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Chapter 13: Nutrition for Disorders of the Gastrointestinal Tract
Terms in this set (30)
1. The purpose of diet therapy for patients with dysphagia is to avoid
Diet therapy for patients with dysphagia centers around providing food and beverages in a form that can be swallowed without entering the lungs (i.e., preventing aspiration). Aspiration of food may lead to pneumonia, but not usually sepsis. Patients with dysphagia have difficulty swallowing, but not usually with reflux or vomiting.
2. The three stages of swallowing are the _____ phases.
a. early, middle, and late
b. oral, laryngeal, and epiglottal
c. bolus, pharyngeal, and posterior
d. oral, pharyngeal, and esophageal
The three stages of swallowing are the oral, pharyngeal, and esophageal phases, referring to where each stage occurs. The larynx and epiglottis are not involved in swallowing.
3. If a patient has difficulty swallowing, the best position for meals is
a. lying flat.
b. sitting upright.
c. lying on one side.
d. leaning backward slightly.
The safest eating position for someone who has trouble swallowing is sitting upright. This allows gravity to help food pass along the esophagus. Leaning back slightly would make it easier for food to enter the airway. It is difficult to swallow when lying flat, even for patients without dysphagia; for patients with dysphagia this position would be very likely to cause aspiration. Lying on one side is less dangerous than lying flat, but is still dangerous for patients with dysphagia.
4. A nurse may suspect that a patient has difficulty swallowing if he or she
a. requests frequent snacks between meals.
b. coughs frequently before and after swallowing.
c. prefers to drink using a straw rather than from an open cup.
d. tends to gulp beverages and eat foods without adequate chewing.
Coughing frequently before and after swallowing may indicate difficulty swallowing. Requesting frequent snacks between meals is simply a sign of hunger. Preference for using straws is not linked with dysphagia. Patients with dysphagia tend to pocket food in their mouths and chew longer than necessary rather than swallowing foods too quickly.
5. If it is left untreated, gastroesophageal reflux disease (GERD) may lead to
b. hiatal hernia.
c. peptic ulcer disease.
d. dumping syndrome.
Untreated GERD may lead to esophagitis, inflammation of the lower esophagus, because stomach acid irritates the esophageal mucosa. Hiatal hernia may cause GERD, but not the reverse. Peptic ulcer disease and dumping syndrome are not related to GERD.
6. An example of a meal that is likely to relax the lower esophageal sphincter and allow gastroesophageal reflux is
a. pasta with marinara sauce and sourdough bread.
b. ham with rice pilaf.
c. fried chicken and pasta salad.
d. chicken and spinach tortilla wrap with spicy salsa.
Foods and beverages that relax the lower esophageal sphincter (allowing stomach contents to back up) include alcohol, carminatives (oil of peppermint or spearmint, garlic, onion), chocolate, high-fat foods (fried foods, high-fat meats, cream sauces, gravies, margarine/butter, cream, oil, salad dressings). Fried chicken and pasta salad are both high in fat and would exacerbate gastroesophageal reflux. The other meals are relatively low in fat and would be much less likely to cause reflux.
7. A patient has a higher risk of peptic ulcer disease (PUD) if they are a chronic user of
a. certain antibiotics.
b. laxatives and stool softeners.
c. magnesium-aluminum antacids.
d. nonsteroidal antiinflammatory drugs.
8. Nutrition therapy for peptic ulcers should be individualized, but most patients should
a. eat a diet high in fiber.
b. eat a diet low in fat.
c. avoid sources of caffeine.
d. drink several glasses of milk daily.
9. Patients who have undergone total or partial gastrectomy may experience
b. lactose intolerance.
c. peptic ulcer disease.
d. dumping syndrome
10. Nutrition therapy for dumping syndrome includes
a. drinking thickened liquids and increasing protein intake.
b. avoiding caffeinated beverages and decreasing fat intake.
c. avoiding snacks between meals and increasing intake of high-calcium foods.
d. drinking liquids between meals and limiting intake of simple carbohydrates.
