2022

Module 5 Activities
NUTRION AND DIET THERAPHY
ANGELICA S. AMANDO BSN 2C
Multiple Choice
1. For a patient who is at high risk of aspiration and is not expected to be able to eat table foods for several months,
an appropriate placement of a feeding tube might be:

a. nasogastric.

b. nasoenteric.

c. gastrostomy.

d. jejunostomy.

2. In selecting an appropriate enteral formula for a patient, the primary consideration is:

a. formula osmolality.

b. the patient’s nutrient needs.

c. availability of infusion pumps.

d. formula cost.

3. An important measure that may prevent bacterial contamination in tube feeding formulas is:

a. nonstop feeding of formula.

b. using the same feeding bag and tubing each day.

c. discarding opened containers of formula not used within 24 hours.

d. adding formula to the feeding container before it empties completely.

4. A difference between continuous and intermittent feedings is that continuous feedings:

a. requires an infusion pump.

b. allows greater freedom of movement.

c. are more similar to normal patterns of eating.

d. are associated with more GI side effects.

5. A patient needs 1800 milliliters of formula a day. If the patient is to receive formula intermittently every four hours,
how many milliliters of formula will she need at each feeding?
a. 225

b. 300

c. 400

d. 425
Enumeration
1. What are the steps in nutrition care process? Define each step.
• There are four steps in the
process:
Step 1: Nutrition Assessment
• is a methodical method for gathering, organizing, and synthesizing crucial and
pertinent data required to pinpoint nutritional issues and their root causes. This step
also entails reassessment for comparing and reassessing data from one interaction to
the next, as well as the gathering of new data that could result in new or amended
nutrition diagnoses depending on the client's state or circumstance. Initial data
collection, continuing appraisal, and analysis of the client's* status in comparison to
acknowledged standards, recommendations, and/or goals are all parts of this
dynamic, ongoing process. Contrastingly, in nutrition monitoring and evaluation,
practitioners from the fields of nutrition and dietetics use the same data to assess
client behavior changes, nutritional status, and the effectiveness of nutrition
interventions.
Step 2: Nutrition Diagnosis
• is the identification and naming of a current nutrition problem or problems by a
nutrition and dietetics practitioner who is in charge of treating them. Medical
diagnoses differ from nutritional diagnostics, which include irregular carbohydrate
consumption (eg, diabetes).
• Nutrition diagnoses are organized into the following three categories:

• Intake: Insufficient, excessive, or unsuitable are words used to characterize the

particular nutrient or substance that is altered; too much or too little of a food or
nutrient in comparison to real or estimated needs.

• Clinical: Difficulty with swallowing, chewing, digesting, absorption, and keeping a

healthy weight are examples of nutrition issues that are related to medical or physical
ailments.

• Behavioral and environmental: The physical environment, access to food,

knowledge, attitudes, and beliefs; and the safety of the food.

Step 3: Nutrition Intervention

• Is a deliberate action (or series of actions) intended to change a behavior, risk factor,
environmental factor, or component of health status connected to nutrition in order
to treat or enhance the diagnosed nutrition diagnosis(es) or nutrition problem (s).
Planning and carrying out the proper interventions allow for the selection of nutrition
treatments and their customization to the needs of the client.
Step 4: Nutrition Monitoring and Evaluation
• Identifies outcomes/indicators relevant to the diagnosis and nutrition intervention
plans and goals.

2. What are the different therapeutic diets used in clinical care? Which patients benefit from these types of
therapeutic diet?
 1. Diets of Altered Consistency
a. Liquid Diet- Replace fluids lost through vomiting, diarrhea, and post-operative malnutrition
in patients with acute infections or digestive issues.
• Clear-Liquid Diet- provides thirst relief and aids in maintaining fluid balance.
Use: after surgery and after severe vomiting or diarrhea.

• Full-Liquid Diet- For patients who are unable to chew due to illness or incapacitation,
provide a sufficient nutritious food.

