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Flashcards for NCLEX-PN level review of nutrition, focused on diet types, feeding assistance, intake and output, and what to report. Cover the answer, recall it, then check. Scope of practice varies by state and facility; follow the rules in your jurisdiction.

== Diet Types ==

;What is included on a clear liquid diet?
:Anything transparent and liquid at body temperature: broth and bouillon, clear juices without pulp, gelatin, plain tea and coffee, clear carbonated beverages, and popsicles without fruit pieces. It is not nutritionally adequate beyond a few days.

;What is added when a diet is advanced from clear liquid to full liquid?
:Milk and milkshakes, cream soups, ice cream, sherbet, pudding and custard, refined or strained hot cereals, yogurt without fruit pieces, and all juices including those with pulp.

;What is a mechanical soft diet used for?
:Clients who have difficulty chewing because of poor dentition, missing or ill-fitting dentures, oral surgery, or fatigue. The texture is modified by chopping, grinding, or moistening, but the nutrients are not restricted.

;What is a low-residue or low-fiber diet, and when is it used?
:A diet limiting whole grains, raw fruits and vegetables, nuts, seeds, and legumes. It is used during acute diverticulitis, inflammatory bowel disease flares, bowel preparation, and early recovery after bowel surgery.

;What foods must be avoided on a gluten-free diet for celiac disease?
:Wheat, rye, and barley in any form, including bread, pasta, most breaded and battered foods, beer, and many sauces. Rice, corn, potato, quinoa, and certified gluten-free oats are safe.

;Which foods are highest in sodium?
:Canned soups and vegetables, cured and processed meats such as ham, bacon, sausage, hot dogs, and deli meat, cheese, pickled foods, salted snacks, condiments such as ketchup and soy sauce, and most restaurant and fast food.

;How can food be made more flavorful for a client on a sodium restriction?
:Use herbs, spices, garlic and onion powder (not garlic or onion salt), lemon juice, vinegar, and salt-free seasoning blends. Do not offer a salt substitute without provider approval, because salt substitutes contain potassium.

;Name common high-potassium foods a renal client should limit.
:Bananas, oranges and orange juice, potatoes, tomatoes and tomato sauce, avocado, spinach, melons, dried fruit such as raisins and apricots, beans, nuts, and salt substitutes.

;Name lower-potassium foods that are usually allowed on a renal diet.
:Apples and applesauce, berries, grapes, canned pears or peaches with the juice drained, cabbage, green beans, cauliflower, cucumber, and lettuce.

;What is a consistent carbohydrate diet?
:The standard diabetic diet. Rather than banning sugar, it distributes a similar amount of carbohydrate across meals and snacks each day so that insulin or oral medication doses match intake. One carbohydrate exchange is about 15 g.

== Feeding Assistance and Safety ==

;How should a client be positioned to eat, and for how long afterward?
:Sitting fully upright at 90 degrees in a chair or high Fowler position in bed during the meal, and kept upright for at least 30 to 60 minutes afterward to prevent reflux and aspiration.

;What are the signs of aspiration during feeding?
:Coughing or choking, a wet or gurgling voice, watering eyes, drooling, food pocketed in the cheek, shortness of breath, color change, and a falling oxygen saturation. Stop feeding and report to the RN immediately.

;Why are straws and thin liquids risky for a client with dysphagia?
:Thin liquids move fastest and are the easiest consistency to aspirate, and a straw delivers a bolus to the back of the throat before the client is ready to swallow. Liquids are thickened as ordered and straws are avoided unless specifically prescribed.

;How should the LPN set up a meal tray for a client who is blind?
:Describe the position of each item using the face of a clock, identify the foods, place utensils and the cup within reach, and encourage self-feeding to preserve independence and dignity.

;What are key points when assisting any client to eat?
:Offer toileting and handwashing first, provide oral care, ensure dentures and glasses are in place, sit at eye level, give small bites, allow time between bites, alternate foods and fluids, avoid asking questions while the client is chewing, and never rush.

;What should the LPN do if a client on a therapeutic diet is found eating food brought in by family that is not allowed?
:Stop the intake, document what and how much was consumed, notify the RN, and reinforce teaching with the client and family about why the restriction exists.

== Intake and Output ==

;Which foods count as fluid intake?
:Anything liquid at body temperature: water, juice, milk, coffee, tea, broth, soup, gelatin, popsicles, ice cream, sherbet, and nutritional supplement drinks. Solid foods such as applesauce, mashed potatoes, and cereal are documented as a percentage of the meal eaten, not as fluid intake.

;How are ice chips documented?
:At approximately half the volume of the container, because melted ice occupies about half the space of the chips. A 200 mL cup of ice chips is recorded as 100 mL.

;What common household-to-metric conversions are used for intake?
:1 ounce equals 30 mL, 1 cup or 8 ounces equals 240 mL, 1 pint equals 480 mL, 1 quart equals about 960 mL, and 1 liter equals 1000 mL.

