Diets and

Nutrition
Archer Review

Macronutrients
Carbs, proteins, and all the good stuff
 Diabetes Mellitus
What to eat Specifics
● Low carb ● Count carbs
○ Average - 60 carbs/meal
○ Complex carbs
● Take insulin with meals
● High proteins
○ Cover carbs
● Fruits ○ Sliding scale for BG correction
● Veggies
● Eat before exercising
○ When BG is highest
 High Protein

Protein in the Diet

 Cholesterol

Fat in the Diet

 NCLEX Question
The client has just been diagnosed with hyperlipidemia. Aside from the
prescribed Atorvastatin, they are advised to lose weight and implement some
dietary changes. The nurse talks to them about possible nutritional modifications.
All of the following are accurate except:

A. Replace vegetable oil with canola oil when cooking.

B. Eat fish like tuna and salmon more often.
C. Eat more fruits and vegetables.
D. Eat more red meats more often.

Answer: D
A is incorrect. Replacing vegetable oils high in polyunsaturated fats with canola oil
(monounsaturated fats) is beneficial to reduce cholesterol levels.

B is incorrect. Fish like tuna and salmon are rich in Omega 3 fatty acids, which help in
reducing harmful cholesterol levels.

C is incorrect. Fruits and vegetables contain fiber, which promotes a healthy cholesterol
level.

D is correct. Red meats are rich in saturated fat. They should be eaten less frequently
because it contributes to high cholesterol levels.

Reference
Nugent, P., et al., Mosby’s Comprehensive Review of Nursing for the NCLEX-RN Examination. 20th Edition, Elsevier 2012
Vitamins
They might be small but they’re oh so important!
Electrolytes
Who needs what and when?!
Foods High in Phosphorus
Foods High in Sodium
NCLEX Question
A nurse recommends that a client who is taking furosemide should increase
their intake of what food?

A. Avocados
B. Iceberg lettuce
C. Plums
D. Apples
Answer: A
The correct answer is A. Furosemide is the most frequently prescribed loop diuretic. It can increase
urine output, even when blood flow to the kidneys is diminished. The rapid excretion of large amounts
of water caused by loop diuretics may produce adverse effects, such as dehydration and electrolyte
imbalances. Potassium loss may result in dysrhythmias. Therefore, potassium supplements and foods
high in potassium are encouraged. Avocado has high levels of potassium in it, which tends to be lower
in a client taking Lasix.

B, C, and D are incorrect. Each of these options offers little no value of potassium to the diet.

NCSBN Client Need

Topic: Physiological Integrity
Subtopic: Pharmacological Therapies
Chapter 28: Drugs for Fluid, Acid-Base and Electrolyte Disorders
Core Concepts in Pharmacology (Holland/Adams)

Specific
Diets
DASH diet
Dietary Approaches to Stop Hypertension

● Low
○ Sodium
○ Fat
● High
○ Calcium
○ Potassium
○ Fiber

Heart Healthy Diet

● Goal:
○ Reduce caloric intake to
achieve/maintain ideal body weight
● Used in:
○ Heart disease
○ MI
○ High cholesterol
○ High BMI
○ Metabolic syndrome
○ CAD
Renal Diet
● Body is unable to regulate fluids and
electrolytes
● Fluid restriction
● Low electrolytes
● Low protein
○ Body can no longer clear urea
● Specifics may depend on their
treatment
○ Are they on dialysis?

Foods with gluten

Ketogenic diet
● Components:
○ High-fat
○ Adequate-protein
○ Low-carbohydrate diet
● Uses
○ Treats hard-to-control epilepsy in children.
The body has so few carbs to use for energy,
it burns fat, which produces ketones.

NCLEX Question
A client is being discharged from the hospital after being admitted because of
hypertension. The nurse is talking to the client about dietary modifications. The
nurse should reinforce their teaching when the client states which of the
following:

A. “I’m glad I can still eat beef and pork every day.”
B. “I will need to get used to eating fruits and vegetables.”
C. “I should stop eating canned foods”
D. “I have already told my son to buy me some yogurt when I get home.”
Answer: A
A is correct. The client’s dietary modifications include low fat, low sodium, high fiber, high calcium, and
potassium diet. The nurse should re-educate the client that eating beef and pork is rich in saturated fats
and should only be eaten sparingly.

