide adaptive eating devices encourage small bites & thorough chewing Give pills with at least 8 oz of fluid (may be thickened) avoid thin liquids and sticky foods
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What is dumping syndrome?
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When the contents of the stomach are rapidly emptied into the small intestine
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A client reports a history of gastric bypass, and is experiencing dizziness, sweating, palpitations, shakiness and confusion. He reports that he ate approximately 2 hours ago. The nurse should suspect:
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hypoglycemia resulting from dumping syndrome. After early symptoms resolve and the intestine is emptied, there is a rapid rise in blood glucose. This is followed by an increase in insulin immediately after the intestine empties which leads to hypoglycemia. Late manifestations like this can occur 1-3 hr after eating.
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A nurse is educating her client about dumping syndrome. She recognizes her teaching was effective when the client states what early signs of dumping syndrome? A. "Hypophosphatemia is a common manifestation of dumping syndrome." B. "Dry, hard stools may occur early in dumping syndrome." C. "Coffee ground emesis is often the first indication of dumping syndrome." D. "Tachycardia, hypotension and and abdominal distention are early signs of dumping sydrome."
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D. "Tachycardia, hypotension and and abdominal pain are early signs of dumping sydrome." Other early signs include: fullness, faintness, diaphoresis, palpitations, nausea, cramping pain, diarrhea, weakness and syncope Hypophosphatemia is a hallmark symptom of refeeding syndrome, constipation results in dry/hard stools, and coffee ground emesis indicates the presence of blood which is not a symptom of dumping sydrome
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What nursing interventions would help a client with dumping syndrome? Name 3
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Recommend small, frequent meals Recommend protein and fat at each meal Tell client to avoid concentrated sugars Advise client to restrict lactose Teach client to drink liquids 1 hours before or after eating Instruct client to lie down for 20-30 minutes after meals to delay gastric emptying-if reflux is a problem assume reclining position Monitor for iron and B12 deficiencies
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A nurse is assessing a client who is postoperative from a gastric bypass who just finished a meal. Which of the following clinical findings are early indications of dumping syndrome? Select all that apply A. Bradycardia B. Dizziness C. Dry skin D. Hypotension E. Diarrhea
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Dizziness, hypotension and diarrhea are correct. Sweating, not dry skin is a sign. Tachycardia instead of bradycardia may occur.
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Dietary changes that help reduce the incidence of constipation include A. increasing fluid intake. B. decreasing milk intake. C. drinking cranberry juice. D. decreasing whole grain intake.
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A. increasing fluid intake
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Dietary care of a patient with gastroesophageal reflux disease includes A. lowering dietary fat intake. B. liberal use of hard candy and peppermints. C. avoiding milk products. D. decreasing foods high in protein.
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A. lowering dietary fat intake.
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Nutrition therapy for patients with irritable bowel syndrome includes A. low dietary fiber intake. B. low protein intake. C. increased dietary fiber intake. D. high fat intake.
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C. increased dietary fiber intake.
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A client presents to the emergency room, reporting that he has been vomiting every 30 to 40 minutes for the past 8 hours. Frequent vomiting puts him at risk for which of the following? A. Metabolic acidosis with hyperkalemia B. Metabolic acidosis with hypokalemia C. Metabolic alkalosis with hyperkalemia D. Metabolic alkalosis with hypokalemia
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D. Metabolic alkalosis with hypokalemia Gastric acid contains large amounts of potassium, chloride, and hydrogen ions. Excessive loss of these substances, such as from vomiting, can lead to metabolic alkalosis and hypokalemia.
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Which of the following complications of gastric resection should the nurse teach the client to watch for? A. Constipation B. Dumping syndrome C. Gastric spasm D. Intestinal spasms
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B. Dumping syndrome Dumping syndrome is a problem that occurs postprandially after gastric resection because ingested food rapidly enters the jejunum without proper mixing and without the normal duodenal digestive processing. Diarrhea, not constipation, may also be a symptom. Gastric or intestinal spasms don't occur, but antispasmodics may be given to slow gastric emptying.
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A nurse is providing teaching to a client who had a partial gastrectomy about measures to reduce the occurance of dumping syndrome. Which of the following instructions should the nurse include in the teaching? A. Consume at least 4 oz of fluid with meals B. Take a short walk after each meal C. Use honey to flavor foods such as cereal D. Eat protein with each meal
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D. Eat protein with each meal. Protein delays digestion which helps allay the occurrence of dumping syndrome. Fluids should be avoided at meal times to decrease gastric stimulation. The client should like down for 15-30 minutes to slow the progress of food through the GI tract. Simple carbs should be avoided because they aggravate the stomach and worsen dumping syndrome.
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A nurse in a provider's office is teaching a client about foods that are high in fiber. Which of the following food choices made by the client indicate a correct understanding of the teaching? Select all that apply. A. Canned peaches B. White rice C. Black beans D. Whole grain bread E. Tomato juice
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Black beans and whole grain bread represent high fiber choices.
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Dietary reference intakes, formerly called recommended daily allowances or RDAs, are what?
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Nutrient allowances for healthy individuals
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Carbohydrates are organic compounds composed of carbon, hydrogen and oxygen (CHO). Their main function is:
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To provide energy for the body
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What is the average minimum amount of carbohydrates needed to fuel the brain?
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130 g/day
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What percentage of calories should carbohydrates make up?
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45 to 65%
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Glucose, fructose and galactose are examples of:
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Monosaccharides-they're simple carbs. Glucose is found in corn syrup, fructose is found in fruits, and galactose is broken down milk sugar
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Starches and fiber are examples of what kind of carbohydrate?
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They are polysaccarides, used for energy storage and to aid in digestion
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Sucrose, lactose and maltose are all examples of what kind of carb?
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Disaccharides-They are used for energy. Lactose helps with calcium and phosphate absorption
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What are some metabolic functions of protein?
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Proteins aid in tissue building and maintenance, balance of nitrogen and water, backup energy, support of metabolic processes (nitrogen balance, transport of nutrients, other vital substances), and support the immune system
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What percentage of your daily calorie intake should be from protein?
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10%, or 46 g/day for women and 56 g/day for men
