[Music] hey guys it's me professor d and welcome back to my channel on this video i'm going to be covering nutrition this is actually part two um i did another video on nutrition last week so if you haven't uh seen part one already please be sure to do so also guys don't forget please like and subscribe below if there's any videos or any content that you'd like to see me cover be sure to go ahead and put in the comment section and i'll make sure i make a video for you so part two of nutrition let's get started first question a client's been receiving two feedings and is tolerating them very well the health care provider determines that the rate of the intermittent two feedings may be advanced the nurse prepares to one increase the feedings by 50 milliliters per day two start an isotonic formula at half strength three infuse a bowl is feeding over five to ten minutes or four begin feeding with 250 to 500 ml at each interval and i'll give you a moment to think of your answer so guys the correct answer is one increase feedings by 50 mls per day so with these intermittent um two feedings you know when the patient gets started off they're usually started at 40 to 60 mls per day once that doctor or the nurse practitioner decides that that patient's ready to be advanced that's really where you want to be you want to increase it by 50 milliliters per day let's go over the other choices choice to start an isotonic uh formula at half strength there's no need you can start at full strength the question is the question here that they're asking about is how to advance the two feedings uh choice three infuse a bolus feeding over five to ten minutes that's that's too short guys that's too short that's too much going into the patient too fast you wanna know what's gonna happen that patient's going to start cramping up they're going to start sweating they're going to start feeling nauseous okay so you really want to do it over 20 to 30 minutes okay so that's why number three is wrong and choice number four begin feedings with 250 to 500 mls at each interval that's too much so each interval you really want to do 150 to 2 250 no more than that so that's why number one's the correct answer you want to increase the feedings by 50 ml per day next question the nurse is aware that there are many many medication the nurse is aware that there are medications that are taken that after the client's taste may influence the dietary intake in reviewing the medications taken by the clients on the unit the nurses will consult with the nutritionist to develop a palatable meal plan for the client taking one ampicillin two morphine three furosemide or four acetaminophen and the correct answer guys are you ready the correct answer is number one ampicillin which is penicillin what it does is a lot of times it changes the taste and so many patients because that taste that it gives them that they really can't taste the food normally they won't want to eat okay ampicillin does have that side effect on some patients not everybody let's look at the other choices one morphine no what morphine does you guys know what morphine is an analgesic it's a narcotic um slows things down morphine can cause constipation it really doesn't change your taste buds if you rosa eurozomine um guys you know furozomide is a diuretic what that does um a side effect of it is that it can decrease the absorption of food so when uh patients taking diuretics you don't want to take uh your diuretics with at the same time that you take the food because what diuretics can do such as lasix it decreases the absorption okay out not of the drug of the food um opposite it decreases the absorption of the drug because let me explain to you what happens very quickly i'm getting on topic but just so you know what happens is um they're both fighting for receptor sites and food wins so what happens is that drug that you're taking which is the lasix it doesn't get absorbed the way it's supposed to that's why so anyway choice number four acetaminophen okay what does that do it's hard on the liver you guys know the sediment acetaminophen that's tylenol you can give it for fever some patients take it for headache but an effect that it does it affects the liver so if a patient's taking a lot of acetaminophen you better be looking at those liver enzymes so anyway back to the answer though the med that can change the taste um is number one ampicillin next question food safety is a concern of a group of adults attending the community health clinic the participants identified to the nurse that they have seen a lot of reports on television about e coli i'm not going to try to say that word is too i'm not i'm going to mess it up so it's e coli and how dangerous it can be when asked where the bacteria comes from the nurse responds that a potential source of e coli is one sausage two soft cheeses three milk products and four ground beef and i'll give you a moment to think of your answer the correct answer guys is for ground beef undercooked meat like um hamburger rare or medium rare if that meat is not cooked it can cause e coli okay so i want to go over the other choices and why they're wrong number one sausage sausage is actually um a source um for that would be sausage sausage sausage sausage botulism so let me explain to you how can you get botulism from things that are canned like canned meats canned fruits okay so for sausages botulism um two soft cheeses soft cheeses you can get it's a bacteria and i'm gonna mess up the name listeriosis no i said it right so uh soft cheeses you can get listeriosis from it milk products shigelliosis all right so number four is the correct answer when it comes ground beef and not when it comes to e coli not only ground beef any meat any meat that's undercooked you can get e coli from another source that you can get e coli from obviously guys stool feces so what happens is if you have workers in the restaurant they go you have a bowel