11. Patients with celiac disease should avoid foods that contain
a. rice, soy, and peanuts.
b. maize, corn, and flax.
c. wheat, rye, and barley.
d. rice, quinoa, and millet.
12. An example of a meal that may contain gluten is
a. baked chicken breast with rice.
b. pork chop with sweet potatoes.
c. grilled steak with baked potato.
d. meatloaf with mashed potatoes.
13. Individuals with lactose intolerance may tolerate foods that contain small amounts of lactose if they are
a. consumed with other foods.
b. well cooked rather than raw.
c. consumed with foods that contain vitamin D.
d. derived from goat's milk rather than cow's milk.
14. Milk may be made suitable for patients with lactose intolerance by treating it with tablets that contain
b. lactase enzyme.
c. vitamin D and calcium.
d. Lactobacillus acidophilus.
15. Major symptoms of inflammatory bowel disease include
a. nausea and vomiting.
b. constipation and flatulence.
c. diarrhea and abdominal pain.
d. weight gain and excessive thirst.
16. The basic meal plan for patients with inflammatory bowel disease should be
a. high protein, low fat.
b. low kcal, high fat.
c. high kcal, low protein.
d. high kcal, high protein.
17. Patients with inflammatory bowel disease may benefit from a high-fiber diet during
a. acute episodes.
b. times of remission.
c. recovery from surgery.
d. preparation for surgery.
18. Fluid loss is most likely to be a problem for a patient with
a. a colostomy.
b. a hiatal hernia.
c. an ileostomy.
d. Crohn's disease.
19. When the entire colon and rectum have been removed, the patient would have
a. a colostomy.
c. an ileostomy.
d. dumping syndrome.
20. As effluent progresses through the colon, it becomes more
21. Short-bowel syndrome occurs in patients who have undergone removal of large portions of the
c. large intestine.
d. small intestine.
22. Patients with short bowel syndrome sometimes require parenteral nutrition support to achieve adequate intakes of nutrients and kcals. It is important for them to return to enteral feedings as soon as possible to prevent
a. loss of sense of taste.
b. loss of lean body mass.
c. atrophy of the intestinal tract.
d. essential fatty acid deficiency.
23. Infection and inflammation of pouchlike protrusions from the muscular layer of the colon is known as
c. Crohn's disease.
d. inflammatory bowel disease.
24. For patients with diverticulosis who are not experiencing active inflammation and infection, the recommended diet is
b. low in fiber.
c. high in fiber.
d. high in protein.
25. When consuming a high-fiber diet, it is important to also consume adequate amounts of
b. calcium and iron.
c. fat-soluble vitamins.
d. complex carbohydrates.
26. Gas in the colon may often be caused by
a. consumption of carbonated beverages.
b. swallowing air while eating or drinking.
c. fermentation of foods by intestinal bacteria.
d. passage of gas into the colon through the colon wall.
27. A common dietary cause of constipation is
a. megacolon or Hirschsprung's disease.
b. inadequate intakes of dietary fiber and fluids.
c. chronic intake of excessive amounts of caffeine.
d. inadequate intakes of fruit and vegetable juices.
28. An example of a high-fiber breakfast is
a. bagel and cream cheese with juice.
b. cornflakes with milk and sliced banana.
c. scrambled eggs with biscuits and honey.
d. oatmeal and whole-wheat toast with jam.
29. Chronic diarrhea is usually caused by
a. foodborne pathogens.
b. inadequate protein intake.
c. intestinal irritation or malabsorption.
d. excessive intake of dietary fiber.
30. Treatment of diarrhea generally begins with
a. a high-fiber, low-fat diet.
b. removal of the cause of diarrhea.
c. adequate fluids to hydrate the patient.
d. a low-fat, low-fiber, or low-lactose diet.
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