;What counts as output?
:Urine, liquid stool, emesis, nasogastric and other tube drainage, wound and drain output, and measurable ostomy output. Estimate and describe diaphoresis and wound saturation when they cannot be measured.

;What weight change should be reported to the RN in a client with heart failure or fluid restriction?
:A gain of 2 to 3 pounds in 24 hours or 5 pounds in a week. Weight change appears before edema and shortness of breath, so it is the earliest warning of fluid retention.

;How is a daily weight obtained accurately?
:Same time each morning, same scale, same amount of clothing, after voiding, usually before breakfast. One kilogram equals about 1 liter of fluid, or about 2.2 pounds per liter.

== Tube Feeding Basics ==

;What is the most important safety measure during a tube feeding?
:Keeping the head of the bed elevated 30 to 45 degrees during the feeding and for at least 30 to 60 minutes after it ends.

;What should the LPN do first if a tube-fed client starts coughing and sounds congested?
:Stop the feeding, keep the head of the bed up, turn the client to the side, and notify the RN. Suction and oxygen are applied as needed and as authorized.

;What is used to flush a feeding tube, and how much?
:Plain water, about 30 mL, before and after feedings and medications and any time the feeding is interrupted. Never use cranberry juice or cola; they do not clear clogs and can worsen them.

;What temperature should enteral formula be when it is given?
:Room temperature. Cold formula causes cramping, nausea, and diarrhea.

;Which tube feeding findings should the LPN report to the RN?
:Coughing or respiratory change, nausea and vomiting, abdominal distention, new or worsening diarrhea or constipation, a tube that will not flush, a tube whose external marking has moved, redness or drainage at a gastrostomy site, and a blood glucose outside ordered parameters.

== Nutrition Across the Lifespan ==

;Which two foods must never be given to an infant under 12 months?
:Honey, because of infant botulism risk, and cow's milk, because it causes intestinal blood loss, is low in iron, and stresses the kidneys.

;How are new foods introduced to an infant?
:One new single-ingredient food at a time, waiting 3 to 5 days before adding the next, so that any allergic reaction can be traced to a specific food. Solids typically start around 6 months.

;What are common choking hazards for young children?
:Whole grapes, hot dog rounds, nuts, popcorn, hard candy, raw carrot chunks, and large spoonfuls of peanut butter.

;Why does a toddler's appetite decrease, and what should the LPN tell the parent?
:Growth slows sharply after infancy, producing normal physiologic anorexia. Reassure the parent, offer small portions of about 1 tablespoon of each food per year of age, allow self-feeding, and avoid using food as a reward or punishment.

;What nutrition changes accompany aging?
:Calorie needs fall while protein, calcium, vitamin D, and vitamin B12 needs stay the same or rise, thirst sensation is blunted so dehydration is common, and taste, smell, dentition, saliva, and appetite all decline. Nutrient-dense foods and scheduled fluids are the answer.

;What barriers to eating should the LPN look for in an older adult?
:Poorly fitting dentures, missing teeth, mouth pain or sores, dry mouth from medications, difficulty swallowing, tremor or weakness limiting utensil use, depression, isolation, inability to shop or cook, and limited income.

== Common Teaching Points ==

;What should a client take an iron supplement with, and what should be avoided?
:Take with a vitamin C source such as orange juice to improve absorption. Separate from milk, calcium supplements, antacids, tea, and coffee by 1 to 2 hours. Dark stools are expected; constipation is managed with fluid and fiber.

;What advice goes with increasing dietary fiber?
:Increase fluid intake at the same time and add fiber gradually. Adding fiber without fluid can cause impaction or obstruction.

;How is hypoglycemia treated in a conscious client who can swallow?
:The rule of 15: give 15 g of fast-acting carbohydrate, such as 4 ounces of regular juice or soda, glucose tablets, or 1 tablespoon of honey, recheck the glucose in 15 minutes, and repeat if it is still below 70 mg/dL. Follow with a protein and carbohydrate snack if the next meal is over an hour away.

;What lifestyle and diet measures reduce GERD symptoms?
:Small frequent meals, no eating within 3 hours of lying down, elevating the head of the bed, weight loss, smoking cessation, and limiting caffeine, chocolate, peppermint, alcohol, fried and fatty foods, citrus, tomato, and carbonated drinks.

;Why must a client on warfarin keep green vegetable intake steady?
:Green leafy vegetables contain vitamin K, which opposes warfarin. Eating far more or far less than usual changes the INR and shifts the client toward clotting or bleeding. Consistency, not elimination, is the goal.

;What should the LPN report about a client's food intake documentation?
:Consistently eating less than about half of meals, refusing meals, unintentional weight loss, new difficulty chewing or swallowing, and complaints of nausea or early fullness. All warrant a report to the RN and often a dietitian referral.

[[Category:Nutrition]]
[[Category:Licensed Practical Nurse (NCLEX-PN)]]
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