diet questions

•You are assigned to feed a patient that gets their food pureed. Their meal tray arrives and it has not been pureed. You should:
Send it back and ask them to puree it

Rationale: Patients are on pureed diets to prevent them from choking. Because patient's are weak and/or unable to chew, pureed diets will essentially do the chewing for them to prevent large pieces of food getting stuck in the esophagus and choking the patient.

•You are setting up a meal tray for a patient who had a stroke and has left-sided weakness. You should set the eating utensils:
On the right side

Rationale: Utensils should be used by the strong hand, and when a nursing assistant sets up the meal, they should place them on the strong side. Physical therapy may eventually want the patient to use the affected side, but unless otherwise instructed, set up the utensils on the unaffected side.

•The nurse informs you that your patient is on aspiration precautions. You know this effects how the patient eats because:
They are at risk for choking

Rationale: Patient's on aspiration precautions are at risk for choking on their food and drink and inhaling it into the lungs which leads to pneumonia and even death. The patients should be fed slowly, while they are sitting up, and be on thickened liquids. If the nursing assistant has any concerns or questions, they should ask the nurse for advice.

•You are taking care of a patient that isn't able to set themselves up to take a drink. You should check on them and offer them a drink:
Every 1-2 hours

Rationale: Because you should be checking on your patients every 1-2 hours, ask this patient during rounds if he/she would like a drink of water during this time. Make sure the water is cold and fresh.

•You are collecting meal trays and notice that your patient didn't eat much of their dinner. You should:
Ask the patient if they would like a different meal

Rationale: Good nutrition is an important part in a patient's healing process. Proteins play a vital role in the healing process, and without eating, many of these proteins are not available for the body to use. The patient may simply not like the food offered and would like a different meal. Never take the meal away if it wasn't eaten and simply disregard the fact that the patient didn't eat.

•You should pass fresh water and ice to your patients:
Every 8 hours

Rationale: Fresh water and ice should be passed every 8 hours or sooner if the patient is out or requests it. Ideally, fresh water and ice should be passed every 4-6 hours, but it must be passed every 8 hours to prevent the growth of bacteria and particles in the water.

•Your patient ate all of their main course, and one side dish. He still has one side dish leftover and doesn't want it. You record that the patient ate this much:
75%

Rationale: Facilities generally count 0, 25, 50, 75 and 100% In this case, the main course would count for 50% and each side dish 25%. Since only one side dish was consumed, 75% of the meal was eaten. Check your facilities policies for specifics on intake documentation.

•You see that your patient is on a NAS diet. You know that this means:
There should be no added salt

Rationale: NAS, or no added sodium, is for patients with cardiac problems, kidney disease and/or high blood pressure. Sodium attracts fluids and can cause fluids overload, high blood pressure, and more. The amount of sodium should be restricted to 2 grams per day.

•Your patient is diagnosed with dehydration. You should make the following change in the amount of fluid consumed daily:
Offer your patient a drink more frequently than normal

Rationale: Dehydration is caused by a number of things, but as part of treatment, a patient should consume a lot of fluids. Because they will need to drink more than patients that aren't dehydrated, they should be offered water more often. Do not force the patient to drink, or threaten that they won't get better. If the patient continually refuses the water, tell the nurse so they can be educated on it being part of their treatment.

•You are assigned to help a patient eat dinner and notice that their beverages must be thickened. This is because:
Thin liquids can cause the patient to choke

Rationale: Patients who are at risk for choking or aspirating their drink are put on thickened liquids to prevent that from happening. Thickener comes in powder and liquid form and can be mixed with any beverage.

•Your diabetic patient asks for an evening snack. Because they are a diabetic, you know the best snack for them is:
Almonds

Rationale: Many kinds of nuts are a great snack for diabetics. They are filling and low in sugar. Chips, cooking, pudding, ice creams and more are full of sugar and should be avoided as a snack for a diabetic. If you are unsure of a good snack idea, ask your nurse for further advice.

•You are assigned to take care of a patient with cancer that is being treated with chemotherapy. You know that their eating habits and appetite will:
Decrease

Rationale: Chemotherapy patients lose their appetite because the treatment makes them nauseous and tired. They generally eat little at meal, or not at all. Do not force them to eat if they are ill. If they are nauseous, let the nurse know and he/she may be able to give them medicine to help with that so they are able to eat.

•Which of the following is NOT appropriate when feeding a patient:
Feeding them in 10 minutes so you have a chance to feed all of your patients

Rationale: When feeding a patient, you should never rush because this can cause the patient to choke or just give up on trying to eat. Feeding patients can take a while, especially if they are weak or tired and chew slowly. Do not to try speed up the process because this can make them choke. Ask for assistance in feeding your other patients if you are running behind.

•You are getting a new patient on the unit that has a PEG tube. You know that you won't need to feed this patient because:
They will be fed by a nurse through the tube

Rationale: Patients with PEG tubes are fed a special concoction of food through their tube. Only a nurse can set up their tube feedings, and a machine regulates how much they get and how often. These are usually given to patients that aren't able to eat through their mouths and can be temporary or permanent.

•The nurse tells you that one of the patients on your assignment is NPO. This means:
They aren't allowed to have anything to eat or drink

Rationale: Patients that are NPO should consume nothing by mouth until the physician says they may. Patients are generally NPO before surgery, if they are intubated or if they have a feeding tube. Their mouths may be swabbed with a moist swab, and ice chips may be allowed. NPO patients are not allowed to consume food or drink beverages