21.2.14: Chapter 14
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 grew up eating foods from their sources and cooking at home, and he participated in frequent exercise that provided him with a solid foundation in healthy lifestyle choices.
2.
a.
The client grew up with the foundational knowledge of eating healthy food and exercising, so the nurse can use this information in the dietary education plan.
3.
a.
Construction work, smoking, and selecting fast food are risk factors for chronic respiratory disease.
4.
b.
Smoking cessation and eating better improves pulmonary health.
5.
c.
The client’s note from last year indicates altered respiratory function and a low-quality diet, and since nutritional counseling was not addressed during that visit, the nurse should instruct the client during this visit.
6.
d.
Pneumonia is a potential complication as the mucosal lining thickens and cough pressure declines in clients with COPD.
Review Questions
1.
c.
Pregnant women should consume a balanced diet that includes protein to support the physiological changes of the mother and the growth of the fetus.
2.
d.
Omega-3 fatty acids are essential to the development and function of the pulmonary system during infancy.
3.
c.
Cognitive and behavioral defects may occur in the fetus whose mother is malnourished.
4.
b.
Foods containing caffeine, like coffee, can potentiate the effects of the bronchodilator leading to tremors, nervousness, anxiety, and heart palpitation.
5.
a.
A pregnant client needs protein, vitamins A, D, E, and omega-3 fatty acids for proper lung function and development of the fetus.
6.
d.
Nutrition plays a role in supporting the immune system, which prevents and treats infections while also repairing lung tissue.
7.
c.
Consuming fruits and vegetable is linked to a decreased risk for developing asthma and a decreased risk for experiencing asthma symptoms such as wheezing.
8.
a.
A diet high in saturated fats has been linked with worsening airway inflammation and lung function.
9.
d.
The main goal of an anti-inflammatory diet is to minimize the duration of and decrease the risk for infection. An anti-inflammatory diet supports the immune system and lung function and decreases oxidation.
10.
a.
Long-term oxygen therapy in COPD clients causes nutritional deficiencies, because low oxygenation to the gastrointestinal tract decreases its ability to function and absorb nutrients.