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Med Surg - Chapter 60 - Care of Patients with Malnutrition: Undernutrition and Obesity

Terms in this set (39)

What behaviors are commonly associated with bulimia nervosa? Select all that apply.
1
Binge eating
2
Self-induced vomiting
3
Self-induced starvation
4
Excessive use of laxatives
5
Hyperactivity and excessive exercise
1
Binge eating
2
Self-induced vomiting
4
Excessive use of laxatives

Bulimia nervosa is an eating disorder that leads to malnutrition. A patient with bulimia nervosa practices binge eating by consuming large amounts of food in a short time, which is followed by purging with the use of laxatives and/or self-induced vomiting. Anorexia nervosa is another eating disorder in which the underweight patient has a fear of fatness leading to self-induced starvation and is often hyperactive and excessively exercising. This condition also leads to malnutrition.
How does the nurse accurately calculate a patient's body mass index (BMI)?
1
BMI = weight (kg)/height (in meters) 2
2
BMI = weight (lb)/height (in inches) 2
3
BMI = weight (kg)/height (in meters)
4
BMI = weight (lb)/height (in meters)
1
BMI = weight (kg)/height (in meters) 2

BMI = weight (kg)/height (in meters) 2 is the only formula that will correctly calculate BMI.
What solution is commonly used to flush a clogged feeding tube?
1
Water
2
Saline
3
Heparin
4
Cranberry juice
1
Water

Patency of a feeding tube can be ensured by flushing it with 30 mL of water and applying gentle pressure with a 50 mL piston syringe. The tube is never flushed with cranberry juice because the solution may be mistaken for blood. It is not necessary to use saline to flush feeding tubes. Heparin is often used to flush intravenous lines, but never feeding tubes.
A patient who reports nausea, vomiting, and diarrhea is ruled out for all gastrointestinal disorders. What could be the possible reason for this patient's condition?
1
Deficiency of pyridoxine and iron
2
Deficiency of vitamin A and riboflavin
3
Deficiency of pyridoxine, zinc, and niacin
4
Deficiency of pyridoxine, riboflavin, and iron
3
Deficiency of pyridoxine, zinc, and niacin

Nausea, vomiting, and diarrhea occur due to pyridoxine, zinc, and niacin deficiencies. Pyridoxine and iron deficiency leads to cheilosis. Vitamin A deficiency and riboflavin deficiency cause the tongue to turn magenta. Stomatitis is caused by pyridoxine, riboflavin, and iron deficiencies.
A patient was diagnosed with excessive amounts of keratin in the hair follicles. Which deficiency may cause this condition in a patient?
1
Niacin
2
Thiamine
3
Vitamin D
4
Vitamin A
4
Vitamin A

An excessive development of keratin in the hair follicles indicates follicular hyperkeratosis, which is caused by vitamin A deficiency. Deficiency of niacin causes bilateral dermatitis. Congestive heart failure is a result of a thiamine deficiency. Vitamin D deficiency leads to osteomalacia.
A patient reports a sensation of tingling, tickling, and prickling in the fingers and toes. What does the nurse suspect as the possible reason for this patient's condition?
1
Deficiency of vitamin B 12
2
Deficiency of vitamin A
3
Deficiency of vitamin D
4
Deficiency of vitamin C
1
Deficiency of vitamin B 12

A sensation of tingling, tickling, prickling in the fingers and toes indicate paresthesia, which occurs due to the deficiency of vitamin B 12 . Deficiency of vitamin A causes xerosis of conjunctiva. Deficiency of vitamin D results in osteomalacia, bone pains, and rickets. Vitamin C deficiency results in swollen and bleeding gums
Which method of tube feeding is similar to intravenous (IV) therapy?
1
Bolus feeding
2
Cyclic feeding
3
Continuous feeding
4
Intermittent feeding
3
Continuous feeding

The continuous feeding method infuses small amounts of food over a specified time, similar to IV therapy. Bolus feeding refers to feedings at set intervals of every 4 hours during a 24-hour period. In cyclic feeding, the infusion of food is usually stopped for 6 hours or longer in a 24-hour period. Intermittent feeding refers to sporadic and irregular feedings administered as needed.
Which potential nutrition deficiency can cause decreased pigmentation of hair?
1
Zinc
2
Protein
3
Vitamin C
4
Vitamin A
2
Protein

