Mosby’s Textbook for Nursing Assistants (9th edition) CH 27

Test 4
Study guide

Loss of appetite

Breathing fluid, food, vomitus, or an object into the lungs

The fuel or energy value value of food

A soft, waxy substance found in the bloodstream and all body cells

A decrease in the amount of water in body tissues

Difficulty ( dys) swallowing (phagia)

Swelling of the body tissues with water

A measuring container for fluids

Having an adequate amount of water in the body tissues

The amount of fluid taken in; input

A substance that is ingested, digested, absorbed, and used by the body

The process involved with the ingestion, digestion, absorbtion, and the use of foods and fluids by the body


Food and Drug Administration



Intake and output



Nothing By Mouth

Omnibus Budget Reconciliation Act of 1987


United States Department of Algriculture

A graduate is
A measuring container for liquid

One gram of fat equals___________ calories

One gram of carbohydrates provides ________calories

My Plate food guidance system encourges
Smart/ healthy food choices and daily activity

Remember to choose _______ foods from the meat and beans group
Lean or low fat meat and poultry.

Which nutrient is needed for tissue growth/repair

Which nutrient provides energy and fiber

Which vitamin is needed for blood clotting
Vitamin K

Which mineral is needed for growth and metabolism

Which mineral is needed for fluid balance

Which mineral is needed for heart function

Food labels contain
Serving size, number of servings in each package, and % of daily allowance

Occurs in the GI system with aging
Taste buds dull, sense of smell dulls, decrease in appetite

OBRA requires that in long term care
Food be served at correct temp, food is appetizing, seasoned, and a resident is served 3 meals a day and offered a snack at bedtime.

Person’s with difficulty swallowing usually require
A Dysphagia diet

A person on a mechanical soft diet can have
Mild cheeses, strained fruit juices, and puddin/plain cake

Someone on a bland diet can have
Foods low in roughage, foods served at moderate temps, no strong spices, no fried foods

On a low carb diet a person can not have
Cheddar cheese, creamed soup, and fried chicken

A diabetic resident does not finish all his/her food. What should you do?
Tell the nurse

High protein diets consist od
Eggs, milk, chees, meat, fish, poultry, breads and cereal.

Signs of Dysphagia
Excessive drooling, pocketing food, and hoarseness after eating

Maintain normal fluid balance in a adult
Consume 2000-2500 ml a day

Infants and young children need
More fluid than adults do

NPO patient
Cannot eat or drink anything.

Counts a fluid intake
Milk, ice cream, and soup

75% of 240 ml of coffee is equal to_____
60 ml

Calorie counts are ordered for a resident. What should you do?
Note what and how much a person ate

The United States Department of Agriculture (USDA) recommends which of the following regarding food choices?
Choosing water over sugary drinks

What recommendations does the USDA make in regard to physical activity
Physical activity at least 3 days a week is best

Which of the following describes social dining in a nursing center?
Residents sit at a table of 4 to 6, and food is served as in a restaurant

Dietary Guidelines focus on
Consuming fewer calories, making informed food choices, being physically active

My Plate encourages
Well balanced meals from all 5 food groups

Who issued the My Plate

What does My Plate do
Helps you to make wide food choices by balancing calories-
eating less, avoiding over sized portions

Increasing certain foods-
half your plate fruits/veggies, at least half your plate grains/whole grains, drinking fat free or low fat milk

Reducing certain foods-
Choosing low sodium foods, drinking water instead of sugary drinks

The USDA recommends that adults do at least one of the following
2 hrs 30 mins of physical activity each week

1 hour 15 mins of vigorous activity each week

5 food groups
Fruits, vegetables, grains, proteins, and dairy

Moderate physical activities
Walking briskly, bicycling, gardening (raking/ trimming bushes), dancing, golf, water aerobics, canoeing, tennis

Vigorous physical exercise
Running/ jogging, walking very fast, bicycling more than 10 mph, heavy yard work, swimming laps, aerobics, competitive basketball, singles tennis

Vitamin A benefits
Growth, vision, healthy hair, skiing and mucous membranes, resistance to infection.

