ATI Nutrition Proctored Exam Study Set

ATI Nutrition Proctored Exam Study Set • Age-related macular degeneration (AMD) (eyes) Ans- o Inc lutein (carotenoid found in vit A) foods - kale, spinach, collards, mustard greens o Inc antioxidants, vit E & B12 • Anorexia nervosa Ans- o Weight pt DAILY @ the same time o Stay w/ pt during and 1hr after meal (pv vomit) o RN sched meals o Privileges based on direct wt gain • Atorvastatin Ans- o Lipitor (tx high cholesterol) o Okay to take w/ OJ, coffee, milk o Contraindicated w/ grapefruit juice (cx inc serum lvl) • Braden scale Ans- 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 Ans- 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 Ans- o Enteral feeding - high protein, fat, & calorie; low carbs (breakdown prod CO2) • Calcium Ans- o Almonds highest o Yogurt 315mg o Cheese 214mg o Egg 25mg o Spinach 122mg • Cancer Ans- o Sensitivity to odor ∴ dec aromatic foods to dec NV o Avoid hot foods d/t odor o Sm, freq meals q2hr o Inc citrus food, pickles, & mouth wash to prod more saliva to dec metallic taste o Inc cal & 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 (dec metallic taste) o Inc fluid & tart f/ taste o Prevention - 4-5 servings (2.5 cups) fruits & veggies/day; limit alcohol; inc whole grain not refined; limit processed meats d/t inc sodium lvl; inc lean cuts w/out skin • Captopril Ans- o Limit potassium rich foods (cantaloupe) • Carbohydrate Ans- 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 Ans- o Inc K to dec risk HTN o Inc fiber to dec cholesterol o Dec trans FA o x2 fatty fish/wk to dec HTN o Limit alcohol & sodium • Celiac Ans- o No gluten (wheat, barely, rye) • Child Ans- o Dec choke ∴ peanut butter & celery, whole grapes, pretzels o 2y/o whole milk o 2y/o low fat milk • Crohn's Disease Ans- o Dec fiber, lactose, fructose o Eat eggs (easily digest & high protein) • Cirrhosis + ascites Ans- o Limit sodium intake 2000mg / 2g o Limit fluids to 1.5L o 0.8-1.2g/kg protein pv malnutrition o consume vit K d/t dec prothrombin prod by liver ∴ @ risk clots • Cleft lip Ans- o Feed upright o Nipple to side of mouth to pv enter nasal passage • Colostomy Ans- o cx loose stool ∴ thicken w/ pectin o return regular diet 6 wk post op o fiber w/ cx obstruction • Constipation Ans- o Inc Ca dec peristalsis • COPD Ans- o 6 sm meals/day o drinks w/ inc protein/cal between meal o add gravy/sauce to pv dry mouth o soft diet will dec SOB w/ chew • DASH diet Ans- o Dec Na to 135-145mEq/L o Glucose 70-110mg/dL o Total cholesterol 200mg/dL • Dehydration Ans- o Cont infusion enteral feeding to pv high carb load w/ each IM feed • Diabetes mellitus Ans- o Goal HgbA1c 7% - shows avg glucse lvl over past few mo ∴ 7% = not follow diet & avg high sugar lvl • Dumping syndrome Ans- o Drink liquid to slow movement o Complex carbs better than simple o Not associate w/ fat or protein content of food o Lie down after eat to slow food movement via GI o Dec fiber to slow gastric emptying • Dysphagia Ans- o Palpate throat 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 Ans- 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 - V • End-stage kidney disease (ESKD) Ans- o Limit potassium intake d/t dec kidney excretion of K • Enteral (w/in GI) tube feed Ans- 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 aspration w/ monitor gastric residuals q4hr, HOB 30-45 degrees, check tube placement w/ xray once @ beginning o Maintain patency by flushing 30-50mL water b4 & after Rx o Dec D - low fat formula, cont feed, warm b4 admin, dec rate to inc abs • Failure to thrive (toddler) Ans- o Dec distraction during feeding o Cont 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 Ans- 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 Ans- o Low fat milk o 4-5 servings unsalted nuts o =1 alcohol/day • Ferrous sulfate (iron) Ans- o Take betw