21.2.18: Chapter 18
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.
a.
Breastfeeding increases the chances that an infant will absorb the proper nutrients because the nutrients provided in breast milk are more bioavailable than those in formula.
2.
d.
Children with galactosemia need to be on a lactose-free diet their entire lives to prevent life-threatening problems.
3.
b.
The problems that Hein faced in pregnancy drastically altered her microbiome and contributed to her infant’s low birth weight and birth at 37 weeks’ gestation. These complications all increased her infant’s risk for Crohn’s disease.
4.
a.
High-fiber foods such as beans should be avoided during inflammatory phases of the disease because they can irritate the inflamed intestinal lining.
Review Questions
1.
a.
The father’s microbiome is not shown to be a contributing factor to the child’s microbiome.
2.
b.
Premature newborns need more calories per kilogram of body weight than a full-term infant does and should get 110–135 kcal/kg/day.
3.
d.
Galactosemia is a genetic disease in which the individual lacks the proper enzymes to convert lactose into glucose.
4.
c.
Adolescents like to be autonomous, but many tend to prefer convenience foods such as fast food. Parents should be instructed to provide a healthy diet whenever possible rather than simply incorporating healthy items into unhealthy diet.
5.
d.
Consuming prebiotic or probiotic foods is conducive to maintaining good gut bacteria. Yogurt, kimchi, and honey are examples of prebiotic foods.
6.
d.
Increasing water and fiber intake is important to prevent and manage constipation, a frequent problem among older adults.
7.
b.
The client should be on a high-fiber diet when not in exacerbation but should be on a low-fiber diet due to inflammatory cycles.
8.
c.
Kefir has anti-inflammatory properties that will help protect the microbiome.
9.
b.
Ciprofloxacin, frequently used for diverticulitis, should not be taken with calcium-rich or calcium-fortified foods because the calcium can hinder ciprofloxacin’s absorption.
10.
d.
Kale can help prevent vitamin K deficiency. Amoxicillin is known to deplete vitamin K and vitamin B
12
.