Vitamin B1 benefits (thiamin)
Muscle tone, nerve function, digestion, appetite, normal elimination, carbohydrate use

Vitamin B2 benefits (riboflavin)
Growth, healthy eyes, protein and carbohydrate metabolism, healthy skin and mucous membrane

Vitamin B3 benefits (niacin)
Protein, fat, and carbohydrate metabolism, nervous system function, appetite, digestive system function

Vitamin B12
Forming red blood cells, protein metabolism, nervous system function

Folate (folic acid)
Forming red blood cells, intestinal function, protein metabolism

Vitamin C (ascorbic acid)
Forming substances that hold together tissues, healthy blood vessels, skin, bones, gums, and teeth. Wound healing, prevent bleeding, resistance to infection

Vitamin D
Absorbing and metabolizing calcium and phosphorus, healthy bones

Vitamin E
Normal reproduction, forming red blood cells, muscle function

Vitamin K
Blood clotting

Vitamin A is found in
Liver, spinich, green leafy and yellow vegetables, yellow fruits, fish liver oils, egg yolks, butter, cream, whole milk

Vitamin B1 is found in
Pork, fish, poultry, eggs liver, breads, pastas, cereals, oatmeal, potatoes, peas, beans, soybeans, peanuts

Vitamin B2 is found in
Milk and milk products, liver, green leafy vegetables, eggs, milk, cheese

Vitamin B3 is found in
Meat, pork, liver, fish, peanuts, breads and cereals, green vegetables, dairy products

Vitamin B12 is found in
Liver, meats, poultry, fish, eggs, milk cheese

Folate is found in
Liver, meats, fish green leafy vegetables, whole grains

Vitamins C is found in
Citrus fruits, tomatoes, potatoes, cabbage, strawberries, green vegetables, melons

Vitamin D is found in
Fish liver oils, milk, butter, liver, exposure to sunlight

Vitamin E is found in
Vegetable oils, milk, eggs, meats, cereals, green leafy vegetables

Vitamin K is found in
Liver, green leafy vegetables, egg yolks, cheese

Calcium benefits
Forming teeth and bones, blood clotting, muscle contraction, heart function, nerve function

Phosphorous benefits
Forming bones and teeth, use of proteins, fats and carbohydrates, nerve and muscle function

Iron benefits
Allows red blood cells to carry oxygen

Iodine benefits
Thyroid gland function, growth, metabolism

Sodium benefita
Fluid balance, nerve and muscle function

Potassium benefits
Nerve function, muscle contraction, heart function

Calcium is found in
Milk/milk products, green leafy vegetables,whole grains, egg yolks, dried peas, beans and nuts

Phosphorous is found in
Meat, fish, poultry, milk/milk products, nuts, egg yolks, dried peas and beans

Iron is found in
Liver, meat eggs, green leafy vegetables, breads, cereals, dried peas, beans and nuts

Iodine is found in
Iodized salt, seafood, shellfish

Sodium is found in
Almost all foods

Potassium is found in
Fruits, vegetables, cereals, meats, dried peas, and beans

Factors that affect eating and nutrition
Culture, religion, finances, appetite, personal choice, body reaction, illness, drugs, chewing problems, swallowing problems, disability, impaired cognitive function, and age; taste and smell dull, appetite decreases, secretion of digestive juices decrease

In a regular house diet
There are no restrictions

In a Therapeutic diet
A doctor orders a special diet be followed

Types of special diets are
Clear liquid, full liquid, mechanical soft, fiber and residue restricted, high fiber, bland, high calorie, calorie controlled, high iron, fat controlled, high protein, gluten free, and diabetic

Clear diet
Foods liquid at body temperature and that leave small amounts of residue; non irritating/non gas forming