B is incorrect. The client’s dietary modifications include low fat, low sodium, high fiber, high calcium, and
potassium diet. Fruits and vegetables have a high fiber and vitamin and mineral content and must be
consumed regularly to help lower blood pressure.

C is incorrect. The client’s dietary modifications include low fat, low sodium, high fiber, high calcium, and
potassium diet. Canned foods have high sodium content due to its preservatives. The patient should
avoid these.

D is incorrect. The client’s dietary modifications include low fat, low sodium, high fiber, high calcium, and
potassium diet. Yogurt is rich in calcium and low in fat.
Reference
Nugent, P., et al., Mosby’s Comprehensive Review of Nursing for the NCLEX-RN Examination. 20th Edition, Elsevier 2012

Diet orders
NPO, clears, and more, oh my!
NPO
● Nothing by mouth
● Pre-op
● Post-op before bowel sounds return

Clear liquids
● Clear liquid diets consist of foods and liquids that are transparent to light and are
liquid when at body temperature.
● This diet is best for patients who have not had oral intake for some time, and for
the first time, a patient eats after complete bowel rest.
● You should be able to see through it. No chunks!
○ Water, flavored water, sports drinks
○ Juice with no pulp
○ Gelatin
○ Tea or coffee (no milk, cream, etc.)
○ Clear broth
○ Ice pops
○ Hard candy
■ Lemon drops
■ Peppermint rounds
Full liquids
● This diet is appropriate as a transition after a clear liquid diet for patients
following surgery
● Should not be the first diet ordered.
○ Ice cream, milkshakes
○ Strained soups
○ Sherbet, Jello
○ Milk
○ Pudding
○ Custards
○ Refined cooked cereals
○ Strained vegetable juices

Miscellaneous
Mechanical soft Fluid-Restricted
● Facilitate mastication
○ Patients without teeth ● Restricted to a certain mL of
○ Jaw surgery or injuries fluids per day
● Swallowing problems ● Heart failure
● Dentition problems ● Renal failure

Thickened Liquids Regular Diet

● Thickened fluids ● No restrictions!
● For trouble swallowing
● Common after strokes
 NCLEX Question
While working in a post-operative unit, the nurse is assigned to take care of a
32-year-old who is post-op day one from an appendectomy. The client has not
eaten for the past three days and is asking when she will be allowed to have a
meal again. Upon consulting with the interdisciplinary team, the primary
healthcare provider decides it is time to place a diet order for your client. Which
diet does the nurse expect the primary healthcare provider will order?

A. Full liquid diet

B. Clear liquid diet
C. Soft diet
D. Mechanical diet

Answer: B
Correct Answer: B. A clear liquid diet is the most appropriate choice for this client. Clear liquid diets
consist of foods and liquids that are transparent to light and are liquid when at body temperature. This
diet is best for clients who have not had oral intake for some time, and for the first time, a client eats
after complete bowel rest.

A is incorrect. A full liquid diet is wrong. This diet is appropriate as a transition after a clear liquid diet
for clients following surgery, but should not be the first diet ordered.

C is incorrect. A soft diet is also wrong, as this is only indicated when clients have difficulty chewing or
swallowing and need foods that are much easier to eat.

D is incorrect. A mechanical diet is not appropriate for this client. This diet consisted of foods that have
been processed so that they do not require some or any chewing. It is used for clients with dental
problems, surgeries to the head and neck, or other disorders that make chewing difficult or unsafe.
NCSBN Client Need:
Topic: Basic Care and Comfort Subtopic: Nutrition and Oral Hydration
Reference
Silvestri, L.; Saunders Comprehensive Review for the NCLEX-RN Examination, ed 6, St. Louis, 2014, Elsevier, pp. 131-132