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NUR 231 Week 2 Study Questions with Correct Answers

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Risk nursing diagnosis labels related to nutrition include: Risk for Aspiration Risk for Imbalanced Nutrition: More/Less than Body Requirements Actual nursing diagnosis labels related to nutrition include: Impaired Swallowing Feeding: Self-Care Deficit Imbalanced Nutrition: More/Less than Body ...

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NUR 231 Week 2 Study Questions with
Correct Answers
Risk nursing diagnosis labels related to nutrition include: ✅Risk for Aspiration

Risk for Imbalanced Nutrition: More/Less than Body Requirements

Actual nursing diagnosis labels related to nutrition include: ✅Impaired Swallowing

Feeding: Self-Care Deficit

Imbalanced Nutrition: More/Less than Body Requirements

Health-promotion nursing diagnosis labels related to nutrition include: ✅Readiness for
Enhanced Nutrition
Readiness for Enhanced Knowledge

Risk ✅nursing diagnoses apply when there is an increased potential or vulnerability
(risk) for a patient to develop a problem or complication, such as a risk for not getting
adequate nutrition.

Recall that risk nursing diagnoses use the following format: ✅Risk nursing diagnosis =
diagnosis label + risk factors

Some examples of complete risk nursing diagnostic statements related to nutrition are:
✅Risk for Imbalanced Nutrition: Less than Body Requirements with risk factors of
chronic nausea and loss of appetite
Risk for Aspiration with risk factor of difficulty swallowing secondary to facial paralysis

Actual ✅nursing diagnoses apply when there is an actual problem or complication,
such as difficulty swallowing.

Recall that actual nursing diagnoses use the following format: ✅Actual nursing
diagnosis = diagnosis label + related factors + defining characteristics

Some examples of complete actual nursing diagnostic statements related to nutrition
are: ✅Impaired Swallowing related to residual effects of neurologic damage secondary
to cerebrovascular accident, as evidenced by gagging and choking with oral intake
attempts

Feeding: Self-Care Deficit related to sensory and motor deficits secondary to spinal cord
injury, as evidenced by bilateral upper-extremity paralysis and an inability to self-feed

,Imbalanced Nutrition: Less than Body Requirements related to inadequate dietary
intake, as evidenced by cachectic (physically wasted) appearance and 40-lb weight loss
in past 6 months

Imbalanced Nutrition: More than Body Requirements related to daily intake of excessive
number of calories, as evidenced by weight gain of 5 lb over a week

Health Promotion ✅nursing diagnoses are used in situations in which the patient
expresses interest in improving their health status through a positive change in
behavior, such as desire to eat a healthier diet.

Recall that health-promotion nursing diagnoses use the following format: ✅Health-
promotion nursing diagnosis = diagnosis label + defining characteristics

Some examples of complete health-promotion nursing diagnostic statements related to
nutrition are: ✅Readiness for Enhanced Nutrition as evidenced by expression of desire
for a balanced, healthy dietary intake and verbalization of American Diabetic
Association nutritional guidelines
Readiness for Enhanced Knowledge as evidenced by patient requesting written
materials about healthy food choices

Risk for Aspiration ✅Nursing Diagnosis

Risk for Aspiration with risk factor of difficulty swallowing secondary to facial paralysis

Measurable Patient-Centered Goal

Patient will not exhibit any signs or symptoms of aspiration during this hospitalization
(e.g., lungs clear, respiratory rate within normal range for patient).

Feed: Self Care Deficit ✅Nursing Diagnosis

Feeding: Self-Care Deficit related to sensory and motor deficits secondary to spinal cord
injury, as evidenced by bilateral upper-extremity paralysis and an inability to self-feed

Measurable Patient-Centered Goal

Patient will demonstrate the ability to use assistive devices for self-feeding before
discharge.

Imbalanced nutrition: less than body requirements ✅Nursing Diagnosis

Imbalanced Nutrition: Less than Body Requirements related to inadequate dietary
intake, as evidenced by cachectic appearance and 40-lb weight loss in past 6 months

Measurable Patient-Centered Goal

, Patient will gain 1 to 2 lbs each week until weight is within normal range.

Imbalanced nutrition: more than body requirements ✅Nursing Diagnosis

Imbalanced Nutrition: More than Body Requirements related to daily intake of excessive
number of calories, as evidenced by weight gain of 5 lb over a week

Measurable Patient-Centered Goal

Patient will identify factors related to obesity before discharge.

Readiness for enhanced nutrition ✅Nursing Diagnosis

Readiness for Enhanced Nutrition related to expression of desire for a balanced,
healthy dietary intake and verbalization of American Diabetic Association nutritional
guidelines

Measurable Patient-Centered Goal

Patient will demonstrate awareness of balanced, nutrient-rich food options for self-
cooked meals by selecting these items from a list before discharge to home.

Patient-centered nutritional goals and dietary care plans ✅most effective if the
patient���s individual dietary preferences and cultural and religious nutritional needs
are considered.

Registered Dietician ✅A registered dietitian is helpful in providing nutritional education
and services that address the psychosocial and economic factors that impact nutrition.

Case Manager ✅responsible for coordinating timely, cost-effective services such as
provision of durable medical equipment, infusion therapy, transportation, and follow-up
care after discharge.

Speech therapist ✅Collaboration with a speech therapist is needed for patients who
have impaired swallowing and/or require restorative therapy.

Psychologist ✅Collaboration with a board-certified psychologist may be necessary if
psychological factors have an impact on the patient���s recovery.

Unlicensed assistive personnel ✅Assistance with feeding can be delegated to
unlicensed assistive personnel (UAP). Registered nurses are responsible for
supervising and guiding care provided by UAP to ensure patient safety.

Implementation and Evaluation of Interventions Related to Nutrition.... ✅

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