movement they don't wash their hands they have some of that stool underneath underneath their fingernails and then they go cook and some of that a feces gets in your food you can get e coli as well e coli is found in the stool okay the nurse recognizes which of the following clients is being at greatest risk for a negative nitrogen balance one a ten-year-old with an infected laceration on the left thumb two a seventy-five-year-old who fell and experienced a mild concussion three a forty-year-old who has partial thickness burns over 15 percent of his body or four a 19 year old who has lost 70 pounds in seven months as a result of dieting and i'll give you a moment to think of your answer okay guys so the correct answer is for a 40 year old who has partial thickness burns over 15 percent of his body so let me say this to because this is how they try to trick you with these other choices how can um you get decreased nitrogen to the point that you don't have enough for your body infection burns uh um trauma especially trauma to the head head injury fever so look how they tried to trick you number one they said and in fact um a ten-year-old with an infected laceration on the left thumb so what they wanted you to do was think oh my gosh infection when you get infection your nitrogen goes down it has to be that but the infections where on the thumb it's a tiny little place right it's not all over their body two a 75 year old who fell in spirits of mild concussion oh my gosh concussion head trauma oh that's nitrogen but look what it says it says mild concussion so as a student when i saw that if i saw that i would have okay i would have held that onto that as a choice okay i'd be like okay maybe possibly right because a mouth concussion in the head that's way worse than the little infection on the finger then we have choice four a 19 year old who lost 70 pounds in seven months as a result of dieting that's losing a lot of weight but like i said losing weight um that's not one of those um risk factors for you to have decreased nitrogen excessively it has to be like burns fever uh um infection trauma like severe trauma head trauma so number three is the answer because look at that they have burns over what 15 of their body okay so by far this is going to be the correct answer there that patient is most at risk for having a negative nitrogen imbalance and let me go a step further don't forget what i um told you guys about in my video that i did burns what is one of the biggest concerns when you have when we have a patient with burns infection right so that's a double whammy so number three is the correct answer next question the nurse is discussing food selection with a client who recently experienced a partial thickness burn over 20 percent of her body the client expresses a reluctance to ingest a large amount of carbs because she successfully lost 50 pounds and does not want to regain the weight the most therapeutic response to the client's nutritional needs is one don't be concerned about regaining the weight until your burns have healed two you need a huge amount of calories to heal so there won't be a weight gain three you will experience a nitrogen imbalance if there aren't enough carbs in your diet four the extra carbs will be utilized for energy so that your protein can be safe to repair your skin and this was a long question with the long choices so i'll give you a moment to think of what you think the answer is okay guys so if you chose four that's the correct answer and let me tell you why not only you see four the extra cards will be used utilized for energy that part addresses the woman's concerns about oh um gaining weight you're letting them know that those carbs that they're going to be eating is not carbs they're just going to make them fat no that carbs going to be giving them energy so for what wound healing and then it goes a step further it says so that your protein what do we use protein for what is protein good for wound healing so that your protein can be saved for repair of your skin you see choices one two and three they do not address um why the carb is important for their body all they address is the patient's concerned about uh losing weight and some of those choices aren't even correct so this is why number four is the correct answer it addresses um the patient's concern about losing weight and it explains to the person why it's important for that patient to get the carbs okay next question the mother the nurse and the mother of an infant are discussing the introduction of solid foods into her child's diet which of the following statements made by the mother reflects the best understanding of the most appropriate manner to introduce new foods one both my husband and i have allergies so i'm very cautious about introducing anything new into her diet two i'm a fussy eater and so are my other children but i will offer her a variety of food so she will have a good appetite three i'll start with non-wheat cereal and then vegetables one new food a week so i can see if something doesn't agree with her four my other children just loved solids and really were a joy to feed i expect she will be as receptive to new foods as they were and i'll give you a moment to think of your answer so guys the correct answer is three the correct answer is the only one that actually addresses how mom plans to introduce new foods that's the only one none of these other choices answer the question because the question is asking which one explains how introducing you foods will be done correctly and number three is the only answer so yes you want to start with non-wheat cereal just in case because lots of um people have allergies especially children one of those allergies happen to be wheat so you want to do non-wheat cereal so you're going to start with the non-wheat cereal and then the vegetables and then what you're going to do each vegetable that you introduce you're going to introduce