C HAPTER 07: N UTRITION A LTERATIONS
AND M ANAGEMENT
Urden: Critical Care Nursing, 9th Edition
MULTIPLE CHOICE
1. What is the rationale for careful intake and output for patients with
pulmonary alterations?
a. Fluid retention occurs with tachypnea.
b. Hemodilution may cause deleterious hypernatremia.
c. Fluid volume excess can lead to right -sided heart failure.
d. Excessive fluid losses may lead to dehydration and hypovolemic
shock.
ANS: C
Pulmonary edema and failure of the right side of the heart may result
from fluid volume excess, which can further worsen the status of
patients with respiratory compromise.
PTS: 1 DIF: Cognitive Level: Creating REF: p. 104
OBJ: Nursing Process Step: Evaluation TOP: Nutrition
MSC: NC LEX: He alth Promotion and Maintenance
2. A patient who has sustained a head injury has increased nutritional needs
related to what physiologic mechanism?
, a. Decreased metabolism as a result of coma
b. Decreased blood sugar from a lack of dietary supplementation
c. Anabolism and wound healing
d. Hypermetabolism and catabolism associated with the injury
ANS: D
Patients with neurologic alterations have increased needs because of
hypermetabolism and catabolism after head injury. Poor food intake is
related to altered state of co nsciousness, dysphagia or other chewing or
swallowing difficulties, or ileus resulting from spinal cord injury or
use of pentobarbital.
PTS: 1 DIF: Cognitive Level: Understanding REF: p.
105 | Box 7 -6 OBJ: Nursing Process Step: Evaluation
TOP: Nutrition MSC: NC LEX: Health Promotion and
Maintenance
3. The patient is receiving corticosteroid treatment for neurologic
alterations. The patient should be routinely monitored for what common
complication of this type of therapy?
a. Hyponatremia
b. Hyperalbuminemia
c. Hyperkalemia
d. Hypergl ycemia
ANS: D
Hypergl ycemia is a common complication in patients receiving
corticosteroids. Needs for protein and calories are increased by
, infection and fever, as may occur in the patient with encephalitis or
meningitis. Needs for pro tein, calories, zinc, and vitamin C are
increased during wound healing, as occurs in trauma patients and
patients with pressure ulcers.
PTS: 1 DIF: Cognitive Level: Appl ying REF: p. 105 |
Box 7-6 OBJ: Nursing Process Step: Assessment TOP:
Nutrition MSC: NC LEX: Health Promotion and Maintenance
4. Which nutritional interventions is a priority for the patient with renal
disease who is receiving dial ysis?
a. Increase fluids to replace losses.
b. Encourage potassium -rich foods to replace losses.
c. Ensure an adequate amount of protein to prevent catabolism.
d. Limit all nutrients to account for altered renal excretion.
ANS: C
Proteins and amino acids are removed during peritoneal dial ysis,
creating a greater nutritional requirement for protein. The renal patient
must receive an adequate amount of protein to prevent catabolism of
body tissues to meet energy needs. Approximatel y 1.5 to 2.0 g
protein/kg/day is required. Certain nutrients such as potassium and
phosphorus are restricted because they are excreted by the kid ney. The
patient has no specific requirement for the fat -soluble vitamins A, E,
and K because they are not removed in appreciable amounts by
dial ysis, and restriction generall y prevents development of toxicit y.
AND M ANAGEMENT
Urden: Critical Care Nursing, 9th Edition
MULTIPLE CHOICE
1. What is the rationale for careful intake and output for patients with
pulmonary alterations?
a. Fluid retention occurs with tachypnea.
b. Hemodilution may cause deleterious hypernatremia.
c. Fluid volume excess can lead to right -sided heart failure.
d. Excessive fluid losses may lead to dehydration and hypovolemic
shock.
ANS: C
Pulmonary edema and failure of the right side of the heart may result
from fluid volume excess, which can further worsen the status of
patients with respiratory compromise.
PTS: 1 DIF: Cognitive Level: Creating REF: p. 104
OBJ: Nursing Process Step: Evaluation TOP: Nutrition
MSC: NC LEX: He alth Promotion and Maintenance
2. A patient who has sustained a head injury has increased nutritional needs
related to what physiologic mechanism?
, a. Decreased metabolism as a result of coma
b. Decreased blood sugar from a lack of dietary supplementation
c. Anabolism and wound healing
d. Hypermetabolism and catabolism associated with the injury
ANS: D
Patients with neurologic alterations have increased needs because of
hypermetabolism and catabolism after head injury. Poor food intake is
related to altered state of co nsciousness, dysphagia or other chewing or
swallowing difficulties, or ileus resulting from spinal cord injury or
use of pentobarbital.
PTS: 1 DIF: Cognitive Level: Understanding REF: p.
105 | Box 7 -6 OBJ: Nursing Process Step: Evaluation
TOP: Nutrition MSC: NC LEX: Health Promotion and
Maintenance
3. The patient is receiving corticosteroid treatment for neurologic
alterations. The patient should be routinely monitored for what common
complication of this type of therapy?
a. Hyponatremia
b. Hyperalbuminemia
c. Hyperkalemia
d. Hypergl ycemia
ANS: D
Hypergl ycemia is a common complication in patients receiving
corticosteroids. Needs for protein and calories are increased by
, infection and fever, as may occur in the patient with encephalitis or
meningitis. Needs for pro tein, calories, zinc, and vitamin C are
increased during wound healing, as occurs in trauma patients and
patients with pressure ulcers.
PTS: 1 DIF: Cognitive Level: Appl ying REF: p. 105 |
Box 7-6 OBJ: Nursing Process Step: Assessment TOP:
Nutrition MSC: NC LEX: Health Promotion and Maintenance
4. Which nutritional interventions is a priority for the patient with renal
disease who is receiving dial ysis?
a. Increase fluids to replace losses.
b. Encourage potassium -rich foods to replace losses.
c. Ensure an adequate amount of protein to prevent catabolism.
d. Limit all nutrients to account for altered renal excretion.
ANS: C
Proteins and amino acids are removed during peritoneal dial ysis,
creating a greater nutritional requirement for protein. The renal patient
must receive an adequate amount of protein to prevent catabolism of
body tissues to meet energy needs. Approximatel y 1.5 to 2.0 g
protein/kg/day is required. Certain nutrients such as potassium and
phosphorus are restricted because they are excreted by the kid ney. The
patient has no specific requirement for the fat -soluble vitamins A, E,
and K because they are not removed in appreciable amounts by
dial ysis, and restriction generall y prevents development of toxicit y.