Deficiency of protein leads to a decreased pigmentation of the hair. Deficiency of zinc results in alopecia. Corkscrew hair is a result of vitamin C deficiency. Vitamin A deficiency causes Bitot's spots in the eyes.
A patient is diagnosed with an enlarged liver and all viral causes have been eliminated. What could be the possible reason for this patient's condition?
1
Deficiency of niacin
2
Deficiency of protein
3
Deficiency of vitamin A
4
Deficiency of vitamin C
2
Deficiency of protein

An enlarged liver indicates hepatomegaly, which is caused by the deficiency of protein. Niacin deficiency leads to a fissured tongue. Dry skin indicates vitamin A deficiency. Bleeding occurs due to a vitamin C deficiency.
Which food items are consumed by a lacto-ovo-vegetarian?
1
Foods of plant origin
2
Milk, cheese, and dairy products
3
Milk, cheese, eggs, and dairy products
4
Milk, dairy products, vegetables, meat, and eggs
3
Milk, cheese, eggs, and dairy products

A lacto-ovo-vegetarian diet includes milk, cheese, eggs, and dairy products. A vegan diet includes only foods of plant origin. A lacto-vegetarian eats milk, cheese, and dairy products. A nonvegetarian diet includes milk, dairy products, vegetables, meat, and eggs.
Which nutrient supplement should be taken by the patient with swollen, bleeding gums?
1
Protein
2
Folic acid
3
Vitamin A
4
Vitamin C
4
Vitamin C

The patient with swollen, bleeding gums may have a vitamin C deficiency, and should take vitamin C supplements. A protein deficiency can cause muscle wastage and edema in the extremities. It also causes decreased pigmentation and loss of hair. Folic acid is essential in preventing anemia. Vitamin A deficiency can cause xerosis of the conjunctiva, keratomalacia, and Bitot's spots. It also may cause dry and scaling skin and follicular hyperkeratosis.
Which statement describing the administration of enteral nutrition using the bolus feeding method is accurate?
1
Enteral product is infused intermittently every 8 hours.
2
Small amounts are infused continuously with a down time of 6 hours daily.
3
Small amounts are infused continuously over a specified period of time.
4
A specific amount of enteral product is fed intermittently every 4 hours.
4
A specific amount of enteral product is fed intermittently every 4 hours.

There are three methods of tube feeding administration. Bolus feeding is an intermittent feeding of a specified amount of enteral product typically administered every 4 hours (not every 8 hours). This is done either manually or by infusion through a mechanical pump or controller device. In continuous feeding, small amounts are infused continuously over a specified time, similar to intravenous therapy. Cyclic feeding is similar to continuous feeding except that infusion is stopped for about 6 hours in a 24-hour period. The down time is to allow for bathing, treatments, and other activities.
What could be the possible reason for the appearance of petechiae in a patient?
1
Deficiency of niacin
2
Deficiency of protein
3
Deficiency of vitamin A
4
Deficiency of vitamin C
4
Deficiency of vitamin C

Petechiae occur due to vitamin C deficiency. Niacin deficiency leads to a fissured tongue. Hepatomegaly occurs due to a protein deficiency. Dry skin indicates a deficiency of vitamin A.
A patient receiving total parenteral nutrition (TPN) exhibits symptoms of congestive heart failure (CHF) and pulmonary edema. Which complication of TPN is the patient most likely experiencing?
1
Calcium imbalance
2
Fluid volume deficit
3
Fluid volume overload
4
Potassium imbalance
3
Fluid volume overload

CHF and pulmonary edema are symptoms of fluid overload. Calcium imbalance, fluid volume deficit, and potassium imbalance do not manifest with CHF and pulmonary edema.
Which hormone is responsible for sensitizing insulin?
1
Leptin
2
Ghrelin
3
Adiponectin
4
Cholecystokinin
3
Adiponectin

Adiponectin is an anti-inflammatory and insulin-sensitizing hormone. Leptin is a hormone released by fat cells and possibly gastric cells; it acts on the hypothalamus to control appetite. Ghrelin is called the "hunger hormone;" it is secreted in the stomach. Ghrelin increases in a fasting state and decreases after a meal. Cholecystokinin is a hormone that stimulates digestive juices.
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