one vegetable a week so that if the page the patient has some kind of allergic reaction we can know what it was because that's the only new thing we introduced in the diet let me take it a step further and tell you guys something else because i see lots of oh sorry guys my cameras actually crazy um i've seen lots of test questions on that in regards to peeds and food introducing new foods you want to save the fruits for last close to last here's why if you introduce foods first that child is not going to want to eat the vegetables at all okay so what you want to do is introduce vegetables first get that child accustomed to vegetables they like vegetables because that's all they know and then slowly introduce fruits otherwise you give them fruits first that's it they're not going to want to eat their vegetables a 25 month old is discussing her concerns regarding her daughter's eating habits with the nurse the most therapeutic response to the mother's statement she's a fussy eater it seems that she will only eat dry cereal and cheese is one as long as she's eating a little from all the food groups and getting enough fluids she'll be all right two her weight and height are right on target so she must be getting what she needs to grow and develop three don't expect her to start liking a variety of foods for several more months just keep offering her what she likes four it's very common for toddlers to be picky eaters try offering her foods frequently and hot and offer high nutrient density snacks such as the cheeses she likes and i'll give you a moment to think of your answer and the correct answer is four it's very common for toddlers to be picky eaters try offering her food frequently and offer high nutrient density snacks such as cheese that she likes so let me explain this to you guys toddlers ages one to three right this is now where they're walking they're exploring they're learning about their environment okay this is also a time where they learn to say no everything you want everything you offer to them no no no they say no to everything why they're establishing their independence okay and this is around the age that they're picky eaters that is um that is a milestone for the for the toddlers around one to three so what you want to do is just keep offering them meals but you want meals that are nutrient dense you don't want to just give them meals if they're empty cars because remember they're toddlers they're exploring their environment what are they doing they're running they're all over the place they don't want to stop they don't want to stop they're going going going going going going so you have to give them what finger foods give them finger foods that they when they're going going going going going going you kind of treat them like a bipolar manic patient okay you treat them like that you give them finger foods because they don't want to stop so while they're going going going you they can have something in their hand that they're eating that is full of nutrients and of course on my last video i talked to you about choking so we don't want to give them anything on that list that's um would put them at risk of choking because what they're going going going going going okay next question which of the following statements by an older adult shows the most need for follow-up regarding the risk for dehydration in this group one i have a glass of water with each meal and whenever i'm thirsty two as long as i drink one as long as i drink whenever i'm thirsty i think i'll be well hydrated three i try not to drink much after dinner so i don't have to get up to urinate at night four i limit my coffee and tea drinking because i don't think they are particularly good for you i'll give you a moment to think of your answer guys the correct answer is two as long as i drink water whenever i'm thirsty i think i'll be well hydrated let's go back to the question the question asked which needs further follow-up let me tell you something when you see a question asking you what needs further follow-up what needs more teaching what would you question when you see those types of phrases what they're really asking you is what's the wrong answer and number two is the right answer everything else is right number one i have a glass of water with each meal and whenever i'm thirsty good that's right that's the correct that's correct so we're not going to choose that because we're looking for the wrong answer three i try not to drink as much after dinner so i don't have to get up to urinate at night that's good remember we're dealing with the elderly population we don't want them getting up in the middle of the night they're still groggy to go urinate and they fall okay so that's a good answer so we're not going to choose that we're looking for the wrong answer choice number four i limit my coffee and tea drinking because i don't think they're particularly good for me good absolutely because tea and coffee have what in it caffeine what kind of population are we dealing with the geriatric population we're dealing with the older population so that's good the only wrong answer in this group is number two as long as i drink whenever i'm thirsty i think i'll be well hydrated what did i tell you in my last video about the the elderly population about their thirst their sense of thirst they don't have it or severely decreased they don't get thirsty so guess what if this patient only drinks when they're thirsty they might get dehydrated until they die they lose their sense of thirst so when it comes to the geriatric population you have to teach your cna your pct to remind that patient every time they go in their room to drink water and you as a nurse you're going to keep keep reminding the patient to take sips of water because why they don't get thirsty all right so you have to keep reminding them hey mr such as such don't forget to sip on that water the nurse is following a newly admitted client regarding