Study Guide for Fundamentals of Nursing The Art and Science of Nursing Care

6.Sample answers:

a.Eat a variety of high-fiber foods daily.

b.Drink six to eight glasses of water daily.

c. Substitute high-fiber foods for lower-fiber foods.

d.Add bran to diet slowly to decrease likelihood

of flatus and distention.

7. a.Anorexia nervosa: Characterized by denial of
   appetite and bizarre eating patterns; may result
   in extremely dangerous amount of weight loss;
   can be fatal. Typical individual is adolescent girl
   from middle or upper socioeconomic class;
   competitive; obsessive; distorted body image.
   b.Bulimia: Characterized by episodes of gorging
   followed by purging. Typical individual is
   college student who fears gaining weight but is
   overwhelmed by periods of intense hunger.


8. a.Sex: Men have higher caloric and protein
   requirements than women because of their
   larger muscle mass.
   b.State of health: The alteration in nutrient
   requirements that results from illness and
   trauma varies with the intensity and duration
   of stress.
   c. Alcohol abuse: Alcohol can alter the body’s use
   of nutrients and thereby its nutrient
   requirements by numerous mechanisms.
   d.Medications: Nutrient absorption may be
   altered by drugs that change the pH of the
   gastrointestinal tract, increase gastrointestinal
   motility, damage the intestinal mucosa, or bind
   with nutrients, rendering them unavailable to
   the body.
   e.Megadoses of nutrient supplements: An excess
   of one nutrient can lead to a deficiency of
   another.
   f. Religion: Nurses need to be aware of dietary
   restrictions associated with religions that might
   affect a patient’s nutritional requirements.
   g.Economics: A person’s food budget affects
   dietary choices and patterns.


9. a.Food diaries: The patient records all food and
   beverages consumed in a specified time period
   (3 to 7 days).
   b.Diet history: 24-hour recall, food frequency
   record, plus interview designed to determine
   past and present food intake and habits
   10.Sample answer:
   The nurse should explain the diet order to the
   patient, screen patients at home who are at nutri-
   tional risk, observe intake and appetite, evaluate
   patient’s tolerance for specific types of foods,
   assist the patient with eating, address potential
   for harmful drug–nutrient interactions, and teach
   nutrition.
   11.Sample answers:
   a.Provide simple verbal instructions; include
   family members when appropriate.
   b.Advise the patient to eliminate any foods that
   are not tolerated.
   c. Offer support and encouragement.


10. a.Clear liquid diet: Only foods that are clear liq-
    uids at room temperature, such as gelatins, fat-
    free bouillon, ice pops, clear juices, and so on;
    inadequate in calories, proteins, and most
    nutrients
    b.Full liquid diet: All liquids that can be poured at
    room temperature, such as clear liquids plus
    milk, plain frozen desserts, pasteurized eggs,
    cereal gruels; high-calorie, high-protein supple-
    ments are recommended if used for more than
    3 days
    c. Soft diet: Regular diets that have been modified
    to eliminate foods that are hard to digest and
    chew, including those that are high in fiber and
    fat, adequate in calories and nutrients, and can
    be used long term


11. a.Nasogastric feeding tube: Inserted through nose
    and into stomach. Advantage: Allows stomach
    to be used as natural reservoir, regulating
    amount of food that enters intestine. Disadvan-
    tage: Introduces risk for aspiration of tube feed-
    ing solution into lungs.
    b.Nasointestinal feeding tube: Passed through the
    nose into the upper portion of the small intes-
    tine. Advantage: Minimal risk for aspiration.
    Disadvantage: Dumping syndrome may
    develop.


12. a.Patient’s progress toward meeting nutritional
    goals
    b.Patient’s tolerance of and adherence to the diet
    when appropriate
    c. Patient’s level of understanding of the diet and
    need for further diet instruction
    d.Findings should be communicated to other
    healthcare team members.
    e.Plan should be revised or terminated as needed.

APPLYING YOUR KNOWLEDGE

REFLECTIVE PRACTICE USING CRITICAL

THINKING SKILLS

Sample Answers

1.What patient teaching might the nurse provide to

help Mr. Johnston meet his nutritional and exercise

needs?

The nurse should assess Mr. Johnston’s eating habits

by conducting a diet history. A diet plan could then

be devised that would contain foods low in fat and

cholesterol, enabling him to lose 1 to 2

pounds/week. The nurse should also set up an exer-

cise program for Mr. Johnston that he could adapt

to his busy lifestyle. For the greatest chance of suc-

cess, the nurse should tailor diet instructions indi-

vidually to Mr. Johnston’s lifestyle, culture,

intellectual ability, and level of motivation.

2.What would be a successful outcome for this patient?

By the end of the visit, Mr. Johnston lists

recommended allowances of grains, vegetables,

fruits, milk, and meat and beans as seen in the

MyPyramid Food Guide

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