Use: following surgery as a transition from clear liquids, acute infection with fever, GI
problems, and so forth.

b. Soft Diet- Given during acute infections, some gastrointestinal illnesses, and during the
postoperative stage to people who are in the early stages of rehabilitation following a surgery,
they provide appropriate nourishment for people who have difficulty chewing.
Use: Transitioning from a full liquid diet to a general diet, patients without teeth or with loose
dentures, and people who have gastrointestinal disorders like a gastric ulcer or cholelithiasis
who cannot tolerate highly spiced, fried, or raw foods are all examples of patients who may
benefit from this treatment.

c. Bland Diet- To those with stomach or duodenal ulcers, gastritis, or ulcerative colitis, a diet
reduced in fiber, roughage, mechanical irritants, and chemical stimulants is recommended.
Use: A hiatus hernia, gastric atony, diarrhea, spastic constipation, hyperchlorhydria (excess
hydrochloric acid), functional GI problems.

2. Modification in Quantity
a. Restriction Diet
• Sodium restricted diet – Reduce the amount of salt in the tissue and encourage water
excretion in patients with high blood pressure.
Use: Heart failure, hypertension, renal disease, cirrhosis, toxemia of pregnancy, and
cortisone therapy.

• Purine restricted diet – Reduce intake of foods that produce uric acid for gout patients.
Use: High uric acid retention, uric acid renal stones, and gout.

• Low residue diet – if taken as directed and/or before abdominal surgery, to lessen stool
bulk and speed up transit.
Use: Bowel inflammation during acute diverticulitis, or ulcerative colitis, preparation for
bowel surgery, esophageal and intestinal stenosis.
b. Elimination Diet- a gluten-free, dairy-free, and nut-free diet is recommended for patients
with food intolerances or total food sensitivity.
c. Increase in the amount of a specific dietary constituent high potassium diet– for high
blood pressure.
• High fiber diet–for constipation
• Iron rich diet–for anemia
3. Modification in Nutrient (Proteins, Fat, Carbohydrate) Content
a. Diabetic diet- Maintain blood glucose levels for individuals with high blood sugar as close to normal
as you can; delay or stop the beginning of diabetic problems.
 b. Fat controlled- people with heart disease should follow a low-cholesterol diet.
c. Low protein diet- for people who have advanced liver disease in addition to renal failure.
d. High protein, high calorie diet- Corrects significant protein losses and restores blood albumin levels
in individuals with HIV, cancer, and malnutrition. Low-fat, low-sodium, and low-cholesterol diets are
all possible modifications.
Use: Burns, hepatitis, cirrhosis, pregnancy, hyperthyroidism, mononucleosis, lack of protein due to
poor eating habits, elderly patients with poor intake, nephritis, nephrosis, and liver and gall bladder
disorders.
e. Weight reduction diet- for overweight and obese patients.

4. Changes in Meal Frequency

a. Small but frequent meals- for those who have gastro-esophageal reflux disease (GERD) as well as
pregnant ladies who are nauseous and vomiting.

5. Changes in Method of Cooking- for elderly individuals and patients eating bland foods.

6. Modification in the Method of Feeding

a. Enteral Feeding- recommended for those with a healthy GI tract.
 Laboratory Activity
I. Using the following assessment data, develop a nutrition care plan. (Use NANDA or other NCP reference books)

Subjective:

Patient reports excessive snacking at work, little exercise, recent weight gain of 10 lb. in past year; willing to attempt 5% weight loss and dietary/lifestyle
changes to reduce LDL-C before trying statin medication.