Full liquid diet
Food liquid at room temperature or that melt at body temperature

Mechanical soft diet
Semi solid foods that are easy to digest

Fiber and residue restricted diet
Foods that leave small amounts of residue in the colon

High fiber diet
Foods that increase residue and fiber in colon to stimulate peristalsis

Bland diet
Food that are non irritating and low in roughage; foods served at moderate temperatures; no strong spices or condiments

High calorie diet
3000-4000 calories daily; include 3 full meals and between meal snacks

Calorie controlled diet
Adequate nutrients while controlling calories to promote weight loss and reduce body fat

High iron diet
Foods high in iron

Fat controlled diet
Foods low in fat and prepared without adding fat

High protein diet
Aides and promotes tissue healing

Sodium controlled diet
A certain amount of sodium is allowed

Gluten free diet
Foods without gluten protein

Diabetes meal plan
The same amount of carbohydrates, protein, and fat are eaten at the same time each day

Diabetic meal plan benefits

Gluten free diet benefits
Celiac disease

Sodium controlled diet benefits
Heart disease, fluid retention, liver diseases, and some kidney diseases

High protein diets benefits
Burns, high fever, infection, and some liver diseases

Fat controlled diets benefit
Heart, gallbladder, and liver diseases; disorders of fat digestion; disease of the pancreas

High iron diet benefits
Anemia; after blood loss; for women during their reproductive years

Calorie controlled diet benefits
Weight loss

High calorie diet benefits
Weight gain and some thyroid problems

Bland diet benefits
Ulcers, gallbladder disorders, and some intestinal disorders; after abdominal surgery

High fiber diet benefits
Constipation and GI disorders

Fiber and residue restricted diet benefits
Diseases of the colon and diarrhea

Fill liquid diet benefits
Advance from clear liquid diet after surgery; for stomach irritation, fever, nausea, and vomiting; for person’s unable to chew, swallow, or digest solid foods.

Mechanical soft diet benefits
Advance from full liquid diet; chewing problems, GI disorders, and infections

Clear liquid diet benefits
After surgery; or acute illness, infection, nausea, and vomitting; to prepare for GI exams

Fluid balance is important because
It is needed for health

What is included in I&O recording
All oral fluids are measured and recorded- water, milk, coffee, tea, juices, soups, and soft drinks. As well as ice cream, sherbet, custard, pudding, gelatin, and popsicles as they all melt at body temperature.

Urine, vomitus, diarrhea, and wound drainage are all recorded as out put. Heavy perspiration may also be recorded

When providing drinking water
If permitted in the agency…..Mugs are taken to the ice and water dispenser. Fill mug with ice first. Then add water.
Follow all policy and procedures of the agency when providing drinking water.

What information do you need to know before providing drinking water?
The person’s fluid orders, if the person can have ice, if the person uses a straw.

Promoting safety when providing drinking water
Make sure mug is labeled with person’s name, room number and bed number
Do not touch the rim or inside of mug lid
Do not let ice scoop touch inside of mug, lid or straw
Do not place ice scoop in ice dispenser/ container
Keep ice chest closed when not in use
Make sure mug is clean.
Check mug for cracks and chips. Provide a new mug if necessary

How to reduce food borne illness
Clean: wash hands, utensils, and counter tops often

Separate: avoid cross contamination. Do not let raw meat, poultry, or their juices touch other foods that will not be cooked

Cook: cook food to safe internal temperature. Use a food thermometer to check the internal temperature. When re-heating cooked food, re-heat to 165 degrees

Chill: refrigerate or freeze food within 2 hours. If the air is 90degrees or higher, chill food with in 1 hour

Bloodborne pathogens A disease producing microbat is transmitted to another person through blood or other body fluids Body fluids Liquid or semi-liquid substance is produced by the body such as blood and feces vomitus saliva drainage from wounds sweat semen …

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