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Potter: Fundamentals of Nursing, 9th Edition: Chapter 45: Nutrition
Potter: Fundamentals of Nursing, 9th Edition: Chapter 45: Nutrition
1. Answer: 2, 3, 4.
Patients who are malnourished on admission are at greater risk of life-threatening complications
such as arrhythmia, pleural effusions, sepsis, or hemorrhage during hospitalization.
2. Answer: 4.
Nitrogen balance is important to determining serum protein status. A negative nitrogen balance is
present when catabolic states exist. When a patient has a decreased protein level, he or she is at
risk for delayed wound healing.
3. Answer: 4.
Stop feeding and place patient on NPO. If choking persists, suction airway. Notify health care
provider.
4. Answer: 1.
Turn the patient on his or her left side to prevent air from entering the left side of the heart. Then
have the patient perform a Valsalva maneuver (holding the breath and “bearing down”).
5. Answer: 4.
When meeting 75% of nutritional needs by enteral feedings or reliable dietary intake, it is usually
safe to discontinue PN therapy.
6. Answer: 1, 3, 4.
Sometimes adding intravenous fat emulsions to parenteral nutrition supports the patient’s need
for supplemental kilocalories, prevents essential fatty acid deficiencies, and helps control
hyperglycemia during periods of stress. Parenteral nutrition is administered at 50% of the
patient’s daily needs for the first 24 hours to assess how he or she is tolerating the infusion.
7. Answer: 7, 1, 3, 4, 2, 5, 6.
8. Answer: 4.
Do not administer feeding when a single gastric residual volume exceeds 500 mL or when two
consecutive measurements (taken 1 hour apart) each exceed 250 mL because of the potential for
aspiration.
9. Answer: 2, 3.
The skills of measuring blood glucose level after skin puncture (capillary puncture) and writing
down the amount the patient ate can be delegated to NAP. The nurse needs to administer enteral
feeding because of the risk of aspiration. The nasogastric tube should never be repositioned by
the NAP for risk of causing injury to the patient.
10. Answer: 3.
Check the medical record to see if there is a medication order for deviations in glucose level; if
not, notify the health care provider. As the nurse you want to get the patient’s blood sugar as
close to normal as possible.
11. Answer: 4.
Infants should not have regular cow’s milk during the first year of life. It is too concentrated for
the infant’s kidneys to manage. There is also an increased risk for developing milk-product
allergies.
12. Answer: 1, 3, 4.
Cheese, eggs, and peanut butter are also useful high-protein alternatives. Vitamin D supplements
are important for improving strength and balance, strengthening bone health, and preventing
bone fractures and falls. Grapefruit and grapefruit juice can interfere with warfarin (Coumadin)
(anticoagulant), preventing its breakdown. This would lead to an increased risk of bleeding.
13. Answer: 2.
A patient receiving continuous enteral feedings should never be placed supine because it
increases the risk for pulmonary aspiration. If the nurse needs to lay the patient in the supine
position, the feedings should be stopped and restarted when the head of the bed is at 45 degrees.
14. Answer: 2.
Use either alcohol or an alcoholic solution of chlorhexidine gluconate to clean the injection port
or catheter hub 15 seconds before and after each time it is used to reduce the risk of a central line
infection.
15. Answer: 2, 4.
Patients suffering from celiac disease or Crohn’s disease need to take vitamin and iron
supplements regularly because they have a deficit resulting from malabsorption.