Objective:

Height: 6’1”

Weight: 268 lb

BMI: 35.4, obesity II

Total cholesterol: 288 mg/dL

Waist circumference: 45”

LDL-C: 214 mg/dL;

HDL-C: 48 mg/dL

EER: 2725 kcal

Triglycerides: 132 mg/dL

Diet order: Weight reduction; heart-healthy diet

Assessment: Abdominal obesity; dietary recall indicates ~3700 kcal intake per day and diet high in fat, saturated fat, trans fat Nutrition

Diagnosis/Plan:

Nutrition Intervention:

Nutrition Assessment Nutrition Diagnosis & Plan of Care Nutrition Intervention Nutrition Evaluation and
Monitoring
Subjective: Patient reports
excessive snacking at work, little
exercise, recent weight gain of 10
lb. in past year; willing to attempt
5% weight loss and dietary/lifestyle
changes to reduce LDL-C before
trying statin medication.
Objective:
Height: 6’1”
Weight: 268 lb BMI: 35.4, obesity II
Total cholesterol:
288 mg/dL Waist circumference:
45” LDL-C: 214 mg/dL;
HDL-C: 48 mg/dL
EER: 2725 kcal Triglycerides: 132
mg/dL
Diet order: Weight reduction;
heart healthy diet
Assessment:
Abdominal obesity; dietary recall nutrition interventions:
indicates ~3700 kcal intake per day
and diet high in fat, saturated fat,
trans fat.
Imbalanced Nutrition: as shown by
reported dysfunctional eating patterns,
weight gain, and raised BMI, greater than
body requirements connected to food
intake that surpasses body demands and
insufficient physical exercise.
Short Term:
The client will be able to: Following a 2-hour
nutrition intervention.
• Declare a realistic self- concept and
body image (a mental and physical
image of yourself that is in line with
one another).
• Demonstrate acceptance of self as
is rather than an idealized image.
Long Term:
The client will be able to after several
• Display acceptable lifestyle and
behavioral modifications, including
those in your eating habits, food
intake and quality, and exercise
routine.
• Obtain a healthy body weight while
maintaining it at its best.
1. Determine whether conditions The client will be able to:
linked to obesity are present or Following a 2-hour nutrition
at risk. intervention.
2. Review your normal workout • Declare a realistic self-
schedule and daily activities. Concept and body
Plan a walking program that is image (a mental and
progressive and customized to physical image of
the aims and preferences of the yourself that is in line
individual. with one another).
• Demonstrate
3. Keep a daily food journal and acceptance of self as is
review it (caloric intake, types
rather than an idealized
and amounts of food, eating image.
patterns and habits).
The client will be able to after
4. Investigate and talk about the several nutrition interventions:
feelings and occasions related
to eating. • Display acceptable
lifestyle and behavioral
5. Utilizing the client's 24-hour modifications, including
memory or weekly meal diary, those in your eating
determine the total number of habits, food intake and
calories consumed and needed. quality, and exercise
routine.
6. Analyze your typical • Obtain a healthy body
consumption of various food weight while
groups. maintaining it at its
best.
7. Discuss the client's self-
perception, particularly how
being overweight affects the
client.
8. To obtain a comparable body
drawing, have the client first
draw themselves in chalk on a
wall before having their actual
 bodies drawn while they are
standing next to it.

9. Discuss the client's weight loss

goals (e.g., for own satisfaction
or self-esteem or to gain
approval from another person).

10. Keep track of the age, gender,

height, weight, and body type.

11. Encourage the client to begin

with minimal and
exercise routine. Obtain
a healthy body weight while
maintaining it at its best
modifications. Determine
reasonable incremental targets
for weekly weight loss.

12. Emphasize need for adequate

fluid intake and taking
fluids between meals rather
than with meals.

13. Talk about healthy snacks, such

as low-fat yogurt with fruit,
nuts, and apple slices, string
cheese reduced in fat, and
peanut butter).

14. Stress the value of stress

management, of avoiding
conflict at mealtimes, and of
eating slowly.
15. Encourage and support
attempts as well
as real weight loss by
giving positive feedback.

16. The need to grant oneself

permission to include desired or
yearned-for foods in a diet plan
is discussed.

17. Obtain proper weights by

periodically weighing as each
individual indicates measures of
the body.

18. As much as feasible, involve the

SO(s) in the therapy strategy.