his dietary history which of the following questions asked by the nurse is most likely to secure additional pertinent information regarding the client statement i think i'm allergic to peanuts one what happens when you eat peanuts two what makes you think you're allergic to peanuts three when did you first notice the sensitivity peanuts four a peanut allergy is very serious how do you manage to avoid them okay guys so the correct answer is one what happens when you eat peanuts why because the question is asking us what question are you going to ask the patient that's going to give you the most important information in regards to their statement saying i think i'm allergic to peanuts let's look at these other choices i'm gonna start from the bottom number four a peanut allergy is very serious how do you manage to avoid them so you did not even find out what makes that patient think that they have this allergy you did not find out if this patient even has a peanut allergy you didn't find that out yet all you said to this patient well this is very serious how do you avoid them when you say that to the patient that's not going to give you the information you need to find out if maybe they really do have a true allergic response to peanuts get rid of number four let's go to number three when did you notice your sensitivity peanuts that question is not going to give you information that you need to find out does this patient really have a true allergic response to peanuts number two what makes you think you're allergic to peanuts as a student and i saw number two i'd be like this is a good one i'm gonna hold on to this because this might be my answer so it's you're between number one and number two now look at number one what happens when you eat peanuts if number one wasn't there number two would have been the answer but because number one is there that is the answer what happens when you eat peanuts if that patient says oh when i eat peanuts um i get um a sour taste in my mouth i don't feel like eating anything else that's not an allergic response if that patient says when i eat peanuts i break out into hives when i eat peanuts i get a rash all over my body when i eat peanuts my tongue starts to swell up when i eat peanuts i feel like my throat's swelling up like every time i swallow it's very painful i feel like i can't breathe when i eat peanuts i start wheezing i can't breathe that is a true allergic response that's what you call a ige mediated response okay a true allergic response why all of those examples i just gave you they're generalized okay these are systemic okay so that's how you find out if a patient really has an allergic response you ask them what happens when you eat it and based on that patient's answer you'll know if it's true allergic response or not so that's why number one is the correct answer the nurse is caring for five kilogram eight month old infant admitted to the hospital by a health care provider who was concerned about the infant's low weight the infant's birth the infant's birth weight was 3.5 kilograms the nurse knows that on average an infant doubles his or her birth weight by what age one two to three months two four to five months three six to seven months four eight to nine months now um most textbooks guys give you just one number this one's giving you a range and i teach from lots of textbooks and most of them are in agreement it's the i'm trying to think if i should tell you the answer or explain it so i'll give you the answer that explain it so the correct answer is four to five months and most textbooks will tell you five months by five months you should see the um infant's weight double and by one year it should triple okay so i hate that um with these choices they kind of gave your range but whatever that's okay because the range still has your answer which is your five months most textbooks agree four to five months the infant's weight will double and by one year you expect that weight to triple which of the following statements by a new mother indicates that the nurse needs to provide additional teaching before the client is discharged home with her infant one i'll be using infant formula which will provide all the nutrition that my new baby needs two i can feed my new baby every three to four hours when i get home three i need to sterilize all my babies bottles and nipples to make sure they don't have any germs four i can put a few drops of honey in my baby's formula to make it taste better okay guys i hope you guys chose before we never ever ever ever ever give um honey or corn syrup to infants okay guess what that could cause botulism okay and let me tell you something infants that's the age from birth to one year once they hit one to three they're now in toddler stage but infants where was i going with my thought was i going to say to you infants all they need from birth to one year they need their milk so whether it's breast milk or formula that's all they need you don't have to add um anything to it let me back up on that statement let me back up on that statement because i have to um clarify something i'm not not all the way to one year because once they hit about um uh four to six months around like the five month you can start introducing um the rice cereal into the formula so when i said that's all they need i mean you don't have to um give them they can't have solids you don't give them anything more really all they need from about birth to that one year is their formula or the rice cereal that you could put in the formula once they hit around that um five month mark okay but never and another thing about honey lots of children who have allergies they tend to have allergies to both honey and corn syrup and when i say allergies not just mild allergies i mean severe allergies the type of allergies where they have a true like i said ig immediate response that they're going to have to have an epipen with them everywhere they go okay