Hesi nutrition Questions And Answers

Hesi nutrition Questions And Answers
Atweektlater,tthetnursetnotestatchangetintthetclient'stweight.tThetnursetconsultstwithtthetnutr
itionist,twhothelpstcompletetat24-
hourtcalorietcount.tThetnutritionisttreportstbackttotthetnursetthattthetclienttweighst110tlbst(5
0tkg),tist67tint(170.2tcm)ttall,tandtistconsumingt700tcaloriestpertday.

Howtshouldtthetnursetexplaintthetresultstoftthetcalorietcountttotthetclienttandtthetspouse?t-
tCORRECTttANSWER-Calorietconsumptiontistinsufficienttandtwilltresulttintweighttloss.



Antaveragetadulttrequirest20ttot35tcaloriestpertkilogramtpertday.tThetclient,twhotweighst110t
poundst(50tkg),tneedstatminimumtoft1000tcaloriestpertdayttotmaintainthertcurrenttweight

Aftertestablishingtpriorities,tthetnursetshouldttaketwhichtactiontnexttintpreventingtthetclienttf
romtaspirating?t-tCORRECTttANSWER-Elevatetthetheadtoftbedttot45tdegrees.

Positioningtthetclienttwiththeadtoftbedtelevatedtwilltdecreasetthetrisktfortaspiration.

Aftertinfusingtthetformulatatt30tmL/hourtfort6thours,tthetnursetcheckstthetclient'stresidualtvol
umetandtobtainst75tmL.tThetprescriptiontfortthetformulatstatestthattthetratetshouldtbetincrea
sedtbyt10tmL/hourtastlongtastthetclient'stresidualtvolumetistlesstthanthalftthetpreviouslytinfu
sedttotaltvolume.

Whichtactiontshouldtthetnursetimplement?t-tCORRECTttANSWER-
Increasetthetratetoftthetformulattot40tmL/hour.

Thetclienttisttoleratingtthetfeedings.tFollowtthetHCPtinstructionstandtincreasetastprescribed
:tThetclientthastreceivedt180tmLtduringtthetprevioust6thours.tHalftoftthattvolumetist90tmLt(18
0/2).tThetresidualtvolumetobtainedtwast75tmL,tsotthetratetoftformulatshouldtbetincreasedtbyt
10tmL/hourttot40tmL/hour.

Beforetnotifyingtthethealthcaretprovidertoftthetdatatreportedtbytthetnutritionist,twhattinforma
tiontistmosttimportanttfortthetnursettotobtain?t-tCORRECTttANSWER-
Client'stcalculatedtbodytmasstindex.

Thetbodytmasstindextistcalculatedtbasedtontthetclient'stheighttandtweighttandtprovidestatpic
turetoftthetclient'stcurrenttnutritionaltstatustregardingtover-tortundernutrition.

Consideringtthetneedtfortdysphagiatprecautions,twhattactiontshouldtthetnursetimplementttot
intervene?t-tCORRECTttANSWER-
InstructtthetUAPttotaddtatthickeningtagentttotalltliquidstpertorders.

, Clientstwithtdysphagiattypicallythavetdifficultytswallowingtliquids,tsotatthickeningtagenttistad
dedttotliquidsttotchangetthetconsistency,tmakingtswallowingteasier.

Thetclienttgraduallytweakenstandtistadmittedttotthetmedicaltunit.tThethealthcaretprovidert(H
CP)trecommendstthetinsertiontoftatfeedingttubetbytmeanstoftatpercutaneoustesophagealtg
astrostomyt(PEG).tThetclienttsignstthetconsenttform,tandtthetproceduretistscheduledtfortthet
nexttday.tThattevening,tthetnursetnotestthattthetclient'stmedicaltrecordtcontainstantadvancet
directivetrequestingtnotresuscitationt(DNR)tinttheteventtoftatcardiopulmonarytarrest,twhichti
stconfirmedtintthetprescriptionstwrittentbytthetHCP.tWhiletthetnursetistconversingtwithtthetcli
enttandtspouse,ttheytbothtconfirmtthattnotheroictmeasurestarettotbetimplemented.

Whattactiontshouldtthetnursettakettotensuretthetclient'stDNRtstatus?t-
tCORRECTttANSWER-

Advisetthetclienttthattthethealthcaretprovidertwilltdocumenttintthetmedicaltrecordtthetdotnottr
esuscitatetdecisiontandtanytexceptions.

Antordertintthetclient'stmedicaltrecordtistenteredtbytthethealthcaretproviderttotinformtthetheal
thcaretteamthowttotrespondtwhentatresuscitationtscenariothappens.tTheretmaytbetantidenti
fyingtwristtbracelettindicatingtthattresuscitationtstatustortformtontthetchart

Thetclientttellstthetnursetthattshethasthadt5ttot7tliquidtdiarrheatstoolstatday,tfortthetlastt2tdays
.

Whattistthetsequencetoftnursingtactions?t-tCORRECTttANSWER-
Telltthetspousettotholdtthetremainingtfeeding.

Auscultatetfortthetpresencetoftboweltsounds.

Assesstthetelasticitytoftthetclient'stskin.

NotifytthetHCPtoftthetdiarrhea.

Firsttinitialtactiontisttottelltthetspousettotholdtthetremainingtfeedingtuntiltfurthertassessmenttc
antbetobtained.tSecond,tauscultatetfortboweltsoundsttotdeterminetifttheretarethyperactiveto
rthypoactivetbowels.tThird,tassesstskintelasticityttotdeterminetwhethertthetclienttistdehydrat
edtandtwilltneedtfurtherthydration.tFinally,tnotifytthetHCPtabouttthetassessmenttfindingstfortf
urthertinstructiontfortthetclient.

Thetclient'stspousetinquirestabouttthetnewlytprescribedtmedication,twhichtistatbrand-
nametdrug,tandtstates,t"Whentwetfilltthistprescription,tIthopetwetcantgettthistintatgenerictfor
m.tMaybetittwon'ttbetastexpensive."

Howtshouldtthetnursetrespond?t-tCORRECTttANSWER-
"Yourtpharmacisttandthealthcaretprovidertcantdeterminetifttheretistatgenerictdrugtthattistatsa
fetalternativettotthetbrand-nametdrug."