You are working with a patient who is being discharged from the acute care
unit after a heart attack. The patient's primary care provider has
prescribed medical nutrition therapy with a diet that is low in sodium and
saturated fat. The patient comes from a family in which food plays an
important role in traditional culture practices.
a. What do you need to know about the patient and the family to assist in
dietary planning?
b. How can you assist this patient to meet the prescribed dietary
requirements? ✔️Ans - a. • Who prepares the food in the home?
• Who buys the food, and where is the food purchased?
• What foods are regularly eaten? Are there special foods for holidays or
family occasions?
• What are the patient's food preferences?
b. Reading of labels and menus (if the patient eats out) will help in the
selection of appropriate foods. The patient and family also may be
informed about possible substitutions for foods, spices, and oils that are
high in sodium and fat. Alternatives, such as polyunsaturated oils, lean
meats, and egg substitutes, may be incorporated into meal preparation. A
separate meal plan for the patient is usually not necessary because
flavorings, such as lemon, can make foods attractive (as well as healthy) for
the entire family. The most difficult times are often during holidays and
special occasions, when food plays a central role in the family's activities.
Low-salt and low-fat substitutions, wherever appropriate, should be used.
Fresh or frozen fruits and vegetables, without sodium or fat-based sauces
or additives, may be more flavorful than low-sodium canned foods. The
patient may be able to eat traditional foods, in moderation, on these
occasions. Realistic expectations may work best for the patient rather than
offering harsh, uncompromising restrictions.
A pregnant woman is at the medical office for a prenatal checkup. What
nutritional recommendations should be provided to this patient?
✔️Ans - • An increase of an additional 30 - 60 g protein daily
• Calcium intake, especially critical during the third trimester
• Supplemental iron
• Folic acid intake increasing to 600 mpg daily during pregnancy
,You are working in a home care agency and have a large older adult patient
population. In planning care, what nutritional considerations should be
taken into account for these patients? ✔️Ans - • Eating a balanced
diet that contains a variety of foods; avoiding too much fat, cholesterol,
sugar, and sodium/salt
• Eating foods that have adequate amounts of starch and fiber, such as
fruits and vegetables and whole-grain cereals and breads
• Avoiding grapefruit and grapefruit juice
• Drinking adequate fluids
• Consuming cream soups and meat-based vegetable soups as nutrient-
dense sources of protein, with cheese, eggs, and peanut butter as useful
high-protein alternatives
• Drinking milk for calcium and Vitamin D; providing calcium supplements
if lactose intolerance is present
• Taking vitamin and nutrient supplements, if necessary, for nutritional
deficits
As an occupational health nurse, you are concerned with positive health
behaviors for the employees. You have noticed that some of the workers are
overweight.
a. Identify the nursing diagnosis and general goals based upon your
observation
b. What should you include in a teaching plan to promote nutritional health
for the employees? ✔️Ans - a. Imbalanced nutrition: more than body
requirements
General goals: safely achieve weight reduction, correct poor dietary
patterns, achieve calorie or nutrient targets on a daily or weekly basis
• Patient loses 1/2 - 1 pound per week
• Patient's daily fat intake is less than 30%
• Patient eliminated sugared beverages from diet
• Patient increases fruit and vegetable servings in diet to five servings per
day
b. • Guidelines for nutrients and calories
• Avoidance in foods high in fat, cholesterol, sugar, and sodium
• Avoidance of "fast foods" and eating out too frequently
• Label reading
• Integration of exercise
• Realistic weight loss goals
• Avoidance of rapid weight loss plans or pills
, • Maintenance of the diet within the work environment and schedule
Increase in blood glucose level ✔️Ans - Hyperglycemia
Breakdown of food products into smaller particles ✔️Ans - Digestion
Production of more complex chemical substances through the synthesis of
nutrients ✔️Ans - Anabolism
All biochemical and physiological process by which the body maintains
itself ✔️Ans - Metabolism
Organic substances in food that are present in small amounts and act as
coenzymes in biochemical reactions ✔️Ans - Vitamins
Inorganic elements that act as catalysts in biochemical reactions
✔️Ans - Minerals
Substances necessary for body functioning ✔️Ans - Nutrients
Breakdown of complex body substances into simpler substances
✔️Ans - Catabolism
Decrease in blood glucose level ✔️Ans - Hypoglycemia
Measurement of size and makeup of body at specific sites ✔️Ans -
Anthropometry
Identify an example of a nutrition objective from Healthy People 2020
✔️Ans - For individuals to decrease saturated fat intake in population 2
years and older; increase the variety of vegetable and fruit intake in the
population 2 years and older; increase grain products intake and
consumption of calcium in the population 2 years and older; reduce daily
intake of sodium in the population 2 years and older
a. Which vitamin is synthesized by the body?
b. What are the fat-soluble vitamins?
c. Identify an example of an antioxidant vitamin ✔️Ans - a. Vitamin K
b. Vitamins A, D, E, and K
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