Deck 20: Diet in Digestive Diseases

Question 1

The American Society of Anesthesiologists' guidelines suggest which of the following intakes is permissible for healthy individuals undergoing elective procedures?

A) Water and apple juice until 1 hour before the procedure
B) Plain tea and unbuttered toast with clear jelly 6 hours before scheduled surgery
C) Infant formula or breast milk 4 hours before an elective procedure begins
D) Light meal containing meat at 5 a.m. before a procedure scheduled for noon

Answer 1

Fried or fatty foods require long hours of digestion and should not be eaten 8 hours or less before the procedure. Something light may be eaten 6 hours before an operation. Infants can be breast fed up to 4 hours prior an operation. Only clear liquids are allowed to be taken 2 hours before any surgical care that requires anesthesia.
Thus, the correct answer is option b.
Water and apple juice are considered clear liquids that can be taken 2 hours before any surgical procedure.
Hence, option 'a' is not correct.
Nonhuman milk or infant formula milk can be taken by a healthy neonate 6 hours before any elective surgery because gastric emptying time of it is similar to solid foods.
Thus, option 'c' is incorrect.
A light meal can be eaten 6 hours before a procedure. But if it contains meat, it can be taken 8 hours before any surgical procedure.
Thus, option 'd' is incorrect.

Question 2

Ms. C were not in such a dire financial situation and ineligible for assistance, what other approaches to improving the family's nutritional intake could be tried?

Answer 2

Supplementary tactics to improve the patient and his/her family's nutritional intake:
Explore the client's preferences for including essential nutrients to his/her diet. Obtain his/her reaction to the diet and offer alternatives to his/her present meal plan. The nurse must take into account the client's choices to improve likelihoods of compliance to the diet modification. Considering the client's requests affirms her status as an individual. Personalizing the diet for his/her condition will amplify the possibility of success.

Question 3

Distinguish between the dietary preparation for gastrointestinal surgery and the dietary preparation for surgery on other body systems.

Answer 3

Dietary preparation for gastrointestinal surgeries:
Gastrointestinal surgeries require that after the operation, oral foods and liquids be postponed longer than surgeries of other body systems. This permits the gastrointestinal tract to heal appropriately before anything is introduced to it. This also lowers the risk that sutures, if any, rupture due to the possible force induced by the ingested food or liquid.

Question 4

Mr. W is a 55-year-old White man admitted to the acute care unit for jaundice and ascites secondary to cirrhosis of the liver. He has gained 15 pounds in the past 3 weeks, and his serum sodium is 125 mEq/L. He is a diagnosed alcoholic who has been through a detoxification program several times in the past 5 years. The dietitian has instructed 1.Mr. W on a 1500-mg sodium diet with a fluid restriction of 1000 mL per day. 1.Ms. M has been diagnosed with gastroesophageal reflux disease. Dietary instructions should include taking:

A) Normal amounts of protein to help tighten the cardiac sphincter.
B) Mint teas to counteract the bitter taste caused by reflux of gastric contents into the esophagus.
C) Small amounts of wine with dinner to aid in relaxation and enjoyment of the meal.
D) Whole milk products to increase the kilocalorie density of the diet.

Question 5

Clients who have had resection of the ileum should be monitored for:

A) Iron-deficiency anemia
B) Fat-soluble vitamin deficiency
C) Calcium and phosphorus deficiency
D) Vitamin B 12 deficiency

Question 6

How would you follow up on 1.Ms. C's implementation of the low-fat diet as well as her overweight and prehypertension (assuming other measurements confirm the readings)?

Question 7

Compare the diet-related interventions for postprandial hypotension and dumping syndrome.

Question 8

A client with cirrhosis of the liver should be asked if he or she experienced ____ before ordering a diet.

A) A headache
B) Vomiting of blood
C) A recent course of antibiotic therapy
D) Hives

Question 9

Identify the mealtime treatment of gastroesophageal reflux disease and hiatal hernia.

Question 10

Which of the following meal components is likely to lessen symptoms of the dumping syndrome?

A) Mashed fresh strawberries
B) Orange sherbet
C) Salt-free tomato juice
D) Whole-wheat toast with dietetic jelly

Question 11

Explain the dietary treatment of celiac disease related to its pathophysiology.

Question 12

Mr. W is a 55-year-old White man admitted to the acute care unit for jaundice and ascites secondary to cirrhosis of the liver. He has gained 15 pounds in the past 3 weeks, and his serum sodium is 125 mEq/L. He is a diagnosed alcoholic who has been through a detoxification program several times in the past 5 years. The dietitian has instructed 1.Mr. W on a 1500-mg sodium diet with a fluid restriction of 1000 mL per day. When the nurse does the beginning of shift assessment, 1.Mr. W says he tried ?cutting down on salt? when he started gaining weight, but it didn?t work. Which of the following statements best reflects a good understanding of 1.Mr. W?s pathology and treatment?

A) Just cutting out added salt is not enough, because many foods are naturally high in sodium.
B) Fluids are always restricted with a low-sodium diet.
C) The ascites is caused by the inability of the liver to produce water-soluble bilirubin.
D) Besides retaining sodium, 1.Mr. W has ascites due to decreased blood pressure in the liver.

Question 13

Differentiate nutritional care for clients with Crohn disease from that for ulcerative colitis.

Question 14

Which of the following foods is allowed for a preoperative client on a low-fiber diet?

A) Bologna sandwich
B) Corn on the cob
C) Canned peaches
D) Banana-nut waffles

Question 15

Relate the nutritional care for clients with hepatitis to that for cirrhosis.

Question 16

How important is dietary modification for the children? How might the interventions be modified for them?

Question 17

Discriminate Wernicke encephalopathy from Korsakoff psychosis as to pathophysiology and treatment, indicating the importance of early interventions.

Question 18

Describe the preoperative limitations of specific fluids recommended by the American Society of Anesthesiologists.

Question 19

Describe the nutritional aspects of medical treatment for cholecystitis.

Question 20

Mr. W is a 55-year-old White man admitted to the acute care unit for jaundice and ascites secondary to cirrhosis of the liver. He has gained 15 pounds in the past 3 weeks, and his serum sodium is 125 mEq/L. He is a diagnosed alcoholic who has been through a detoxification program several times in the past 5 years. The dietitian has instructed 1.Mr. W on a 1500-mg sodium diet with a fluid restriction of 1000 mL per day. 1.Mr. W vomits immediately after his next meal. The physician then orders a hydrating solution of 5% dextrose in water intravenously. If thiamin is not included in that order, the nurse should inquire about it because:

A) Thiamin is necessary to predigest the dextrose for immediate absorption.
B) Deficiency of thiamin causes delirium tremens.
C) Intravenous glucose without thiamin in the cirrhosis client can precipitate the Wernicke- Korsakoff syndrome.
D) Thiamin prevents folic acid stores from being diluted by the hydrating solution.

Question 21

Discuss cystic fibrosis as to pathophysiology and dietary treatment.