so we don't play with that we do not introduce it um we try not to even introduce it until they're toddlers okay number 42 oh i'm sorry let me back up number 42. let me back up um let's go through these other choices choice one two and three are all correct these are all correct one i'll be using infant formula which will provide all the nutrition that my new baby needs that's 100 correct you don't have to add anything two i can feed my baby every three to four hours when i get home absolutely because that's when they're going to want to feed every three to four hours you're going to be changing those diapers same because remember the baby's so small they're just tiny right so everything that comes in is gonna come out so that's how often you're gonna be changing diapers three i need to sterilize all my babies bottles and nipples to make sure they don't have any germs of course because you don't want the baby to get an infection so one two and three are all correct but we were looking for the wrong answer because in the question it said which one needs additional teaching whenever you see something asking you which one needs additional teaching which one would you clarify which one um would you have to follow up on things like that what they're really asking you is which one is the wrong answer next question one easy way that parents of teenagers can ensure that they're getting enough iodine in their diets to support the increased thyroid activity during adolescence is to one give the child a multivitamin daily two use iodized table salt three keep fresh fruit and vegetables on hand for snacks four serve a red meat at least once a week now guys they tried to trick you because the other choices are great choices like you want to do that you want to the correct answer is number two by the way you want to give them multivitamins that's fine you want to make sure they have fresh fruits and vegetables you want to make sure they have protein but this specific question what are they asking about thyroid function okay so when they're asking about the thyroid function and to help with the thyroid function the correct answer is two use iodized salt why because of the iodine and here in the u.s we really don't have that problem that much because our salt has iodine in it unless you choose a salt without it our salt has iodine in it but that iodine that's why it makes number two the correct answer the iodine is needed for thyroid function okay guys a last question the nurse is counseling a 64 year old client that it is important to eat plenty of fruits and vegetables but the client should avoid which of the following because it can inhibit the absorption of some drugs one oranges two grapefruit three pineapple or four asparagus guys the correct answer is grapefruit let me tell you something oh my gosh i can't tell you how many drugs that patients cannot take grapefruit with if you ever have a pharmacology question and the patient's taking a drug it says which food should the patient avoid if you have no clue what the answer is and you see grapefruit choose it that's how many drugs that grapefruit has um um uh um interactions with bad interactions that we don't want okay that's contraindicated so if you don't know what the answer is and you see grapefruit go ahead and choose it because grapefruit decreases the absorption of so many drugs i have passed my time but there's some good concepts on here that i see on test questions all the time that i want you guys to know so i'm going to go ahead and keep going next question the menu excuse me when a menu planning for a newly diagnosed diabetic client who practices judaism the nurse should avoid which of the following dishes one vegetable beef soup two chicken pot pie three beef lasagna or four scrambled eggs and the correct answer guys is oh here's my question the correct answer is beef lasagna why because in the jewish um culture they do not cultural religion they do not um eat uh meat with dairy products and of course lasagna has the ground beef and the cheese right so that's why that's the correct answer last question the nurse is caring for a 55 year old male client who knows that due to his religious beliefs he's most likely a vegetarian which of the following religions encourages encourage a vegetarianism one christ a church of jesus christ of latter-day saints two seventh-day adventists three judaism four pentecostal and the correct answer guys is to seventh-day adventist okay that religion they actually encourage um plant-based diet and a lot of another question i've seen um many times appear on tests in foundations for culture and i've seen this pop up on nclex as well and ati hesi so something else you need to know about the seventh-day adventist um no shellfish they don't eat lobster crabs uh um shellfish they don't eat okay so guys i hope this video was helpful like i said if you had didn't watch part one on the nutrition please watch it because there's so many important concepts on there and um as i said in my first video i promise you guys i've been doing this for years i'm not gonna age myself but these questions that i choose are questions that i've seen pop up on exams on nclex on ati on hessie on midterms quiz finals they come up over and over and over they're very important concepts for you know so if i'm talking about it that means you need to know it so whenever i do a video and i um cover concept that you you never heard about it or you're not familiar with it go look it up go into your textbook and look it up because i promise you you're going to see it again somewhere i hope you guys enjoyed this video please guys please don't forget to like like the video don't forget to subscribe so and uh so that every time i make a video you can get a notification and if you have any friends that are in the nursing program that you know that these videos would be helpful to them share it share it guys okay i'll see you next time bye