21.2.12: Chapter 12
Unfolding Case Study
1.
c.
The Mini Nutritional Assessment is a nutritional screening tool for older clients.
2.
a.
The client will need education regarding foods rich in iron to consume at home.
3.
b.
Using Maslow’s hierarchy of needs framework, understanding the physical environment should be the first consideration. It is essential to understand if the client will be cooking or eating prepared meals before considering other options.
4.
d.
Eating smaller portions more frequently is a strategy that can overcome decreased food intake that occurs due to getting full quickly. Although hypertension and diabetes are not risk factors for worsening anemia, decreased taste is a physiological consequence of the change in density of taste buds that occurs with aging.
5.
a.
A holistic approach to client teaching includes spiritual influences, emotional influences, physical influences, and social determinants of health.
6.
b.
The client’s cognitive functioning will determine if a caregiver needs to be present for the educational session.
7.
c.
Ms. Foster is choosing food options and making plans for meals. She will be in the action stage of change once she begins modifying her diet.
8.
a.
The nurse should recognize that change is a cyclic process and that successes and failures are expected.
Review Questions
1.
a.
Vitamin K is a fat-soluble vitamin necessary for the synthesis and activation of coagulation factors II (prothrombin), VII, IX, and X.
2.
c.
Folate deficiency in pregnancy can lead to macrocytic anemia in mothers and neural tube defects in fetuses.
3.
b.
Long-term alcohol use can cause the malabsorption of Vitamin B
12
.
4.
c.
These are all possible signs of scurvy, or vitamin C deficiency.
5.
c.
Iron is better absorbed when taken with vitamin C, found in orange juice, and on an empty stomach.
6.
a.
An older adult with anemia is likely to experience hypotension and/or lightheadedness, which is a significant risk for falls.
7.
a.
Animal meat, fish, eggs, and dairy are sources of vitamin B
12
.
8.
a.
Health literacy is the only modifiable psychosocial factor listed.
9.
a.
Providing written material before determining the client’s preferred learning style, without assessing their preference and without giving time to ask questions, is not consistent with holistic nursing care.
10.
a.
The nurse should consider that a change in behavior typically takes 6 months to achieve.
Unfolding Case Study
1.
b.
The client’s hypertension is concerning, because individuals who are already predisposed to high blood pressure before pregnancy are at an increased risk for having more complications during pregnancy due to the increase in vascular volume and increased stress on the body.
2.
d.
Tara needs to avoid fried foods, undercooked foods, and foods high in fat. The steak is cooked properly and broccoli is a good source of nutrients.
3.
c.
To help with heart health in both the client and fetus, the best answer choice is to increase fruits and vegetables.
4.
b.
High blood pressure is associated with pre-eclampsia, which can cause premature birth.
5.
a.
The client’s BMI places them in the severe obesity BMI category.
6.
b.
To help encourage good food choices, involve children in preparing meals.
7.
d.
Apples would be the best choice, because the other options are high in fat and sodium.
8.
a.
Foods high in fiber can help lower cholesterol levels.
9.
d.
The client is taking furosemide, which is a diuretic. Diuretics increase the risk for water-soluble vitamin deficiencies particularly if the client is not able to eat a varied, nutrient-rich diet.
10.
b.
The choice for a healthy heart diet is to choose grilled or baked protein with vegetables and low to no sugar substances.
Review Questions
1.
b.
The pregnant client who has a pre-existing heart condition will need to increase calories by 340 calories daily to gain the necessary amount of weight but not an excessive amount that can strain their cardiovascular system.
2.
b.
Infants can be introduced to pureed fruits and vegetables and infant cereals at 6 months.
3.
c.
The banana is the best choice for the snack as it is low in fat and sugar.
4.
b.
Adults should strive for an intake of less than 2300 mg of sodium daily.
5.
a.
Social media and peers can strongly influence adolescent eating habits.
6.
c.
Long-term complications of eating disorders cause electrolyte imbalances, prolong QT intervals, which can cause arrhythmias, and can eventually lead to heart failure due to the stress on the heart.
7.
b.
Red meat and full-fat dairy products can elevate cholesterol levels.
8.
c.
Shrimp is a lean source of protein, whole grain rice is a complex carbohydrate, and vegetables are an excellent source of nutrients.
9.
a.
Clients who are taking warfarin should be instructed to have a consistent intake of leafy green vegetables, which can affect the clotting factors associated with the warfarin.
10.
d.
A meal of grilled chicken, onions, green peppers, and avocado with corn tortillas is lower in fat than the other choices.